Гематоспинно-мозговой барьер при травме спинного мозга: научный обзор с учетом собственного экспериментального опыта

Цель исследования. Анализ механизмов нарушения проницаемости гематоспинно-мозгового барьера после травмы спинного мозга и оценка его влияния на развитие вторичных повреждений, в том числе в областях, отдаленных от эпицентра повреждения.

Материал и методы. Статья представляет собой анализ 45 публикаций, дополненный собственными экспериментальными данными. Поиск статей проведен в научных базах данных PubMed, Scopus и Web of Science по исследуемой теме. Экспериментальные данные получены с использованием конфокальной микроскопии и детекции биолюминесценции на модели контузионной травмы спинного мозга крысы.

Результаты. Рассмотрена проблема дезинтеграции барьера в отдаленной от эпицентра повреждения области. Показано, что травма спинного мозга значительно увеличивает проницаемость гематоспинно-мозгового барьера, что способствует усиленной трансмиграции иммунных клеток и высвобождению цитотоксических молекул. Результаты собственных исследований на модели дозированной контузионной травмы в торакальном отделе спинного мозга крысы иллюстрируют увеличение проницаемости барьера не только в эпицентре повреждения, но и практически по всей длине органа. Это обстоятельство особенно значимо для поясничного отдела спинного мозга, где локализуются нейронные сети, критически важные для поддержания и восстановления двигательной функции.

Заключение. Обсуждены потенциальные причины дистантного нарушения барьера, включая возможное влияние молекул-биомаркеров повреждения, которые из эпицентра травмы поступают в отдаленные области спинного мозга через кровоток или спинно-мозговую жидкость. Освещены перспективность клинического приложения эффективных экспериментальных подходов для сдерживания нарушения и восстановления гематоспинно-мозгового барьера и отсутствие трансляционных исследований в этом направлении.

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