McCabe Joseph T, Tucker Laura B
Pre-clinical Studies Core, Center for Neuroscience and Regenerative Medicine, Bethesda, IL, United States.
Department of Anatomy, Physiology & Genetics, F.E. Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Front Neurol. 2020 Sep 30;11:541050. doi: 10.3389/fneur.2020.541050. eCollection 2020.
Approaches to furthering our understanding of the bioeffects, behavioral changes, and treatment options following exposure to blast are a worldwide priority. Of particular need is a more concerted effort to employ animal models to determine possible sex differences, which have been reported in the clinical literature. In this review, clinical and preclinical reports concerning blast injury effects are summarized in relation to sex as a biological variable (SABV). The review outlines approaches that explore the pertinent role of sex chromosomes and gonadal steroids for delineating sex as a biological independent variable. Next, underlying biological factors that need exploration for blast effects in light of SABV are outlined, including pituitary, autonomic, vascular, and inflammation factors that all have evidence as having important SABV relevance. A major second consideration for the study of SABV and preclinical blast effects is the notable lack of consistent model design-a wide range of devices have been employed with questionable relevance to real-life scenarios-as well as poor standardization for reporting of blast parameters. Hence, the review also provides current views regarding optimal design of shock tubes for approaching the problem of primary blast effects and sex differences and outlines a plan for the regularization of reporting. Standardization and clear description of blast parameters will provide greater comparability across models, as well as unify consensus for important sex difference bioeffects.
进一步了解爆炸暴露后的生物效应、行为变化和治疗选择的方法是全球的优先事项。尤其需要更加协调一致地努力利用动物模型来确定可能存在的性别差异，临床文献中已有相关报道。在这篇综述中，关于爆炸伤影响的临床和临床前报告根据性别这一生物学变量（SABV）进行了总结。该综述概述了探索性染色体和性腺类固醇在将性别界定为生物学独立变量方面的相关作用的方法。接下来，根据SABV概述了爆炸影响需要探索的潜在生物学因素，包括垂体、自主神经、血管和炎症因素，所有这些因素都有证据表明与SABV具有重要相关性。研究SABV和临床前爆炸影响的第二个主要考虑因素是明显缺乏一致的模型设计——使用了各种各样的装置，但其与现实生活场景的相关性存疑——以及爆炸参数报告的标准化程度较低。因此，该综述还提供了关于用于解决原发性爆炸影响和性别差异问题的激波管最佳设计的当前观点，并概述了报告规范化计划。爆炸参数的标准化和清晰描述将提高模型之间的可比性，并就重要的性别差异生物效应达成共识。
