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. 2020 Nov 30;21(23):9144. doi: 10.3390/ijms21239144

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© 2020 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Stress induced rise in interleukin (IL)-1, IL-6, and cortisol levels as well as SNS activation causes peripheral insulin resistance, a Glu-OCN-drop and an increased leptin synthesis. In impaired blood brain barrier (BBB) after traumatic brain injury (TBI) central leptin levels and central effects are extremely increased, causing unphysiologic SNS-activation, Glu-OCN drop and disinhibition of bone formation after TBI which possibly causes the phenomenon of accelerated bone healing after combined bony and central trauma.