慢性硬膜下血肿液的补体抑制

IF 4.5 2区 医学 Q2 CELL BIOLOGY Inflammation Pub Date : 2024-12-09 DOI:10.1007/s10753-024-02210-3
Niklas Marklund, Shaian Zolfaghari, Gustaf Westerberg, Karsten Ruscher, Elisabet Englund, Henrietta Nittby Redebrandt
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引用次数: 0

摘要

背景:新出现的数据表明慢性硬膜下血肿(CSDH)的复杂病理生理可能与炎症反应有关。补体系统在急性创伤环境中被激活,尽管其在CSDH中的作用尚不清楚。为了研究补体系统在CSDH病理生理中的作用,我们分析了血液和血肿液生物标志物,以及CSDH膜和硬脑膜的免疫组织化学。材料和方法:我们在20例CSDH患者手术时同时采集CSDH液和外周血。取硬脑膜及CSDH囊组织切片,免疫组化检测C5b-C9或C5a沉积。炎症和补体激活的生物标志物通过21-多重试验进行分析,包括脂联素、Clusterin、补体因子C9和CRP。补体因子C5a通过商业R-plex电化学发光试验单独分析。结果:外周血和配对CSDH之间有10项生物标志物显著差异,其中CSDH液中有2项显著升高(Clusterin和Cystatin C), CSDH液中有8项显著改变的生物标志物显著降低,包括C5a、补体9和脂联素。硬脑膜和CSDH膜的C5a、C5b-C9膜攻击复合物无免疫反应性。结论:CSDH中补体抑制剂Clusterin水平升高,C5a和C9水平降低。膜攻击复合物C5b-C9未在CSDH周围的膜或硬脑膜中检测到。抑制补体可导致CSDH中碎片清除减少以及继发性炎症反应。
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Complement Inhibition in Chronic Subdural Hematoma Fluid.

Background: Emerging data suggest a complex pathophysiology of chronic subdural hematoma (CSDH) to which an inflammatory response might contribute. The complement system is activated in acute traumatic setting, although its role in CSDH is unknown. To investigate the complement system in CSDH pathophysiology, we analyzed blood and hematoma fluid biomarkers, as well as immunohistochemistry of the CSDH membrane and dura.

Materials and methods: We simultaneously collected CSDH fluid and peripheral blood from 20 CSDH patients at the time of surgery. Biopsies of the dura mater and the CSDH capsule were obtained and analyzed by immunohistochemistry for C5b-C9 or C5a deposition. Biomarkers of inflammation and complement activation were analyzed by a 21-multiplex assay, including Adiponectin, Clusterin, Complement factor C9 and CRP. Complement factor C5a was analyzed separately by a commercial R-plex electrochemiluminescence assay.

Results: Ten biomarkers differed significantly between peripheral blood and paired CSDH of which two were significantly increased in CSDH fluid (Clusterin and Cystatin C). Eight of the significantly altered biomarkers were significantly decreased in CSDH fluid, including C5a, Complement 9 and Adiponectin. There was no immunoreactivity for C5a or the C5b-C9 membrane attack complex in the dura or CSDH membrane.

Conclusions: In CSDH levels of the complement inhibitor Clusterin were increased, whereas levels of C5a and C9 were decreased. Membrane attack complex C5b-C9 was not detected in the membrane or dura surrounding the CSDH. Inhibition of complement could lead to reduced clearance of debris in the CSDH as well as secondary inflammatory reactions.

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来源期刊
Inflammation
Inflammation 医学-免疫学
CiteScore
9.70
自引率
0.00%
发文量
168
审稿时长
3.0 months
期刊介绍: Inflammation publishes the latest international advances in experimental and clinical research on the physiology, biochemistry, cell biology, and pharmacology of inflammation. Contributions include full-length scientific reports, short definitive articles, and papers from meetings and symposia proceedings. The journal''s coverage includes acute and chronic inflammation; mediators of inflammation; mechanisms of tissue injury and cytotoxicity; pharmacology of inflammation; and clinical studies of inflammation and its modification.
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