A Historical Perspective on Sports Concussion: Where We Have Been and Where We Are Going.

The approach to sports concussion diagnosis and management has been evolving at an unprecedented rate over the last several years. So much so, that committees at all level of sports have implemented concussion protocols and made adjustments to certain league rules in an effort to minimize the risk of head injury. With this newfound attention has come an even greater push by the scientific community to address the many questions that remain. The aim of this review article is to present the topic of sports concussion by means of discreet eras. It begins by introducing the very first mentions of concussion, dating back to ancient Greece, to present day, highlighting important periods along the way. It then goes on to review emerging scientific data, from biomarkers and serum studies, to imaging modalities, and brain networking. All of which will hopefully contribute to both the diagnostic and therapeutic approach to sports concussion.

Therapeutic potential of H11 kinase for the ischemic heart.

H11 kinase (H11K) is a small heat shock protein expressed predominantly in the heart and skeletal muscle, which plays a critical role in the maintenance of cardiac cell survival and in promoting cell growth through the activation of complementary signaling pathways. An overexpression of H11K was detected in various forms of heart disease, both in animal models and in patients, including acute and chronic ventricular dysfunction, and myocardial hypertrophy. Overexpression of H11K was reproduced in a cardiac-specific transgenic model, which led to significant progress in understanding the role and mechanism of action of the protein. Increased expression of H11K confers a cardioprotection that is equivalent to ischemic preconditioning; it promotes cardiac hypertrophy while maintaining contractile function. The overexpression of H11K is sufficient to activate most of the signaling pathways involved in cardiac cell growth and survival, including the phosphatidylinositol-3-kinase/Akt pathway, the AMP-dependent protein kinase, the PKCepsilon pathway of ischemic preconditioning, the nitric oxide pathway of delayed cardioprotection, and the mTOR pathway of cell growth. As a result, the survival response triggered by H11K in the heart includes antiapoptosis, cytoprotection, preconditioning, growth, and metabolic stimulation. In addition to activating signaling pathways, H11K promotes the subcellular translocation and crosstalk of intracellular messengers. This review discusses the biological function of H11K, its molecular mechanisms of action, and its potential therapeutic relevance. In particular, we discuss how preemptive conditioning of the heart by H11K might be beneficial for patients with ischemic heart disease who would be at risk of further irreversible cardiac damage.