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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rosped</journal-id><journal-title-group><journal-title xml:lang="ru">Российский педиатрический журнал имени М.Я. Студеникина</journal-title><trans-title-group xml:lang="en"><trans-title>M.Ya. Studenikin Russian Pediatric Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3033-9006</issn><issn pub-type="epub">3033-9014</issn><publisher><publisher-name>ФГАУ «НМИЦ здоровья детей» Минздрава России</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.46563/2026-1-1-8-17</article-id><article-id custom-type="elpub" pub-id-type="custom">rosped-2026</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL INVESTIGATIONS</subject></subj-group></article-categories><title-group><article-title>Типовой патологический процесс и маркеры повреждения мозга при лёгкой черепно-мозговой травме у детей</article-title><trans-title-group xml:lang="en"><trans-title>Typical pathological process and markers of brain damage in mild traumatic brain injury in children</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5046-0377</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сорокина</surname><given-names>Е. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Sorokina</surname><given-names>Elena G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сорокина Елена Геннадьевна, канд. биол. наук, вед. специалист методического отдела</p><p>e-mail: sorokelena@mail.ru</p></bio><bio xml:lang="en"><p>Elena G. Sorokina, MD, PhD, leading researcher, Methodical department</p><p>e-mail: sorokelena@mail.ru</p></bio><email xlink:type="simple">sorokelena@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8433-7783</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Реутов</surname><given-names>В. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Reutov</surname><given-names>Valentin P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Реутов Валентин Палладиевич, доктор биол. наук, вед. науч. сотр.</p><p>e-mail: valentinreutov@mail.ru</p></bio><email xlink:type="simple">valentinreutov@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2018-050X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семёнова</surname><given-names>Ж. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenova</surname><given-names>Zhanna B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Семёнова Жан­на Борисовна, доктор мед. наук, проф., рук. отд-я нейротравмы</p><p>e-mail: jseman@mail.ru</p></bio><email xlink:type="simple">jseman@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9418-4418</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карасёва</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Karaseva</surname><given-names>Olga V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карасёва Ольга Вита­льевна, доктор мед. наук, руководитель отдела сочетанной травмы, анестезио- логии-реанимации</p><p>e-mail: karaseva.o@list.ru</p></bio><email xlink:type="simple">karaseva.o@list.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4679-0533</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Смирнов</surname><given-names>И. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Smirnov</surname><given-names>Ivan E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Смирнов Иван Евгеньевич, доктор мед. наук, проф., нач. методического отдела</p><p>e-mail: smirnov@nczd.ru</p></bio><email xlink:type="simple">smirnov@nczd.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Medical Research Center for Children’s Health</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУН «Институт высшей нервной деятельности и нейрофизиологии РАН»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Higher Nervous Activity and Neurophysiology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУЗ «Научно-исследовательский институт неотложной детской хирургии и травматологии — Клиника доктора Рошаля» Департамента здравоохранения г. Москвы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical and Research Institute of Emergency Pediatric Surgery and Trauma — Dr Roshal’s Clinic</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>27</day><month>03</month><year>2026</year></pub-date><volume>1</volume><issue>1</issue><fpage>8</fpage><lpage>17</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сорокина Е.Г., Реутов В.П., Семёнова Ж.Б., Карасёва О.В., Смирнов И.Е., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Сорокина Е.Г., Реутов В.П., Семёнова Ж.Б., Карасёва О.В., Смирнов И.Е.</copyright-holder><copyright-holder xml:lang="en">Sorokina E.G., Reutov V.P., Semenova Z.B., Karaseva O.V., Smirnov I.E.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rosped.ru/jour/article/view/2026">https://www.rosped.ru/jour/article/view/2026</self-uri><abstract><sec><title>Введение</title><p>Введение. Несмотря на доминирование лёгкой черепно-мозговой травмы (ЛЧМТ) в структуре травматизма у детей, биохимические показатели повреждения мозга при ЛЧМТ и сотрясении мозга изучены недостаточно. Этот факт затрудняет прогнозирование исходов при этих повреждениях мозга у детей. Цель: определить изменения маркеров повреждения мозга в крови детей, перенёсших ЛЧМТ, c акцентом на сотрясение мозга в сравнении с изменениями у больных со среднетяжёлой ЧМТ (СТЧМТ).Материалы и методы. Обследовано 136 детей, из них у 35 детей с сотрясением головного мозга (15 баллов по шкале комы Глазго (ШКГ)), 65 детей с ЛЧМТ (13–14 баллов по ШКГ) и 36 детей с СТЧМТ (9–12 баллов ШКГ) в первые 1–2 дня после ЧМТ проводили определение содержания в сыворотке/плазме крови таких маркеров повреждения мозга, как глиальный белок S100b, кислый фибриллярный белок GFAP, αII-спектрин (продукт распада спектрина — SBDP-145), 2 типа аутоантител (аАТ) к рецепторам глутамата (GluRc) — NMDA (NR2) и АМРА (GluR1) подтипов, продукты деградации этих рецепторов — пептидов, соответствующих N-концевым участкам NMDA и AMPA GluRc (NR2 и AMPA1 пептиды), а также содержание оксидов азота (NOх) (NO2 –+NO3–) и 3-нитротирозина (NT). Концентрации этих соединений в сыворотке/плазме крови определялись иммуноферментными методами.Результаты. У значительной части детей с ЛЧМТ уже в первые дни после ЧМТ было выявлено увеличение содержания маркеров окислительного стресса (NOx, NT) и значительное возрастание уровня аАТ к NMDA GluRc в крови. У детей с СТЧМТ показатели повреждения мозга (S100b, GFAP, αII-спектрин, NOx и продукты деградации NMDA GluRc-NR2-пептиды) превышали таковые у детей с ЛЧМТ. Напротив, уровень аАТ к NMDA GluRc и продукты деградации АМРА GluRc-АМРА1 пептиды имели максимальные значения именно у детей с сотрясением мозга.Заключение. Установлено, что у детей с ЛЧМТ (ШКГ = 15) большинство показателей уже в первые дни после травмы оказывается на верхней границе или превышает верхнюю границу нормы, что свидетельствует о разной степени реакции головного мозга на травматический стресс. У детей с сотрясением головного мозга высокий уровень аАТ к NMDA GluRc на фоне низкого содержания продуктов их деградации — NR2 пептидов в первые дни после ЧМТ может указывать на более выраженные компенсаторные механизмы, направленные на уменьшение гиперстимуляции NMDA GluRc при ЛЧМТ. В то же время более высокое содержание АМРА1 пептидов у детей с сотрясением мозга может быть начальным признаком диффузно-аксонального повреждения.</p></sec><sec><title>Участие авторов</title><p>Участие авторов: Сорокина Е.Г., Реутов В.П., Семенова Ж.Б. — концепция, дизайн и написание текста; Семено- ва Ж.Б., Сорокина Е.Г., Карасева О.В. — сбор и обработка материала; Смирнов И.Е. — редактирование. Все соавто- ры — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.Финансирование. Исследование не имело финансовой поддержки.Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.</p></sec><sec><title>Поступила 18</title><p>Поступила 18.01.2026Принята к печати 10.02.2026Опубликована 27.02.2026</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Despite the dominance of mild traumatic brain injury (mTBI) in the structure of TBI, the biochemical parameters of mild brain damage in brain concussions have not been sufficiently studied. This fact makes it difficult to predict the outcomes of concussions that are part of the mild form of TBI. Aim of the work: identify changes in markers of brain damage in children’s blood who underwent mTBI with an emphasis on brain concussions, and compare the indicators with a group of children with moderate TBI (mdTBI).Materials and methods. One hundred thirty six children were examined, including 35 children with concussion (15 points on the Glasgow Coma Scale (GCS)), 65 children with mTBI (13–14 points on the GCS) and 36 children with mdTBI (9–12 points on the GCS). In the first 1–2 days after TBI, the content of such markers of brain damage as glial protein S100b, acidic fibrillary protein GFAP, αII-spectrin (spectrin breakdown product — SBDP-145), 2 types of autoantibodies (aAT) to glutamate receptors (GluRc) — NMDA (NR2) and AMPA (GluR1) subtypes, degradation products of these receptors — peptides corresponding to the N-terminal regions of NMDA and AMPA GluRc (NR2 and AMPA1 peptides), as well as the content of nitric oxides (NOx) (NO2– + NO3–) and 3-nitrotyrosine (NT). The concentrations of these compounds in blood serum/plasma were determined by enzyme immunoassays.Results. In the first days after TBI, a significant proportion of children with mTBI showed an increase in the content of oxidative stress markers (NOx, NT) and a significant increase in the level of aAb to NMDA GluRc in the blood. In children with mdTBI, indicators of brain damage (S100b, GFAP, αII-spectrin, NOx, and NMDA GluRc degradation products — NR2 peptides) exceeded those in children with mTBI. On the contrary, the level of aAb to NMDA GluRc and the degradation products of AMPA GluRc — AMPA 1 peptides had maximum values in the group of mTBI in children with brain concussions.Conclusion. It has been shown that in many children with mTBI (GCS = 14–15), most of the indicators are at the upper limit or exceed the upper limit of the normal values, which indicates a different degree of brain response to mild traumatic stress. In children with concussion, a high level of aAb to NMDA GluRc against the background of a low content of their degradation products, NR2 peptides, in the first days after TBI may indicate more pronounced compensatory mechanisms aimed at reducing NMDA GluRc hyperstimulation in mTBI. At the same time, a higher content of AMPA 1 peptides in children with concussions may be the initial signs of diffuse axonal damage.Contribution: Sorokina E.G., Reutov V.P., Semenova Zh.B. — concept, design and writing the text; Semenova Zh.B., Sorokina E.G., Karaseva O.V. — collection and processing of the material; Smirnov I.E. — editing the text. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.Acknowledgments. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.</p></sec><sec><title>Received</title><p>Received: January 18, 2026Accepted: February 10, 2026Published: February 27, 2026</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>дети</kwd><kwd>лёгкая черепно-мозговая травма</kwd><kwd>сотрясение головного мозга</kwd><kwd>маркеры повреждения мозга</kwd><kwd>глутаматные рецепторы</kwd><kwd>активные формы азота</kwd></kwd-group><kwd-group xml:lang="en"><kwd>children</kwd><kwd>mild traumatic brain injury</kwd><kwd>brain concussion</kwd><kwd>markers of brain damage</kwd><kwd>glutamate receptors</kwd><kwd>active forms of nitrogen</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Dewan M.C., Mummareddy N., Wellons J.C. 3rd, Bonfield C.M. Epidemiology of global pediatric traumatic brain injury: qualitative review. 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