Natural Compounds as a Therapeutic Intervention following Traumatic Brain Injury: The Role of Phytochemicals

Abstract

There has been a tremendous focus on the discovery and development of neuroprotective agents that might have clinical relevance following traumatic brain injury (TBI). This type of brain injury is very complex and is divided into two major components. The first component, a primary injury, occurs at the time of impact and is the result of the mechanical insult itself. This primary injury is thought to be irreversible and resistant to most treatments. A second component or secondary brain injury, is defined as cellular damage that is not immediately obvious after trauma, but that develops after a delay of minutes, hours, or even days. This injury appears to be amenable to treatment. Because of the complexity of the secondary injury, any type of therapeutic intervention needs to be multi-faceted and have the ability to simultaneously modulate different cellular changes. Because of diverse pharmaceutical interactions, combinations of different drugs do not work well in concert and result in adverse physiological conditions. Research has begun to investigate the possibility of using natural compounds as a therapeutic intervention following TBI. These compounds normally have very low toxicity and have reduced interactions with other pharmaceuticals. In addition, many natural compounds have the potential to target numerous different components of the secondary injury. Here, we review 33 different plant-derived natural compounds, phytochemicals, which have been investigated in experimental animal models of TBI. Some of these phytochemicals appear to have potential as possible therapeutic interventions to offset key components of the secondary injury cascade. However, not all studies have used the same scientific rigor, and one should be cautious in the interpretation of studies using naturally occurring phytochemical in TBI research.

Reduced Neuroinflammation and Improved Functional Recovery after Traumatic Brain Injury by Prophylactic Diet Supplementation in Mice

“…Studies have shown that TBI patients can endure feeding via the small bowel, however, in the long-term patients need to convert to gastric feeding to allow for rehabilitation [ 54 , 55 ]. Individuals need to be monitored for dysphagia and other negative outcomes that can affect the quality of life and appropriate oral nutrition [ 56 , 57 ]. The influence of early nutrition support may be the critical factor for promising outcomes following TBI.…”

Neural-respiratory inflammasome axis in traumatic brain injury

“…These include: calcium channel blockers, corticosteroids, excitatory amino acids inhibitors, NMDA receptor antagonists, anti-inflammatory drugs, free radical scavengers, magnesium sulfate, and growth factors (20). Because of the complexity of secondary injury mechanisms, treatment options must be multi-faceted and have the ability to simultaneously modulate different cellular changes (21). The use of hypothermia and temperature management protocols has also proven to be successful in the reduction of secondary injury mechanisms after severe TBI (22).…”

Effects of curcuminoids on inflammatory and oxidative stress biomarkers and clinical outcomes in critically ill patients: A randomized double‐blind placebo‐controlled trial

“…There is controversy on the efficacy of common therapeutic agents used for TBI treatment (Lucke‐Wold et al, 2018; Scheff & Ansari, 2017). Because of diverse side effects of chemical anti‐inflammatory therapeutic agents, herbal medicine has been proposed as an alternative medical strategy following TBI (Wang et al, 2016).…”

“…There is controversy on the efficacy of common therapeutic agents used for TBI treatment (Lucke-Wold et al, 2018;Scheff & Ansari, 2017).…”