创伤性脑损伤:连接病理生理学见解和精确治疗策略。

IF 5.9 2区 医学 Q2 CELL BIOLOGY
Neural Regeneration Research Pub Date : 2026-03-01 Epub Date: 2025-03-25 DOI:10.4103/NRR.NRR-D-24-01398
Yujia Lu, Jie Jin, Huajing Zhang, Qianying Lu, Yingyi Zhang, Chuanchuan Liu, Yangfan Liang, Sijia Tian, Yanmei Zhao, Haojun Fan
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引用次数: 0

摘要

血脑屏障破坏和神经炎症反应是影响疾病进展和治疗结果的重要病理特征。本文系统地分析了目前对创伤性脑损伤中血脑屏障破坏和神经炎症之间的双向关系的理解,以及新兴的联合治疗策略。文献综述表明,血脑屏障破坏和神经炎症反应是创伤性脑损伤后的主要病理特征。在创伤性脑损伤急性期,病理表现为原发性血脑屏障破坏和炎症级联反应的激活。在亚急性期,病理特征以修复机制和炎症调节为特征。在慢性期,病理表现为持续的低度炎症和血脑屏障的不完全恢复。各种生理变化,如血脑屏障结构改变、炎症级联反应和细胞外基质重塑等,相互作用,并受遗传、年龄、性别和环境因素的影响。血脑屏障通透性和神经炎症之间的动态平衡是由激素,特别是性激素和应激相关激素调节的。此外,胃肠激素的作用也越来越受到重视。目前创伤性脑损伤的治疗策略包括多种方法,如常规药物联合、多模态神经监测、高压氧治疗和无创脑刺激。人工智能在治疗决策和个性化治疗方面也显示出潜力。新兴的顺序组合策略和精准医学方法有助于改善治疗效果;然而,对慢性创伤性脑损伤的机制研究不足、技术整合困难等挑战依然存在。未来对创伤性脑损伤的研究应侧重于个性化治疗策略、技术标准化、成本效益评估和解决合并症患者的需求。应采用多学科方法来加强治疗和改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traumatic brain injury: Bridging pathophysiological insights and precision treatment strategies.

Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes. This review systematically analyzes the current understanding of the bidirectional relationship between blood-brain barrier disruption and neuroinflammation in traumatic brain injury, along with emerging combination therapeutic strategies. Literature review indicates that blood-brain barrier disruption and neuroinflammatory responses are key pathological features following traumatic brain injury. In the acute phase after traumatic brain injury, the pathological characteristics include primary blood-brain barrier disruption and the activation of inflammatory cascades. In the subacute phase, the pathological features are characterized by repair mechanisms and inflammatory modulation. In the chronic phase, the pathological features show persistent low-grade inflammation and incomplete recovery of the blood-brain barrier. Various physiological changes, such as structural alterations of the blood-brain barrier, inflammatory cascades, and extracellular matrix remodeling, interact with each other and are influenced by genetic, age, sex, and environmental factors. The dynamic balance between blood-brain barrier permeability and neuroinflammation is regulated by hormones, particularly sex hormones and stress-related hormones. Additionally, the role of gastrointestinal hormones is receiving increasing attention. Current treatment strategies for traumatic brain injury include various methods such as conventional drug combinations, multimodality neuromonitoring, hyperbaric oxygen therapy, and non-invasive brain stimulation. Artificial intelligence also shows potential in treatment decision-making and personalized therapy. Emerging sequential combination strategies and precision medicine approaches can help improve treatment outcomes; however, challenges remain, such as inadequate research on the mechanisms of the chronic phase traumatic brain injury and difficulties with technology integration. Future research on traumatic brain injury should focus on personalized treatment strategies, the standardization of techniques, cost-effectiveness evaluations, and addressing the needs of patients with comorbidities. A multidisciplinary approach should be used to enhance treatment and improve patient outcomes.

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来源期刊
Neural Regeneration Research
Neural Regeneration Research CELL BIOLOGY-NEUROSCIENCES
CiteScore
8.00
自引率
9.80%
发文量
515
审稿时长
1.0 months
期刊介绍: Neural Regeneration Research (NRR) is the Open Access journal specializing in neural regeneration and indexed by SCI-E and PubMed. The journal is committed to publishing articles on basic pathobiology of injury, repair and protection to the nervous system, while considering preclinical and clinical trials targeted at improving traumatically injuried patients and patients with neurodegenerative diseases.
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