An article from the February 2019 edition of Neuropharmacology published by researchers from the Department of Physical Medicine & Rehabilitation from the University of Pittsburgh (USA) explores exciting new avenues for designing effective rehabilitation interventions in patients with traumatic brain injury. ‘Rehabilomics’ is a research framework for evaluating the neurobiology of complex health states with the purpose of developing tailored, patient-centered interventions. Biomarkers are actively explored to inform the influence of physiology on patient outcome in TBI. In this paper, authors focus on conceptualizing a humoral triad for TBI rehabilitation (inflammation, neurotrophins and glucocorticoids) emphasizing a broad vision for biomarker inclusion beyond typical brain-derived biomarkers, to capture and/or reflect important neurological and non-neurological pathology associated with TBI as a chronic condition. Humoral signaling molecules are explored as important signaling and regulatory drivers of these chronic conditions and their impact on function. It is suggested that secondary injury cascades involved in the humoral triad are influenced by the systemic response to TBI and the development of non-neurological organ dysfunction (NNOD). Potential points of intervention to modify inflammation, hormonal, or neurotrophic support through rehabilitation interventions are discussed. Finally, exercise, pharmacotherapies, and biologics are reviewed as relevant therapies influencing the humoral triad and TBI recovery.
Rehabilomics, TBI, inflammation, neurotrophins, glucocorticoids
The Rehabilomics research framework defines a humoral triad in TBI rehabilitation: inflammation, neurotrophins and glucocorticoids