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Chapter 9.  Translational Research and New Approaches 143

to diagnose the severity of TBI is challenging when relying solely on clinical parameters. Early appearance of a TBI bio- marker would be invaluable as a tool in determining when a player may return to full contact activity or when it is safe to return a soldier to the battlefield. Proteomic research in this field is ongoing in attempts to identify novel biomarkers in the cerebral spinal fluid that correlate with the severity of TBI and predictors of recovery.

Metabolomics

Metabolomics refers to the characterization of the cellular, small-molecule metabolite pool that is present in biological systems. It provides an overview of the metabolic status and the biochemical processes occurring in a given set of condi- tions. The metabolites that are studied include sugars, amino acids, lipids, steroids, and triglycerides. Metabolomics allows for the opportunity to identify biomarkers or biomarker changes in biological fluids related to an environmental stres- sor. One application of this technique is the analysis of the urinary metabolic profile of kidney transplant recipients when evaluating for acute or chronic cellular rejection. If one could identify a unique metabolite for this process, then patients could be treated for rejection without the need for biopsy. One advantage of using metabolomics is that bio- markers from metabolomic profiling studies can be trans- lated from preclinical studies to the clinical setting since many endogenous metabolites such as sugars, amino acids, and lipids are species-independent, whereas gene transcripts and proteins often show interspecies variation. However, one disadvantage is that, in contrast to the human genome, the human metabolome is not well characterized. There are nearly 3,000 endogenous metabolites that are present in the human body and only a subset has been identified, character- ized, and archived in web-accessible databases. Metabolic profiling is in its early stages but should continue to grow, as technology improves and more metabolites are identified and characterized.

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