Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden.
Turku Brain Injury Centre, University of Turku and Turku University Hospital, Turku, Finland.
Acta Neurochir (Wien). 2021 Sep;163(9):2581-2594. doi: 10.1007/s00701-021-04928-7. Epub 2021 Jul 17.
To date, there is neither any pharmacological treatment with efficacy in traumatic brain injury (TBI) nor any method to halt the disease progress. This is due to an incomplete understanding of the vast complexity of the biological cascades and failure to appreciate the diversity of secondary injury mechanisms in TBI. In recent years, techniques for high-throughput characterization and quantification of biological molecules that include genomics, proteomics, and metabolomics have evolved and referred to as omics.
In this narrative review, we highlight how omics technology can be applied to potentiate diagnostics and prognostication as well as to advance our understanding of injury mechanisms in TBI.
The omics platforms provide possibilities to study function, dynamics, and alterations of molecular pathways of normal and TBI disease states. Through advanced bioinformatics, large datasets of molecular information from small biological samples can be analyzed in detail and provide valuable knowledge of pathophysiological mechanisms, to include in prognostic modeling when connected to clinically relevant data. In such a complex disease as TBI, omics enables broad categories of studies from gene compositions associated with susceptibility to secondary injury or poor outcome, to potential alterations in metabolites following TBI.
The field of omics in TBI research is rapidly evolving. The recent data and novel methods reviewed herein may form the basis for improved precision medicine approaches, development of pharmacological approaches, and individualization of therapeutic efforts by implementing mathematical "big data" predictive modeling in the near future.
迄今为止,对于创伤性脑损伤(TBI)既没有有效的药物治疗方法,也没有能够阻止疾病进展的方法。这是由于人们对生物级联反应的复杂性认识不完整,也未能认识到 TBI 中继发性损伤机制的多样性。近年来,高通量描述和量化生物分子的技术已经发展起来,并被称为组学,包括基因组学、蛋白质组学和代谢组学。
在这篇叙述性评论中,我们强调了组学技术如何应用于增强诊断和预后,以及推进我们对 TBI 损伤机制的理解。
组学平台提供了研究正常和 TBI 疾病状态下分子途径功能、动态和改变的可能性。通过先进的生物信息学,从小的生物样本中可以分析大量的分子信息数据集,并提供有价值的病理生理机制知识,当与临床相关数据连接时,可用于预后建模。在 TBI 这样复杂的疾病中,组学可以进行广泛的研究,包括与易感性、继发性损伤或不良预后相关的基因组成,以及 TBI 后代谢物的潜在改变。
TBI 研究中的组学领域正在迅速发展。本文回顾的最新数据和新方法可能为未来通过实施数学“大数据”预测建模来改进精准医学方法、开发药物治疗方法和个体化治疗提供基础。