Targeting complement and chronic inflammation after traumatic brain injury

创伤性脑损伤（TBI）在最初的机械损伤后，其特征在于继发性脑损伤的动态过程。 涉及慢性神经炎症的损伤，涉及长期的认知和运动 损伤和影响功能恢复。补体激活是免疫系统的主要组成部分。 越来越多的证据表明，补体在传播损伤中起作用 至少在急性期。然而，补体也可以有助于体内平衡和修复。 脑损伤后的机制，我们已经在中风模型中证明了替代途径是一种神经保护机制。 最佳治疗靶点，因为它的抑制减少了补体激活的病理性放大， 不干扰被认为对维持稳态重要的其他补体途径 中枢神经系统的活性和修复机制。基于我们在中风模型中的工作和在一个 TBI模型，在这项初步研究中，我们将调查的特点，慢性炎症反应后， 小鼠TBI（控制皮质撞击，CCI），并研究长期给予替代治疗的效果。 补体途径抑制剂通过不同的策略特异性靶向脑损伤部位。在 此外，根据我们的数据显示补体抑制和康复治疗的协同作用， 我们将确定结合位点靶向补体调节和康复治疗对 小鼠CCI后的长期认知和运动恢复。成功实现我们的目标将提供 一个强有力的理由，并建立一个Merit建议的可行性，详细的机制研究的作用 C在TBI后慢性神经炎症反应中的作用，以及神经炎症反应在TBI后慢性神经炎症反应中的作用。 脑损伤、修复和经验驱动的神经可塑性。这些研究也将为一个 更详细的临床前评估已确定的候选药物。

After initial mechanical insult, Traumatic Brain Injury (TBI) is characterized by a dynamic process of secondary injury that involves chronic neuroinflammation which is implicated in long-term cognitive and motor impairments and impacts recovery of function. Complement activation is a major component of the inflammatory cascade, and there is increasing evidence that complement plays a role in propagating injury after TBI, at least in the acute phase. However, complement can also contribute to homeostatic and reparative mechanisms after brain injury, and we have demonstrated in a stroke model that the alternative pathway is an optimal target for therapy because its inhibition reduces pathologic amplification of complement activation, but does not interfere with other complement pathways thought to be important for maintenance of homeostatic activity and reparative mechanisms in the CNS. Based on our work in stroke models and preliminary data in a TBI model, in this pilot study we will investigate the characteristics of the chronic inflammatory response after murine TBI (controlled cortical impact, CCI) and investigate the effects of chronically administered alternative complement pathway inhibitors that are specifically targeted to the site of brain injury by different strategies. In addition, based on our data showing a cooperative effect of complement inhibition and rehabilitation therapy, we will determine the effects of combining site-targeted complement modulation and rehabilitation therapy on long-term cognitive and motor recovery after murine CCI. Successful accomplishment of our aims will provide a strong rationale and establish the feasibility for a Merit proposal for detailed mechanistic studies into the role of C in the chronic neuroinflammatory response after TBI, and the role of the neuroinflammatory response in brain injury, repair and experience-driven (rehab) neural plasticity. These studies will also set the stage for a more detailed preclinical evaluation of an identified candidate drug.