• Duncan C Humphries, Stephen O'Neill, Emma Scholefield, David A Dorward, Alison C Mackinnon, Adriano G Rossi, Christopher Haslett, AndrewsPeter J DPJDCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom., Jonathan Rhodes, and Kevin Dhaliwal.
• MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.
• Crit. Care Med. 2018 Sep 1; 46 (9): e937e944e937-e944.

ObjectivesMild traumatic brain injury in the form of concussion is extremely common, and the potential effects on pulmonary priming have been underestimated. The aim of this study was to characterize the pulmonary response following mild traumatic brain injury and assess the pulmonary susceptibility to lung injury after a subsequent innocuous pulmonary insult.DesignExperimental in vivo study.SettingUniversity research laboratory.SubjectsMale CD1 mice.InterventionsWe developed a model of concussive traumatic brain injury in mice followed by pulmonary acid microaspiration. To assess the dependent role of neutrophils in mediating pulmonary injury, we specifically depleted neutrophils.Measurements And Main ResultsLateral fluid percussion to the brain resulted in neuronal damage and neutrophil infiltration as well as extensive pulmonary interstitial neutrophil accumulation but no alveolar injury. Following subsequent innocuous acid microaspiration, augmented alveolar neutrophil influx led to the development of pulmonary hemorrhage that was reduced following neutrophil depletion.ConclusionsThis model shows for the first time that innocuous acid microaspiration is sufficient to induce neutrophil-mediated lung injury following mild concussion and that the extracranial effects of mild traumatic brain injury have been underestimated.

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