Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China. Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China.
Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China. Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China. Neuroendocrinology Group, Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney, Australia.
Nutr Rev. 2023 Jul 10;81(8):1051-1062. doi: 10.1093/nutrit/nuac099.
The neurovascular unit (NVU) is composed of neurons, glial cells, and blood vessels. NVU dysfunction involves the processes of neuroinflammation, and microcirculatory disturbances, as well as neuronal injury after traumatic brain injury (TBI). Traditional anti-inflammatory drugs have limited efficacy in improving the prognosis of TBI. Thus, treatments that target NVU dysfunction may provide a breakthrough. A large number of clinical studies have shown that the nutritional status of patients with TBI was closely related to their conditions and prognoses. Nutrient complexes and complementary therapies for the treatment of TBI are therefore being implemented in many preclinical studies. Importantly, the mechanism of action for this treatment may be related to repair of NVU dysfunction by ensuring adequate omega-3 fatty acids, curcumin, resveratrol, apigenin, vitamins, and minerals. These nutritional supplements hold promise for translation to clinical therapy. In addition, dietary habits also play an important role in the rehabilitation of TBI. Poor dietary habits may worsen the pathology and prognosis of TBI. Adjusting dietary habits, especially with a ketogenic diet, may improve outcomes in patients with TBI. This article discusses the impact of clinical nutrition on NVU dysfunction after TBI, focusing on nutritional complexes and dietary habits.
神经血管单元 (NVU) 由神经元、神经胶质细胞和血管组成。NVU 功能障碍涉及神经炎症和微循环障碍过程,以及创伤性脑损伤 (TBI) 后的神经元损伤。传统的抗炎药物在改善 TBI 预后方面效果有限。因此,针对 NVU 功能障碍的治疗方法可能是一个突破。大量临床研究表明,TBI 患者的营养状况与其病情和预后密切相关。因此,许多临床前研究正在实施针对 TBI 的营养复合物和补充疗法。重要的是,这种治疗的作用机制可能与通过确保足够的ω-3 脂肪酸、姜黄素、白藜芦醇、芹菜素、维生素和矿物质来修复 NVU 功能障碍有关。这些营养补充剂有望转化为临床治疗。此外,饮食习惯在 TBI 的康复中也起着重要作用。不良的饮食习惯可能会使 TBI 的病理和预后恶化。调整饮食习惯,特别是生酮饮食,可能会改善 TBI 患者的预后。本文讨论了临床营养对 TBI 后 NVU 功能障碍的影响,重点讨论了营养复合物和饮食习惯。