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Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury

The loss of cerebral autoregulation (CA) is a common and detrimental secondary injury mechanism following acute brain injury and has been associated with worse morbidity and mortality. However patient outcomes have not as yet been conclusively proven to have improved as a result of CA-directed thera...

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Autores principales: Smith, Claudia A, Carpenter, Keri LH, Hutchinson, Peter J, Smielewski, Peter, Helmy, Adel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10369156/
https://www.ncbi.nlm.nih.gov/pubmed/37132274
http://dx.doi.org/10.1177/0271678X231171991
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author Smith, Claudia A
Carpenter, Keri LH
Hutchinson, Peter J
Smielewski, Peter
Helmy, Adel
author_facet Smith, Claudia A
Carpenter, Keri LH
Hutchinson, Peter J
Smielewski, Peter
Helmy, Adel
author_sort Smith, Claudia A
collection PubMed
description The loss of cerebral autoregulation (CA) is a common and detrimental secondary injury mechanism following acute brain injury and has been associated with worse morbidity and mortality. However patient outcomes have not as yet been conclusively proven to have improved as a result of CA-directed therapy. While CA monitoring has been used to modify CPP targets, this approach cannot work if the impairment of CA is not simply related to CPP but involves other underlying mechanisms and triggers, which at present are largely unknown. Neuroinflammation, particularly inflammation affecting the cerebral vasculature, is an important cascade that occurs following acute injury. We hypothesise that disturbances to the cerebral vasculature can affect the regulation of CBF, and hence the vascular inflammatory pathways could be a putative mechanism that causes CA dysfunction. This review provides a brief overview of CA, and its impairment following brain injury. We discuss candidate vascular and endothelial markers and what is known about their link to disturbance of the CBF and autoregulation. We focus on human traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH), with supporting evidence from animal work and applicability to wider neurologic diseases.
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spelling pubmed-103691562023-07-27 Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury Smith, Claudia A Carpenter, Keri LH Hutchinson, Peter J Smielewski, Peter Helmy, Adel J Cereb Blood Flow Metab Review Articles The loss of cerebral autoregulation (CA) is a common and detrimental secondary injury mechanism following acute brain injury and has been associated with worse morbidity and mortality. However patient outcomes have not as yet been conclusively proven to have improved as a result of CA-directed therapy. While CA monitoring has been used to modify CPP targets, this approach cannot work if the impairment of CA is not simply related to CPP but involves other underlying mechanisms and triggers, which at present are largely unknown. Neuroinflammation, particularly inflammation affecting the cerebral vasculature, is an important cascade that occurs following acute injury. We hypothesise that disturbances to the cerebral vasculature can affect the regulation of CBF, and hence the vascular inflammatory pathways could be a putative mechanism that causes CA dysfunction. This review provides a brief overview of CA, and its impairment following brain injury. We discuss candidate vascular and endothelial markers and what is known about their link to disturbance of the CBF and autoregulation. We focus on human traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH), with supporting evidence from animal work and applicability to wider neurologic diseases. SAGE Publications 2023-05-03 2023-08 /pmc/articles/PMC10369156/ /pubmed/37132274 http://dx.doi.org/10.1177/0271678X231171991 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Smith, Claudia A
Carpenter, Keri LH
Hutchinson, Peter J
Smielewski, Peter
Helmy, Adel
Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
title Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
title_full Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
title_fullStr Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
title_full_unstemmed Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
title_short Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
title_sort candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10369156/
https://www.ncbi.nlm.nih.gov/pubmed/37132274
http://dx.doi.org/10.1177/0271678X231171991
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