背景:近年来,科学界的注意力集中在大脑废物代谢产物的清除系统上,叫做淋巴系统,基于其在外周组织中与淋巴系统的相似性以及AQP4胶质通道的相关作用,于2012年首次描述。因此,许多研究集中在神经病理学的情况下,其在器官损伤中的作用,包括TBI.
方法:为了评估淋巴系统在TBI发病机制中的作用,2022年3月23日,根据PRISMA指南,使用SCOPUS和Medline(通过PubMed)数据库对文献进行了系统回顾,在选择过程后产生12篇文章。
结论:本综述表明AQP4的改变与物质S100b的积累有关,GFAP,NSE,法医领域已知的TBI标记。此外,AQP4功能的改变有利于水肿,which,如前所述,构成继发性脑损伤的改变。此外,大脑的特定区域被证明容易改变淋巴通路,表明他们参与了TBI后的损伤.因此,进一步的研究是强制性的。在这方面,还提出了关于尸体的研究协议,基于分析的证据。
BACKGROUND: In recent years, the attention of the scientific world has focused on a clearance system of brain waste metabolites, called the glymphatic system, based on its similarity to the lymphatic system in peripheral tissue and the relevant role of the
AQP4 glial channels and described for the first time in 2012. Consequently, numerous studies focused on its role in organ damage in cases of neuropathologies, including TBI.
METHODS: To evaluate the role that the glymphatic system has in the pathogenesis of TBI, on 23 March 2022, a systematic
review of the literature according to PRISMA guidelines was carried out using the SCOPUS and Medline (via PubMed) databases, resulting in 12 articles after the selection process.
CONCLUSIONS: The present
review demonstrated that an alteration of
AQP4 is associated with the accumulation of substances S100b, GFAP, and NSE, known markers of TBI in the forensic field. In addition, the alteration of the functionality of
AQP4 favors edema, which, as already described, constitutes alterations of secondary brain injuries. Moreover, specific areas of the brain were demonstrated to be prone to alterations of the glymphatic pathway, suggesting their involvement in post-TBI damage. Therefore, further studies are mandatory. In this regard, a study protocol on cadavers is also proposed, based on the analyzed evidence.