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使用渗透转运装置减轻创伤性脑损伤后的脑水肿

Reduction of cerebral edema after traumatic brain injury using an osmotic transport device.

作者信息

McBride Devin W, Szu Jenny I, Hale Chris, Hsu Mike S, Rodgers Victor G J, Binder Devin K

机构信息

1 B2K Group (Biotransport & Bioreaction Kinetics Group), Department of Bioengineering and the Center for Bioengineering Research, University of California Riverside , Riverside, California.

出版信息

J Neurotrauma. 2014 Dec 1;31(23):1948-54. doi: 10.1089/neu.2014.3439. Epub 2014 Oct 14.

Abstract

Traumatic brain injury (TBI) is significant, from a public health standpoint, because it is a major cause of the morbidity and mortality of young people. Cerebral edema after a TBI, if untreated, can lead to devastating damage of the remaining tissue. The current therapies of severe TBI (sTBI), as outlined by the Brain Trauma Foundation, are often ineffective, thus a new method for the treatment of sTBI is necessary. Herein, the reduction of cerebral edema, after TBI, using an osmotic transport device (OTD) was evaluated. Controlled cortical impact (CCI) was performed on adult female CD-1 mice, and cerebral edema was allowed to form for 3 h, followed by 2 h of treatment. The treatment groups were craniectomy only, craniectomy with a hydrogel, OTD without bovine serum albumin (BSA), and OTD. After CCI, brain water content was significantly higher for animals treated with a craniectomy only, craniectomy with a hydrogel, and OTD without BSA, compared to that of control animals. However, when TBI animals were treated with an OTD, brain water content was not significantly higher than that of controls. Further, brain water content of TBI animals treated with an OTD was significantly reduced, compared to that of untreated TBI animals, TBI animals treated with a craniectomy and a hydrogel, and TBI animals treated with an OTD without BSA. Here, we demonstrate the successful reduction of cerebral edema, as determined by brain water content, after TBI using an OTD. These results demonstrate proof of principle for direct water extraction from edematous brain tissue by direct osmotherapy using an OTD.

摘要

从公共卫生角度来看,创伤性脑损伤(TBI)意义重大,因为它是年轻人发病和死亡的主要原因。TBI后的脑水肿若不治疗,会导致剩余脑组织遭受毁灭性损伤。如脑创伤基金会概述的,目前严重TBI(sTBI)的治疗方法往往无效,因此需要一种新的sTBI治疗方法。在此,评估了使用渗透转运装置(OTD)减轻TBI后脑水肿的效果。对成年雌性CD-1小鼠进行控制性皮质撞击(CCI),让脑水肿形成3小时,随后进行2小时治疗。治疗组分别为仅行颅骨切除术、颅骨切除术加用水凝胶、不含牛血清白蛋白(BSA)的OTD以及OTD。CCI后,仅行颅骨切除术、颅骨切除术加用水凝胶以及不含BSA的OTD治疗的动物,其脑含水量显著高于对照动物。然而,当用OTD治疗TBI动物时,其脑含水量并不显著高于对照组。此外,与未治疗的TBI动物、行颅骨切除术加用水凝胶治疗的TBI动物以及不含BSA的OTD治疗的TBI动物相比,用OTD治疗的TBI动物的脑含水量显著降低。在此,我们证明了使用OTD可成功减轻TBI后脑水肿,这由脑含水量测定得出。这些结果证明了通过使用OTD进行直接渗透疗法从水肿脑组织中直接提取水分的原理。

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