Cerebral Lactate Metabolism After Traumatic Brain Injury.

Détails

ID Serval
serval:BIB_881133C464C1
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Cerebral Lactate Metabolism After Traumatic Brain Injury.
Périodique
Current Neurology and Neuroscience Reports
Auteur(s)
Patet C., Suys T., Carteron L., Oddo M.
ISSN
1534-6293 (Electronic)
ISSN-L
1528-4042
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
16
Numéro
4
Pages
31
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Cerebral energy dysfunction has emerged as an important determinant of prognosis following traumatic brain injury (TBI). A number of studies using cerebral microdialysis, positron emission tomography, and jugular bulb oximetry to explore cerebral metabolism in patients with TBI have demonstrated a critical decrease in the availability of the main energy substrate of brain cells (i.e., glucose). Energy dysfunction induces adaptations of cerebral metabolism that include the utilization of alternative energy resources that the brain constitutively has, such as lactate. Two decades of experimental and human investigations have convincingly shown that lactate stands as a major actor of cerebral metabolism. Glutamate-induced activation of glycolysis stimulates lactate production from glucose in astrocytes, with subsequent lactate transfer to neurons (astrocyte-neuron lactate shuttle). Lactate is not only used as an extra energy substrate but also acts as a signaling molecule and regulator of systemic and brain glucose use in the cerebral circulation. In animal models of brain injury (e.g., TBI, stroke), supplementation with exogenous lactate exerts significant neuroprotection. Here, we summarize the main clinical studies showing the pivotal role of lactate and cerebral lactate metabolism after TBI. We also review pilot interventional studies that examined exogenous lactate supplementation in patients with TBI and found hypertonic lactate infusions had several beneficial properties on the injured brain, including decrease of brain edema, improvement of neuroenergetics via a "cerebral glucose-sparing effect," and increase of cerebral blood flow. Hypertonic lactate represents a promising area of therapeutic investigation; however, larger studies are needed to further examine mechanisms of action and impact on outcome.
Mots-clé
Age Distribution, Cerebral Infarction/epidemiology, Female, Hospital Mortality, Humans, Incidence, Ischemic Attack, Transient/epidemiology, Male, Registries, Spain/epidemiology, Stroke/diagnosis, Stroke/epidemiology
Pubmed
Web of science
Création de la notice
07/07/2013 12:29
Dernière modification de la notice
03/03/2018 19:03
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