A groundbreaking study by researchers at Rutgers Health has uncovered a way to precisely identify and target trauma sites in the body within minutes of injury. The findings , published in the journal Med (Cell Press), could revolutionize emergency care by enabling real-time diagnostics and site-specific treatments delivered within minutes of injury.
A team of scientists, led by Renata Pasqualini and Wadih Arap at the Rutgers Cancer Institute – New Jersey's only NCI-designated Comprehensive Cancer Center together with RWJBarnabas Health –discovered something new about how the body reacts to injury. When cells are damaged, like in a major bone break, calcium levels inside the cells spike, which causes certain proteins to change shape. These changed proteins, called the "traumome," are only found in injured tissues and show up right after an injury happens. This discovery opens up a new way to treat injuries directly, without affecting healthy parts of the body.
"The moment trauma occurs, specific proteins undergo structural changes, creating a molecular footprint of injury," said Arap. "This opens the door to delivering diagnostics or therapies directly to the site – without affecting healthy tissues."
This discovery has relevance in emergency treatment because many medicines can affect healthy organs when they're given too soon. With this new approach, doctors could deliver treatments like imaging agents, clotting factors or antibiotics directly to the injured area, which would help the body heal faster with fewer side effects.
"Our long-term vision is a simple injection that autonomously finds and treats injury sites," said Pasqualini. "This could be transformative for battlefield medicine and emergency trauma care, where every second matters."
The team used advanced testing on a pig model with major injuries to find tiny protein pieces called peptides. These peptides are like guides that can find and stick to the specific proteins that change when the body gets hurt. One of these peptides stands out because it can attach to a protein that changes shape when calcium levels rise after an injury. This makes it possible to use special scans, like PET or MRI, to see exactly where the injury is in the body.
The trauma-targeting peptide worked the same way in rats, which shows that this injury "signature" is similar in all mammals, including humans.
The work was supported by the Defense Advanced Research Projects Agency (DARPA), an agency of the U.S. Department of Defense, underscoring its strategic value in both civilian and military medical applications. "Non-compressible bleeding remains a leading cause of death among soldiers before they reach a hospital, and localized treatment could dramatically improve survival rates, which was the original impetus of this research," said Jon Mogford, a study co-author and former DARPA official.
The next phase of research will involve linking therapeutic agents to the trauma site-homing peptides and testing them in animal models before moving to early human clinical trials. The team envisions translational applications ranging from battlefield medicine to civilian trauma response and possibly even sports injuries or surgical recovery.
"We are actively developing peptide-drug conjugates and imaging agents based on this discovery," said Arap. "The traumome concept may also have applications beyond trauma, including in surgery, inflammation and tissue regeneration."
