Zhang Wei, Zou Jun, Zhang Lingli
School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, China.
College of Athletic Performance, Shanghai University of Sport, Shanghai, 200438, China.
Adv Sci (Weinh). 2025 Aug;12(31):e03149. doi: 10.1002/advs.202503149. Epub 2025 Jul 14.
Traumatic brain injury (TBI), which refers to damage caused by external forces to the brain, significantly affects systemic organs and tissues, especially bone homeostasis. An increasing number of studies have revealed bidirectional crosstalk between the brain and bone, and the interactions between these systems in the context of TBI remain unclear. Here, existing research on the relationship between the brain and bone is summarized to explore their interactions and underlying mechanisms in TBI. Clinical studies indicate that long-term loss of bone mass and increased risk of osteoporosis occur in patients after TBI. Interestingly, the rate of bone healing is accelerated when patients with TBI also suffer from fractures, which then worsens the prognosis of TBI. The bidirectional effects and underlying mechanisms that connect TBI and bone through neurohormones, neuropeptides, neurotransmitters, and mechanical factors are reviewed. The promising applications of bone marrow mesenchymal stromal cells, their derived extracellular vesicles, and bone-derived factors for TBI recovery are also elucidated. Strategies to prevent osteoporosis management and potential mechanisms to accelerate fracture healing after TBI are proposed based on the brain-bone axis, and results are expected to translate into a clinical scenario for TBI and bone disease.
创伤性脑损伤（TBI）是指外力对大脑造成的损伤，会显著影响全身器官和组织，尤其是骨稳态。越来越多的研究揭示了大脑与骨骼之间的双向交互作用，而在创伤性脑损伤背景下这些系统之间的相互作用仍不清楚。在此，总结了关于大脑与骨骼关系的现有研究，以探讨它们在创伤性脑损伤中的相互作用及潜在机制。临床研究表明，创伤性脑损伤患者会出现长期骨质流失以及骨质疏松风险增加。有趣的是，创伤性脑损伤患者同时发生骨折时，骨愈合速度会加快，进而使创伤性脑损伤的预后恶化。本文综述了通过神经激素、神经肽、神经递质和机械因素将创伤性脑损伤与骨骼联系起来的双向作用及潜在机制。还阐明了骨髓间充质基质细胞、其衍生的细胞外囊泡以及骨源性因子在创伤性脑损伤恢复中的潜在应用。基于脑-骨轴提出了预防骨质疏松管理的策略以及加速创伤性脑损伤后骨折愈合的潜在机制，预期研究结果将转化为针对创伤性脑损伤和骨疾病的临床方案。
