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神经系统对神经创伤的反应:神经创伤后脑血管和细胞变化的叙述性综述。

Nervous System Response to Neurotrauma: A Narrative Review of Cerebrovascular and Cellular Changes After Neurotrauma.

机构信息

Qena Faculty of Medicine, South Valley University, Qena, 83621, Egypt.

College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Al Qassim, Saudi Arabia.

出版信息

J Mol Neurosci. 2024 Feb 17;74(1):22. doi: 10.1007/s12031-024-02193-8.

Abstract

Neurotrauma is a significant cause of morbidity and mortality worldwide. For instance, traumatic brain injury (TBI) causes more than 30% of all injury-related deaths in the USA annually. The underlying cause and clinical sequela vary among cases. Patients are liable to both acute and chronic changes in the nervous system after such a type of injury. Cerebrovascular disruption has the most common and serious effect in such cases because cerebrovascular autoregulation, which is one of the main determinants of cerebral perfusion pressure, can be effaced in brain injuries even in the absence of evident vascular injury. Disruption of the blood-brain barrier regulatory function may also ensue whether due to direct injury to its structure or metabolic changes. Furthermore, the autonomic nervous system (ANS) can be affected leading to sympathetic hyperactivity in many patients. On a cellular scale, the neuroinflammatory cascade medicated by the glial cells gets triggered in response to TBI. Nevertheless, cellular and molecular reactions involved in cerebrovascular repair are not fully understood yet. Most studies were done on animals with many drawbacks in interpreting results. Therefore, future studies including human subjects are necessarily needed. This review will be of relevance to clinicians and researchers interested in understanding the underlying mechanisms in neurotrauma cases and the development of proper therapies as well as those with a general interest in the neurotrauma field.

摘要

神经创伤是全球发病率和死亡率的一个重要原因。例如,外伤性脑损伤(TBI)每年导致美国超过 30%的所有与伤害相关的死亡。其根本原因和临床后果在不同病例中有所不同。此类损伤后,患者的神经系统容易发生急性和慢性变化。在这种情况下,脑血管破裂的影响最为常见和严重,因为即使没有明显的血管损伤,脑损伤也可能使脑血管自动调节功能(脑灌注压的主要决定因素之一)丧失。血脑屏障的调节功能也可能受到影响,无论是由于其结构的直接损伤还是代谢变化。此外,自主神经系统(ANS)也可能受到影响,导致许多患者出现交感神经过度活跃。在细胞水平上,胶质细胞介导的神经炎症级联反应会对 TBI 做出反应。然而,目前还不完全了解参与脑血管修复的细胞和分子反应。大多数研究都是在动物身上进行的,在解释结果方面存在许多缺陷。因此,需要包括人类受试者在内的未来研究。这篇综述将对关注神经创伤病例中潜在机制以及适当治疗方法开发的临床医生和研究人员以及对神经创伤领域有一般兴趣的人具有相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5b6/10874332/93a3ad095bdf/12031_2024_2193_Fig1_HTML.jpg

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