Patomorfologie zánětlivé odpovědi na poranění mozku, hladiny interleukinů v krvi a genové polymorfismy
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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
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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
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Soud Lék., 59, 2014, No. 4, p. 40-47
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Original Article
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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Anatomical pathology Forensic medical examiner ToxicologyArticle was published in
Forensic Medicine
2014 Issue 4
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