Mammis Antonios, McIntosh Tracy K, Maniker Allen H
Department of Neurosurgery, UMDNJ New Jersey Medical School, Newark, NJ 07103, USA.
Surg Neurol. 2009 May;71(5):527-31; discussion 531. doi: 10.1016/j.surneu.2008.02.040. Epub 2008 Sep 11.
In the United States, TBI remains a major cause of morbidity and mortality in children and young adults. A total of 1.5 million Americans experience head trauma every year, and the yearly economic cost of this exceeds $56 billion. The magnitude of this problem has generated a great deal of interest in elucidating the complex molecular mechanism underlying cell death and dysfunction after TBI and in the development of neuroprotective agents that will reduce morbidity and mortality.
A review of recent literature on EPO, TBI, and apoptosis is conducted with analysis of pathophysiologic mechanisms of TBI. In addition, animal experiments and clinical trials pertaining to mechanisms of cell death in TBI and EPO as a neuroprotective agent are reviewed.
The literature and evidence for EPO as a potent inhibitor of apoptosis and promising therapeutic agent in a variety of neurological insults, including trauma, are mounting. With the recent interest in clinical trials of EPO in human stroke, it is both timely and prudent to consider the use of this pharmaceutical avenue in TBI in man.
在美国，创伤性脑损伤（TBI）仍然是儿童和年轻人发病和死亡的主要原因。每年共有150万美国人遭受头部创伤，其每年的经济成本超过560亿美元。这个问题的严重性引发了人们对阐明TBI后细胞死亡和功能障碍背后复杂分子机制的极大兴趣，以及对开发能降低发病率和死亡率的神经保护剂的兴趣。
对近期有关促红细胞生成素（EPO）、TBI和细胞凋亡的文献进行综述，并分析TBI的病理生理机制。此外，还综述了与TBI中细胞死亡机制以及EPO作为神经保护剂相关的动物实验和临床试验。
越来越多的文献和证据表明，EPO作为一种有效的细胞凋亡抑制剂，在包括创伤在内的各种神经损伤中是一种有前景的治疗药物。鉴于近期人们对EPO在人类中风临床试验的兴趣，考虑在人类TBI中采用这种药物途径既及时又谨慎。
