Traumatic brain injury (TBI) remains the leading cause of injury-related death and disability. Brain edema, one of the most major complications of TBI, contributes to elevated intracranial pressure, and poor prognosis following TBI. Nerve growth factor (NGF) appears to be a viable strategy to treat brain edema and TBI. Unfortunately, due to its poor blood-brain barrier (BBB) permeability, the clinical application of NGF has been greatly limited. We previously demonstrated that intranasal NGF could bypass the BBB and distribute throughout the brain. Here we further studied whether intranasal NGF could attenuate TBI-induced brain edema and its putative mechanisms. TBI was produced by a modified weight-drop model. We found that intranasal administration of NGF (5μg/d) attenuated the brain edema, as assayed by hemisphere water content, at 12h, 24h and 72h after TBI induction. This attenuation was associated with a prominent decrease of the content of aquaporin-4, which plays a pivotal role in the formation of brain edema. By the use of RT-PCR and ELISA, we showed that intranasal NGF markedly inhibited the transcription and expression of pro-inflammatory cytokines including IL-1β and TNF-α. An electrophoretic mobility shift assay (EMSA) displayed a significant activation of nuclear factor-κB following TBI, which was, however, much lowered in the NGF-treated rats. Furthermore, upon intranasal NGF supplementation, mitochondria-mediated apoptosis following TBI was minimized, as indicated by upregulation of Bcl-2 and downregulation of caspase-3. Collectively, our findings suggested that intranasal NGF may be a promising strategy to treat brain edema and TBI.

译文

:脑外伤(TBI)仍然是与伤害相关的死亡和残疾的主要原因。脑水肿是TBI最主要的并发症之一,导致颅内压升高,TBI后预后较差。神经生长因子(NGF)似乎是治疗脑水肿和TBI的可行策略。不幸的是,由于其不良的血脑屏障(BBB)通透性,NGF的临床应用受到了极大的限制。我们先前证明了鼻内NGF可以绕过BBB并分布在整个大脑中。在这里,我们进一步研究了鼻内NGF是否可以减轻TBI诱导的脑水肿及其可能的机制。 TBI是通过修改后的体重减轻模型产生的。我们发现鼻内施用NGF(5μg/ d)可以减轻脑水肿,通过​​TBI诱导后12h,24h和72h的半球水含量进行分析。这种衰减与aquaporin-4含量的显着下降有关,aquaporin-4的含量在脑水肿的形成中起着关键作用。通过使用RT-PCR和ELISA,我们显示鼻内NGF明显抑制促炎细胞因子包括IL-1β和TNF-α的转录和表达。电泳迁移率迁移分析(EMSA)显示TBI后核因子-κB的显着激活,但是在NGF治疗的大鼠中其活性大大降低。此外,鼻内补充NGF后,TBI后线粒体介导的凋亡得以最小化,如Bcl-2的上调和caspase-3的下调所示。总体而言,我们的研究结果表明,鼻内NGF可能是治疗脑水肿和TBI的一种有前途的策略。

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