Pérez-Arredondo Adán, Cázares-Ramírez Eduardo, Tristán-López Luis, Jiménez-Gutiérrez Carlos, Pérez-Lozano Diana L, Martínez-Hernández Ivette A, Vega-Rangel Valentina, Narváez-González Hugo F, Rios Camilo, Martínez-Vargas Marina, Navarro Luz, Carmona-Aparicio Liliana
Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico.
Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Investigación Clínica Experimental, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico.
Neurol Int. 2025 Sep 9;17(9):145. doi: 10.3390/neurolint17090145.
Amino acid biomarkers have a crucial influence on our understanding of brain injury mechanisms, and their plasma concentrations may indicate neurological damage and recovery patterns. Pediatric mild traumatic brain injury (mTBI) assessment particularly benefits from such molecular indicators, as clinical presentations can be subtle and variable. However, current diagnostic and prognostic tools lack reliable biochemical markers that can track the temporal evolution of injuries and recovery.
We conducted a prospective longitudinal cohort study involving 36 pediatric mTBI patients and 44 controls to characterize the temporal evolution of key amino acids and their derived indices. Blood samples were collected at 3, 6, 12, and 24 h and at 7, 14, and 28 days post-injury, with amino acids quantified using high-performance liquid chromatography.
Our analysis revealed significant temporal changes in glutamate, glutamine, and glycine concentrations, with glutamate peaking at day 7 before declining, while glutamine showed steady increases throughout. The GLN/GLU ratio demonstrated an early excitatory imbalance followed by astrocytic compensation, and the GLX ratio indicated progressive recovery.
These patterns represent continuous neurochemical processes involving excitotoxicity and glial regulation, suggesting potential utility as biomarkers for mTBI diagnosis and monitoring. While further validation using larger cohorts is needed, these findings provide compelling evidence of the efficacy of using amino acid profiles to track pediatric mTBI progression and recovery.
氨基酸生物标志物对我们理解脑损伤机制具有至关重要的影响，其血浆浓度可能表明神经损伤和恢复模式。儿科轻度创伤性脑损伤（mTBI）评估尤其受益于此类分子指标，因为临床表现可能很微妙且多变。然而，目前的诊断和预后工具缺乏可靠的生化标志物来追踪损伤和恢复的时间演变。
我们进行了一项前瞻性纵向队列研究，纳入36名儿科mTBI患者和44名对照，以表征关键氨基酸及其衍生指标的时间演变。在受伤后3、6、12和24小时以及7、14和28天采集血样，使用高效液相色谱法定量氨基酸。
我们的分析显示谷氨酸、谷氨酰胺和甘氨酸浓度存在显著的时间变化，谷氨酸在第7天达到峰值后下降，而谷氨酰胺则持续稳定增加。GLN/GLU比值显示早期兴奋性失衡，随后是星形胶质细胞的代偿，GLX比值表明逐渐恢复。
这些模式代表了涉及兴奋性毒性和胶质细胞调节的连续神经化学过程，表明其作为mTBI诊断和监测生物标志物的潜在用途。虽然需要使用更大的队列进行进一步验证，但这些发现提供了令人信服的证据，证明使用氨基酸谱追踪儿科mTBI进展和恢复的有效性。
