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Citation
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Merchant-Borna K, Lee H, Wang D, Bogner V, van Griensven M, Gill J, Bazarian JJ. J. Neurotrauma 2016; 33(17): 1576-1585. |
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Abstract
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OBJECTIVE: To identify genome-wide changes in peripheral gene expression before and after sports-related concussion (SRC).
Design, Setting, and Participants: 253 collegiate contact athletes underwent collection of peripheral blood mononuclear cells (PBMC) before the sport season (baseline). Sixteen athletes who subsequently developed a SRC, along with 16 non-concussed teammate controls, underwent repeat collection of PBMC within 6 hours of injury (acutely). Concussed athletes underwent additional sample collection at 7 days post-injury (sub-acutely).
Main Outcomes and Measures: mRNA expression at baseline was compared to mRNA expression acutely and sub-acutely post-SRC. To estimate the contribution of physical exertion to gene changes, baseline samples from athletes who subsequently developed a SRC were compared to samples from uninjured teammate controls collected at the acute timepoint. Clinical outcome was determined by changes in post-concussive symptoms, postural stability, and cognition from baseline to the sub-acute time point.
Results: SRC athletes had significant changes in mRNA expression at both the acute and sub-acute time points. There were no significant expression changes among controls. Acute transcriptional changes centered on interleukins 6 and 12, toll-like receptor 4, and NF-κB. Sub-acute gene expression changes centered on NF-κB, follicle stimulating hormone, chorionic gonadotropin, and protein kinase catalytic subunit. All SRC athletes were clinically back to baseline by day 7.
Conclusions and Relevance: Acute post-SRC transcriptional changes reflect regulation of the innate immune response and the transition to adaptive immunity. By 7 days, transcriptional activity is centered on regulating the hypothalamic-pituitary-adrenal axis. Future efforts to compare expressional changes in fully recovered athletes to those who don't recover from SRC could suggest putative targets for therapeutic intervention.
Language: en |