title: Preinjury alcohol exposure attenuates the neuroinflammatory response to traumatic brain injury.
abstract: BACKGROUND
  Traumatic brain injury (TBI) initiates a neuroinflammatory response that increases the risk of TBI-related mortality. Acute alcohol intoxication at the time of TBI is associated with improved survival. Ethanol is recognized as a systemic immunomodulator that may also impart neuroprotection. The effects of alcohol on TBI-induced neuroinflammation, however, are unknown. We hypothesized that ethanol treatment prior to TBI may provide neuroprotection by diminishing the neuroinflammatory response to injury.
  
  
  METHODS
  Mice underwent gavage with ethanol (EtOH) or water (H2O) prior to TBI. Animals were subjected to blunt TBI or sham injury (Sham). Posttraumatic rapid righting reflex (RRR) and apnea times were assessed. Cerebral and serum samples were analyzed by ELISA for inflammatory cytokine levels. Serum neuron-specific enolase (NSE), a biomarker of injury severity, was also measured.
  
  
  RESULTS
  Neurologic recovery from TBI was more rapid in H2O-treated mice compared with EtOH-treated mice. However, EtOH/TBI mice had a 4-fold increase in RRR time compared with EtOH/Sham, whereas H2O/TBI mice had a 15-fold increase in RRR time compared with H2O/Sham. Ethanol intoxication at the time of TBI significantly increased posttraumatic apnea time. Preinjury EtOH treatment was associated with reduced levels of proinflammatory cytokines IL-6, KC, MCP-1, and MIP-1α post TBI. NSE was significantly increased post injury in the H2O/TBI group compared with H2O/Sham but was not significantly reduced by EtOH pretreatment.
  
  
  CONCLUSIONS
  Alcohol treatment prior to TBI reduces the local neuroinflammatory response to injury. The decreased neurologic and inflammatory impact of TBI in acutely intoxicated patients may be responsible for improved clinical outcomes.
authors.affiliation: Department of Surgery, Institute for Military Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address: md-goodman@hotmail.com.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Goodman
authors.forename: Amy T
authors.initials: AT
authors.lastname: Makley
authors.forename: Eric M
authors.initials: EM
authors.lastname: Campion
authors.forename: Lou Ann W
authors.initials: LA
authors.lastname: Friend
authors.forename: Alex B
authors.initials: AB
authors.lastname: Lentsch
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Pritts
mesh_terms: D000818:Animals; D001930:Brain Injuries / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D016207:Cytokines / Q000378:metabolism; D004660:Encephalitis / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control*; D000431:Ethanol / Q000008:administration & dosage*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D023421:Models, Animal; D010751:Phosphopyruvate Hydratase / Q000378:metabolism; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology; D013997:Time Factors
chemical_list: D016207:Cytokines; D000431:Ethanol; D010751:Phosphopyruvate Hydratase
keywords: Alcohol; Inflammation; Neuroinflammation; Traumatic brain injury