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- ItemEmbargomiR‑9‑5p is downregulated in serum extracellular vesicles of patients treated with biperiden after traumatic brain injury(Universidade Federal de São Paulo, 2024-08-23) Kajitani, Gustavo Satoru [UNIFESP]; Belangero, Sintia Iole Nogueira [UNIFESP]; http://lattes.cnpq.br/2623781262478620; http://lattes.cnpq.br/3744655540260834Traumatic brain injury (TBI) is a prevalent and debilitating condition, which often leads to the development of posttraumatic epilepsy (PTE), a condition that yet lacks preventive strategies. Biperiden, an anticholinergic drug, is a promising candidate that has shown efficacy in murine models of PTE. MicroRNAs (miRNAs), small regulatory RNAs, can help in understanding the biological basis of PTE and act as TBIand PTErelevant biomarkers that can be detected peripherally, as they are present in extracellular vesicles (EVs) that cross the bloodbrain barrier. This study aimed to investigate miRNAs in serum EVs from patients with TBI, and their association with biperiden treatment and PTE. Blood samples of 37 TBI patients were collected 10 days after trauma and treatment initiation in a doubleblind clinical trial. A total of 18 patients received biperiden, with three subjects developing PTE, and 19 received placebo, with two developing PTE. Serum EVs were characterized by size distribution and protein profiling, followed by highthroughput sequencing of the EV miRNome. Differential expression analysis revealed no significant differences in miRNA expression between TBI patients with and without PTE. Interestingly, miR95p displayed decreased expression in biperidentreated patients compared to the placebo group. This miRNA regulates genes enriched in stress response pathways, including axonogenesis and neuronal death, relevant to both PTE and TBI. These findings indicate that biperiden may alter miR95p expression in serum EVs, which may play a role in TBI resolution.