Burke Neurological Institute.
Brain and Mind Research Institute.
Curr Opin Neurol. 2019 Dec;32(6):815-821. doi: 10.1097/WCO.0000000000000752.
This review aims to discuss examples of changes in glucose (sugar) metabolism after traumatic brain injury (TBI). It will attempt to provide an understanding of what changes in glucose metabolism mean for the injured brain. It will further identify potential therapeutic target(s) emanating from our growing understanding of glucose pathways and their roles in TBI.
Although a significant fraction of glucose is utilized for the energy production in the brain, a small fraction is utilized in other, often ignored pathways. Recent studies have unraveled unexpected biological effects of glucose through these pathways, including redox regulation, genetic and epigenetic regulation, glycation of proteins, nucleotide synthesis and amino acid synthesis.
A number of regulatory players in minor glucose metabolic pathways, such as folate and chondroitin sulfate proteoglycans, have recently been identified as potential targets to restore cognitive functions. Targeting of these players should be combined with the supplementation of alternative energy substrates to achieve the maximal cognitive restoration after TBI. This multimodal therapeutic strategy deserves testing in various models of TBI.
Supplemental digital video content 1: Video that demonstrates an effective therapeutic strategy for the cognitive restoration after TBI. http://links.lww.com/CONR/A46.
本文旨在讨论创伤性脑损伤（TBI）后葡萄糖（糖）代谢变化的实例。本文将尝试探讨葡萄糖代谢变化对受损大脑意味着什么，并进一步确定潜在的治疗靶点，这些靶点源自我们对葡萄糖途径及其在 TBI 中的作用的理解不断加深。
尽管大脑中很大一部分葡萄糖用于能量产生，但一小部分葡萄糖用于其他经常被忽视的途径。最近的研究通过这些途径揭示了葡萄糖出人意料的生物学效应，包括氧化还原调节、遗传和表观遗传调节、蛋白质糖化、核苷酸合成和氨基酸合成。
最近发现，一些次要葡萄糖代谢途径中的调节因子，如叶酸和软骨素硫酸蛋白聚糖，可能是恢复认知功能的潜在靶点。这些靶点的靶向治疗应与替代能量底物的补充相结合，以实现 TBI 后最大程度的认知恢复。这种多模式治疗策略值得在各种 TBI 模型中进行测试。
补充数字视频内容 1：展示 TBI 后认知恢复的有效治疗策略的视频。http://links.lww.com/CONR/A46。
