Bhargavi K M, Gowthami Niya, Chetan G K, Srinivas Bharath M M
Department of Clinical Psychopharmacology and Neurotoxicology (CPNT), National Institute of Mental Health and Neurosciences (NIMHANS), No. 2900, Hosur Road, Bangalore, 560029, India; Department of Human Genetics, NIMHANS, No. 2900, Hosur Road, Bangalore, 560029, India.
Department of Clinical Psychopharmacology and Neurotoxicology (CPNT), National Institute of Mental Health and Neurosciences (NIMHANS), No. 2900, Hosur Road, Bangalore, 560029, India.
Neurochem Int. 2025 Jan;182:105904. doi: 10.1016/j.neuint.2024.105904. Epub 2024 Nov 16.
Traumatic Brain Injury (TBI) is a global healthcare concern with considerable mortality and morbidity. Early diagnosis and timely treatment are critical for optimal clinical prognosis in TBI patients. Injury to the brain tissue following TBI is categorized into primary and secondary injury events, with the former being acute, while the latter evolves over a long period. Although surgical intervention is effective to treat primary injury, secondary injury events that could contribute to long term neurological deterioration, cognitive impairment and neurodegeneration do not have appropriate pharmacotherapy. To address this lacuna, studies based on modern medicine to explore novel drugs in TBI have met with limited success. This has led to focussed efforts to assess natural products capable of targeting multiple pathways in TBI. Complex natural mixtures and isolated phytochemicals capable of targeting redox mechanisms, neuroinflammation, mitochondrial dysfunction, cell death pathways and other specific targets etc. have been characterized. However, the field has met with certain limitations and challenges with inadequate clinical studies and trials being the most important concern. The current review provides an overview of the dietary factors, nutraceuticals, natural extracts, and phytochemicals that could be potentially applied in neuroprotection, TBI therapy and long-term management of cognitive symptoms and other neurological deficits.
创伤性脑损伤（TBI）是一个全球性的医疗问题，具有相当高的死亡率和发病率。早期诊断和及时治疗对于TBI患者的最佳临床预后至关重要。TBI后脑组织损伤分为原发性和继发性损伤事件，前者是急性的，而后者则在很长一段时间内演变。虽然手术干预对治疗原发性损伤有效，但可能导致长期神经功能恶化、认知障碍和神经退行性变的继发性损伤事件尚无合适的药物治疗方法。为了解决这一空白，基于现代医学探索TBI新型药物的研究取得的成功有限。这促使人们集中精力评估能够靶向TBI中多种途径的天然产物。能够靶向氧化还原机制、神经炎症、线粒体功能障碍、细胞死亡途径和其他特定靶点等的复杂天然混合物和分离的植物化学物质已得到表征。然而，该领域面临着一定的局限性和挑战，其中临床研究和试验不足是最重要的问题。本综述概述了可能应用于神经保护、TBI治疗以及认知症状和其他神经功能缺损的长期管理的饮食因素、营养保健品、天然提取物和植物化学物质。
