单次与重复性创伤性脑损伤:关于慢性后果、神经病理学及TDP-43蛋白病作用的当前认知
Single Versus Repetitive Traumatic Brain Injury: Current Knowledge on the Chronic Outcomes, Neuropathology and the Role of TDP-43 Proteinopathy.
作者信息
Janković Tamara, Pilipović Kristina
机构信息
Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia.
出版信息
Exp Neurobiol. 2023 Aug 31;32(4):195-215. doi: 10.5607/en23008.
Traumatic brain injury (TBI) is one of the most important causes of death and disability in adults and thus an important public health problem. Following TBI, secondary pathophysiological processes develop over time and condition the development of different neurodegenerative entities. Previous studies suggest that neurobehavioral changes occurring after a single TBI are the basis for the development of Alzheimer's disease, while repetitive TBI is considered to be a contributing factor for chronic traumatic encephalopathy development. However, pathophysiological processes that determine the evolvement of a particular chronic entity are still unclear. Human post-mortem studies have found combinations of amyloid, tau, Lewi bodies, and TAR DNA-binding protein 43 (TDP-43) pathologies after both single and repetitive TBI. This review focuses on the pathological changes of TDP-43 after single and repetitive brain traumas. Numerous studies have shown that TDP-43 proteinopathy noticeably occurs after repetitive head trauma. A relatively small number of available preclinical research on single brain injury are not in complete agreement with the results from the human samples, which makes it difficult to draw specific conclusions. Also, as TBI is considered a heterogeneous type of injury, different experimental trauma models and injury intensities may cause differences in the cascade of secondary injury, which should be considered in future studies. Experimental and post-mortem studies of TDP-43 pathobiology should be carried out, preferably in the same laboratories, to determine its involvement in the development of neurodegenerative conditions after one and repetitive TBI, especially in the context of the development of new therapeutic options.
创伤性脑损伤(TBI)是成人死亡和残疾的最重要原因之一,因此是一个重要的公共卫生问题。TBI后,继发性病理生理过程会随着时间推移而发展,并影响不同神经退行性疾病的发生。先前的研究表明,单次TBI后出现的神经行为变化是阿尔茨海默病发生的基础,而重复性TBI被认为是慢性创伤性脑病发生的一个促成因素。然而,决定特定慢性疾病演变的病理生理过程仍不清楚。人体尸检研究发现,单次和重复性TBI后均存在淀粉样蛋白、tau蛋白、路易小体和TAR DNA结合蛋白43(TDP - 43)病理改变的组合。本综述重点关注单次和重复性脑外伤后TDP - 43的病理变化。大量研究表明,重复性头部外伤后明显会出现TDP - 43蛋白病变。现有的关于单次脑损伤的临床前研究数量相对较少,且与人体样本的结果并不完全一致,这使得难以得出具体结论。此外,由于TBI被认为是一种异质性损伤类型,不同的实验创伤模型和损伤强度可能会导致继发性损伤级联反应的差异,这在未来的研究中应予以考虑。应开展TDP - 43病理生物学的实验和尸检研究,最好在同一实验室进行,以确定其在单次和重复性TBI后神经退行性疾病发生中的作用,特别是在开发新治疗方案的背景下。