BME 262 – Cell and Tissue Engineering
Professor Hani Awad
Cellular Therapy for the Treatment of Moderate to
Severe Traumatic Brain Injury
Traumatic brain injuries occur when external forces cause traumatic injury to the brain. They directly affect 1.5 million Americans annually, and annually result in 100,000 cases of life-long impairment with substantial loss of function. Today there are 3.2 million Americans living with long-term disability as a result of brain injury (Congressional Brain Injury Task Force, 2012). It is estimated that 2.5 to 6.5 million individuals live with consequences of TBI (National Institue of Health). ...view middle of the document...
, 2008). Congress has formed a brain injury task force, and there are currently many opportunities for federal funding relating to the treatment of TBI. Because there are no FDA approved therapies, the field is wide open for innovation. It is estimated that TBI results in $60 billion annually in societal impact. In addition to the significant economic costs, TBI has recently received significant media attention due to large numbers of war heros and high profile athletes dealing with the long-term effects of TBI. Because of these factors, there is significant motivation to seek better solutions for treating TBI, but there are still no definitive answers. In this paper we discuss in detail the traditional clinical approaches, their shortcomings, the current state of the art, and where the science of treating TBI may be headed in the years to come.
Traditional Clinical Approaches:
Individuals with moderate to severe traumatic brain injury typically present with any combination of symptoms associated with head injuries including headache, vomiting, dilation of pupils, slurred speech, weakness, confusion, or complete loss of consciousness (National Institute of Neurological Disorders and Stroke, 2012). Because nothing can be done to reverse damage caused by the trauma, emergency treatment aims at restoring haemostasis to prevent any further damage. This includes supplying oxygen, managing blood pressure, and relieving intracranial pressure. If an individual survive the TBI, it is likely that they will require rehabilitation for an extended period of time. It is widely known that a ‘general’ treatment for TBI is unrealistic as each person presents varying level of injury as well as side effects (TBI.com).
Programs of acute rehabilitation as well as long-term acute care aim to integrate the patient back into life without nursing care. The treatment aims to increase the person’s capacity to function in all aspects of family and community life. This includes the ability to interact with friends and family, as well as work in some capacity, and function normally in society with little or no supervision. The treatments are classified as either restorative or compensatory. Restorative training focuses on improving a specific cognitive function, and compensatory training focuses on adapting to the presence of a cognitive deficit (National Institute of Health). While these treatments are widely used, there is limited data supporting the efficacy of these approaches due to the heterogeneity of the disease. While data does exist concerning cellular plasticity of neurons and the limited ability of the brain to recover, the brain cannot fully recover from TBI.
Anatomy and Physiology of the Brain:
The Brain is one of the largest and arguably the most complex organs in the body. It contains billions of nerves communicating with one another via trillions of synapses. Together, these nerves are responsible for...