Hiebert John B, Shen Qiuhua, Thimmesch Amanda R, Pierce Janet D
School of Nursing, University of Kansas, Kansas City, Kansas.
Am J Med Sci. 2015 Aug;350(2):132-8. doi: 10.1097/MAJ.0000000000000506.
Traumatic brain injury (TBI) is a major cause of death and disability in the United States and causes mitochondrial damage leading to impaired brain function. The purpose of this review is to (1) describe TBI processes and manifestations, (2) examine the mitochondrial alterations after TBI, specifically increased reactive oxygen species production, decreased bioenergetics and apoptosis and (3) current TBI treatments. There are various degrees of severity of TBI, yet all affect mitochondrial function. Currently, health care professionals use various methods to assess TBI severity-from brain imaging to serum biomarkers. The major cause of TBI-associated brain damage is secondary injury, which is mainly from mitochondrial injury dysfunction. Mitochondrial injury leads to oxidative stress and subsequent apoptosis and decreased cellular energy production. These brain cellular alterations impair neurologic functions, which are observed in individuals with TBI. The complex mitochondrial dysfunction after TBI requires treatment that specifically addresses the secondary injury. There are numerous therapies being used, including (1) hypothermia, (2) hyperbaric oxygen, (3) exercise and (4) antioxidants. Researchers are exploring novel approaches to prevent, diagnose and treat TBI focusing on maintaining mitochondrial function.
创伤性脑损伤(TBI)是美国死亡和残疾的主要原因,会导致线粒体损伤,进而损害脑功能。本综述的目的是:(1)描述TBI的过程和表现;(2)研究TBI后的线粒体改变,特别是活性氧生成增加、生物能量学降低和细胞凋亡;(3)介绍当前的TBI治疗方法。TBI有不同程度的严重程度,但都会影响线粒体功能。目前,医护人员使用各种方法来评估TBI的严重程度——从脑部成像到血清生物标志物。TBI相关脑损伤的主要原因是继发性损伤,主要源于线粒体损伤功能障碍。线粒体损伤会导致氧化应激以及随后的细胞凋亡和细胞能量产生减少。这些脑细胞改变会损害神经功能,在TBI患者中可以观察到。TBI后复杂的线粒体功能障碍需要专门针对继发性损伤的治疗方法。目前正在使用多种疗法,包括:(1)低温疗法;(2)高压氧疗法;(3)运动疗法;(4)抗氧化剂疗法。研究人员正在探索预防、诊断和治疗TBI的新方法,重点是维持线粒体功能。