氧化应激与神经血管炎症在创伤性脑损伤发病机制中的相互作用。

Interactions of oxidative stress and neurovascular inflammation in the pathogenesis of traumatic brain injury.

作者信息

Abdul-Muneer P M, Chandra Namas, Haorah James

机构信息

Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198, USA,

出版信息

Mol Neurobiol. 2015;51(3):966-79. doi: 10.1007/s12035-014-8752-3. Epub 2014 May 28.

Abstract

Traumatic brain injury (TBI) is a major cause of death in the young age group and leads to persisting neurological impairment in many of its victims. It may result in permanent functional deficits because of both primary and secondary damages. This review addresses the role of oxidative stress in TBI-mediated secondary damages by affecting the function of the vascular unit, changes in blood-brain barrier (BBB) permeability, posttraumatic edema formation, and modulation of various pathophysiological factors such as inflammatory factors and enzymes associated with trauma. Oxidative stress plays a major role in many pathophysiologic changes that occur after TBI. In fact, oxidative stress occurs when there is an impairment or inability to balance antioxidant production with reactive oxygen species (ROS) and reactive nitrogen species (RNS) levels. ROS directly downregulate proteins of tight junctions and indirectly activate matrix metalloproteinases (MMPs) that contribute to open the BBB. Loosening of the vasculature and perivascular unit by oxidative stress-induced activation of MMPs and fluid channel aquaporins promotes vascular or cellular fluid edema, enhances leakiness of the BBB, and leads to progression of neuroinflammation. Likewise, oxidative stress activates directly the inflammatory cytokines and growth factors such as IL-1β, tumor necrosis factor-α (TNF-α), and transforming growth factor-beta (TGF-β) or indirectly by activating MMPs. In another pathway, oxidative stress-induced degradation of endothelial vascular endothelial growth factor receptor-2 (VEGFR-2) by MMPs leads to a subsequent elevation of cellular/serum VEGF level. The decrease in VEGFR-2 with a subsequent increase in VEGF-A level leads to apoptosis and neuroinflammation via the activation of caspase-1/3 and IL-1β release.

摘要

创伤性脑损伤(TBI)是年轻人群死亡的主要原因,许多受害者会出现持续性神经功能障碍。由于原发性和继发性损伤,它可能导致永久性功能缺陷。本综述探讨氧化应激在TBI介导的继发性损伤中的作用,其通过影响血管单元功能、血脑屏障(BBB)通透性变化、创伤后水肿形成以及调节各种病理生理因素,如与创伤相关的炎症因子和酶。氧化应激在TBI后发生的许多病理生理变化中起主要作用。事实上,当抗氧化剂产生与活性氧(ROS)和活性氮(RNS)水平之间的平衡受损或无法维持时,就会发生氧化应激。ROS直接下调紧密连接蛋白,并间接激活基质金属蛋白酶(MMPs),从而导致BBB开放。氧化应激诱导的MMPs和液体通道水通道蛋白激活导致血管和血管周围单元松弛,促进血管或细胞性肺水肿,增强BBB的渗漏,并导致神经炎症进展。同样,氧化应激直接激活炎症细胞因子和生长因子,如白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和转化生长因子-β(TGF-β),或通过激活MMPs间接激活。在另一条途径中,MMPs诱导的内皮血管内皮生长因子受体-2(VEGFR-2)降解导致细胞/血清血管内皮生长因子(VEGF)水平随后升高。VEGFR-2减少,随后VEGF-A水平升高,通过激活半胱天冬酶-1/3和释放IL-1β导致细胞凋亡和神经炎症。

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