- 作者：Jose L. Pascual ; Mohammad A. Murcy ; Shenghui Li ; Wanfeng Gong ; Rachel Eisenstadt ; Kenichiro Kumasaka ; Carrie Sims ; Douglas H. Smith ; Kevin Browne ; Steve Allen ; Jill Baren
- 关键词：Intravital microscopy ; Neutrophil ; Endothelium ; Blood-brain barrier ; Traumatic brain injury ; Progesterone
- 刊名：The American Journal of Surgery
- 出版年：December, 2013
- 年：2013
- 卷：206
- 期：6
- 页码：840-846
- 全文大小：549 K
Background
Progesterone (PRO) may confer a survival advantage in traumatic brain injury (TBI) by reducing cerebral edema. We hypothesized that PRO reduces edema by blocking polymorphonuclear (PMN) interactions with endothelium (EC) in the blood-brain barrier (BBB).Methods
CD1 mice received repeated PRO (16 mg/kg intraperitoneally) or vehicle (cyclodextrin) for 36 hours after TBI. Sham animals underwent craniotomy without TBI. The modified Neurological Severity Score graded neurologic recovery. A second craniotomy allowed in聽vivo observation of pial EC/PMN interactions and vascular macromolecule leakage. Wet/dry ratios assessed cerebral edema.
Results
Compared with the vehicle, PRO reduced subjective cerebral swelling (2.9 卤 .1 vs 1.2 卤 .1, P < .001), PMN rolling (95 卤 1.8 vs 57 卤 2.0 cells/100 渭m/min, P < .001), total EC/PMN adhesion (2.0 卤 .4 vs .8 卤 .1 PMN/100 渭m, P < .01), and vascular permeability (51.8% 卤 4.9% vs 27.1% 卤 4.6%, P < .01). TBI groups had similar a Neurological Severity Score and cerebral wet/dry ratios (P > .05).
Conclusions
PRO reduces live pericontusional EC/PMN and BBB macromolecular leakage after TBI. Direct PRO effects on the microcirculation warrant further investigation.