The Evolution and Recurrence of Chronic Subdural Hematoma was Associated with Different Distribution of Macrophage M1/M2 Polarization

作者：Xiaoyao Yi, Jianhe Yue, Shengtao Yue, Jing Li, Xiang Zhang, Guanjian Zhao, Jun Tang, Chen Jin, Ning Huang, Yuan Cheng · 发表于：Inflammation · 年份：2025 · DOI：10.1007/s10753-025-02318-0 · 被引用次数：8 · 研究领域：Neurosurgical Procedures and Complications、Intracerebral and Subarachnoid Hemorrhage Research、Spinal Hematomas and Complications

The pathogenesis of chronic subdural hematoma (CSDH) has traditionally been associated with inflammation, but the efficacy of anti-inflammatory drug therapy is limited. Recent literatures suggest that immune dysregulation rather than sole inflammation, plays a vital role in the development of CSDH. In this study, the dynamics of macrophage polarization were explored to elucidate changes in immune status during CSDH evolution. Nakaguchi computerized tomography (CT) classification method was employed to categorize CSDH into four types, including homogeneous, laminar, separated and trabecular subtypes. Samples from the hematoma cavity were collected. The percentages of M1 and M2 macrophages and the M1/M2 proportion were determined by flow cytometry. The M1-related inflammatory (IL-1β, IL-6, IL-12, and TNF-α) and M2-related anti-inflammatory factors (IL-4, IL-10, IL-13, and TGF-β) were measured by ELISA. The relationship among CT subtypes, macrophage polarization and recurrence were evaluated by univariate and multivariate logistic regression analyses. A nomogram was established to score significant factors, and the bootstrap method was used for internal validation to calculate the concordance index (C-index) and generating calibration plots. A total of 127 patients with CSDH were included, among which 28 cases (22.04%) experienced recurrence within three months post-surgery. Significant differences were found in the percentages of M1 and M2 macrophages, the M1/M2 ratio, and rela...