Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
The Geneva Foundation, Tacoma, WA 98402, USA
*Peethambaran Arun, peethambaran.arun.civ@health.mil
收稿:2025-09-04,
修回:2026-03-06,
纸质出版:2026-03
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Rex Jeya Rajkumar Samdavid Thanapaul, Manoj Y. Govindarajulu, Chetan Y. Pundkar, 等. Pathophysiology-guided biomarkers and therapeutics for precision trauma medicine in polytrauma with musculoskeletal injuries[J/OL]. 军事医学研究(英文), 2026.
Thanapaul RJRS, Govindarajulu MY, Pundkar CY, Arun P. Pathophysiology-guided biomarkers and therapeutics for precision trauma medicine in polytrauma with musculoskeletal injuries. Mil Med Res. 2026;13(1):100014.
Rex Jeya Rajkumar Samdavid Thanapaul, Manoj Y. Govindarajulu, Chetan Y. Pundkar, 等. Pathophysiology-guided biomarkers and therapeutics for precision trauma medicine in polytrauma with musculoskeletal injuries[J/OL]. 军事医学研究(英文), 2026. DOI: 10.1016/j.mmr.2026.100014.
Thanapaul RJRS, Govindarajulu MY, Pundkar CY, Arun P. Pathophysiology-guided biomarkers and therapeutics for precision trauma medicine in polytrauma with musculoskeletal injuries. Mil Med Res. 2026;13(1):100014. DOI: 10.1016/j.mmr.2026.100014.
Polytrauma with predominant musculoskeletal (MSK) injury
resulting from blast
blunt
and crush mechanisms
remains a leading and complex challenge in both military and civilian medicine. These injuries not only disrupt tissues structurally but also trigger systemic cascades involving immune imbalance
endothelial dysfunction
mitochondrial stress
and premature cellular senescence. Such pathological processes contribute to both immediate clinical instability and long-term complications such as fibrosis
aberrant bone formation
neuroinflammation
and chronic disability. Conventional injury assessments
which rely heavily on anatomical scoring and nonspecific blood markers
fail to capture the dynamic molecular landscape underlying these conditions. To address this critical gap
we performed a comprehensive scoping review integrating evidence from basic science
translational studies
and clinical research published between January 2000 to June 2025
with particular emphasis on recent advances. The review highlights the discovery and validation of emerging blood-based and molecular biomarkers
including fatty acid-binding protein 3
syndecan-1
galectin-3
and trauma-associated microRNAs
as well as innovative diagnostic paradigms such as wearable biosensors
minimally invasive liquid biopsy platforms
and artificial intelligence (AI)-driven analytics. Unlike prior reviews
our analysis uniquely integrates findings across both military and civilian trauma contexts
providing actionable frameworks for clinical application. Building on these insights
we outline a practical roadmap: 1) deploys integrated multi-marker panels for early risk stratification
2) expands inclusive trauma biobanking to capture diverse injury phenotypes
and 3) uses adaptive
data-driven tools for real-time triage and personalized intervention. This approach links acute systemic responses to downstream recovery and rehabilitation
offering actionable guidance for both military and civilian trauma systems.
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