Citation

Rovegno M, Soto PA, Sáez JC, von Bernhardi R. Med. Intensiva 2012; 36(1): 37-44.

Vernacular Title

Mecanismos biologicos involucrados en la propagacion del dano en el traumatismo

Affiliation

Laboratorio de Neurociencias y Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile; Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad, Católica de Chile, Chile.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.medin.2011.06.008

PMID

21903299

Abstract

Traumatic brain injury (TBI) is a worldwide health problem that is especially prevalent in young adults. It is characterized by one or more primary injury foci, with secondary spread to initially not compromised areas via cascades of inflammatory response, excitotoxicity, energy failure conditions, and amplification of the original tissue injury by glia. In theory, such progression of injury should be amenable to management. However, all neuroprotective drug trials have failed, and specific treatments remain lacking. These negative results can be explained by a neuron centered approach, excluding the participation of other cell types and pathogenic mechanisms. To change this situation, it is necessary to secure a better understanding of the biological mechanisms determining damage progression or spread. We discuss the biological mechanisms involved in the progression of post-trauma tissue damage, including the general physiopathology of TBI and cellular mechanisms of secondary damage such as inflammation, apoptosis, cell tumefaction, excitotoxicity, and the role of glia in damage propagation. We highlight the role of glia in each cellular mechanism discussed. Therapeutic approaches related to the described mechanisms have been included. The discussion is completed with a working model showing the convergence of the main topics.

Language: es