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7BIOCHEMICAL MECHANISMS OF NEURAL TISSUE DAMAGE IN MILD BRAIN CONTUSION
Zhukovskyi O.
MD, PhD;
Higher State Educational Establishment "Bukovinian State Medical University "
ABSTRACT
The state of pro- and antioxidant systems in patients with mild brain contusion has been studied. The definite patterns of the functioning of these systems in this pathology have been disclosed. Keywords: mild brain contusion, pathogenesis, antioxidant systems.
Introduction. Mild traumatic brain injury (TBI) is one of the most common types of nervous system lesions. Nearly 80% of all mild TBI cases are presented by mild brain contusion (MBC) [1]. Despite the term "mild" this type of trauma is characterized by high frequency of posttraumatic complications. The cause of it should be found in peculiarities of acute period of TBI when a cascade of irreversible changes in neural tissue is formed [2].
It has been proved that activation of lipid peroxi-dation and biopolymers is an early universal and extremely sensitive marker of injury. It is characteristic of various pathological conditions including traumatic lesions of nervous system. The complexity of this problem is determined by favorable conditions for the progression of free radical pathology in central nervous system that include high lipid content (optimal substrate for lipid peroxidation), maximum oxygen consumption, well developed system of biological membranes. These facts stipulate particular susceptibility of brain for oxidative injury of cerebral structures [3]. Given the above we considered it appropriate to assess
In the blood samples of all patients on the first day there was an increase of activity of catalase which is an enzyme of first line of defense. Catalase is one of the basic enzymes of antioxidant protection and elevation of its activity on the first day after TBI points at activation of lipid peroxidation in patients with MBC. Assessment of dynamic changes has shown gradual decrease of catalase activity which gives evidence of debilitation of proper antioxidant protection.
the extent and dynamics of pro- and antioxidant imbalance in patients with MBC.
Materials and methods. We have examined 23 patients with brain contusion aged 18-43 years and the control group which comprised 15 practically healthy individuals comparable by age and sex. Mild brain contusion was diagnosed based on neurological and instrumental examination. Biochemical studies were done in plasma and erythrocytes of patients and donors. Blood sampling was performed in the morning on an empty stomach on the first, third and fifth day after traumatic injury. It included malonic aldehyde, ceruloplasmin, medium weight molecules, glutathione, HS-groups, catalase activity.
Results and discussion. The degree of activation of free radical processes was assessed by content of ma-lonic aldehyde which is one of the final products of li-pid peroxidation. On the first day the level of malonic aldehyde was practically equal to normal ranges. However on the third day and especially on the fifth day we have observed noticeable increase of plasma level of malonic aldehyde by 38.6% (Table 1).
Table 1
On the first day in patients with concussion there was insignificant elevation of glutathione as the basic component of protective glutathione system in comparison to the results of control group. However on the third day we observed sharp decline of glutathione level in compared to the original data. The component of glu-tathione is sulfhydryl (SH) group which plays important role in normal functioning of membrane struc-
The dynamics of pro- and antioxidant systems indexes in patients with mild brain contusion
1st day 3rd day 5th day Control
Malonic aldehyde, ^mol/L 18,55+0,38 p<0,05 25,7+0,6 p<0,05 26,8+0,46 7,74+0,28
Ceruloplasmin, mg/L 231,8+4,2 p<0,05 212,5+2,7 184,6+2,9 186,26+2,3
Catalase activity, ^mol/min L 38,4+0,7 p<0,05 25,8+0,73 12,6+0,43 11,62+0,3
Glutathione 0,71+0,015 p<0,05 0,54+0,02 0,36+0,014 0,30+0,015
SH-groups, ^mol/ml 2,41+0,06 p<0,05 1,9+0,03 1,72+0,03 1,58+0,02
Significance of differences in comparison with control group (p): * - p<0.05; ** - p<0.01; *** - p<0.001.
tures. On the first day after trauma there was mild elevation of SH-groups level but then it was followed by decrease of their level.
In all patients with mild brain contusion on the first day after trauma we found increase of ceruloplas-min activity as manifestation of defense response. By the third day this level increases almost by 40% in comparison to control group, but then it significantly decreases. It has been proved that ceruloplasmin is the basic antioxidant of blood plasma both in normal and in pathology which prevents and inhibits lipid peroxi-dation by oxidation of bivalent iron. Antioxidant effect of ceruloplasmin depends on its feroxidase activity. We can assume that ceruloplasmin takes part in destruction of toxic free radicals of superoxide anion which is a product of aerobic metabolism.
So we can make a conclusion that mobilization of protective antioxidant mechanisms in the brain softens primary activation of lipid peroxidation. However it is followed by their further exhaustion that leads to destructive changes of nervous cells. That is why early determination, prevention and correction of secondary brain injury largely determine the results of treatment.
Conclusions.
1. In patients with mild brain contusion activation of free radical oxidation is most pronounced in five days after traumatic brain injury.
2. On the first day of trauma there is expressed activation of protective antioxidant factors (increased activity of catalase, content of ceruloplasmin, SH-groups, glutathione). The dynamic observation has shown gradual decrease of antioxidant activity.
Attention is drawn to the need of the further study of biochemical processes that lead to irreversible changes in nervous tissue, as well as development and implementation of the drugs for correction of energetic metabolism and protection against secondary destruction of the cells.
References
1. R.J. Swatzyna, The elusive nature of mild traumatic brain injury, Biofeedback, Vol. 37, Issue 3 (2009) 92-95.
2. M. Prins, T. Greco, D. Alexander, C.C. Giza, The pathophysiology of traumatic brain injury at a glance, Dis Model Mech, 6 (2013) 1307-1315.
3. A. Rodriguez-Rodriguez, J.J. Egea-Guerro, F. Murillo-Cabezas, A. Carillo-Vico, Oxidative stress in traumatic brain injury, Curr Med Chem, 21(10) (2014) 1201-11.
4. A.M. Arent, L.F. de Souza, R. Walz, A.L. Dafre, Rerspectives on molecular biomarkers of oxida-tive stress and antioxidant strategies in traumatic brain injury, BioMed Research International, 2014(2014), Article ID 723060, 18 pages, http://dx.doi.org/10.1155/2014/723060.
ПЛАЦЕНТАРНАЯ НЕДОСТАТОЧНОСТЬ У БЕРЕМЕННЫХ ЖЕНЩИН С РУБЦОМ НА МАТКЕ
Камилова М.Я.
Таджикский научно-исследовательский институт акушерства, гинекологии и перинатологии МЗ и СЗН РТ, зав. акушерским отделом, Юнусова С.Х.
Таджикский научно-исследовательский институт акушерства, гинекологии и перинатологии МЗ и СЗН РТ, аспирант 1- го года обучения,
Узакова У.Д.
Таджикский медицинский университет, Доцент кафедры акушерства и гинекологии
THE PLACENTAL INSUFFICENTLY IN PREGNANT WOMAN
WITH UTERI SCAR
Kamilova M. Y.,
State Establishment Scientific research Institute of Obstetrics, Gynecology and Perinatology, Ministry of Health and social Protection of population of the Republic of Tajikistan, Dushanbe-city, head of obstetric department
Unusova S.H.
State Establishment Scientific research Institute of Obstetrics, Gynecology and Perinatology, Ministry of Health and social Protection of population of the Republic of Tajikistan, Dushanbe-city, 1-t year graduate student,
Uzakova U.D.
Tajik Medical University, chair of the Obstetrics and
Gynecology, docent
