title: The Use of Circulating miRNAs as Biomarkers for Oxidative Stress in Critically Ill Polytrauma Patients.
abstract: BACKGROUND
  The diversity of primary and secondary traumatic injuries specific for the critically ill polytrauma patient is complicating the therapeutic management in the absence of a strict assessment of the biological changes. Inflammation, redox imbalance, and immunosuppression can be quantified by various biochemical parameters; however, they do not fully respond to the current requirements. Another phenomenon responsible for worsening the clinical status and for the development of complications in such patients is oxidative stress. Its aggressiveness combined with biochemical and physiological imbalances leads to increased morbidity and mortality. To minimize the effects induced by free radicals, various substances are administered with high antioxidant capacity. However, the dosage optimization for each patient is difficult without strict monitoring of oxidative stress. In this paper we will summarize and present the pathophysiology of oxidative stress, as well as the specificity of miRNAs for a series of molecular changes at the cellular level.
  
  
  METHODS
  For this study the available literature on specific databases such as PubMed, Embase and Scopus was thoroughly analyzed. Each article has been carefully reviewed, extracting useful information for this study. The keywords used to select the relevant articles were "oxidative stress", "antioxidant therapy", "microRNAs biomarkers", and "critically ill patients".
  
  
  RESULTS
  For this study, 121 scientific articles relevant to our topic were analyzed. Currently, quantification of oxidative stress is achieved through indirect correlations with plasma levels of specific biomarkers. For a more specific evaluation of the redox status, numerous studies were conducted on the use of circulating miRNAs as biomarkers in this regard.
  
  
  CONCLUSIONS
  Introducing miRNAs can revolutionize both monitoring and therapy modulation in these patients, adapting to the organic damage.
authors.forename: Ovidiu Horea
authors.initials: OH
authors.lastname: Bedreag
authors.forename: Dorel
authors.initials: D
authors.lastname: Sandesc
authors.forename: Sorin Dan
authors.initials: SD
authors.lastname: Chiriac
authors.forename: Alexandru Florin
authors.initials: AF
authors.lastname: Rogobete
authors.forename: Alina Carmen
authors.initials: AC
authors.lastname: Cradigati
authors.forename: Mirela
authors.initials: M
authors.lastname: Sarandan
authors.forename: Raluca
authors.initials: R
authors.lastname: Dumache
authors.forename: Radu
authors.initials: R
authors.lastname: Nartita
authors.forename: Marius
authors.initials: M
authors.lastname: Papurica
mesh_terms: D015415:Biomarkers / Q000097:blood; D016638:Critical Illness; D006801:Humans; D035683:MicroRNAs / Q000097:blood*; D009104:Multiple Trauma / Q000378:metabolism*; D018384:Oxidative Stress
chemical_list: D015415:Biomarkers; D035683:MicroRNAs