Dept. of Neurology, University of Ulm, School of Medicine, Germany.
Dept. of Neurology, University of Ulm, School of Medicine, Germany.
Int Immunopharmacol. 2017 Oct;51:66-75. doi: 10.1016/j.intimp.2017.08.002. Epub 2017 Aug 12.
Ethanol intoxication is a common comorbidity in traumatic brain injury. To date, the effect of ethanol on TBI pathogenic cascades and resulting outcomes remains debated. A closed blunt weight-drop murine TBI model has been implemented to investigate behavioral (by sensorimotor and neurological tests), and neuro-immunological (by tissue cytokine arrays and immuno-histology) effects of ethanol intoxication on TBI. The effect of the occurrence of traumatic intracerebral hemorrhage was also studied. The results indicate that ethanol pretreatment results in a faster and better recovery after TBI with reduced infiltration of leukocytes and reduced microglia activation. These outcomes correspond to reduced parenchymal levels of GM-CSF, IL-6 and IL-3 and to the transient upregulation of IL-13 and VEGF, indicating an early shift in the cytokine profile towards reduced inflammation. A significant difference in the cytokine profile was still observed 24h post injury in the ethanol pretreated mice, as shown by the delayed peak in IL-6 and by the suppression of GM-CSF, IFN-γ, and IL-3. Seven days post-injury, ethanol-pretreated mice displayed a significant decrease both in CD45+ cells infiltration and in microglial activation. On the other hand, in the case of traumatic intracerebral hemorrhage, the cytokine profile was dominated by KC, CCL5, M-CSF and several interleukins and ethanol pretreatment did not produce any modification. We can thus conclude that ethanol intoxication suppresses the acute neuro-inflammatory response to TBI, an effect which is correlated with a faster and complete neurological recovery, whereas, the presence of traumatic intracerebral hemorrhage overrides the effects of ethanol.
乙醇中毒是创伤性脑损伤的常见合并症。迄今为止,乙醇对 TBI 发病机制级联反应及其结果的影响仍存在争议。目前已经建立了一种闭合性钝器打击小鼠 TBI 模型,用于研究乙醇中毒对 TBI 的行为(通过感觉运动和神经学测试)和神经免疫影响(通过组织细胞因子阵列和免疫组织化学)。还研究了创伤性颅内出血的发生对 TBI 的影响。结果表明,乙醇预处理可加快 TBI 后的恢复速度,使白细胞浸润减少,小胶质细胞激活减少。这些结果与实质 GM-CSF、IL-6 和 IL-3 水平降低以及 IL-13 和 VEGF 的短暂上调相对应,表明细胞因子谱向炎症减轻的早期转变。与未预处理的 TBI 小鼠相比,乙醇预处理的 TBI 小鼠在损伤后 24 小时的细胞因子谱仍存在显著差异,表现为 IL-6 峰值延迟和 GM-CSF、IFN-γ 和 IL-3 受抑制。损伤后 7 天,乙醇预处理的小鼠 CD45+细胞浸润和小胶质细胞激活均显著减少。另一方面,在创伤性颅内出血的情况下,细胞因子谱以 KC、CCL5、M-CSF 和几种白细胞介素为主,而乙醇预处理并未产生任何影响。因此,我们可以得出结论,乙醇中毒抑制了 TBI 的急性神经炎症反应,这种作用与更快和完全的神经恢复相关,而创伤性颅内出血的存在则削弱了乙醇的作用。