Blood-based metabolomics to predict severity and patient outcomes in traumatic brain injury (meTBI)

Traumatic brain injury (TBI) is associated with a complex metabolic disruption that results in energy crisis, which is a consequence of multiple mechanisms including classical ischaemia, diffusion hypoxia, mitochondrial dysfunction and increased energy needs. The broad assumption has been that these metabolic changes are the consequence of metabolic failure. Our studies so far show that TBI associated with a specific metabolic profile, which is exacerbated proportionally to the severity of TBI. We hypothesize that these and potentially other metabolites reflect TBI pathophysiology and they may exhibit diagnostic potential in the full spectrum of TBI.

EU project CENTER-TBI currently prospectively collects clinical data including records from 5400 patients, files of imaging workup as well as blood samples from TBI patients from 60 sites of 18 countries. Our overall objective is to apply metabolic profiling of serum in the CENTER-TBI cohort to study the utility of the existing as well as to identify novel biomarkers of TBI which are also predictive of patient outcomes. These studies will be complemented by functional studies aiming to elucidate the underlying metabolic pathways in TBI. The project will be a major step forward in the disease detection and prognosis. We will combine innovative blood-based molecular biomarkers to conventional clinical biomarkers, not only to detect TBI, but also to detect and classify the underlying pathophysiological processes.