ReviewTreatment of traumatic brain injury with anti-inflammatory drugs

- Anti-inflammatory drugs are highly effective when dosed before or soon after experimental traumatic brain injury.
- When dosed hours after injury, however, many of the same drugs have little efficacy.
- Better knowledge of the inflammatory response after TBI would assist in the design and dosing of anti-inflammatory drugs

Traumatic brain injury rapidly induces inflammation. This inflammation is produced both by endogenous brain cells and circulating inflammatory cells that enter from the brain. Together they drive the inflammatory response through a wide variety of bioactive lipids, cytokines and chemokines. A large number of drugs with anti-inflammatory action have been tested in both preclinical studies and in clinical trials. These drugs either have known anti-inflammatory action or inhibit the inflammatory response through unknown mechanisms. The results of these preclinical studies and clinical trials are reviewed. Recommendations are suggested on how to improve preclinical testing of drugs to make them more relevant to evaluate for clinical trials.