In vivo leukocyte-mediated brain microcirculatory inflammation: a comparison of osmotherapies and progesterone in severe traumatic brain injury

被引：13

作者：

Kumasaka, Kenichiro ^{[1
]}

Marks, Joshua A. ^{[1
]}

Eisenstadt, Rachel ^{[1
]}

Murcy, Mohammad A. ^{[1
]}

Samadi, Davoud ^{[1
]}

Li, Shengjie ^{[1
]}

Johnson, Victoria ^{[2
]}

Browne, Kevin D. ^{[2
]}

Smith, Douglas H. ^{[2
]}

Schwab, C. William ^{[1
]}

Pascual, Jose L. ^{[1
]}

机构：

[1] Univ Penn, Dept Surg, Div Traumatol Surg Crit Care & Emergency Surg, Philadelphia, PA 19104 USA

[2] Univ Penn, Perelman Sch Med, Ctr Brain Injury & Repair, Dept Neurosurg, Philadelphia, PA 19104 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2014年 / 208卷 / 06期

关键词：

Intravital microscopy; Neuroinflammation; Traumatic brain injury; Osmotherapy; Progesterone; Polymorphonuclear neutrophil; HYPERTONIC SALINE; HEMORRHAGIC-SHOCK; CEREBRAL MICROCIRCULATION; NEUTROPHIL ACTIVATION; MANNITOL; RESUSCITATION; NEUROPROTECTION; THERAPY; BARRIER; IMPACT;

D O I：

10.1016/j.amjsurg.2014.08.004

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: Mannitol, hypertonic saline, and progesterone may blunt leukocyte recruitment after traumatic brain injury (TBI). We hypothesized that progesterone reduces pericontusional recruitment of leukocytes to a greater extent than either osmotherapy a day after TBI. METHODS: CD1 mice underwent controlled cortical impact and were treated with osmotherapy (mannitol and hypertonic saline) or progesterone. Thirty-two hours after TBI, live pial microscopy was used to evaluate leukocyte-endothelial interactions and immunohistochemistry was used for the detection of pericontusional tissue polymorphonuclear neutrophils. Neurologic recovery was assessed before sacrifice. RESULTS: Mannitol resulted in the lowest in vivo leukocyte recruitment compared with progesterone (795 +/- 282 vs 1,636 +/- 434 LEU/100 mm/minutes, P < .05). Mannitol also displayed lower tissue accumulation of leukocytes as compared with progesterone (5.7 +/- 1.7 vs 15.2 +/- .1 LEU/mm(2), P -.03). However, progesterone resulted in better neurologic recovery than either osmotherapy. CONCLUSIONS: Leukocyte recruitment to injured brain is lowest with mannitol administration. How different agents alter progression of secondary brain injury will require further evaluation in humans. (C) 2014 Elsevier Inc. All rights reserved.

引用

页码：961 / 967

页数：7

共 30 条

[21] Early management of severe traumatic brain injury [J].