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炎症小体处于创伤性脑损伤和创伤后癫痫的交叉点。

Inflammasomes at the crossroads of traumatic brain injury and post-traumatic epilepsy.

作者信息

Javalgekar Mohit, Jupp Bianca, Vivash Lucy, O'Brien Terence J, Wright David K, Jones Nigel C, Ali Idrish

机构信息

The Department of Neuroscience, School of Translational Medicine, Monash University, 99, Commercial Road, Melbourne, Australia.

Department of Neurology, The Alfred Hospital, 99 commercial road, Melbourne, Australia.

出版信息

J Neuroinflammation. 2024 Jul 16;21(1):172. doi: 10.1186/s12974-024-03167-8.

Abstract

Post-traumatic epilepsy (PTE) is one of the most debilitating consequences of traumatic brain injury (TBI) and is one of the most drug-resistant forms of epilepsy. Novel therapeutic treatment options are an urgent unmet clinical need. The current focus in healthcare has been shifting to disease prevention, rather than treatment, though, not much progress has been made due to a limited understanding of the disease pathogenesis. Neuroinflammation has been implicated in the pathophysiology of traumatic brain injury and may impact neurological sequelae following TBI including functional behavior and post-traumatic epilepsy development. Inflammasome signaling is one of the major components of the neuroinflammatory response, which is increasingly being explored for its contribution to the epileptogenic mechanisms and a novel therapeutic target against epilepsy. This review discusses the role of inflammasomes as a possible connecting link between TBI and PTE with a particular focus on clinical and preclinical evidence of therapeutic inflammasome targeting and its downstream effector molecules for their contribution to epileptogenesis. Finally, we also discuss emerging evidence indicating the potential of evaluating inflammasome proteins in biofluids and the brain by non-invasive neuroimaging, as potential biomarkers for predicting PTE development.

摘要

创伤后癫痫(PTE)是创伤性脑损伤(TBI)最具致残性的后果之一,也是最难治疗的癫痫类型之一。新型治疗方案是目前尚未满足的迫切临床需求。尽管目前医疗保健的重点已转向疾病预防而非治疗,但由于对该疾病发病机制的了解有限,进展甚微。神经炎症与创伤性脑损伤的病理生理学有关,可能会影响TBI后的神经后遗症,包括功能行为和创伤后癫痫的发展。炎性小体信号传导是神经炎症反应的主要组成部分之一,人们越来越多地探索其在癫痫发生机制中的作用以及作为抗癫痫新治疗靶点的可能性。本综述讨论了炎性小体作为TBI和PTE之间可能的联系环节的作用,特别关注针对炎性小体治疗及其下游效应分子对癫痫发生作用的临床和临床前证据。最后,我们还讨论了新出现的证据,这些证据表明通过非侵入性神经成像评估生物流体和大脑中的炎性小体蛋白作为预测PTE发展的潜在生物标志物的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f49b/11250980/e4a08762da11/12974_2024_3167_Figa_HTML.jpg

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