Therapeutic strategies to target acute and long-term sequelae of pediatric traumatic brain injury.
Therapeutic strategies to target acute and long-term sequelae of pediatric traumatic brain injury.
复制标题
针对小儿创伤性脑损伤的急性和长期后遗症的治疗策略。
DOI：
10.1016/j.neuropharm.2018.06.025
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发表时间：
2019
影响因子：
4.7
通讯作者：
Raghupathi,Ramesh
中科院分区：
文献类型：
--
作者：
Huh,JimmyW;Raghupathi,Ramesh
儿童创伤性脑损伤(TBI)仍然是儿童发病率和死亡率的主要原因之一。实验和临床研究表明，发育年龄、损伤类型(弥漫性和局灶性)和性别可能在发育中的大脑对创伤的反应中发挥重要作用。在过去几十年中，急性神经外科干预和神经危重护理方面的进展有所改善，并导致死亡率下降。然而，幸存者留下了终生的行为缺陷，这突显了更好地定义这些功能变化背后的细胞机制的必要性。更好地了解这些机制，其中一些机制开始于急性创伤后时期，可能会导致有针对性的治疗战略。在设计临床前实验以测试儿童脑损伤的治疗策略时，主要考虑的因素包括使用适合年龄的和与病理相关的模型，随着动物年龄的增长而测试的功能结果，青春期及以后的测试，性别作为一个生物变量，以及认识到在成年脑损伤的动物模型中被证明有效的剂量和给药策略可能对发育中的大脑无效。本文是题为《创伤性脑损伤的新治疗方法》特刊的一部分。
Pediatric traumatic brain injury (TBI) remains one of the leading causes of morbidity and mortality in children. Experimental and clinical studies demonstrate that the developmental age, the type of injury (diffuse vs. focal) and sex may play important roles in the response of the developing brain to a traumatic injury. Advancements in acute neurosurgical interventions and neurocritical care have improved and led to a decrease in mortality rates over the past decades. However, survivors are left with life-long behavioral deficits underscoring the need to better define the cellular mechanisms underlying these functional changes. A better understanding of these mechanisms some of which begin in the acute post-traumatic period may likely lead to targeted treatment strategies. Key considerations in designing pre-clinical experiments to test therapeutic strategies in pediatric TBI include the use of age-appropriate and pathologically-relevant models, functional outcomes that are tested as animals age into adolescence and beyond, sex as a biological variable and the recognition that doses and dosing strategies that have been demonstrated to be effective in animal models of adult TBI may not be effective in the developing brain.This article is part of the Special Issue entitled “Novel Treatments for Traumatic Brain Injury”.