Department of Neurology, University of Missouri, Columbia, Missouri, USA.
GMERS Medical College and Hospital, Sola, Ahmedabad.
Curr Opin Clin Nutr Metab Care. 2024 Mar 1;27(2):168-177. doi: 10.1097/MCO.0000000000001008. Epub 2024 Jan 3.
Traumatic brain injury (TBI) is a significant public health concern with substantial morbidity and mortality rates in the United States. Current management strategies primarily focus on symptomatic approaches and prevention of secondary complications. However, recent research highlights the potential role of ketone bodies, particularly beta-hydroxybutyrate (BHB), in modulating cellular processes involved in TBI. This article reviews the metabolism of BHB, its effect in TBI, and its potential therapeutic impact in TBI.
BHB can be produced endogenously through fasting or administered exogenously through ketogenic diets, and oral or intravenous supplements. Studies suggest that BHB may offer several benefits in TBI, including reducing oxidative stress, inflammation, controlling excitotoxicity, promoting mitochondrial respiration, and supporting brain regeneration. Various strategies to modulate BHB levels are discussed, with exogenous ketone preparations emerging as a rapid and effective option.
BHB offers potential therapeutic advantages in the comprehensive approach to improve outcomes for TBI patients. However, careful consideration of safety and efficacy is essential when incorporating it into TBI treatment protocols. The timing, dosage, and long-term effects of ketone use in TBI patients require further investigation to fully understand its potential benefits and limitations.
创伤性脑损伤(TBI)是一个重大的公共健康问题,其发病率和死亡率在美国都很高。目前的治疗策略主要集中在对症治疗和预防继发性并发症上。然而,最近的研究强调了酮体,特别是β-羟丁酸(BHB)在调节与 TBI 相关的细胞过程中的潜在作用。本文综述了 BHB 的代谢、在 TBI 中的作用以及在 TBI 中的潜在治疗作用。
BHB 可以通过禁食在体内产生,也可以通过生酮饮食、口服或静脉补充剂在体外产生。研究表明,BHB 可能对 TBI 有多种益处,包括减轻氧化应激、炎症、控制兴奋性毒性、促进线粒体呼吸和支持大脑再生。讨论了几种调节 BHB 水平的策略,外源性酮制剂作为一种快速有效的选择出现。
BHB 在改善 TBI 患者预后的综合治疗方法中具有潜在的治疗优势。然而,在将其纳入 TBI 治疗方案时,必须仔细考虑安全性和有效性。酮类物质在 TBI 患者中的使用时机、剂量和长期效果需要进一步研究,以充分了解其潜在的益处和局限性。