Department of Surgery, Division of Trauma and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Shock. 2024 Jan 1;61(1):112-119. doi: 10.1097/SHK.0000000000002256. Epub 2023 Nov 15.
Patients 65 years and older account for an increasing proportion of traumatic brain injury (TBI) patients. Aged TBI patients experience increased morbidity and mortality compared with young TBI patients. We previously demonstrated a marked accumulation of CD8 + T-cells within the brains of aged TBI mice compared with young TBI mice. Therefore, we hypothesized that blocking peripheral T-cell infiltration into the injured brain would improve neurocognitive outcomes in aged mice after TBI. Young and aged male C57BL/6 mice underwent TBI via controlled cortical impact versus sham injury. Two hours after injuries, mice received an anti-CD49d antibody (aCD49d Ab) to block peripheral lymphocyte infiltration or its isotype control. Dosing was repeated every 2 weeks. Mortality was tracked. Neurocognitive testing for anxiety, associative learning, and memory was assessed. Motor function was evaluated. Plasma was collected for cytokine analysis. Flow cytometry was used to phenotype different immune cells within the brains. Consequently, aCD49d Ab treatment significantly improved post-TBI survival, anxiety level, associative learning, memory, and motor function in aged mice 2 months after TBI compared with isotype control treated mice. aCD49d Ab treatment augmented T H 2 response in the plasma of aged mice 2 months after TBI compared with isotype control-treated mice. Notably, aCD49d Ab treatment significantly reduced activated CD8 + cytotoxic T-cells within aged mouse brains after TBI. Contrastingly, no difference was detected in young mice after aCD49d Ab treatment. Collectively, aCD49 Ab treatment reduced T-cells in the injured brain, improved survival, and attenuated neurocognitive and gait deficits. Hence, aCD49d Ab may be a promising therapeutic intervention in aged TBI subjects-a population often excluded in TBI clinical trials.
65 岁及以上的患者占创伤性脑损伤 (TBI) 患者的比例不断增加。与年轻的 TBI 患者相比,老年 TBI 患者的发病率和死亡率更高。我们之前的研究表明,与年轻的 TBI 小鼠相比,老年 TBI 小鼠的大脑中 CD8+T 细胞明显积聚。因此,我们假设阻断外周 T 细胞浸润受伤的大脑将改善 TBI 后老年小鼠的神经认知结果。年轻和老年雄性 C57BL/6 小鼠通过皮质控制撞击或假损伤接受 TBI。损伤后 2 小时,小鼠接受抗 CD49d 抗体(aCD49d Ab)以阻断外周淋巴细胞浸润或其同种型对照。剂量每 2 周重复一次。跟踪死亡率。评估焦虑、联想学习和记忆的神经认知测试。评估运动功能。收集血浆进行细胞因子分析。使用流式细胞术分析大脑内不同免疫细胞的表型。结果,与同种型对照治疗的小鼠相比,aCD49d Ab 治疗显著提高了 TBI 后 2 个月老年小鼠的 TBI 后生存率、焦虑水平、联想学习、记忆和运动功能。与同种型对照治疗的小鼠相比,aCD49d Ab 治疗在 TBI 后 2 个月增加了老年小鼠血浆中的 TH2 反应。值得注意的是,与同种型对照治疗的小鼠相比,aCD49d Ab 治疗显著降低了 TBI 后老年小鼠大脑中活化的 CD8+细胞毒性 T 细胞。相比之下,在接受 aCD49d Ab 治疗的年轻小鼠中未检测到差异。总之,aCD49 Ab 治疗减少了受伤大脑中的 T 细胞,提高了生存率,并减轻了神经认知和步态缺陷。因此,aCD49d Ab 可能是老年 TBI 患者的一种有前途的治疗干预措施——这是 TBI 临床试验中经常排除的人群。