Microdialysis Monitoring in Clinical Traumatic Brain Injury and Its Role in Neuroprotective Drug Development
The AAPS Journal
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Thelin, E., Carpenter, K., Hutchinson, P., & Helmy, A. (2017). Microdialysis Monitoring in Clinical Traumatic Brain Injury and Its Role in Neuroprotective Drug Development. The AAPS Journal, 19 (2), 367-376. https://doi.org/10.1208/s12248-016-0027-7
Injuries to the central nervous system continue to be vast contributors to morbidity and mortality; specifically, traumatic brain injury (TBI) is the most common cause of death during the first four decades of life. Several modalities are used to monitor patients suffering from TBI in order to prevent detrimental secondary injuries. The microdialysis (MD) technique, introduced during the 1990s, presents the treating physician with a robust monitoring tool for brain chemistry in addition to conventional intracranial pressure monitoring. Nevertheless, some limitations remain, such as limited spatial resolution. Moreover, while there have been several attempts to develop new potential pharmacological therapies in TBI, there are currently no available drugs which have shown clinical efficacy that targets the underlying pathophysiology, despite various trials investigating a plethora of pharmaceuticals. Specifically in the brain, MD is able to demonstrate penetration of the drug through the blood-brain barrier into the brain extracellular space at potential site of action. In addition, the downstream effects of drug action can be monitored directly. In the future, clinical MD, together with other monitoring modalities, can identify specific pathological substrates which require tailored treatment strategies for patients suffering from TBI.
drug delivery, human, microdialysis, monitoring, pharmacokinetics, traumatic brain injury
The author(s) gratefully acknowledge receipt of the following financial support. Medical Research Council (Grant nos. G0600986 ID79068 and G1002277 ID98489) and National Institute for Health Research Biomedical Research Centre, Cambridge (Neuroscience Theme; Brain Injury and Repair Theme). Authors’ support: EPT—the Swedish Society of Medicine (Grant no. SLS-587221) and the Swedish Brain Foundation; KLHC—the National Institute for Health Research Biomedical Research Centre, Cambridge (Neuroscience Theme; Brain Injury and Repair Theme); PJH—the National Institute for Health Research Professorship, the Academy of Medical Sciences/Health Foundation Senior Surgical Scientist Fellowship and the National Institute for Health Research Biomedical Research Centre, Cambridge; AH—the Medical Research Council/Royal College of Surgeons of England Clinical Research Training Fellowship (Grant no. G0802251).
Cambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
MEDICAL RESEARCH COUNCIL (G0802251)
External DOI: https://doi.org/10.1208/s12248-016-0027-7
This record's URL: https://www.repository.cam.ac.uk/handle/1810/262873
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