Effect of therapeutic phlebotomy on neuroinflammation following traumatic brain injury in rats

Traumatic brain injury (TBI) is a global health problem. Persian medical manuscripts recommended phlebotomy as a potent treatment for TBI. This study aimed to evaluate the possible effect of saphenous vein phlebotomy (SVP) on neuroinflammation after TBI.

Adult male Wistar rats were divided randomly into three main groups (n = 12): sham group, TBI group, and TBI+SVP group. Induction of trauma was made through a controlled cortical impactor (CCI) device and SVP treatment was applied 10 min after TBI. Then, neurological functions were evaluated 6 and 24 hours post-surgery. Furthermore, 6 hours after bloodletting inflammatory and oxidative stress biomarkers were measured in the rats' brains.

Therapeutic phlebotomy could improve neurological scores post-TBI. In addition, phlebotomy application significantly reduced proinflammatory cytokines (IL- 1β, IL-17, and TNF-α) and oxidative stress factors as shown by reduction of malondialdehyde (MDA) and elevation of superoxide dismutase (SOD) with no significant effect on glutathione peroxidase (GPx) and nitric oxide (NO) in the brain 6 h after TBI.

Finally, SVP possibly through its attenuation of neuroinflammation and free radicals, and also increased antioxidant activity in the rats' brains could ameliorate neurological impairment following TBI.