Neuroprotection for traumatic brain injury: translational challenges and emerging therapeutic strategies

摘要

Traumatic brain injury (TBI) causes secondary biochemical changes that contribute to subsequent tissue damage and associated neuronal cell death. Neuroprotective treatments that limit secondary tissue loss and/or improve behavioral outcome have been well established in multiple animal models of TBI. However, translation of such neuroprotective strategies to human injury have been disappointing, with more than thirty controlled clinical trials having failed. Both conceptual issues and methodological differences between preclinical and clinical injury have undoubtedly contributed to these translational difficulties. More recently, changes in experimental approach, as well as altered clinical trial methodologies, have raised cautious optimism regarding outcomes of future clinical trials. Here, we critically review developing experimental neuroprotective strategies that show promise and propose criteria for improving the probability of successful clinical translation.