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创伤性脑损伤的神经保护策略:研究不同临床方法的有效性。

Neuroprotection strategies in traumatic brain injury: Studying the effectiveness of different clinical approaches.

作者信息

Buccilli Barbara, Alan Albert, Baha' Aljeradat, Shahzad Akmal, Almealawy Yasser F, Chisvo Nathan Simbarashe, Ennabe Michelle, Weinand Martin

机构信息

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States.

Global Neurosurgical Alliance, United States.

出版信息

Surg Neurol Int. 2024 Jan 26;15:29. doi: 10.25259/SNI_773_2023. eCollection 2024.

Abstract

BACKGROUND

This review delves into clinical strategies aimed at addressing the complexities of traumatic brain injury (TBI), specifically focusing on pharmaceutical interventions and stem cell therapies as potential avenues for enhancing TBI outcomes.

METHODS

A thorough review of clinical strategies for TBI management, encompassing pharmaceutical and nonpharmaceutical interventions, was performed. PubMed, MEDLINE and clinical trial databases were searched to identify relevant studies and clinical trials. Inclusion criteria consisted of studies involving pharmaceutical agents and other clinical approaches (i.e., stem cell therapies) targeting neuroinflammation, excitotoxicity, oxidative stress, and neurodegeneration in TBI. Data from clinical trials and ongoing research initiatives were analyzed to assess the current status and potential of these clinical approaches.

RESULTS

Many trials have been conducted to face the challenge that is TBI. These interventions are designed to target critical aspects of secondary brain injury, encompassing neuroinflammation, excitotoxicity, oxidative stress, and neurodegeneration. Despite this, there is no panacea or definitive remedy for this condition. Combining therapies in a patient-tailored approach seems to be our best chance to improve these patients' outcomes, but systematic protocols are needed.

CONCLUSION

Clinical strategies represent dynamic and continually evolving pathways in TBI management. This review provides an extensive overview of the existing landscape of clinical approaches and promising new studies and outlines their influence on patient outcomes. By highlighting challenges and presenting opportunities, it contributes to the ongoing mission to advance clinical care for individuals impacted by TBI.

摘要

背景

本综述深入探讨针对创伤性脑损伤(TBI)复杂性的临床策略,特别关注药物干预和干细胞疗法作为改善TBI预后的潜在途径。

方法

对TBI管理的临床策略进行了全面综述,包括药物和非药物干预。检索了PubMed、MEDLINE和临床试验数据库以确定相关研究和临床试验。纳入标准包括涉及针对TBI中神经炎症、兴奋性毒性、氧化应激和神经退行性变的药物制剂和其他临床方法(即干细胞疗法)的研究。对临床试验和正在进行的研究计划的数据进行了分析,以评估这些临床方法的现状和潜力。

结果

已经开展了许多试验来应对TBI这一挑战。这些干预措施旨在针对继发性脑损伤的关键方面,包括神经炎症、兴奋性毒性、氧化应激和神经退行性变。尽管如此,对于这种疾病并没有万灵药或确定的治疗方法。以患者为导向的联合治疗似乎是改善这些患者预后的最佳机会,但需要系统的方案。

结论

临床策略是TBI管理中动态且不断发展的途径。本综述对现有临床方法的格局以及有前景的新研究进行了广泛概述,并概述了它们对患者预后的影响。通过突出挑战并呈现机会,它有助于推进对受TBI影响个体的临床护理这一持续使命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b168/10858774/eb58e528c3ad/SNI-15-29-g001.jpg

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