Thakur Manisha, Vasudeva Neeru, Sharma Sunil, Datusalia Ashok Kumar
Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science & Technology, Hisar, Haryana, India.
Department of Pharmacology and Toxicology/Regulatory Toxicology, National Institute of Pharmaceutical Education and Research, Raebareli, Uttar Pradesh, India.
CNS Neurol Disord Drug Targets. 2022 Aug 30. doi: 10.2174/1871527321666220830164432.
BACKGROUND & OBJECTIVE: Traumatic brain injury is an outcome of the physical or mechanical impact of external forces on the brain. Thus, the silent epidemic has complex pathophysiology affecting the brain along with extracranial or systemic complications in more than one organ system, including the heart, lungs, liver, kidney, gastrointestinal and endocrine system. which is referred to as Multi-Organ Dysfunction Syndrome. It is driven by three interconnected mechanisms such as systemic hyperinflammation, paroxysmal sympathetic hyperactivity, and immunosuppression-induced sepsis. These multifaceted pathologies accelerate the risk of mortality in clinical settings by interfering with the functions of distant organs through hypertension, cardiac arrhythmias, acute lung injury, neurogenic pulmonary edema, reduced gastrointestinal motility, Cushing ulcers, acute liver failure, acute kidney injury, coagulopathy, endocrine dysfunction, and many other impairments. The pharmaceutical treatment approach for this is highly specific in its mode of action and linked to a variety of side effects, including hallucinations, seizures, anaphylaxis, teeth, bone staining, etc. Therefore, alternative natural medicine treatments are widely accepted due to their broad complementary or synergistic effects on the physiological system with minor side effects.
This review is a compilation of the possible mechanisms behind the occurrence of multiorgan dysfunction and reported medicinal plants with organoprotective activity that have not been yet explored against traumatic brain injury and thereby, highlighting the marked possibilities of their effectiveness in the management of multiorgan dysfunction. As a result, we attempted to respond to the hypothesis against the usage of medicinal plants to treat neurodegenerative diseases.
创伤性脑损伤是外力对大脑造成物理或机械冲击的结果。因此,这一隐匿性疾病具有复杂的病理生理学,不仅会影响大脑,还会引发多个器官系统(包括心脏、肺、肝脏、肾脏、胃肠道和内分泌系统)的颅外或全身并发症,即多器官功能障碍综合征。它由全身炎症反应、阵发性交感神经过度兴奋和免疫抑制诱发的脓毒症这三种相互关联的机制驱动。这些多方面的病理状况通过高血压、心律失常、急性肺损伤、神经源性肺水肿、胃肠蠕动减弱、库欣溃疡、急性肝衰竭、急性肾损伤、凝血功能障碍、内分泌功能障碍以及许多其他损害,干扰远处器官的功能,从而增加了临床环境中的死亡风险。针对这种情况的药物治疗方法作用方式高度特异,且伴有多种副作用,包括幻觉、癫痫发作、过敏反应、牙齿和骨骼染色等。因此,替代天然药物治疗因其对生理系统具有广泛的互补或协同作用且副作用较小而被广泛接受。
本综述汇总了多器官功能障碍发生背后的可能机制,以及已报道的具有器官保护活性但尚未针对创伤性脑损伤进行研究的药用植物,从而突出了它们在治疗多器官功能障碍方面显著的有效性可能性。因此,我们试图回应关于使用药用植物治疗神经退行性疾病的假说。