Modulation of cerebral ketone metabolism following traumatic brain injury in humans.

Détails

ID Serval
serval:BIB_D9054B5A55E4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Modulation of cerebral ketone metabolism following traumatic brain injury in humans.
Périodique
Journal of cerebral blood flow and metabolism
Auteur(s)
Bernini A., Masoodi M., Solari D., Miroz J.P., Carteron L., Christinat N., Morelli P., Beaumont M., Abed-Maillard S., Hartweg M., Foltzer F., Eckert P., Cuenoud B., Oddo M.
ISSN
1559-7016 (Electronic)
ISSN-L
0271-678X
Statut éditorial
Publié
Date de publication
24/10/2018
Peer-reviewed
Oui
Pages
271678X18808947
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Résumé
Adaptive metabolic response to injury includes the utilization of alternative energy substrates - such as ketone bodies (KB) - to protect the brain against further damage. Here, we examined cerebral ketone metabolism in patients with traumatic brain injury (TBI; n = 34 subjects) monitored with cerebral microdialysis to measure total brain interstitial tissue KB levels (acetoacetate and β-hydroxybutyrate). Nutrition - from fasting vs. stable nutrition state - was associated with a significant decrease of brain KB (34.7 [10th-90th percentiles 10.7-189] µmol/L vs. 13.1 [6.5-64.3] µmol/L, p < 0.001) and blood KB (668 [168.4-3824.9] vs. 129.4 [82.6-1033.8] µmol/L, p < 0.01). Blood KB correlated with brain KB (Spearman's rho 0.56, p = 0.0013). Continuous feeding with medium-chain triglycerides-enriched enteral nutrition did not increase blood KB, and provided a modest increase in blood and brain free medium chain fatty acids. Higher brain KB at the acute TBI phase correlated with age and brain lactate, pyruvate and glutamate, but not brain glucose. These novel findings suggest that nutritional ketosis was the main determinant of cerebral KB metabolism following TBI. Age and cerebral metabolic distress contributed to brain KB supporting the hypothesis that ketones might act as alternative energy substrates to glucose. Further studies testing KB supplementation after TBI are warranted.
Mots-clé
Traumatic brain injury, cerebral metabolism, glucose, ketones, nutrition
Pubmed
Open Access
Oui
Création de la notice
05/11/2018 9:57
Dernière modification de la notice
09/05/2019 1:59
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