Role of Citicoline in the Management of Traumatic Brain Injury

Secades, Julio J

doi:10.3390/ph14050410

Cited by 21 publications

(28 citation statements)

References 79 publications

(87 reference statements)

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“…As well, CTN has anticonvulsive, sedative, and anxiolytic activities (Abdolmaleki et al 2016 ). Of interest, CTN can attenuate neuroinflammation by inhibiting the release of pro-inflammatory cytokines including tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), IL-1β, and monocyte chemoattractant protein 1 (MCP-1) with activation release of anti-inflammatory cytokines IL-10 (Al-Mosawi 2019 ; Secades 2021 ). CTN regulates neuronal energy balance by controlling ATP levels and the activity of Na + /K + -ATPase (Piamonte et al 2020 ).…”

Section: Neuroprotective Effect Of Citicolinementioning

confidence: 99%

Citicoline and COVID-19: vis-à-vis conjectured

Al-Kuraishy

Al-Buhadily

Al-Gareeb

et al. 2022

Naunyn-Schmiedeberg's Arch Pharmacol

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Coronavirus disease 2019 (COVID-19) is a current pandemic disease caused by a novel severe acute respiratory syndrome coronavirus virus respiratory type 2 (SARS-CoV-2). SARS-CoV-2 infection is linked with various neurological manifestations due to cytokine-induced disruption of the blood brain barrier (BBB), neuroinflammation, and peripheral neuronal injury, or due to direct SARS-CoV-2 neurotropism. Of note, many repurposed agents were included in different therapeutic protocols in the management of COVID-19. These agents did not produce an effective therapeutic eradication of SARS-CoV-2, and continuing searching for novel anti-SARS-CoV-2 agents is a type of challenge nowadays. Therefore, this study aimed to review the potential anti-inflammatory and antioxidant effects of citicoline in the management of COVID-19.

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Section: Neuroprotective Effect Of Citicolinementioning

confidence: 99%

Citicoline and COVID-19: vis-à-vis conjectured

Al-Kuraishy

Al-Buhadily

Al-Gareeb

et al. 2022

Naunyn-Schmiedeberg's Arch Pharmacol

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“…It mediates neuronal membrane integrity and repair, and it accelerates the reabsorption of cerebral oedema and the restoration of the blood–brain barrier integrity after TBI 15,19 . Citicoline also increases cerebral dopamine and norepinephrine levels, which causes improved hypoxia tolerance 20 …”

Section: Treatment Conceptmentioning

confidence: 99%

“… 15 , 19 Citicoline also increases cerebral dopamine and norepinephrine levels, which causes improved hypoxia tolerance. 20 …”

Section: Treatment Conceptmentioning

confidence: 99%

A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury—Two case reports

Trimmel

Herzer

Derdak

et al. 2022

Clinical Case Reports

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Severe traumatic brain injury (sTBI) is a major cause of death and disability worldwide, resulting in a significant individual and socioeconomic burden. Current treatment guidelines do not include any recommendations for neuroprotective or neuoregenerative drugs. Here, we present a combined treatment with Cerebrolysin and Citicoline in two cases. Both drugs are experimentally better than clinically proven in their own effectiveness, but there is almost no clinical data on the combination of the two. Our case study hints at a promising approach that may improve neurological outcome after sTBI. The first patient was a 29 years male motorcyclist suffered polytrauma in a high-speed accident. He had severe bilateral chest trauma and fractures in both thighs and an sTBI. In addition to surgical and standard neurocritical care according to the evidence-based guidelines, he was given neuroprotective therapy with Cerebrolysin (50 ml/day) and Citicoline (3 g/day), by continuous intravenous infusion (IV), for 21 days.The second patient was a 30 years male ski mountaineer who had suffered a fall over 300 m in open terrain. In addition to the sTBI, he had fractures in the cervical spine, ribs, pelvis, and lower extremities, as well as lung contusions and massive soft tissue trauma. After initial treatment in a local hospital, he was transferred to our department and received the same neuroprotective drugs, like all of our patients with sTBI. Considering the severity of the injuries (Injury Severity Score[ISS]: 43/50, Revised Trauma Score [RTS: 5.0304, 2.7794]) and the unfavorable outcome probability (Hukkelhoven Score) of 93.1% and 82.6%, the outcomes of both patients are surprisingly encouraging 1 year after the accident. They achieved a Glasgow Outcome Score of 6 and 5 and grades 2 and 4 on the modified Rankin Scale, respectively. Currently, both are able to take care of themselves in activities of daily life to a large extent. Neuroprotective drugs may improve the regeneration of cell membranes, improve blood brain barrier integrity, and reduce neuroinflammation leading to secondary damage to the injured brain.How to cite this article: Trimmel H, Herzer G, Derdak C, Kettenbach J, Grgac I. A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury-Two case reports.

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“…CDP-choline or 5’-cytidinediphosphocholine, generically known as citicoline has been employed clinically in the management of TBI [ 123 ]. In TBI, lipid peroxidation by phospholipases [ 124 ], i.e., PLA2, has been considered to play a crucial role in the pathophysiology of TBI; the number of experimental studies demonstrated that the PLA2 inhibition by CDP-choline exhibited a beneficial effect in brain injury [ 125 ].…”

Section: Choline-specific Therapeutic Strategies For the Amelioration Of Tbi And Coexisting Neurological Diseasesmentioning

confidence: 99%

Dynamics of Choline-Containing Phospholipids in Traumatic Brain Injury and Associated Comorbidities

Javaid

Farooq

Rehman

et al. 2021

IJMS

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The incidences of traumatic brain injuries (TBIs) are increasing globally because of expanding population and increased dependencies on motorized vehicles and machines. This has resulted in increased socio-economic burden on the healthcare system, as TBIs are often associated with mental and physical morbidities with lifelong dependencies, and have severely limited therapeutic options. There is an emerging need to identify the molecular mechanisms orchestrating these injuries to life-long neurodegenerative disease and a therapeutic strategy to counter them. This review highlights the dynamics and role of choline-containing phospholipids during TBIs and how they can be used to evaluate the severity of injuries and later targeted to mitigate neuro-degradation, based on clinical and preclinical studies. Choline-based phospholipids are involved in maintaining the structural integrity of the neuronal/glial cell membranes and are simultaneously the essential component of various biochemical pathways, such as cholinergic neuronal transmission in the brain. Choline or its metabolite levels increase during acute and chronic phases of TBI because of excitotoxicity, ischemia and oxidative stress; this can serve as useful biomarker to predict the severity and prognosis of TBIs. Moreover, the effect of choline-replenishing agents as a post-TBI management strategy has been reviewed in clinical and preclinical studies. Overall, this review determines the theranostic potential of choline phospholipids and provides new insights in the management of TBI.

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Role of Citicoline in the Management of Traumatic Brain Injury

Cited by 21 publications

References 79 publications

Citicoline and COVID-19: vis-à-vis conjectured

Citicoline and COVID-19: vis-à-vis conjectured

A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury—Two case reports

Dynamics of Choline-Containing Phospholipids in Traumatic Brain Injury and Associated Comorbidities

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