Kasturi Badrinarayanan S, Stein Donald G
Brain Research Laboratory, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Restor Neurol Neurosci. 2009;27(4):265-75. doi: 10.3233/RNN-2009-0475.
Traumatic brain injury (TBI) -induced brain edema can be reduced by acute progesterone (PROG) treatment in young adult males and females, and in aged males. To extend these findings we tested these hypotheses: 1. Acute PROG treatment post-TBI will reduce cortical edema in aged females as much as in young adults. 2. TBI will induce edema in sub-cortical structures (SCS): the thalamus (TH), hypothalamus (HT), brain stem (BS) and anterior pituitary (AP). 3. Acute, systemic PROG treatment post-TBI will reduce edema in SCS.
Young adult (n = 42) and aged (n = 40), bilaterally ovariectomized rats were given medial frontal cortical (MFC) contusion injury, treated with PROG (16 mg/kg body weight) or vehicle at 1, 6 and 24 hours post-injury and killed at 6, 24 and 48 hours post-injury. Their brains were removed and the target areas isolated and measured for water content.
TBI induced cortical and delayed sub-cortical edema. Acute PROG treatment decreased this edema. At 6 hours post-TBI serum PROG levels were substantially elevated in both young and aged, PROG-treated, groups, but were higher in the latter.
Acute PROG treatment post-TBI could prove an effective intervention to prevent or attenuate systemic, post-injury cortical and sub-cortical edema in young and aged females.
创伤性脑损伤（TBI）所致脑水肿可通过急性给予孕酮（PROG）治疗在年轻成年雄性和雌性以及老年雄性中减轻。为扩展这些发现，我们检验了以下假设：1. TBI后急性给予PROG治疗对老年雌性皮质水肿的减轻程度与年轻成年雌性相同。2. TBI会在皮质下结构（SCS）中诱发水肿，这些结构包括丘脑（TH）、下丘脑（HT）、脑干（BS）和垂体前叶（AP）。3. TBI后急性全身性给予PROG治疗会减轻SCS中的水肿。
对年轻成年（n = 42）和老年（n = 40）双侧卵巢切除的大鼠造成内侧额叶皮质（MFC）挫伤性损伤，在损伤后1小时、6小时和24小时用PROG（16毫克/千克体重）或赋形剂进行治疗，并在损伤后6小时、24小时和48小时处死。取出它们的大脑，分离并测量目标区域的含水量。
TBI诱发了皮质水肿和延迟性皮质下水肿。急性PROG治疗减轻了这种水肿。在TBI后6小时，年轻和老年接受PROG治疗的组血清PROG水平均大幅升高，但老年组更高。
TBI后急性给予PROG治疗可能是预防或减轻年轻和老年雌性损伤后全身性皮质和皮质下水肿的有效干预措施。
