Ritter Katharina, Baalmann Markus, Dolderer Christopher, Ritz Ulrike, Schäfer Michael K E
Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
Biomedicines. 2024 Jun 24;12(7):1399. doi: 10.3390/biomedicines12071399.
Traumatic brain injury (TBI) and long bone fractures are a common injury pattern in polytrauma patients and modulate each other's healing process. As only a limited number of studies have investigated both traumatic sites, we tested the hypothesis that brain-bone polytrauma mutually impacts neuro- and osteopathological outcomes. Adult female C57BL/6N mice were subjected to controlled cortical impact (CCI), and/or osteosynthetic stabilized femoral fracture (FF), or sham surgery. Neuromotor and behavioral impairments were assessed by neurological severity score, open field test, rotarod test, and elevated plus maze test. Brain and bone tissues were processed 42 days after trauma. CCI+FF polytrauma mice had increased bone formation as compared to FF mice and increased mRNA expression of bone sialoprotein (BSP). Bone fractures did not aggravate neuropathology or neuroinflammation assessed by cerebral lesion size, hippocampal integrity, astrocyte and microglia activation, and gene expression. Behavioral assessments demonstrated an overall impaired recovery of neuromotor function and persistent abnormalities in anxiety-related behavior in polytrauma mice. This study shows enhanced bone healing, impaired neuromotor recovery and anxiety-like behavior in a brain-bone polytrauma model. However, bone fractures did not aggravate TBI-evoked neuropathology, suggesting the existence of outcome-relevant mechanisms independent of the extent of brain structural damage and neuroinflammation.
创伤性脑损伤(TBI)和长骨骨折是多发伤患者常见的损伤模式,且相互影响对方的愈合过程。由于仅有少数研究同时调查了这两个创伤部位,我们检验了以下假设:脑-骨多发伤会相互影响神经和骨病理结果。成年雌性C57BL/6N小鼠接受控制性皮质撞击(CCI)和/或骨固定稳定型股骨骨折(FF),或假手术。通过神经严重程度评分、旷场试验、转棒试验和高架十字迷宫试验评估神经运动和行为障碍。创伤后42天对脑和骨组织进行处理。与FF小鼠相比,CCI+FF多发伤小鼠的骨形成增加,骨唾液蛋白(BSP)的mRNA表达增加。通过脑损伤大小、海马完整性、星形胶质细胞和小胶质细胞激活以及基因表达评估,骨折并未加重神经病理学或神经炎症。行为评估表明,多发伤小鼠的神经运动功能恢复总体受损,且在焦虑相关行为方面持续存在异常。本研究显示,在脑-骨多发伤模型中,骨愈合增强、神经运动恢复受损以及出现焦虑样行为。然而,骨折并未加重TBI引起的神经病理学改变,这表明存在与结果相关的机制,独立于脑结构损伤程度和神经炎症。