多巴胺介导针刺对创伤性脑损伤的唤醒作用及潜在机制

Arousal effect and potential mechanism of dopamine-mediated acupuncture on traumatic brain injury

创伤性脑损伤(TBI)是由直接外力引起的脑损伤,其预后取决于损伤的程度和意识水平的变化。及时从昏迷中苏醒是TBI治疗中首先要解决的棘手问题。因此,需要开发安全有效的方法及时唤醒TBI昏迷。多巴胺(DA)及其神经系统受体参与觉醒的调节。多巴胺能神经元的数量和活性可影响细胞功能和神经炎症反应,对TBI后的觉醒过程也具有重要意义。目前常见的TBI觉醒疗法也可能与多巴胺能神经元的激活有关。针刺对TBI后的及时觉醒、意识水平恢复和功能康复具有有益作用。其机制可能与针刺对DA及其受体的靶向调控有关。在针刺急救疗法中,针刺12井穴以其操作简单、超早干预等优势,在TBI后的及时觉醒及一系列后续神经修复作用方面显示出巨大潜力。本文综述了DA在调节觉醒中的作用以及DA系统在针刺治疗TBI中的作用和可能机制,为TBI昏迷的及时觉醒提供了新的视角。

Traumatic brain injury(TBI)is a brain injury caused by direct external forces,and its prognosis depends on the extent of the damage and the changes in level of consciousness.Timely awakening from a coma is the first thorny problem to be solved in TBI treatment.Therefore,there is a need for the development of safe and effective methods for timely awakening after TBI coma.Dopamine(DA)and its receptors in the nervous system are involved in the regulation of wakefulness.The amount and activity of dopaminergic neurons can affect cellular function and neuroinflammatory response,and are also significant for the awakening process after TBI.The current common awakening therapy for TBI may also be related to the activation of dopaminergic neurons.Acupuncture plays a beneficial role in timely awakening,recovery of conscious level,and functional rehabilitation after TBI.The mechanism may be related to the targeted regulation of DA and its receptors via acupuncture.Among acupuncture first aid therapies,acupuncture at hand 12 Jing-Well points,with its advantages of simple operation and ultra-early intervention,has shown great promise in timely awakening following TBI and triggering a series of subsequent nerve repair effects in the treatment of TBI.We here present a review that provides a new perspective for the timely awakening from TBI-induced coma,with a focus on the role of DA in the regulation of wakefulness and the efficacy and potential mechanism of DA systems in the treatment of TBI by acupuncture.