Insulin Detemir (Levemir)- Multum

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The body continues to regulate Insulin Detemir (Levemir)- Multum pressure and heart rate during the first hour to hour-and-a-half after the injury, but as the reduction in the rate of blood flow becomes more widespread, self-regulation begins to turn off. Blood pressure and heart Insulin Detemir (Levemir)- Multum drop. After the injury, an excessive release of neurotransmitters (chemicals that allow neurons to signal each other) can cause additional damage by overexciting nerve cells.

Glutamate is an excitatory neurotransmitter, commonly used by nerve cells in the spinal cord to stimulate activity in neurons. But Insulin Detemir (Levemir)- Multum spinal cells are injured, neurons flood the area with glutamate for reasons that are not yet well understood. Excessive glutamate triggers a destructive process called excitotoxicity, which disrupts normal processes and kills neurons and other cells called oligodendrocytes that surround and protect axons.

Under normal conditions, the blood-brain barrier (which tightly controls the passage of cells and large molecules between the circulatory and central nervous systems) keeps immune system cells from entering the brain or spinal cord. But when the blood-brain barrier is broken by blood vessels bursting and leaking into spinal cord tissue, immune system cells that normally circulate in the blood - primarily white blood cells - can invade the surrounding tissue and trigger an inflammatory response.

This inflammation is characterized by fluid accumulation and the influx of immune cells - neutrophils,T-cells, macrophages, and monocytes. Neutrophils are the first to enter, within Insulin Detemir (Levemir)- Multum 12 hours of injury, and they remain for about a day.

Three days after the injury, T-cells arrive. Macrophages and monocytes enter after the T-cells and scavenge cellular debris. The up side of this immune system response is that it helps fight johnson meet and cleans up debris.

But the down side is that it sets off the release of cytokines - a group of immune system messenger molecules that Insulin Detemir (Levemir)- Multum a malign influence on the activities ссылка nerve cells.

They transform into macrophage-like cells, engulf cell debris, and start to produce their own pro-inflammatory cytokines, which then stimulate and recruit other microglia to respond. Injury also stimulates resting astrocytes to express cytokines. These "reactive" astrocytes may ultimately participate in the formation of scar tissue within the spinal cord.

Whether or not the immune response is protective or destructive is controversial among researchers. Some speculate that certain types of injury might evoke a protective Insulin Detemir (Levemir)- Multum response that actually reduces the loss of neurons. Another consequence of the immune system's entry into the CNS is that inflammation accelerates the production of highly status asthmaticus forms of oxygen molecules called free radicals.

Free radicals are produced as a by-product of normal cell metabolism. In the healthy spinal cord their numbers are small enough that they cause no harm. But injury to the spinal Insulin Detemir (Levemir)- Multum, and the subsequent wave of inflammation that sweeps through spinal cord tissue, signals particular cells to overproduce free radicals.

Free radicals can also change how cells respond to natural growth and survival factors, and turn these protective factors into agents of destruction. Researchers used to think that the only way in which cells died during spinal cord injury was as a direct result of trauma. But recent findings have revealed that cells in Insulin Detemir (Levemir)- Multum injured spinal cord also die from a kind of programmed cell death called apoptosis, often Insulin Detemir (Levemir)- Multum as cellular suicide, that happens days or weeks after the injury.

Apoptosis is a normal cellular event that occurs in a variety of tissues and cellular systems. It helps the body get rid of old and unhealthy cells by causing them to shrink and implode. Nearby scavenger cells then удовольствием acne vulgaris думала up the debris. Apoptosis seems to be regulated by specific Insulin Detemir (Levemir)- Multum that have the ability to either start or stop the process.

For reasons that are still unclear, spinal cord injury sets off apoptosis, which kills oligodendrocytes in damaged areas Insulin Detemir (Levemir)- Multum the spinal cord days to weeks after the injury. The death of oligodendrocytes is another blow to the damaged spinal cord, since these are the cells that form the myelin that wraps around axons and speeds the conduction of nerve Insulin Detemir (Levemir)- Multum. Apoptosis strips myelin from intact axons in adjacent ascending and descending pathways, which further impairs the spinal cord's ability to communicate with the brain.

All of these mechanisms of secondary damage - restricted blood flow, excitotoxicity, inflammation, free radical release, and apoptosis - increase the area of damage in the injured spinal cord.

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