Distinguishing the Unique Neuropathological Profile of Blast Polytrauma.
Distinguishing the Unique Neuropathological Profile of Blast Polytrauma.
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DOI：
10.1155/2017/5175249
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发表时间：
2017
影响因子：
--
通讯作者：
VandeVord P
中科院分区：
文献类型：
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作者：
Hubbard WB;Greenberg S;Norris C;Eck J;Lavik E;VandeVord P
爆炸暴露后持续的创伤性脑损伤（爆炸引起的TBI）最近被证明是军事人员日益严重的问题。肺等器官损伤的发生率有所下降，但目前的流行病学仍造成巨大的公共卫生负担。此外，未受保护的平民以惊人的速度遭受原发性爆炸性肺损伤（PBLI）。通常，轻至中度的PBLI病例通过医疗干预可以存活，这使得越来越多的爆炸诱发多发性创伤（BPT）幸存者出现爆炸诱发轻度TBI（mTBI）症状。目前，缺乏模拟BPT的临床前模型，这对于确定BPT的独特损伤机制及其管理至关重要。为了满足这一需求，我们的小组表征了BPT的啮齿动物模型，并将结果与爆炸诱导的mTBI模型进行了比较。在损伤后7天对啮齿动物进行旷场（OF）性能试验。在BPT后第7天进行免疫组织化学以评价细胞结果。与冲击波诱导的mTBI相比，BPT中反应性星形胶质细胞（GFAP）、细胞凋亡（裂解的caspase-3表达）和血管损伤（SMI-71）的水平显著升高。下游缺氧标志物（HIF-1α和VEGF）仅在BPT后升高。这项研究强调了在处理BPT时需要独特的治疗方法和院前管理。
Traumatic brain injury sustained after blast exposure (blast-induced TBI) has recently been documented as a growing issue for military personnel. Incidence of injury to organs such as the lungs has decreased, though current epidemiology still causes a great public health burden. In addition, unprotected civilians sustain primary blast lung injury (PBLI) at alarming rates. Often, mild-to-moderate cases of PBLI are survivable with medical intervention, which creates a growing population of survivors of blast-induced polytrauma (BPT) with symptoms from blast-induced mild TBI (mTBI). Currently, there is a lack of preclinical models simulating BPT, which is crucial to identifying unique injury mechanisms of BPT and its management. To meet this need, our group characterized a rodent model of BPT and compared results to a blast-induced mTBI model. Open field (OF) performance trials were performed on rodents at 7 days after injury. Immunohistochemistry was performed to evaluate cellular outcome at day seven following BPT. Levels of reactive astrocytes (GFAP), apoptosis (cleaved caspase-3 expression), and vascular damage (SMI-71) were significantly elevated in BPT compared to blast-induced mTBI. Downstream markers of hypoxia (HIF-1α and VEGF) were higher only after BPT. This study highlights the need for unique therapeutics and prehospital management when handling BPT.