TBI Rehabilomics Research: Conceptualizing a humoral triad for designing effective rehabilitation interventions.
Wagner, A. K. a,b,c,d,*; Kumar, R. G. a,b,e
[Article] Neuropharmacology. 145(PB):133-144, February 2019.

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Most areas of medicine use biomarkers in some capacity to aid in understanding how personal biology informs clinical care. This article draws upon the Rehabilomics research model as a translational framework for programs of precision rehabilitation and intervention research focused on linking personal biology to treatment response using biopsychosocial constructs that broadly represent function and that can be applied to many clinical populations with disability. The summary applies the Rehabilomics research framework to the population with traumatic brain injury (TBI) and emphasizes 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. Importantly, 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). Biomarkers have been successfully leveraged in other medical fields to inform pre-randomization patient selection for clinical trials, however, this practice largely has not been utilized in TBI research. As such, the applicability of the Rehabilomics research model to contemporary clinical trials and comparative effectiveness research designs for neurological and rehabilitation populations is emphasized. Potential points of intervention to modify inflammation, hormonal, or neurotrophic support through rehabilitation interventions are discussed.

This article is part of the Special Issue entitled "Novel Treatments for Traumatic Brain Injury".

HIGHLIGHTS:

* This review overviews Rehabilomics as a conceptual framework that can guide rehabilitation intervention studies, including TBI.

* This review focuses on the impact of inflammation, neurotrophins, and glucocorticoids as relevant biomarkers after TBI.

* The humoral triad is introduced in relation to inflammation, neurotrophins and glucocorticoids in the context of TBI.

* Exercise, pharmacotherapies, and biologics are reviewed as relevant therapies influencing the humoral triad and TBI recovery.

(C) 2019Elsevier, Inc.