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      Microglia Activation as a Biomarker for Traumatic Brain Injury

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          Abstract

          Traumatic brain injury (TBI) has become the signature wound of wars in Afghanistan and Iraq. Injury may result from a mechanical force, a rapid acceleration-deceleration movement, or a blast wave. A cascade of secondary cell death events ensues after the initial injury. In particular, multiple inflammatory responses accompany TBI. A series of inflammatory cytokines and chemokines spreads to normal brain areas juxtaposed to the core impacted tissue. Among the repertoire of immune cells involved, microglia is a key player in propagating inflammation to tissues neighboring the core site of injury. Neuroprotective drug trials in TBI have failed, likely due to their sole focus on abrogating neuronal cell death and ignoring the microglia response despite these inflammatory cells’ detrimental effects on the brain. Another relevant point to consider is the veracity of results of animal experiments due to deficiencies in experimental design, such as incomplete or inadequate method description, data misinterpretation, and reporting may introduce bias and give false-positive results. Thus, scientific publications should follow strict guidelines that include randomization, blinding, sample-size estimation, and accurate handling of all data (Landis et al., 2012). A prolonged state of inflammation after brain injury may linger for years and predispose patients to develop other neurological disorders, such as Alzheimer’s disease. TBI patients display progressive and long-lasting impairments in their physical, cognitive, behavioral, and social performance. Here, we discuss inflammatory mechanisms that accompany TBI in an effort to increase our understanding of the dynamic pathological condition as the disease evolves over time and begin to translate these findings for defining new and existing inflammation-based biomarkers and treatments for TBI.

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          Most cited references81

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          Control of microglial neurotoxicity by the fractalkine receptor.

          Microglia, the resident inflammatory cells of the CNS, are the only CNS cells that express the fractalkine receptor (CX3CR1). Using three different in vivo models, we show that CX3CR1 deficiency dysregulates microglial responses, resulting in neurotoxicity. Following peripheral lipopolysaccharide injections, Cx3cr1-/- mice showed cell-autonomous microglial neurotoxicity. In a toxic model of Parkinson disease and a transgenic model of amyotrophic lateral sclerosis, Cx3cr1-/- mice showed more extensive neuronal cell loss than Cx3cr1+ littermate controls. Augmenting CX3CR1 signaling may protect against microglial neurotoxicity, whereas CNS penetration by pharmaceutical CX3CR1 antagonists could increase neuronal vulnerability.
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            A call for transparent reporting to optimize the predictive value of preclinical research.

            The US National Institute of Neurological Disorders and Stroke convened major stakeholders in June 2012 to discuss how to improve the methodological reporting of animal studies in grant applications and publications. The main workshop recommendation is that at a minimum studies should report on sample-size estimation, whether and how animals were randomized, whether investigators were blind to the treatment, and the handling of data. We recognize that achieving a meaningful improvement in the quality of reporting will require a concerted effort by investigators, reviewers, funding agencies and journal editors. Requiring better reporting of animal studies will raise awareness of the importance of rigorous study design to accelerate scientific progress.
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              The epidemiology of traumatic brain injury.

              To describe the most recent estimates of the incidence and prevalence of traumatic brain injury (TBI) and review current issues related to measurement and use of these data. State of the science literature for the United States and abroad was analyzed and issues were identified for (1) incidence of TBI, (2) prevalence of lifetime history of TBI, and (3) incidence and prevalence of disability associated with TBI. The most recent estimates indicate that each year 235 000 Americans are hospitalized for nonfatal TBI, 1.1 million are treated in emergency departments, and 50 000 die. The northern Finland birth cohort found that 3.8% of the population had experienced at least 1 hospitalization due to TBI by 35 years of age. The Christchurch New Zealand birth cohort found that by 25 years of age 31.6% of the population had experienced at least 1 TBI, requiring medical attention (hospitalization, emergency department, or physician office). An estimated 43.3% of Americans have residual disability 1 year after hospitalization with TBI. [corrected] The most recent estimate of the prevalence of US civilian residents living with disability following hospitalization with TBI is 3.2 million. Estimates of the incidence and prevalence of TBI are based on varying sources of data, methods of calculation, and assumptions. Informed users should be cognizant of the limitations of these estimates when determining their applicability.
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                Author and article information

                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                02 January 2013
                26 March 2013
                2013
                : 4
                : 30
                Affiliations
                [1] 1Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida Tampa, FL, USA
                [2] 2James A. Haley Veterans Administration Hospital Tampa, FL, USA
                [3] 3Rashid Laboratory for Developmental Neurobiology, Silver Child Development Center, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida Tampa, FL, USA
                Author notes

                Edited by: Frank Tortella, Walter Reed Army Institute of Research, USA

                Reviewed by: Linda Noble, University of California San Francisco, USA; V. Wee Yong, University of Calgary, Canada

                *Correspondence: Cesar V. Borlongan, Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida, 12901 Bruce. B. Downs Blvd., MDC78, Tampa, FL 33612, USA. e-mail: cborlong@ 123456health.usf.edu

                This article was submitted to Frontiers in Neurotrauma, a specialty of Frontiers in Neurology.

                Article
                10.3389/fneur.2013.00030
                3607801
                23531681
                45208673-be7f-4367-ae07-a7ac9d5723b9
                Copyright © 2013 Hernandez-Ontiveros, Tajiri, Acosta, Giunta, Tan and Borlongan.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.

                History
                : 02 November 2012
                : 10 March 2013
                Page count
                Figures: 2, Tables: 0, Equations: 0, References: 102, Pages: 9, Words: 8346
                Categories
                Neuroscience
                Review Article

                Neurology
                head trauma,microglia,inflammatory response,secondary cell death,anti-inflammatory therapy,brain imaging

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