Sharma Rishabh, Chu Erskine, Dill Larissa K, Shad Ali, Zamani Akram, O'Brien Terence J, Casillas-Espinosa Pablo M, Shultz Sandy R, Semple Bridgette D
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Department of Neurology, Alfred Health, Prahran, Victoria, Australia.
J Neurotrauma. 2023 Feb;40(3-4):365-382. doi: 10.1089/neu.2022.0033. Epub 2022 Nov 8.
Pediatric traumatic brain injury (TBI) is a major public health issue, and a risk factor for the development of post-traumatic epilepsy that may profoundly impact the quality of life for survivors. As the majority of neurotrauma research is focused on injury to the adult brain, our understanding of the developing brain's response to TBI remains incomplete. Neuroinflammation is an influential pathophysiological mechanism in TBI, and is thought to increase neuronal hyperexcitability, rendering the brain more susceptible to the onset of seizures and/or epileptogenesis. We here hypothesized that peripheral blood-derived macrophages, recruited into the injured brain via C-C motif ligand 2 (CCL2) chemokine/C-C chemokine receptor type 2 (CCR2) signaling, contributes to neuroinflammation and thus seizure susceptibility after experimental pediatric TBI. Using gene-deficient mice in the controlled cortical impact (CCI) model of TBI, in 3-week-old male mice we found that TBI led to an increase in susceptibility to pentylenetetrazol (PTZ)-evoked seizures, associated with considerable cortical tissue loss, a robust cellular neuroinflammatory response, and oxidative stress. Intriguingly, although -deficiency increased CCL2 levels in serum, it did not exacerbate seizure susceptibility or the neuroinflammatory cellular response after pediatric TBI. Similarly, acute post-injury treatment with a CCR2 antagonist did not influence seizure susceptibility or the extent of tissue damage in wild-type (WT) mice. Together, our findings suggest that CCR2 is not a crucial driver of epileptogenesis or neuroinflammation after TBI in the developing brain. We propose that age may be an important factor differentiating our findings from previous studies in which targeting CCL2/CCR2 has been reported to be anti-inflammatory, neuroprotective or anti-seizure.
小儿创伤性脑损伤(TBI)是一个重大的公共卫生问题,也是创伤后癫痫发生的一个危险因素,可能会对幸存者的生活质量产生深远影响。由于大多数神经创伤研究都集中在成人大脑损伤方面,我们对发育中大脑对TBI的反应的了解仍然不完整。神经炎症是TBI中一种有影响力的病理生理机制,被认为会增加神经元的过度兴奋性,使大脑更容易发生癫痫发作和/或癫痫形成。我们在此假设,通过C-C基序配体2(CCL2)趋化因子/C-C趋化因子受体2型(CCR2)信号招募到受伤大脑中的外周血源性巨噬细胞,会导致神经炎症,从而增加实验性小儿TBI后的癫痫易感性。在TBI的控制性皮质撞击(CCI)模型中使用基因缺陷小鼠,我们发现在3周龄雄性小鼠中,TBI导致对戊四氮(PTZ)诱发的癫痫发作的易感性增加,这与相当程度的皮质组织损失、强烈的细胞神经炎症反应和氧化应激有关。有趣的是,虽然基因缺陷会增加血清中CCL2的水平,但它并不会加重小儿TBI后的癫痫易感性或神经炎症细胞反应。同样,在野生型(WT)小鼠中,损伤后急性给予CCR2拮抗剂并不影响癫痫易感性或组织损伤程度。总之,我们的研究结果表明,CCR2不是发育中大脑TBI后癫痫形成或神经炎症的关键驱动因素。我们提出,年龄可能是一个重要因素,使我们的研究结果与之前报道靶向CCL2/CCR2具有抗炎、神经保护或抗癫痫作用的研究有所不同。