Soltani Zahra, Nazari Masoud, Babaei Meisam, Shakeri Habibesadat, Jalali Sediqeh, Hajali Vahid, Keshavarzi Zakieh
Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Afzalipor Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
College of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Acta Neurol Belg. 2025 Mar 7. doi: 10.1007/s13760-025-02755-6.
Traumatic brain injury (TBI) is a widespread, serious public health concern with substantial lasting effects, such as impacting the endocrine system. Here, we review the complications and consequences of TBI on the hypothalamic-pituitary axis (HPA) and connected endocrine glands, which are essential for maintaining body balance. Endocrine dysfunctions caused by TBI, especially hypopituitarism, can result in hormonal imbalances that impact various physiological systems, such as growth, metabolism, reproduction, and stress responses. These dysfunctions can cause issues like adrenal insufficiency, hypothyroidism, and hypogonadism, greatly affecting the quality of life of survivors. In cases of moderate to severe TBI, up to 40% of individuals may suffer from post-TBI hypopituitarism, leading to extended morbidity. The introduced treatment methods concentrate on different therapeutic options, including hormone replacement therapies (HRTs) (corticosteroid, growth, thyroid, and sex hormones replacement therapies), emerging plant-based bioactive compounds, and other options to address particular deficiencies. Simultaneously, there is a growing interest in novel bioactive compounds derived from plants because of their neuroprotective and anti-inflammatory properties. In addition, certain populations, such as veterans and children, are more likely to develop endocrine dysfunction due to TBI. Comprehensive, cross-disciplinary care and individualized treatment plans are crucial to improve outcomes and long-term recovery for TBI patients. Further investigation is needed to enhance diagnostic instruments, explore novel therapies, and establish predictive biomarkers for early intervention in TBI-induced endocrine disorders.
创伤性脑损伤（TBI）是一个广泛存在的严重公共卫生问题，具有重大的长期影响，例如对内分泌系统产生影响。在此，我们综述TBI对下丘脑 - 垂体轴（HPA）及相关内分泌腺的并发症和后果，这些对于维持身体平衡至关重要。TBI引起的内分泌功能障碍，尤其是垂体功能减退，可导致激素失衡，进而影响各种生理系统，如生长、代谢、生殖和应激反应。这些功能障碍可引发肾上腺功能不全、甲状腺功能减退和性腺功能减退等问题，极大地影响幸存者的生活质量。在中度至重度TBI病例中，高达40%的个体可能会出现创伤后垂体功能减退，导致发病期延长。所介绍的治疗方法集中在不同的治疗选择上，包括激素替代疗法（HRTs）（皮质类固醇、生长激素、甲状腺激素和性激素替代疗法）、新兴的植物源生物活性化合物以及其他针对特定缺陷的选择。同时，由于植物源新型生物活性化合物具有神经保护和抗炎特性，人们对其的兴趣与日俱增。此外，某些人群，如退伍军人和儿童，因TBI更易发生内分泌功能障碍。全面、跨学科的护理和个性化治疗方案对于改善TBI患者的预后和长期康复至关重要。需要进一步研究以改进诊断工具、探索新疗法并建立预测生物标志物，以便对TBI诱发的内分泌紊乱进行早期干预。
