Unité de Neuroanesthésie-Réanimation, Hôpital de la Pitié Salpêtrière 43-87, Boulevard de l'Hôpital, F-75013 Paris, France.
Inserm, Maladies Neurodéveloppementales et Neurovasculaires, Université Paris Cité, F-75019 Paris, France.
Int J Mol Sci. 2022 Sep 23;23(19):11193. doi: 10.3390/ijms231911193.
Head trauma is the most common cause of disability in young adults. Known as a silent epidemic, it can cause a mosaic of symptoms, whether neurological (sensory-motor deficits), psychiatric (depressive and anxiety symptoms), or somatic (vertigo, tinnitus, phosphenes). Furthermore, cranial trauma (CT) in children presents several particularities in terms of epidemiology, mechanism, and physiopathology-notably linked to the attack of an immature organ. As in adults, head trauma in children can have lifelong repercussions and can cause social and family isolation, difficulties at school, and, later, socio-professional adversity. Improving management of the pre-hospital and rehabilitation course of these patients reduces secondary morbidity and mortality, but often not without long-term disability. One hypothesized contributor to this process is chronic neuroinflammation, which could accompany primary lesions and facilitate their development into tertiary lesions. Neuroinflammation is a complex process involving different actors such as glial cells (astrocytes, microglia, oligodendrocytes), the permeability of the blood-brain barrier, excitotoxicity, production of oxygen derivatives, cytokine release, tissue damage, and neuronal death. Several studies have investigated the effect of various treatments on the neuroinflammatory response in traumatic brain injury in vitro and in animal and human models. The aim of this review is to examine the various anti-inflammatory therapies that have been implemented.
颅脑创伤是导致年轻人残疾的最常见原因。颅脑创伤被称为“沉默的流行病”,它会引起一系列症状,包括神经症状(感觉运动障碍)、精神症状(抑郁和焦虑症状)和躯体症状(眩晕、耳鸣、幻视)。此外,儿童颅脑创伤在流行病学、发病机制和病理生理学方面存在一些特殊性,主要与发育不成熟的器官受到攻击有关。与成年人一样,儿童颅脑创伤也会产生终身影响,导致其社会隔离和家庭隔离、在学校遇到困难,以及以后在社会职业方面遇到逆境。改善这些患者的院前和康复治疗管理可以降低继发性发病率和死亡率,但往往无法避免长期残疾。慢性神经炎症是导致这种情况的一个假设因素,它可能伴随着原发性损伤,并促进其发展为三级损伤。神经炎症是一个涉及多种因素的复杂过程,如神经胶质细胞(星形胶质细胞、小胶质细胞、少突胶质细胞)、血脑屏障通透性、兴奋毒性、氧衍生产物的产生、细胞因子的释放、组织损伤和神经元死亡。许多研究已经在体外和动物及人类模型中研究了各种治疗方法对创伤性脑损伤的神经炎症反应的影响。本文旨在研究已实施的各种抗炎治疗方法。