Traumatic Brain Injury: Oxidative Stress and Novel Anti-Oxidants Such as Mitoquinone and Edaravone
Helene Ismail,
Zaynab Shakkour,
Maha Tabet,
Samar Abdelhady,
Abir Kobaisi,
Reem Abedi,
Leila Nasrallah,
Gianfranco Pintus,
Yusra Al-Dhaheri,
Stefania Mondello,
Riyad El-Khoury,
Ali H. Eid,
Firas Kobeissy,
Johnny Salameh
Affiliations
Helene Ismail
Department of Neurology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
Zaynab Shakkour
Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
Maha Tabet
Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
Samar Abdelhady
Faculty of Medicine, Alexandria University, Alexandria 21544, Egypt
Abir Kobaisi
Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
Reem Abedi
Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
Leila Nasrallah
Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
Gianfranco Pintus
Department of Medical Laboratory Sciences, University of Sharjah, Sharjah 27272, UAE
Yusra Al-Dhaheri
Department of Biology, College of Science, United Arab Emirates University, Al-Ain 15551, UAE
Stefania Mondello
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98165 Messina, Italy
Riyad El-Khoury
Department of Pathology and Laboratory Medicine, Neuromuscular Diagnostic Laboratory, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
Ali H. Eid
Department of Pharmacology and Toxicology, American University of Beirut, Beirut 1107 2020, Lebanon
Firas Kobeissy
Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
Johnny Salameh
Department of Neurology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
Traumatic brain injury (TBI) is a major health concern worldwide and is classified based on severity into mild, moderate, and severe. The mechanical injury in TBI leads to a metabolic and ionic imbalance, which eventually leads to excessive production of reactive oxygen species (ROS) and a state of oxidative stress. To date, no drug has been approved by the food and drug administration (FDA) for the treatment of TBI. Nevertheless, it is thought that targeting the pathology mechanisms would alleviate the consequences of TBI. For that purpose, antioxidants have been considered as treatment options in TBI and were shown to have a neuroprotective effect. In this review, we will discuss oxidative stress in TBI, the history of antioxidant utilization in the treatment of TBI, and we will focus on two novel antioxidants, mitoquinone (MitoQ) and edaravone. MitoQ can cross the blood brain barrier and cellular membranes to accumulate in the mitochondria and is thought to activate the Nrf2/ARE pathway leading to an increase in the expression of antioxidant enzymes. Edaravone is a free radical scavenger that leads to the mitigation of damage resulting from oxidative stress with a possible association to the activation of the Nrf2/ARE pathway as well.
