Di Pietro Valentina, Yakoub Kamal M, Scarpa Ugo, Di Pietro Cinzia, Belli Antonio
Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom.
Surgical Reconstruction and Microbiology Research Centre, National Institute for Health Research, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Front Neurol. 2018 Jun 14;9:429. doi: 10.3389/fneur.2018.00429. eCollection 2018.
Traumatic brain injury (TBI) is a serious problem that causes high morbidity and mortality around the world. Currently, no reliable biomarkers are used to assess the severity and predict the recovery. Many protein biomarkers were extensively studied for diagnosis and prognosis of different TBI severities such as S-100β, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), neurofilament light chain (NFL), cleaved tau protein (C-tau), and ubiquitin C-terminal hydrolase-L1 (UCH-L1). However, none of these candidates is currently used in the clinical practice, due to relatively low sensitivity, for the diagnosis of mild TBI (mTBI) or mild to moderate TBI (MMTBI) patients who are clinically well and do not have a detectable intracranial pathology on the scans. MicroRNAs (miRNAs or miRs) are a class of small endogenous molecular regulators, which showed to be altered in different pathologies, including TBI and for this reason, their potential role in diagnosis, prognosis and therapeutic applications, is explored. Promising miRNAs such as miR-21, miR-16 or let-7i were identified as suitable candidate biomarkers for TBI and can differentiate mild from severe TBI. Also, they might represent new potential therapeutic targets. Identification of miRNA signature in tissue or biofluids, for several pathological conditions, is now possible thanks to the introduction of new high-throughput technologies such as microarray platform, Nanostring technologies or Next Generation Sequencing. This review has the aim to describe the role of microRNA in TBI and to explore the most commonly used techniques to identify microRNA profile. Understanding the strengths and limitations of the different methods can aid in the practical use of miRNA profiling for diverse clinical applications, including the development of a point-of-care device.
创伤性脑损伤(TBI)是一个严重的问题,在全球范围内导致高发病率和死亡率。目前,尚无可靠的生物标志物用于评估病情严重程度和预测恢复情况。许多蛋白质生物标志物已被广泛研究用于不同严重程度TBI的诊断和预后,如S-100β、胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、神经丝轻链(NFL)、裂解的tau蛋白(C-tau)和泛素C末端水解酶-L1(UCH-L1)。然而,由于相对较低的敏感性,目前这些候选物均未用于临床实践,无法用于诊断临床上状况良好且扫描未发现颅内病变的轻度TBI(mTBI)或轻度至中度TBI(MMTBI)患者。微小RNA(miRNA或miR)是一类小的内源性分子调节剂,已显示在包括TBI在内的不同病理状态中发生改变,因此,人们正在探索它们在诊断、预后和治疗应用中的潜在作用。有前景的miRNA,如miR-21、miR-16或let-7i,已被确定为TBI的合适候选生物标志物,并且可以区分轻度和重度TBI。此外,它们可能代表新的潜在治疗靶点。由于引入了新的高通量技术,如微阵列平台、纳米串技术或下一代测序,现在可以识别组织或生物流体中针对几种病理状况的miRNA特征。本综述旨在描述微小RNA在TBI中的作用,并探索最常用的识别微小RNA谱的技术。了解不同方法的优缺点有助于将miRNA谱分析实际应用于各种临床应用,包括开发即时检测设备。