Exploring exosomal transcriptomics as a theragnostic signature in traumatic brain injury patients: A pilot study

Introduction: TBI is a major global cause of injury-related deaths. Survivors often experience neuropsychiatric symptoms, and the pathophysiological mechanisms for recovery post-TBI remain poorly understood. We hypothesize that "exosomes" which are nanovesicles, facilitating cell-to-cell communication, may be important mediators of molecular and cellular changes involved in neurological symptoms following TBI. We aim to characterize and quantify the plasma-derived exosomes using an exo-transcriptomic platform to compare inflammation-related gene expression profiles and correlate them with molecular and clinical variables in TBI patients

Methods: The ongoing work is a pilot, prospective, case-control study with adult mild to severe, non-penetrating TBI patients (n=45), and 15 age-matched controls. Blood was sampled serially at baseline, 24 and 24 hrs post-injury. Exosomes and exosomal-RNA was isolated and purified using commercially available kits. The characterization of exosomes will be conducted using the dynamic light scattering (DLS) and immuno-blotting. Exosomal-RNA will be analyzed for of inflammatory gene profiling using TaqMan Human Inflammation array by RT-PCR.

Results: We anticipate getting distinct gene expression profiles of differently upregulated or downregulated inflammatory genes that could serve as signature biomarkers for varying degrees of TBI severity. Dysregulation of these plasma exosomal RNAs might indicate neuronal inflammation that can last long after the injury and may result in persistent post-injury symptoms in TBI patients.

Conclusions & Significance: Characterizing exosomes and correlating them with molecular and real-time clinical characteristics would inform a foundational mechanistic framework for disease monitoring and outcome prediction post-TBI, and may serve as diagnostic and prognostic biomarkers or "liquid biopsy" to provide a rationale for pre-clinical, clinical and translational research focused on novel therapeutics.

Nothing to declare. I don't have any conflict of intrest