Recent advances in neurotrauma
Recent advances in neurotrauma
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DOI：
10.1093/jnen/59.8.641
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发表时间：
2000-08-01
影响因子：
3.2
通讯作者：
Nicoll, JAR
中科院分区：
文献类型：
--
作者：
Graham, DI;McIntosh, TK;Nicoll, JAR
详细介绍了人类急性创伤性脑损伤 (TBI) 的发生频率和结果，以及主要局灶性和弥漫性病理的分类，并概述了其在提取实验室模型中的机制。特别强调弥漫性轴突损伤，这是结果的主要决定因素。损伤引发的细胞和分子级联反应参考轴突和细胞骨架异常的诱导、坏死和凋亡细胞死亡、Ca2+的作用进行描述。细胞因子和自由基，以及 DNA 损伤。结论是，人类 TBI 具有异质性，反映了遗传背景（APOE 基因多态性）影响 6 个月结果的患者中不同比例的各种病理。尽管对 TBI 的理解已经取得了相当大的进展，但仍有许多问题有待确定。然而，对病理生理事件的更深入了解可能会导致改善合理靶向治疗结果的可能性。
The frequency of and outcome from acute traumatic brain injury (TBI) in humans are detailed together with a classification of the principal focal and diffuse pathologies, and their mechanisms in extract laboratory models are outlined. Particular emphasis is given to diffuse axonal injury, which is a major determinant of outcome. Cellular and molecular cascades triggered by injury are described with reference to the induction of axolemmal and cytoskeletal abnormalities, necrotic and apoptotic cell death, the role of Ca2+. cytokines and free radicals, and damage to DNA. It is concluded that TBI in humans is heterogeneous, reflecting various pathologies in differing proportions in patients whose genetic background (APOE gene polymorphisms) contributes to the outcome at 6 months. Although considerable progress has been made in the understanding of TBI, much remains to be determined. However, a deeper understanding of the pathophysiological events may lead to the possibility of improving outcome from rational targeted therapy.