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辐射诱导的脑损伤:机制洞察与肠-脑轴疗法的前景

Radiation-Induced Brain Injury: Mechanistic Insights and the Promise of Gut-Brain Axis Therapies.

作者信息

Li Mengting, Tong Fan, Wu Bian, Dong Xiaorong

机构信息

Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Hubei Key Laboratory of Precision Radiation Oncology, Wuhan 430022, China.

出版信息

Brain Sci. 2024 Dec 23;14(12):1295. doi: 10.3390/brainsci14121295.

Abstract

Radiation therapy is widely recognized as an efficacious modality for treating neoplasms located within the craniofacial region. Nevertheless, this approach is not devoid of risks, predominantly concerning potential harm to the neural structures. Adverse effects may encompass focal cerebral necrosis, cognitive function compromise, cerebrovascular pathology, spinal cord injury, and detriment to the neural fibers constituting the brachial plexus. With increasing survival rates among oncology patients, evaluating post-treatment quality of life has become crucial in assessing the benefits of radiation therapy. Consequently, it is imperative to investigate therapeutic strategies to mitigate cerebral complications from radiation exposure. Current management of radiation-induced cerebral damage involves corticosteroids and bevacizumab, with preclinical research on antioxidants and thalidomide. Despite these efforts, an optimal treatment remains elusive. Recent studies suggest the gut microbiota's involvement in neurologic pathologies. This review aims to discuss the causes and existing treatments for radiation-induced cerebral injury and explore gut microbiota modulation as a potential therapeutic strategy.

摘要

放射治疗被广泛认为是治疗位于颅面部区域肿瘤的一种有效方式。然而,这种方法并非没有风险,主要涉及对神经结构的潜在损害。不良反应可能包括局灶性脑坏死、认知功能受损、脑血管病变、脊髓损伤以及对构成臂丛神经的神经纤维的损害。随着肿瘤患者生存率的提高,评估放疗后的生活质量已成为评估放射治疗益处的关键。因此,研究减轻辐射暴露引起的脑部并发症的治疗策略势在必行。目前对放射性脑损伤的处理包括使用皮质类固醇和贝伐单抗,同时对抗氧化剂和沙利度胺进行了临床前研究。尽管做出了这些努力,但最佳治疗方法仍难以捉摸。最近的研究表明肠道微生物群与神经病理学有关。本综述旨在讨论放射性脑损伤的原因和现有治疗方法,并探索调节肠道微生物群作为一种潜在的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e62/11674909/7423d5256765/brainsci-14-01295-g001.jpg

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