Vonder Haar Cole, Peterson Todd C, Martens Kris M, Hoane Michael R
University of British Columbia, Vancouver, BC, Canada.
Stanford University, Palo Alto, CA, USA.
Brain Res. 2016 Jun 1;1640(Pt A):114-129. doi: 10.1016/j.brainres.2015.12.030. Epub 2015 Dec 23.
With the numerous failures of pharmaceuticals to treat traumatic brain injury in humans, more researchers have become interested in combination therapies. This is largely due to the multimodal nature of damage from injury, which causes excitotoxicity, oxidative stress, edema, neuroinflammation and cell death. Polydrug treatments have the potential to target multiple aspects of the secondary injury cascade, while many previous therapies focused on one particular aspect. Of specific note are vitamins, minerals and nutrients that can be utilized to supplement other therapies. Many of these have low toxicity, are already FDA approved and have minimal interactions with other drugs, making them attractive targets for therapeutics. Over the past 20 years, interest in supplementation and supraphysiologic dosing of nutrients for brain injury has increased and indeed many vitamins and nutrients now have a considerable body of the literature backing their use. Here, we review several of the prominent therapies in the category of nutraceutical treatment for brain injury in experimental models, including vitamins (B2, B3, B6, B9, C, D, E), herbs and traditional medicines (ginseng, Gingko biloba), flavonoids, and other nutrients (magnesium, zinc, carnitine, omega-3 fatty acids). While there is still much work to be done, several of these have strong potential for clinical therapies, particularly with regard to polydrug regimens. This article is part of a Special Issue entitled SI:Brain injury and recovery.
由于众多药物在治疗人类创伤性脑损伤方面失败，越来越多的研究人员对联合疗法产生了兴趣。这主要是由于损伤造成的多模式性质，它会导致兴奋性毒性、氧化应激、水肿、神经炎症和细胞死亡。多种药物治疗有可能针对继发性损伤级联反应的多个方面，而许多先前的疗法只关注一个特定方面。特别值得注意的是可用于补充其他疗法的维生素、矿物质和营养物质。其中许多毒性低，已获得美国食品药品监督管理局（FDA）批准，并且与其他药物的相互作用最小，这使得它们成为有吸引力的治疗靶点。在过去20年里，人们对补充营养物质以及对脑损伤进行超生理剂量给药的兴趣有所增加，事实上现在许多维生素和营养物质都有大量文献支持它们的使用。在这里，我们综述了实验模型中脑损伤营养治疗类别中的几种主要疗法，包括维生素（B2、B3、B6、B9、C、D、E）、草药和传统药物（人参、银杏）、类黄酮以及其他营养物质（镁、锌、肉碱、ω-3脂肪酸）。虽然仍有许多工作要做，但其中几种疗法具有很强的临床治疗潜力，特别是在多种药物联合治疗方案方面。本文是名为“SI：脑损伤与恢复”的特刊的一部分。
