Bennett Rachel E, Brody David L
Department of Neurology, Washington University , St. Louis, Missouri.
J Neurotrauma. 2014 Oct 1;31(19):1647-63. doi: 10.1089/neu.2013.3320. Epub 2014 Jul 16.
The pathological processes that lead to long-term consequences of multiple concussions are unclear. Primary mechanical damage to axons during concussion is likely to contribute to dysfunction. Secondary damage has been hypothesized to be induced or exacerbated by inflammation. The main inflammatory cells in the brain are microglia, a type of macrophage. This research sought to determine the contribution of microglia to axon degeneration after repetitive closed-skull traumatic brain injury (rcTBI) using CD11b-TK (thymidine kinase) mice, a valganciclovir-inducible model of macrophage depletion. Low-dose (1 mg/mL) valganciclovir was found to reduce the microglial population in the corpus callosum and external capsule by 35% after rcTBI in CD11b-TK mice. At both acute (7 days) and subacute (21 days) time points after rcTBI, reduction of the microglial population did not alter the extent of axon injury as visualized by silver staining. Further reduction of the microglial population by 56%, using an intermediate dose (10 mg/mL), also did not alter the extent of silver staining, amyloid precursor protein accumulation, neurofilament labeling, or axon injury evident by electron microscopy at 7 days postinjury. Longer treatment of CD11b-TK mice with intermediate dose and treatment for 14 days with high-dose (50 mg/mL) valganciclovir were both found to be toxic in this injury model. Altogether, these data are most consistent with the idea that microglia do not contribute to acute axon degeneration after multiple concussive injuries. The possibility of longer-term effects on axon structure or function cannot be ruled out. Nonetheless, alternative strategies directly targeting injury to axons may be a more beneficial approach to concussion treatment than targeting secondary processes of microglial-driven inflammation.
导致多次脑震荡产生长期后果的病理过程尚不清楚。脑震荡期间轴突受到的原发性机械损伤可能会导致功能障碍。据推测,继发性损伤是由炎症诱发或加剧的。大脑中的主要炎症细胞是小胶质细胞,它是一种巨噬细胞。本研究旨在使用CD11b - TK(胸苷激酶)小鼠(一种缬更昔洛韦诱导的巨噬细胞耗竭模型)来确定小胶质细胞在重复性闭合性颅脑创伤性脑损伤(rcTBI)后对轴突退变的作用。研究发现,低剂量(1毫克/毫升)的缬更昔洛韦可使CD11b - TK小鼠在rcTBI后胼胝体和外囊中的小胶质细胞数量减少35%。在rcTBI后的急性(7天)和亚急性(21天)时间点,通过银染观察,小胶质细胞数量的减少并未改变轴突损伤的程度。使用中等剂量(10毫克/毫升)使小胶质细胞数量进一步减少56%,同样未改变银染程度、淀粉样前体蛋白积累、神经丝标记或损伤后7天通过电子显微镜观察到的轴突损伤情况。在该损伤模型中,发现用中等剂量对CD11b - TK小鼠进行更长时间治疗以及用高剂量(50毫克/毫升)缬更昔洛韦治疗14天均具有毒性。总之,这些数据最符合以下观点:小胶质细胞在多次脑震荡性损伤后对急性轴突退变没有作用。不能排除对轴突结构或功能产生长期影响的可能性。尽管如此,直接针对轴突损伤的替代策略可能比针对小胶质细胞驱动的炎症继发过程的策略对脑震荡治疗更有益。