Current diagnosis of disease is often based, in whole or in part, on subjective criteria. Furthermore, correctly predicting how the disease will progress, or what treatments will be most effective for which patients, is even more uncertain. Therefore, discovering and establishing objective markers of disease and long-term outcome are vital for advancing patient care.
The aim of my laboratory is to identify molecules in easily accessible human body fluids (e.g., blood and saliva) that have diagnostic or prognostic value. These biomarkers can be used, for example, to diagnose a condition, monitor disease progression, or evaluate treatment efficacy. Their utility is great for disease conditions lacking established diagnostic criteria or clinical cases with insufficient information.
Traumatic brain injury (TBI) can occur after blunt, penetrating, or blast injury to the head as a result, for example, of a car accident, gunshot wound, or improvised explosive device, respectively. Particularly for patients with mild TBI, details of the trauma used in diagnosis of TBI (e.g., loss of consciousness, post-traumatic amnesia) are often self-reported, and brain scans show no signs of injury. Whereas primary pathologies of TBI occur within minutes to hours of trauma and are therefore difficult to monitor, secondary pathologies and recovery are amenable to biomarker discovery and application. For instance, biomarker levels one day after injury are prognostic for subsequent increased intracranial pressure five days after injury. Thus, biomarkers give clinicians diagnostic information and advance warning of outcome, prompting interventions to avoid invasive procedures such as bone flap removal.
My laboratory utilizes biochemical techniques to discover molecular biomarkers of acute and chronic traumatic brain injury. These proteins or metabolites may increase or decrease in the saliva or blood plasma of TBI patients as a consequence of blood-brain barrier compromise, providing a quick and quantitative diagnostic test. Often, individual biomarkers do not have sufficient diagnostic accuracy, but a combination of several biomarkers, called a biomarker signature, bolsters their effectiveness. These innovations will help evacuate TBI patients from far-forward battlefields or rural areas, inform return-to-play/work/duty decisions and speed the time to life-saving care.