TY - JOUR
T1 - Complex Feed-Forward and Feedback Mechanisms Underlie the Relationship between Traumatic Brain Injury and the Gut-Microbiota-Brain Axis
AU - Patterson, T. Tyler
AU - Nicholson, Susannah
AU - Wallace, David
AU - Hawryluk, Gregory W.J.
AU - Grandhi, Ramesh
N1 - Publisher Copyright:
© 2019 by the Shock Society. Unauthorized reproduction of this article is prohibited.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Traumatic brain injury (TBI) contributes to nearly 1 in 3 injury-related deaths in the United States and accounts for a substantial public health burden and cost. The current literature reports that physiologic responses in the gastrointestinal system after TBI include, but are not limited to, epithelial barrier dysfunction, microbiota changes, and immunologic transformations. Recent evidence suggests gut alterations after TBI modify the homeostasis of the bidirectional gut-microbiota-brain axis, resulting in altered immune responses in the periphery and the brain. This cascade possibly contributes to impaired central nervous system (CNS) healing. Although attention to the gut-brain-microbiota axis has been increasing in the literature, the precise mechanisms underlying the changes observed after TBI remain unclear. The purpose of this review are to describe our current understanding regarding alterations to the gut-microbiota-brain axis after TBI, highlight the pathophysiologic changes involved, and evaluate how these variations modify healing in the CNS or even contribute to secondary injury. We also discuss current investigations into potential medical therapies directed at the gut-microbiota-brain axis, which might offer improved outcomes after TBI.
AB - Traumatic brain injury (TBI) contributes to nearly 1 in 3 injury-related deaths in the United States and accounts for a substantial public health burden and cost. The current literature reports that physiologic responses in the gastrointestinal system after TBI include, but are not limited to, epithelial barrier dysfunction, microbiota changes, and immunologic transformations. Recent evidence suggests gut alterations after TBI modify the homeostasis of the bidirectional gut-microbiota-brain axis, resulting in altered immune responses in the periphery and the brain. This cascade possibly contributes to impaired central nervous system (CNS) healing. Although attention to the gut-brain-microbiota axis has been increasing in the literature, the precise mechanisms underlying the changes observed after TBI remain unclear. The purpose of this review are to describe our current understanding regarding alterations to the gut-microbiota-brain axis after TBI, highlight the pathophysiologic changes involved, and evaluate how these variations modify healing in the CNS or even contribute to secondary injury. We also discuss current investigations into potential medical therapies directed at the gut-microbiota-brain axis, which might offer improved outcomes after TBI.
KW - Gastrointestinal system
KW - gut-microbiota-brain axis
KW - immune response
KW - pathophysiology
KW - traumatic brain injury
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U2 - 10.1097/SHK.0000000000001278
DO - 10.1097/SHK.0000000000001278
M3 - Review article
C2 - 30335675
AN - SCOPUS:85066057591
SN - 1073-2322
VL - 52
SP - 318
EP - 325
JO - Shock
JF - Shock
IS - 3
ER -