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Extracellular Vesicle and Plasma miRNAs as Candidate Biomarkers of Traumatic Brain Injury in the Context of Polytrauma.

Overview

Authors: Cora Rebecca Schindler1, Dirk Henrich1, Lena Krämer1, Inna Schaible1, Jason-Alexander Hörauf1, Aileen Ritter1, Philipp Störmann1, Rald Victor Maria Groven2, Markus Huber-Lang3, Ingo Marzi1, Liudmila Leppik1
  1. Department of Trauma Surgery and Orthopedics, University Hospital of Goethe University Frankfurt, 60323 Frankfurt am Main, Germany
  2. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
  3. Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, 89081 Ulm, Germany
Journal: International journal of molecular sciences, volume 27, issue 10, article 4248
Dates: received 20 March 2026; accepted 8 May 2026; published online 10 May 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.3390/ijms27104248 · PMID 42196237 · PMCID PMC13206937 · OpenAlex W7160946331
Open access: gold, a free copy (OpenAlex)
Status: data only
Categories: genetics / omics (modality), human (organism), traumatic brain injury (population)
Methods: Statistics, Connectivity
Keywords: traumatic brain injury, extracellular vesicles, biomarkers, miRNA, polytrauma
MeSH: Biomarkers*, Brain Injuries, Traumatic*, Extracellular Vesicles*, MicroRNAs*, Multiple Trauma*, Adult, Female, Gene Expression Profiling, Humans, Male, Middle Aged, Prognosis (* major topic)
Topic: Extracellular vesicles in disease (Molecular Biology, Biochemistry, Genetics and Molecular Biology), according to OpenAlex
Funding: German Research Foundation (465409392)
Citations: not cited yet (Europe PMC); 56 references in the paper

Abstract

Severe traumatic brain injury (TBI) is a leading cause of mortality and long-term disability in polytrauma (PT) patients, and its clinical outcome remains difficult to predict due to clinical heterogeneity and secondary injury mechanisms. Current diagnostic and prognostic approaches based on clinical assessment and imaging are limited, particularly in PT where neurological evaluation is often impaired. This study aimed to compare plasma- and extracellular vesicle (EV)-associated microRNA (miRNA) signatures in patients with severe TBI and healthy controls to identify their potential as minimally invasive biomarkers and to improve understanding of molecular responses. For profiling circulating miRNAs, blood samples were collected at ≤3 h and at 48 h after admission. In the screening phase, plasma samples of n = 15 patients with severe isolated TBI (Abbreviated Injury Scale [AIS]Head ≥ 4, all other AIS ≤ 1) and n = 15 age- and sex-matched healthy controls were pooled (n = 5/pool) and subjected to next-generation sequencing (NGS). In the following validation phase, n = 25 severely injured trauma patients (Injury Severity Score [ISS] ≥ 16) were enrolled and stratified into PT without TBI (PT; AISHead = 0; n = 13) and isolated TBI (n = 12). Differentially expressed candidate miRNAs identified in the screening phase were validated in individual plasma and EV samples using reverse transcription droplet digital polymerase chain reaction (RT-ddPCR). Functional enrichment and pathway analyses were performed using miRNet. NGS identified more differentially expressed miRNAs in plasma (ER: 103; 48 h: 65) than in EVs (Emergency Room [ER]: 14; 48 h: 32). Functional enrichment analysis indicated associations with pathways related to cellular stress, senescence, growth factor signaling, transcriptional regulation, and apoptosis. In validation, 12 of 16 plasma and 10 of 15 EV-miRNAs were confirmed as differentially expressed in TBI patients; among these, three plasma and four EV miRNAs differed between TBI and PT. After adjustment, most plasma miRNAs were associated with injury severity rather than group status. EV miRNA profiles showed heterogeneous patterns, with miR-1469 associated with TBI group status in adjusted analysis, while miR-1237-5p was linked to injury severity and other EV miRNAs showed no consistent group-specific effects. Plasma miRNAs mainly correlated with systemic injury markers, whereas EV miR-1469 showed a moderate association with the Glasgow Coma Scale (GCS). Overall, circulating miRNA profiles after injury appear to be predominantly influenced by systemic trauma severity rather than TBI-specific effects. Plasma miRNAs mainly reflected general injury burden, whereas EV-associated miRNAs showed more heterogeneous patterns, with miR-1469 emerging as a candidate associated with TBI after adjustment for clinical covariates. These findings suggest that EV-derived miRNAs, particularly miR-1469, may provide more targeted signals related to brain injury and warrant further investigation.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

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Data

Datasets cited

Data Availability Statement

The data discussed in this publication have been deposited in NCBI’s Gene Expression Omnibus [56] and are accessible through GEO Series accession number GSE325396 (https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE325396) (https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE325396, submitted on 19 March 2026).

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 1, 28 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 11 authors, 5 keywords, 12 MeSH terms, 1 funder, 55 references.

Cite

This paper

Schindler, C. R., Henrich, D., Krämer, L., Schaible, I., Hörauf, J.-A., Ritter, A., Störmann, P., Groven, R. V. M., Huber-Lang, M., Marzi, I., & Leppik, L. (2026). Extracellular Vesicle and Plasma miRNAs as Candidate Biomarkers of Traumatic Brain Injury in the Context of Polytrauma. International journal of molecular sciences, 27(10), 4248. https://doi.org/10.3390/ijms27104248

BibTeX

@article{schindler2026extracellular,
author = {Schindler, Cora Rebecca and Henrich, Dirk and Krämer, Lena and Schaible, Inna and Hörauf, Jason-Alexander and Ritter, Aileen and Störmann, Philipp and Groven, Rald Victor Maria and Huber-Lang, Markus and Marzi, Ingo and Leppik, Liudmila},
title = {{Extracellular Vesicle and Plasma miRNAs as Candidate Biomarkers of Traumatic Brain Injury in the Context of Polytrauma}},
journal = {International journal of molecular sciences},
year = {2026},
month = may,
volume = {27},
number = {10},
pages = {4248},
publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},
issn = {1422-0067},
doi = {10.3390/ijms27104248},
url = {https://doi.org/10.3390/ijms27104248},
pmid = {42196237},
pmcid = {PMC13206937}
}

RIS

TY - JOUR
AU - Schindler, Cora Rebecca
AU - Henrich, Dirk
AU - Krämer, Lena
AU - Schaible, Inna
AU - Hörauf, Jason-Alexander
AU - Ritter, Aileen
AU - Störmann, Philipp
AU - Groven, Rald Victor Maria
AU - Huber-Lang, Markus
AU - Marzi, Ingo
AU - Leppik, Liudmila
TI - Extracellular Vesicle and Plasma miRNAs as Candidate Biomarkers of Traumatic Brain Injury in the Context of Polytrauma
T2 - International journal of molecular sciences
J2 - Int J Mol Sci
PY - 2026
DA - 2026/05/10
VL - 27
IS - 10
SP - 4248
SN - 1422-0067
PB - Multidisciplinary Digital Publishing Institute (MDPI)
DO - 10.3390/ijms27104248
UR - https://doi.org/10.3390/ijms27104248
LA - en
ER -

CSL-JSON

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