# Identifying APOE related lipid biomarkers for diagnosing chronic neurocognitive deficits in TBI patients

> **NIH VA I01** · JAMES A. HALEY VA MEDICAL CENTER · 2022 · —

## Abstract

Traumatic brain injury (TBI) affects over 300,000 troops from the Operation Iraqi Freedom (OIF)/Operation
Enduring Freedom (OEF). Mild TBI (mTBI) is the most prevalent brain injury from these conﬂicts and
represents 90% of all brain injuries. However, clinical presentation of mTBI overlaps with those of subjects
suffering from post-traumatic stress disorder (PTSD), which is also a prevalent condition that afﬂicts 30% of the
soldiers returning from the OIF/OEF. The pathophysiology of TBI remains difﬁcult to dissect owing to the
heterogenous nature of the injuries that occur in the military population. A number of neuropathological studies
using brain tissue from professional football players and military veterans who sustained TBI in life showed
accumulation of amyloid and tau, both of which are key pathologies of Alzheimer's disease (AD). Recent
studies show that blood Aβ and tau levels are also altered in blood of subjects with mTBI. Studies conducted
by the Roskamp Institute scientists and others showed that individuals with the apolipoprotein (APOE) ε4 allele
and a diagnosis of TBI suffered from learning and memory impairment that was consistent with AD.
Nevertheless, detecting AD related pathology in mTBI subjects remains a critical challenge and therefore
discovery of blood biomarkers will greatly enhance our ability to detect preclinical AD in subjects with mTBI.
 We have shown that omega-3 and omega-6 polyunsaturated fatty acid (PUFA) content within blood
phospholipids (PL) are altered in ε4 carriers with preclinical mild cognitive impairment (MCI) or AD. These
blood PL are also altered in ε4 carriers with TBI compared to controls and non-ε4 carriers. The omega-3 and
omega-6 PUFA can undergo a series of enzymatic and non-enzymatic processes which result in generation of
bioactive lipid metabolites that inﬂuence a range of inﬂammatory and oxidative stress parameters which are
relevant to both AD and TBI pathologies. Levels of sphingomyelin (SM) are altered in AD and TBI patients and
these lipids can be further metabolized to generate ceramides that are potent modulators of inﬂammation. We
therefore hypothesize that an examination of bioactive lipid metabolites (i.e. eicosanoids, isoprostanes,
resolvins, lipoxins, ceramides and sphingosine) will be useful in differentiating mTBI subjects from healthy
controls and those with conditions which present with similar symptoms. These bioactive lipid metabolites will
also help predict cognitive decline indicative of subsequent AD risk. We have developed lipidomic assays that
take advantage of the nano-ﬂow Ultra high pressure liquid chromatography (UHPLC) systems and the high
mass accuracy and high resolution capabilities of the Q-Exactive hybrid quadruple Orbitrap mass
spectrometer, allowing us to efﬁciently and accurately identify and quantify hundreds of bioactive lipid
metabolites. We will apply this technology to identify novel blood lipid metabolites that can differentiate
subjects with mTBI fr...

## Key facts

- **NIH application ID:** 10454875
- **Project number:** 5I01RX002767-04
- **Recipient organization:** JAMES A. HALEY VA MEDICAL CENTER
- **Principal Investigator:** Laila Abdullah
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10454875

## Citation

> US National Institutes of Health, RePORTER application 10454875, Identifying APOE related lipid biomarkers for diagnosing chronic neurocognitive deficits in TBI patients (5I01RX002767-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10454875. Licensed CC0.

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