| Abstrakt: |
Under the conditions of stress caused by the hostilities in Ukraine, steroid hormones play a leading role in regulating the body's adaptive functions Combat traumatic brain injury (TBI) creates an additional burden on the system of neurosteroid epigenetic regulation, the reaction of which is transformed internally systemically during the development of the consequences of trauma. This transformation over time requires serious study, as it should be taken into account when choosing tactics for effective treatment of patients. The aim of the study was to investigate changes in the concentration of progesterone, cortisol and testosterone in the blood serum and cerebrospinal fluid (CSF) of combatants with mild combat TBI in the acute and intermediate periods after contusion or concussion. In 65 patients with combat TBI: 15 - in the acute and 16 - in the intermediate period after brain contusion; 16 - in the acute and 18 - in the intermediate period after concussion, as well as in 7 conditionally healthy male subjects, the levels of progesterone, cortisol and testosterone in the blood serum (in patients with combat TBI - also in CSF) were studied by ELISA upon admission to the hospital. Studies have shown that serum progesterone levels significantly decrease in patients with contusions (by about 40%) in the acute period after TBI and do not recover in the future. Concussion causes a 30% decrease in serum levels of the hormone in the intermediate period after the injury. In CSF during the intermediate period, the concentration of the hormone significantly decreases by 20-25% compared to the acute period in both groups of combatants. Serum cortisol tends to increase significantly after combat TBI both in the acute and intermediate periods. In CSF during the intermediate period, the concentration of the hormone increases by 1.5-2.0 times compared to the acute period in both groups of combatants. Serum testosterone has a decreased level in the acute period after brain contusion with a tendency to recover in the future. In CSF during the intermediate period, the concentration of the hormone decreases by 3.5-4.0 times compared to the acute period in both groups of combatants. The ratio of cortisol/testosterone in the blood serum practically does not change over time, but the effects of cortisol over testosterone after brain contusion are much more prevalent. In CSF, the ratio of hormones increases in favor of cortisol by 6-8 times in the intermediate period after injury in both groups of combatants. The ratio of cortisol/progesterone in the blood serum of combatants also has a significant advantage in favor of cortisol, especially in the intermediate period after brain contusion. In CSF, the ratio of hormones increases in favor of cortisol by 2.0-2.5 times in the intermediate period after i njury in both groups of combatants. Thus, cortisol levels increase after combat TBI The level of testosterone, which was reduced in the blood serum in the acute period after brain contusion, is somewhat restored, but in the CSF in the intermediate period after the injury, the hormone content is sharply limited in both groups of combatants. in both serum and CSF, with the most pronounced increase in CSF in the intermediate period. The level of progesterone, a precursor of cortisol and testosterone, is significantly reduced in both serum and CSF, especially in the intermediate period after trauma. Changes in the ratio of cortisol/testosterone and cortisol/progesterone in favor of cortisol indicate the dominance and intensification of stress and catabolic effects of cortisol, especially at the brain level, in combatants of both groups, most of all in the intermediate period after trauma. The obtained data demonstrate an increase in the deficit of compensatory and restorative capabilities of the neurosteroidal regulation in the dynamics of time after combat TBI. This fact requires special attention to the choice of the temporal strategy for the treatment of combatants with TBI. [ABSTRACT FROM AUTHOR] |
