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创新视角下的创伤性脑损伤:生物标志物和新的药物靶点。

Innovative Insights into Traumatic Brain Injuries: Biomarkers and New Pharmacological Targets.

机构信息

IRCCS Centro Neurolesi Bonino Pulejo, Via Provinciale Palermo, SS 113, Contrada Casazza, 98124 Messina, Italy.

出版信息

Int J Mol Sci. 2024 Feb 17;25(4):2372. doi: 10.3390/ijms25042372.

Abstract

A traumatic brain injury (TBI) is a major health issue affecting many people across the world, causing significant morbidity and mortality. TBIs often have long-lasting effects, disrupting daily life and functionality. They cause two types of damage to the brain: primary and secondary. Secondary damage is particularly critical as it involves complex processes unfolding after the initial injury. These processes can lead to cell damage and death in the brain. Understanding how these processes damage the brain is crucial for finding new treatments. This review examines a wide range of literature from 2021 to 2023, focusing on biomarkers and molecular mechanisms in TBIs to pinpoint therapeutic advancements. Baseline levels of biomarkers, including neurofilament light chain (NF-L), ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), Tau, and glial fibrillary acidic protein (GFAP) in TBI, have demonstrated prognostic value for cognitive outcomes, laying the groundwork for personalized treatment strategies. In terms of pharmacological progress, the most promising approaches currently target neuroinflammation, oxidative stress, and apoptotic mechanisms. Agents that can modulate these pathways offer the potential to reduce a TBI's impact and aid in neurological rehabilitation. Future research is poised to refine these therapeutic approaches, potentially revolutionizing TBI treatment.

摘要

创伤性脑损伤 (TBI) 是一个全球性的重大健康问题,影响着许多人,导致高发病率和死亡率。TBI 通常会产生长期影响,扰乱日常生活和功能。TBI 会对大脑造成两种类型的损伤:原发性和继发性。继发性损伤尤其关键,因为它涉及初始损伤后发生的复杂过程。这些过程会导致大脑中的细胞损伤和死亡。了解这些过程如何损伤大脑对于寻找新的治疗方法至关重要。本综述考察了 2021 年至 2023 年的大量文献,重点关注 TBI 中的生物标志物和分子机制,以确定治疗进展。TBI 中生物标志物(包括神经丝轻链 (NF-L)、泛素羧基末端水解酶-L1 (UCH-L1)、Tau 和胶质纤维酸性蛋白 (GFAP))的基线水平对认知结果具有预后价值,为个性化治疗策略奠定了基础。就药物学进展而言,目前最有前途的方法主要针对神经炎症、氧化应激和细胞凋亡机制。能够调节这些途径的药物有潜力减轻 TBI 的影响并促进神经康复。未来的研究有望完善这些治疗方法,有可能彻底改变 TBI 的治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9853/10889179/fe31c13ef687/ijms-25-02372-g001.jpg

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