Die Rolle von Kortikosteroiden bei Traumata des Myelons und der peripheren Nerven – Pathophysiologie und experimentelle Ergebnisse

Zusammenfassung

Traumatische Verletzungen des Rückenmarkes und peripherer Nerven sind medizinisch komplexe Zustände, die das gesamte Leben verändern. Der pathophysiologische und molekularpathologische Erkenntnisgewinn über Schädigungsmechanismen nach einer Rückenmarkverletzung (SCI) und einer peripheren Nervenverletzung (PNI) haben zu neuen Therapieansätzen geführt. Es konnten bereits ermutigende tierexperimentelle Ergebnisse mit dem Einsatz unterschiedlicher Kortikosteroide gezeigt werden. Diese Übersichtsarbeit soll über die pathophysiologischen Grundlagen der SCI und PNI informieren und die Rolle von Kortikosteroiden, als mögliches beeinflussendes Agens, im Rahmen der Krankheitsbilder beleuchten.

Abstract

Traumatic spinal cord injuries (SCI) and peripheral nerve injuries (PNI) are medically complex situations that change the whole life. The pathophysiological and molecular pathological amount of new knowledge about injury mechanisms after SCI and PNI have led to new therapeutic approaches. Encouraging animal experiments could be already demonstrating the beneficial use of different corticosteroids. This review is intended to provide information on the pathophysiological basis of SCI and PNI, as well as the role of corticosteroids as a possible influencing agent in the context of the disease patterns.

Fazit

Der pathophysiologische und molekularpathologische Erkenntnisgewinn über Schädigungsmechanismen nach SCI und PNI sowie die Identifikation inhibitorischer und trophischer Faktoren haben zu neuen Therapieansätzen geführt. Die durchaus ermutigenden tierexperimentellen Ergebnisse einer peritraumatischen MPSS-Therapie können allerdings nur einen Beitrag leisten hinsichtlich der Therapie einer SCI und PNI. Zurzeit scheint es so, dass die Kombination unterschiedlicher, komplementärer Therapiestrategien die Grundlage für synergistisch wirksame zukünftige Therapien bildet.

Schlüsselwörter

Kortikosteroide - traumatische Querschnittlähmung - traumatische periphere Nervenverletzung

Keywords

corticosteroids - acute spinal cord injury - peripheral nerve injury

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