Patomorfologie zánětlivé odpovědi na poranění mozku, hladiny interleukinů v krvi a genové polymorfismy

English version

Autoři: David Vajtr ^1,2; Drahomira Springer ³; Libor Staněk ⁴; Oldrich Benada ⁵; Filip Samal ⁶; Michal Beran ⁷; Premysl Strejc ¹; Richard Prusa ²; Tomas Zima ³
Působiště autorů: Department of forensic medicine and toxicology, Charles University 1st Medical Faculty and General teaching hospital, Prague Czech Republic ¹; Department of medical biochemistry and pathobiochemistry, Charles University 2nd Medical Faculty and University hospital Motol, Prague, Czech Republic ²; Department of clinical biochemistry and laboratory diagnostics, Charles University 1st Medical Faculty and General teaching hospital Prague, Czech Republic ³; Department of pathology, Charles University 1st Medical Faculty and General teaching hospital, Prague, Czech Republic ⁴; Laboratory of molecular structure characterization, Institute of microbiology, Academy of sciences of the Czech Republic, Prague Czech Republic ⁵; Department of neurosurgery, KNTB Zlin, Czech Republic ⁶; Department of forensic medicine, Charles University, 2nd Medical Faculty and Hospital Na Bulovce, Prague, Czech Republic ⁷
Vyšlo v časopise: Soud Lék., 59, 2014, No. 4, p. 40-47
Kategorie: Původní práce

Souhrn

Naše studie se zabývá kinetikou akutní zánětlivé reakce (interleukinů a vaskulárního endoteliálního růstového faktoru VEGF) po traumatu mozku ve vztahu k aktivaci mikrogliálních mozkových buněk u pacientů s expanzní kontuzí v rámci sekundárního traumatu mozku. Interleukin IL-6, monocyt chemoatrahující protein (MCP-1) a VEGF mají rozdílný časový nástup u skupin pacientů s rozvojem a bez rozvoje expanzní kontuze mozku (p<0.05). Hodnoty VEGF v krvi byly významně vyšší u pacientů s nekomplikovanou mozkovou kontuzí ve srovnání s nižšími hodnotami u pacientů s expanzní kontuzí mozku. Pacienti s rozvojem sepse měli výrazný vzestup koncentrací TNF alpha a interleukinu IL-8 v průběhu prvních 72 hodin. P-selektin glykoprotein ligand PSGL a CD68 imunopozitivní mikrogliové elementy byly detekovány u obou typů, ložiskových i difuzních poranění mozku, zejména v perivaskulárních prostorech a imunopozitivita korelovala s nálezem telolysosomů v cytoplasmě mikroglie. Pozorovali jsme, že některé polymorfismy genů PAI-1, MTHFR, eNOS, VEGF a Apo E při genetickém vyšetření pacientů s traumatem mozku byly spojené s projevem ucpávání kapilár nahromaděnými leukocyty u případů expanzních kontuzí mozku.

Klíčová slova:
poranění mozku – akutní zánětlivá reakce – mikroglie – interleukiny – vaskulární endoteliální růstový faktor – monocyt chemoatrahující protein-1 – genový polymorfismus

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