Interview with Dr Jules B. Puschett

Posted Wed, Oct, 07,2015

This author interview is by Dr Jules B. Puschett, of Texas A&M University. Dr Puschett's full paper, Comparison of neurocognitive testing and the measurement of marinobufagenin in mild traumatic brain injury: a preliminary report, is available for download in Journal of Experimental Neuroscience.

Please summarize of the contents of the article.
We evaluated the potential applicability of the measurement of a circulating hormonal substance called marinobufagenin (MBG) in athletes who have sustained brain trauma (concussion) as a diagnostic aid in the decision-making process as to when they are ready to return to play. We compared our observations to the current standard of care, provided by neurocognitive testing (NCT). We found that the results obtained utilizing the NCT scores generally tracked the urinary MBG values for the first week or two post-concussion. However, when the athletes (football players) then returned to play, their MBG values again rose.

How did you come to be involved in this study?
In animal experiments, we determined that concussions were accompanied by elevations in MBG and reflected alterations in brain tissue related to the concussion. We also noted that when we administered an antagonist of MBG that we developed, called resibufagenin (RBG), one hour after the brain trauma, the brain histology 24 hours later showed a dramatic amelioration of the inflammation and vascular damage caused by the concussion. In addition, the excretion of MBG in the urine returned to levels seen in control (sham) rats.

What was previously known?
There have been no other studies of MBG in either animals or human patients with traumatic brain injury (TBI) prior to our studies. We studied MBG in brain trauma because of the properties of MBG and RBG that we had discovered in hypertension.

How has your work in this area advanced understanding of the topic?
We propose that measurement of MBG may be a more reliable measure of the status of the brain injury than are NCT. Furthermore, if RBG proves to be effective and safe when given to human patients, it could be determined to be the first reliable treatment for brain trauma whether that results from a blow to the head due to a sports injury or, as we have determined, from an auto accident or a battlefield injury.

What do you regard as being the most important aspect(s) of the results reported in the article?
a) MBG may be a more accurate predictor of the status and level of the brain injury than other methods previously available.

b) If so, this finding could lead to the development of an agent ( e.g. RBG) that for the first time represents an example of personalized and effective therapy of concussion.

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