Singer Kathleen E, McGlone Emily D, Collins Sean M, Wallen Taylor E, Morris Mackenzie C, Schuster Rebecca M, England Lisa G, Robson Matthew J, Goodman Michael D
Department of General Surgery, University of Cincinnati, Cincinnati, Ohio.
James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
J Surg Res. 2023 Feb;282:183-190. doi: 10.1016/j.jss.2022.09.017. Epub 2022 Oct 26.
Traumatic brain injury (TBI) can lead to neurocognitive decline, in part due to phosphorylated tau (p-tau). Whether p-tau accumulation worsens in the setting of polytrauma remains unknown. Propranolol has shown clinical benefit in head injuries; however, the underlying mechanism is also unknown. We hypothesize that hemorrhagic shock would worsen p-tau accumulation but that propranolol would improve functional outcomes on behavioral studies.
A murine polytrauma model was developed to examine the accumulation of p-tau and whether it can be mitigated by early administration of propranolol. TBI was induced using a weight-drop model and hemorrhagic shock was achieved via controlled hemorrhage for 1 h. Mice were given intraperitoneal propranolol 4 mg/kg or saline control. The animals underwent behavioral testing at 30 d postinjury and were sacrificed for cerebral histological analysis. These studies were completed in male and female mice.
TBI alone led to increased p-tau generation compared to sham on both immunohistochemistry and immunofluorescence (P < 0.05). The addition of hemorrhage led to greater accumulation of p-tau in the hippocampus (P < 0.007). In male mice, p-tau accumulation decreased with propranolol administration for both polytrauma and TBI alone (P < 0.0001). Male mice treated with propranolol also outperformed saline-control mice on the hippocampal-dependent behavioral assessment (P = 0.0013). These results were not replicated in female mice; the addition of hemorrhage did not increase p-tau accumulation and propranolol did not demonstrate a therapeutic effect.
Polytrauma including TBI generates high levels of hippocampal p-tau, but propranolol may help prevent this accumulation to improve both neuropathological and functional outcomes in males.
创伤性脑损伤(TBI)可导致神经认知功能下降,部分原因是磷酸化tau蛋白(p-tau)。在多发伤情况下p-tau积累是否会加剧尚不清楚。普萘洛尔已显示出对头部损伤有临床益处;然而,其潜在机制也不清楚。我们假设失血性休克会加剧p-tau积累,但普萘洛尔会改善行为学研究中的功能结局。
建立了一种小鼠多发伤模型,以研究p-tau的积累情况以及早期给予普萘洛尔是否可以减轻这种积累。使用重物坠落模型诱导TBI,并通过控制性出血1小时实现失血性休克。给小鼠腹腔注射4mg/kg普萘洛尔或生理盐水对照。在受伤后30天对动物进行行为测试,并处死进行脑组织学分析。这些研究在雄性和雌性小鼠中完成。
与假手术组相比,单独的TBI在免疫组织化学和免疫荧光上均导致p-tau生成增加(P<0.05)。出血的加入导致海马中p-tau积累更多(P<0.007)。在雄性小鼠中,对于多发伤和单独的TBI,给予普萘洛尔后p-tau积累均减少(P<0.0001)。接受普萘洛尔治疗的雄性小鼠在海马依赖性行为评估中也优于生理盐水对照小鼠(P=0.0013)。这些结果在雌性小鼠中未得到重复;出血的加入并未增加p-tau积累,且普萘洛尔未显示出治疗效果。
包括TBI在内的多发伤会产生高水平的海马p-tau,但普萘洛尔可能有助于预防这种积累,以改善雄性小鼠的神经病理学和功能结局。