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traumatic brain injury, pathogenesis, neuroinflammation

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Ziablitsev , S., Panova , T., Kolesnikova , S., & Nahornyi , O. (2020). BRAIN INJURY: MEDICO-SOCIAL AND SCIENTIFIC ASPECTS. Review. Medical Science of Ukraine (MSU), 16(1), 57-66.


The review provides up-to-date data on the medico-social significance and scientific aspects of traumatic brain injury (TBI), in particular, the processes of neuroinflammation and the development of autoimmune reactions. According to the results of the analysis of open literature (PumMed database), it is established that among persons of working age, TBI holds the first place in the mortality structure, which is 2-3 times higher in Ukraine than similar indicators of economically developed countries. Each year, TBI costs the world economy about $ 400 billion, which is 0.5% of the gross world product. From a scientific point of view, TBI can be regarded as a continuous, possibly lifelong, process that affects multiple organ systems and can be a cause of traumatic disease. The main pathogenetic mechanisms of TBI that successively change each other (necrosis, axonal damage, gliosis/microgliosis, apoptosis, demyelinization and neuroregeneration) are highlighted.
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1. Guk AP. [Clinical and epidemiological characteristics of traumatic brain injury in Ukraine for 1999-2008] // Ukraine. Nation's health. 2011; 2: 52-6. [in Ukrainian]. Mode access: file:///C:/Users/Lenovo/Downloads/Uzn_2011_2_9%20(1).pdf
2. Humanenko EK, Nemchenko NS, Badalov VI. [Pathobiochemical features of severe combined traumatic brain injury] // Bulletin of the Russian military med. academies. 2000; 1: 46-50. [in Russian]
3. Yelsky VN, Zyablitsov SV. [Neurohormonal regulatory mechanisms in traumatic brain injury] – Donetsk: New World; 2008. 240 p. [in Russian] Mode access:$
4. Yelsky VN, Kardash AM, Gorodnik GA. [Pathophysiology, diagnosis and intensive care of severe traumatic brain injury] / Ed. Cherniy. – Donetsk: New World, 2004. 200 p. [in Russian]
5. Zyablytsev SV, Chernobrivtsev PA, Korovka NJ. [Dynamics of markers of post-traumatic and autoimmune damage in traumatic brain injury] // Neurosciences: theoretical and clinical aspects. 2013; 9(1-2): 17-20. [in Ukrainian].
6. Lichterman LB. [Traumatic brain injury]. – M.: Medical newspaper, 2003: 357 p. [in Russian]. Mode access:
7. Lyovkin OA, Goldovsky BM, Serikov KV. [Analysis of the special teams of emergency (medical) medical assistance suffered from severe traumatic brain injury] // Medicine urgent. states. 2014; 7: 118-20. [in Ukrainian]. Mode access:
8. Mamytova EL. [Features of immune disorders in the acute period of traumatic brain injury] // Bulletin of Avicenna. 2013; 4: 72-6. [in Russian]. URL:
9. Pedachenko EG, Semisalov SY, Yelsky VN, Kardash AM. [Clinical epidemiology of traumatic brain injury]. - Donetsk: Apex; 2002. 156 p. [in Russian]
10. Romodanov AP, Kopiev OV, Pedachenko EG, Parkhomets VP, etc. [Pathogenetic substantiation of periods of traumatic brain disease] // Neurosurgery Issues. 1990; 6: 10-3. [in Russian]
11. Romodanov AP, Lisyaniy NI. [Traumatic brain injury and immunological reactivity of the body]. - Kiev: Health’s, 1991. 150 p. [in Russian]
12. Sarkisov DS. [The ratio of structural and functional changes in the dynamics of the pathological process] // Soviet medicine. 1982; 4: 58-62. [in Russian]
13. [Combined mechanical injury. Terminology and classification of mechanical damage: (Training manual)] / Bagnenko SF (ed.). SPb.: Research Institute of Ambulance them. I.I. Janelidze, 2001; 1: 1-36. [in Russian]
14. Taitslin VI. [Closed craniocerebral trauma and its consequences] // Intern. med. journal. 2002; 8(1-2): 58-62. [in Russian]
15. Cherniy VI, Kardash AM, Gorodnik GA. [Diagnosis and treatment of edema and swelling of the brain]. - Kiev: Health’s; 1997. 228 с. [in Russian]
16. Cherniy TV. The concept of pathogenetic neuroprotection of the infected brain (clinical-experimental doslezhennya) [disertatsiya]. Lugansk. 2013. 320 c. [in Ukraine]
17. Arima Y, Harada М, Kamimura D et al. Regional Neural Activation Defines a Gateway for Autoreactive T Cells to Cross the Blood-Brain Barrier // Cell. 2012; 148 (3): 447-57. doi: 10.1016/j.cell.2012.01.022
18. Bortolotti P, Faure E, Kipnis E. Inflammasomes in Tissue Damages and Immune Disorders After Trauma // Front Immunol. 2018; 9: 1900. doi: 10.3389/fimmu.2018.01900. eCollection 2018.
19. Deepika A, Devi BI, Shukla D, Sathyaprabha TN, Christopher R, Ramesh SS. Neuroimmunology of Traumatic Brain Injury: A Longitudinal Study of Interdependency of Inflammatory Markers and Heart Rate Variability in Severe Traumatic Brain Injury // J Neurotrauma. 2018; 35(10): 1124-31. doi: 10.1089/neu.2017.5151.
20. Dolmans RGF, Hulsbergen AFC, Gormley WB, Broekman MLD. Routine blood tests for severe traumatic brain injury: can they predict outcomes? // World Neurosurg. 2020. 136: e60-e67. doi: 10.1016/j.wneu.2019.10.086.
21. Evran S, Calis F, Akkaya E, Baran O, Cevik S, Katar S, Gurevin EG, Hanimoglu H, Hatiboglu MA, Armutak EI, Karatas E, Kocyigit A, Kaynar MY. The effect of high mobility group box-1 protein on cerebral edema, blood-brain barrier, oxidative stress and apoptosis in an experimental traumatic brain injury model // Brain Res Bull. 2020. 154: 68-80. doi: 10.1016/j.brainresbull.2019.10.013.
22. Faul M, Wald MM, Xu L, Coronado VG. Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths, 2002-2006. - U.S. Department Of Health And Human Services. 2010 Mar.: 74 p.
23. Hazeldine J, Lord JM, Belli A. Traumatic brain injury and peripheral immune suppression: primer and prospectus // Front. Neurol. 2015; 6:235. doi: 10.3389/fneur.2015.00235.
24. Hirsiger S, Simmen HP, Werner CM, Wanner GA, Rittirsch D. Danger signals activating the immune response after trauma // Mediators Inflamm. 2012; 2012: 315941. doi: 10.1155/2012/315941.
25. Huber-Lang M, Lambris JD, Ward PA. Innate immune responses to trauma // Nat Immunol. 2018; 19 (4): 327-41.
26. Itoh T, Satou T, Nishida S, Tsubaki M, Imano M, Hashimoto S. Edaravone protects against apoptotic neuronal cell death and improves cerebral function after traumatic brain injury in rats // Neurochem Res. 2010; 35(2): 348-55.
27. Jochems D, van Wessem KJP, Houwert RM, Brouwers HB, Dankbaar JW, van Es MA, Geurts M, Slooter AJC, Leenen LPH. Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury // Crit Care Res Pract. 2018; 2018: 3769418. doi: 10.1155/2018/3769418.
28. Khellaf A, Khan DZ, Helmycorresponding A. Recent advances in traumatic brain injury // J Neurol. 2019; 266(11): 2878-89. doi: 10.1007/s00415-019-09541-4
29. Leclercq PD, Stephenson MS, Murray L. Simple morphometry of axonal Swellings can not be used in isolation for dating lesion after traumatic brain injury // J. Neurotrauma. 2002; 19 (10): 1183-92. DOI: 10.1089 / 08977150260337985
30. Liu ZM, Chen QX, Chen ZB, Tian DF, Li MC, Wang JM, Wang L, Liu BH, Zhang SQ, Li F, Ye H, Zhou L. RIP3 deficiency protects against traumatic brain injury (TBI) through suppressing oxidative stress, inflammation and apoptosis: Dependent on AMPK pathway // Biochem Biophys Res Commun. 2018; 499(2): 112-9. doi: 10.1016/j.bbrc.2018.02.150.
31. Lorente L, Martín MM, González-Rivero AF, Pérez-Cejas A, Argueso M, Ramos L, Solé-Violán J, Cáceres JJ, Jiménez A, García-Marín V. High Serum Caspase-Cleaved Cytokeratin-18 Levels and Mortality of Traumatic Brain Injury Patients // Brain Sci. 2019; 9(10). pii: E269. doi: 10.3390/brainsci9100269.
32. Louveau A, Smirnov I, Keyes TJ, Eccles JD, Rouhani SJ, Peske JD, Derecki NC, Castle D, Mandell JW, Lee KS, Harris TH, Kipnis J. Structural and functional features of central nervous system lymphatic vessels // Nature. 2015; 523(7560): 337-41. doi: 10.1038 / nature14432.
33. Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research // Lancet Neurol. 2017; 16(12): 987-1048. doi: 10.1016/S1474-4422(17)30371-X.
34. Majdan M, Plancikova D, Brazinova A, Rusnak M, Nieboer D, Feigin V, Maas A. Epidemiology of traumatic brain injuries in Europe: a cross-sectional analysis // Lancet Public Health. 2016; 1(2): e76-e83. doi: 10.1016/S2468-2667(16)30017-2.
35. Masel BE, DeWitt DS. Traumatic brain injury: a disease process, not an event // J Neurotrauma. 2010; 27(8): 1529-40. doi: 10.1089/neu.2010.1358.
36. McKee CA, Lukens JR. Emerging Roles for the Immune System in Traumatic Brain Injury // Front Immunol. 2016; 7: 556. doi: 10.3389/fimmu.2016.00556. eCollection 2016.
37. Morganti-Kossmann MC, Rancan M, Stahel PF, Kossmann T. Inflammatory response in acute traumatic brain injury: a double-edged sword // Curr Opin Crit Care. 2002; 8(2): 101-5. doi: 10.1097/00075198-200204000-00002.
38. Nokkari A, Abou-El-Hassan H, Mechref Y, Mondello S, Kindy MS, Jaffa AA, Kobeissy F. Implication of the Kallikrein-Kinin System in Neurological Disorders: Quest for Potential Biomarkers and Mechanisms // Prog Neurobiol. 2018; 165-167: 26-50. doi: 10.1016/j.pneurobio.2018.01.003
39. Pin-On P, Saringkarinkul A, Punjasawadwong Y, Kacha S, Wilairat D. Serum electrolyte imbalance and prognostic factors of postoperative death in adult traumatic brain injury patients: A prospective cohort study // Medicine (Baltimore). 2018; 97(45): e13081. doi: 10.1097/MD.0000000000013081.
40. Rodney T, Osier N, Gill J. Pro- and anti-inflammatory biomarkers and traumatic brain injury outcomes: A review // Cytokine. 2018;110: 248-56. doi: 10.1016/j.cyto.2018.01.012.
41. Rovegno M. Soto P.A., Sáez J.C. [et al.] Biological mechanisms involved in the spread of traumatic brain damage // Med Intensiva. 2012; 36(1): 37-44. doi: 10.1016/j.medin.2011.06.008.
42. Rowland B, Savarraj JPJ, Karri J, Zhang X, Cardenas J, Choi HA, Holcomb JB, Wade CE. Acute Inflammation in Traumatic Brain Injury and Polytrauma Patients Using Network Analysis // Shock. 2020; 53(1):24-34. doi: 10.1097/SHK.0000000000001349.
43. Sauaia A, Moore FA, Moore EE. Postinjury Inflammation and Organ Dysfunction // Crit Care Clin. 2017; 33(1): 167-91. doi: 10.1016/j.ccc.2016.08.006.
44. Semple BD, Kossmann Т, Morganti-Kossmann МС, Semple D. Role of chemokines in CNS health and pathology: a focus on the CCL2/CCR2 and CXCL8/CXCR2 networks // J Cereb Blood Flow Metab. 2010; 30 (3): 459-73. doi: 10.1038/jcbfm.2009.240.
45. Shibahashi K, Sugiyama K, Okura Y, Hoda H, Hamabe Y. Multicenter Retrospective Cohort Study of "Talk and Die" After Traumatic Brain Injury // World Neurosurg. 2017; 107: 82-86. doi: 10.1016/j.wneu.2017.07.117.
46. Sun X, Lee J, Navas T, Baldwin DT, Stewart TA, Dixit VM. RIP3, a novel apoptosis-inducing kinase // J Biol Chem. 1999; 274 (24): 16871-5. doi:10.1074/jbc.274.24.16871.
47. Thelin EP, Tajsic T, Zeiler FA, Menon DK, Hutchinson PJA, Carpenter KLH, Morganti-Kossmann MC, Helmy A. Monitoring the Neuroinflammatory Response Following Acute Brain Injury // Front Neurol. 2017; 8: 351. doi: 10.3389/fneur.2017.00351. eCollection 2017.
48. Unterberg A, Schneider GH, Gottschalk J. Development of traumatic brain edema in old versus young rats // Acta. Neurochirurgica. 1994; 60: 431-3. doi: 10.1007/978-3-7091-9334-1_117.
49. Ziablitsev SV, Pishchulina SV, Kolesnikova SV. Systemic effects of unspecific inflammatory reaction at traumatic brain injury // Fiziol zhurn. 2016; 62(1): 67-72. doi: 10.15407/fz62.01.068.
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