Department of Anesthesiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA.
Exp Brain Res. 2021 Oct;239(10):2939-2950. doi: 10.1007/s00221-021-06178-6. Epub 2021 Jul 29.
Traumatic brain injury (TBI) is one of the main causes of death and disability in both civilian and military population. TBI may occur via a variety of etiologies, all of which involve trauma to the head. However, the neuroprotective drugs which were found to be very effective in animal TBI models failed in phase II or phase III clinical trials, emphasizing a compelling need to review the current status of animal TBI models and therapeutic strategies. No single animal model can adequately mimic all aspects of human TBI owing to the heterogeneity of clinical TBI. However, due to the ethical limitations, it is difficult to precisely emulate the TBI mechanisms that occur in humans. Therefore, many animal models with varying severity and mechanisms of brain injury have been developed, and each model has its own pros and cons in its implementation for TBI research. These challenges pose a need for study of continued TBI mechanisms, brain injury severity, duration, treatment strategies, and optimization of animal models across the neurotrauma research community. The aim of this review is to discuss (1) causes of TBI, (2) its prevalence in military and civilian population, (3) classification and pathophysiology of TBI, (4) biomarkers and detection methods, (5) animal models of TBI, and (6) the advantages and disadvantages of each model and the species used, as well as possible treatments.
创伤性脑损伤(TBI)是民用和军用人群中死亡和残疾的主要原因之一。TBI 可能由多种病因引起,所有这些病因都涉及头部创伤。然而,在动物 TBI 模型中发现的神经保护药物在 II 期或 III 期临床试验中失败,这强调了迫切需要审查当前的动物 TBI 模型和治疗策略的现状。由于临床 TBI 的异质性,没有单一的动物模型可以充分模拟人类 TBI 的所有方面。然而,由于伦理限制,很难精确模拟在人类中发生的 TBI 机制。因此,已经开发了许多具有不同严重程度和脑损伤机制的动物模型,每种模型在用于 TBI 研究时都有其自身的优缺点。这些挑战需要持续研究 TBI 机制、脑损伤严重程度、持续时间、治疗策略,并在神经创伤研究界优化动物模型。本文的目的是讨论(1)TBI 的原因,(2)其在军民人群中的流行程度,(3)TBI 的分类和病理生理学,(4)生物标志物和检测方法,(5)TBI 的动物模型,以及(6)每种模型和所用物种的优缺点,以及可能的治疗方法。