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Dou Y, Fei X, He X, Huan Y, Wei J, Wu X, Lyu W, Fei Z, Li X, Fei F. Homer1a reduces inflammatory response after retinal ischemia/reperfusion injury. Neural Regen Res 2024; 19:1608-1617. [PMID: 38051906 PMCID: PMC10883521 DOI: 10.4103/1673-5374.386490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/25/2023] [Indexed: 12/07/2023] Open
Abstract
Abstract
JOURNAL/nrgr/04.03/01300535-202407000-00042/figure1/v/2023-11-20T171125Z/r/image-tiff
Elevated intraocular pressure (IOP) is one of the causes of retinal ischemia/reperfusion injury, which results in NLRP3 inflammasome activation and leads to visual damage. Homer1a is reported to play a protective role in neuroinflammation in the cerebrum. However, the effects of Homer1a on NLRP3 inflammasomes in retinal ischemia/reperfusion injury caused by elevated IOP remain unknown. In our study, animal models were constructed using C57BL/6J and Homer1flox/
–/Homer1a+/
–/Nestin-Cre+/
– mice with elevated IOP-induced retinal ischemia/reperfusion injury. For in vitro experiments, the oxygen-glucose deprivation/reperfusion injury model was constructed with Müller cells. We found that Homer1a overexpression ameliorated the decreases in retinal thickness and Müller cell viability after ischemia/reperfusion injury. Furthermore, Homer1a knockdown promoted NF-κB P65Ser536 activation via caspase-8, NF-κB P65 nuclear translocation, NLRP3 inflammasome formation, and the production and processing of interleukin-1β and interleukin-18. The opposite results were observed with Homer1a overexpression. Finally, the combined administration of Homer1a protein and JSH-23 significantly inhibited the reduction in retinal thickness in Homer1flox/
–/Homer1a+/
–/Nestin-Cre+/
– mice and apoptosis in Müller cells after ischemia/reperfusion injury. Taken together, these studies demonstrate that Homer1a exerts protective effects on retinal tissue and Müller cells via the caspase-8/NF-κB P65/NLRP3 pathway after I/R injury.
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Affiliation(s)
- Yanan Dou
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Xiaowei Fei
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Xin He
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Yu Huan
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Jialiang Wei
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Xiuquan Wu
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Weihao Lyu
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Zhou Fei
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Xia Li
- Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Fei Fei
- Department of Ophthalmology, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
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Hanafi I, Munder E, Ahmad S, Arabhamo I, Alziab S, Badin N, Omarain A, Jawish MK, Saleh M, Nickl V, Wipplinger T, Wipplinger C, Nickl R. War-related traumatic brain injuries during the Syrian armed conflict in Damascus 2014-2017: a cohort study and a literature review. BMC Emerg Med 2023; 23:35. [PMID: 36977988 PMCID: PMC10053936 DOI: 10.1186/s12873-023-00799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/24/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The decade-long Syrian armed conflict killed or injured more than 11% of the Syrian population. Head and neck injuries are the most frequent cause of war-related trauma, about half of which are brain injuries. Reports about Syrian brain trauma victims were published from neighboring countries; However, none are available from Syrian hospitals. This study aims to report war-related traumatic brain injuries from the Syrian capital. METHODS We conducted a retrospective cohort study between 2014 and 2017 at Damascus Hospital, the largest public hospital in Damascus, Syria. Target patients were the victims of combat-related traumatic brain injuries who arrived alive and were admitted to the neurosurgery department or to another department but followed by the neurosurgery team. The collected data included the mechanism, type, and site of injury based on imaging findings; types of invasive interventions; intensive-care unit (ICU) admissions; as well as neurological status at admission and discharge including several severity scales. RESULTS Our sample consisted of 195 patients; Ninety-six of them were male young adults, in addition to 40 females and 61 children. Injuries were caused by shrapnel in 127 (65%) cases, and by gunshots in the rest, and most of them (91%) were penetrating. Sixty-eight patients (35%) were admitted to the ICU, and 56 (29%) underwent surgery. Neurological impairment was reported in 49 patients (25%) at discharge, and the mortality rate during hospitalization was 33%. Mortality and neurological impairment associated significantly with higher values on clinical and imaging severity scores. CONCLUSIONS This study captured the full spectrum of war-related brain injuries of civilians and armed personnel in Syria without the delay required to transport patients to neighboring countries. Although the clinical presentation of injuries at admission was not as severe as that in previous reports, the inadequate resources (i.e., ventilators and operation rooms) and the lack of previous experience with similar injuries might have resulted in the higher mortality rate. Clinical and imaging severity scales can provide a handy tool in identifying cases with low probability of survival especially with the shortage of personal and physical resources.
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Affiliation(s)
- Ibrahem Hanafi
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Damascus University, Mazzah, Damascus, Syria.
| | - Eskander Munder
- Faculty of Medicine, Syrian Private University, Mazzah, Damascus, Syria
| | - Sulafa Ahmad
- Faculty of Medicine, Damascus University, Mazzah, Damascus, Syria
| | - Iman Arabhamo
- Faculty of Medicine, Syrian Private University, Mazzah, Damascus, Syria
| | - Suzan Alziab
- Faculty of Medicine, Damascus University, Mazzah, Damascus, Syria
| | - Noor Badin
- Faculty of Medicine, Damascus University, Mazzah, Damascus, Syria
| | - Ahmad Omarain
- Faculty of Medicine, Damascus University, Mazzah, Damascus, Syria
| | | | - Muhannad Saleh
- Division of Neurosurgery, Department of Surgery, Damascus Hospital, Damascus, Syria
| | - Vera Nickl
- Department of Neurosurgery, Würzburg University, Würzburg, Germany
| | - Tamara Wipplinger
- Department of Neurosurgery, Würzburg University, Würzburg, Germany
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, USA
| | | | - Robert Nickl
- Department of Neurosurgery, Würzburg University, Würzburg, Germany
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Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes. Mil Med Res 2023; 10:3. [PMID: 36631894 PMCID: PMC9835351 DOI: 10.1186/s40779-022-00438-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter, leading to complex and compound eye injuries. However, few studies have comprehensively investigated the clinical features of different eye injury types or possible risk factors for poor prognosis. METHODS We retrospectively reviewed all consecutive records of explosive eye injuries (1449 eyes in 1115 inpatients) in 14 tertiary referral hospitals in China over 12 years (between January 2008 and December 2019). Data on demographics, eye injury types, ocular findings, treatments, and factors affecting visual prognosis were extracted from a standardized database of eye injuries and statistically analyzed. RESULTS Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies (IOFBs) resulted in 55.17% of open globe injuries (OGIs) and contusion caused 60.22% of close globe injuries (CGIs). Proliferative vitreous retinopathy (PVR) was more common in perforating (47.06%) and IOFB (26.84%) than in penetrating (8.79%) injuries, and more common with laceration (24.25%) than rupture (9.22%, P < 0.01). However, no difference was observed between rupture and contusion. Ultimately, 9.59% of eyes were removed and the final vision was ≤ 4/200 in 45.82% of patients. Poor presenting vision [odds ratio (OR) = 5.789], full-thickness laceration of the eyeball ≥ 5 mm (OR = 3.665), vitreous hemorrhage (OR = 3.474), IOFB (OR = 3.510), non-mechanical eye injury (NMEI, OR = 2.622, P < 0.001), rupture (OR = 2.362), traumatic optic neuropathy (OR = 2.102), retinal detachment (RD, OR = 2.033), endophthalmitis (OR = 3.281, P < 0.01), contusion (OR = 1.679), ciliary body detachment (OR = 6.592), zone III OGI (OR = 1.940), and PVR (OR = 1.615, P < 0.05) were significant negative predictors for poor visual outcomes. CONCLUSIONS Explosion ocular trauma has complex mechanisms, with multiple eyes involved and poor prognosis. In lethal level I explosion injuries, eyeball rupture is a serious condition, whereas contusion is more likely to improve. In level II injuries, IOFBs are more harmful than penetrating injuries, and level IV represents burn-related eye injuries. PVR is more associated with penetrating mechanisms than with OGI. Identifying the risk predictors for visual prognosis can guide clinicians in the evaluation and treatment of ocular blast injuries.
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Shakarchy-Kaminsky N, Megreli J, Kaminsky D, Tsur AM, Nadler R, Radomislensky I, Gelikas S, Glassberg E, Benov A, Furer A. Combat-related ocular injuries in the Israel Defense Forces during the years 2013 to 2019. J Trauma Acute Care Surg 2021; 91:S241-S246. [PMID: 34108415 DOI: 10.1097/ta.0000000000003233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ocular injuries account for up to 13% of battle injuries, despite the implementation of advanced protective eyewear (PE). The aim of this study was to describe the extent of ocular injuries over the last years among Israel Defense Forces soldiers and to examine the change in PE policy introduced in 2013 and the effect of a high-intensity conflict on ocular injury characteristics. METHODS This retrospective registry-based analysis derived data from the Israel Defense Forces Trauma Registry and included soldiers who sustained combat-related ocular injuries between the years 2013 and 2019. Demographic data and injury characteristics of casualties, as well as information regarding the use of PE, were collected and analyzed. RESULTS A total of 2,312 military casualties were available for this study; the incidence of combat-related ocular injuries was 8.9% (n = 113). Ocular injuries occurred among male soldiers (98.2%) with a mean ± SD age of 22.7 ± 4.6 years; mechanism of injury was penetrating in 59.3% of the casualties and blunt in 22.1% of the casualties, ocular injury was isolated in 51.3% of the casualties, and others sustained concomitant injuries including head (32.7%), upper extremity injury (17.7%), lower extremity (15.9%), torso (8.0%), neck (6.2%), and other (5.9%) injuries. Ocular injuries rate was similar among casualties who used PE (11.2%) and those who did not use PE (13.0%) while injured (p = 0.596). Rate of open globe injuries was 9.1% in casualties who used PE and 39.5% (p = 0.002) in casualties who did not. CONCLUSION Eye protection may significantly reduce ocular injuries severity. Education of the combatants on the use of PE and guidance of medical teams on proper assessment, initial treatment, and rapid evacuation of casualties are needed to improve visual outcomes of the casualties further. LEVEL OF EVIDENCE Epidemiological study, level IV.
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Affiliation(s)
- Nitzan Shakarchy-Kaminsky
- From the Trauma and Combat Medicine Branch (N.S.-K., J.M., D.K., A.M.T., R.N., I.R., S.G., A.B.), Surgeon General's Headquarters, Israel Defense Forces; Department of Medicine "B" (A.M.T.), Sheba Medical Center, Tel Hashomer, Ramat Gan, affiliated to Sackler Faculty of Medicine, Tel Aviv University; Department of General Surgery and Transplantation-Surgery B (R.N.), Chaim Sheba Medical Center, Tel Hashomer, Affiliated to Sackler School of Medicine, Tel Aviv; The Azrieli Faculty of Medicine (E.G., A.B.), Bar-Ilan University, Safad, Israel; Uniformed Services University of the Health Sciences (E.G.), Bethesda, Maryland; Surgeon General's Headquarters (E.G.), Israel Defense Forces; and Research and Academic Division (A.F.), Israel Defense Forces Medical Corps, Ramat Gan; Department of Military Medicine (A.F.), Jerusalem, Israel
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