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In more chronic phases of injury, however, reactive astrocytes have been suggested to inhibit neurite outgrowth by operating as a chemical barrier by releasing a variety of CSPGs, as discussed above, and as a complex, three-dimensional physical barrier [52], [58], [59], [64].
While these studies have been performed in normal animals or within hours of the onset of inflammation, the situation during more chronic phases of inflammatory disease remains unclear.
Again, the interpretation was that over-activation of mTOR in astroglia in the more chronic phases of HS may nurture a local pro-epileptogenic microenvironment.
In clinical cases of SCI, TGFβ1 appears to be primarily associated with acute injury responses, with other isoforms being expressed at more chronic phases of injury (Buss et al., 2008).
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Energy expenditure is then found to increase significantly in the more chronic phase of sepsis or critical illness [ 39].
When successful, the stress response transitions from an acute "exuberant" phase (perhaps with transient overreaction) into a more chronic phase that precedes recovery.
However, T cells again did not affect the initiation phase of the disease; instead, the effect was noted in the more chronic phase of the disease.
Looking forward, it would be interesting to let the study run longer to observe the long-term host reactions as the infection develops into a more chronic phase.
In the hAPLN group, 4/20 (20%) biopsies were consistent with the acute setting (TMA), while the majority 16/20 (80%) had a more chronic phase of hAPLN.
If the patient survives the acute phase, this is followed by a more chronic phase of critical illness when the patient becomes quite vulnerable to recurrent infection and other complications, which can lead to a return to the acute phase.
A dissociation between high plasma cortisol and low ACTH in patients has been observed in the more chronic phase of critical illness induced by severe sepsis and multiple trauma [ 1].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com