Trauma care often suffers from delays in identifying the precise location of injury and delivering targeted treatment, especially in emergency and battlefield settings. When medications are administered systemically, they may harm healthy tissues and organs, particularly if given too early. Rapid and accurate detection of injury sites is critical to avoid such complications and improve outcomes. Researchers have now discovered that trauma immediately alters the structure of specific proteins, creating a unique injury molecular signature. This opens up the possibility of using these changes to guide treatments directly to the site of injury within minutes of its occurrence.

Researchers at Rutgers Health (Brunswick, NJ, USA) have developed a new trauma-targeting approach using a molecular marker they identified as the “traumome”—a set of proteins that change shape in response to calcium spikes within cells following injury. These altered proteins are unique to injured tissue and appear immediately after damage occurs. The team screened for small peptides that bind specifically to these structurally changed proteins. One such peptide was found to attach to a calcium-triggered conformational change in a trauma-specific protein. The researchers created a system where these peptides could be tagged with imaging agents, such as those used in PET or MRI scans, allowing clinicians to visualize the exact location of trauma in the body in real time. The ultimate goal is to develop a simple injectable that autonomously identifies and treats injury sites with site-specific delivery of therapies like clotting factors, antibiotics, or imaging tracers.

The study, published in Med (Cell Press), demonstrated successful testing of the trauma-targeting peptide in pig models with major injuries. The peptide reliably located injury sites by binding to the traumome, and the same results were replicated in rat models, suggesting that the molecular injury signature is conserved across mammals, including humans. These findings validate the feasibility of using trauma-specific peptides as diagnostic and therapeutic tools for real-time injury localization. The researchers now plan to miniaturize and refine this approach into a deployable diagnostic and treatment system for trauma care, with the goal of revolutionizing how trauma is managed in critical settings.

"The moment trauma occurs, specific proteins undergo structural changes, creating a molecular footprint of injury. This opens the door to delivering diagnostics or therapies directly to the site – without affecting healthy tissues," said Dr. Wadih Arap, co-lead author of the study.

“Our long-term vision is a simple injection that autonomously finds and treats injury sites,” added researcher Renata Pasqualin. “This could be transformative for battlefield medicine and emergency trauma care, where every second matters.”

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