Emerging treatments for traumatic brain injury.
Emerging treatments for traumatic brain injury.
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DOI：
10.1517/14728210902769601
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发表时间：
2009-03
影响因子：
3.4
通讯作者：
Chopp M
中科院分区：
文献类型：
--
作者：
Xiong Y;Mahmood A;Chopp M
本文综述了创伤性脑损伤（TBI）的临床前或临床试验中有前景的治疗方法。描述了脑外伤后神经功能缺损的病理生理学。概述了选择治疗的TBI与神经保护和神经恢复的作用。本文综述了与神经保护和神经修复治疗方法相关的临床前TBI研究和临床TBI试验。几乎所有神经保护的II/III期临床试验都未能显示出对TBI患者预后的任何一致改善。未来十年将见证越来越多的临床试验，这些试验将寻求将临床前研究发现转化为临床。有希望的药物或细胞治疗方法包括促红细胞生成素及其氨甲酰化形式、他汀类药物、骨髓基质细胞、干细胞单独或联合或与生物材料结合，通过神经保护减少脑损伤，通过血管生成、神经发生和突触发生促进脑重塑，最终目标是改善TBI患者的功能结局。此外，丰富的环境和自愿体育锻炼在促进TBI后的功能预后方面表现出希望，应该单独评估或与其他治疗方法联合作为TBI的治疗方法。
This review summarizes promising approaches for the treatment of traumatic brain injury (TBI), which are either in preclinical or clinical trials. The pathophysiology underlying neurological deficits after TBI is described. An overview of select therapies for TBI with neuroprotective and neurorestorative effects is presented. A literature review of pre-clinical TBI studies and clinical TBI trials related to neuroprotective and neurorestorative therapeutic approaches is provided. Nearly all phase II/III clinical trials in neuroprotection have failed to show any consistent improvement in outcome for TBI patients. The next decade will witness an increasing number of clinical trials which seek to translate preclinical research discoveries to the clinic. Promising drug- or cell-based therapeutic approaches include erythropoietin and its carbamylated form, statins, bone marrow stromal cells, stem cells singularly or in combination or with biomaterials to reduce brain injury via neuroprotection and promote brain remodeling via angiogenesis, neurogenesis, and synaptogenesis with a final goal to improve functional outcome of TBI patients. In addition, enriched environment and voluntary physical exercise show promise in promoting functional outcome after TBI, and should be evaluated alone or in combination with other treatments as therapeutic approaches for TBI.