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New potential-treatment options in brain injury due to acute carbon monoxide poisoning in future

Published:August 28, 2016DOI:https://doi.org/10.1016/j.jns.2016.08.056
      Carbon monoxide (CO) poisoning remains one of the important causes of poisoning-related deaths and acute or delayed neurological complications are still major problems (its incidence has been reported as nearly 3–40%) for survivor-patients after CO poisoning [
      • Weaver L.K.
      Hyperbaric oxygen therapy for carbon monoxide poisoning.
      ]. Although we have sufficient amount of information about reasons of brain injury due to acute CO poisoning at gross and microscopically level, our knowledge of pathophysiological changes at tissue level was limited until recently [
      • Levy R.J.
      Carbon monoxide pollution and neurodevelopment: a public health concern.
      ]. Recently studies have been showed that oxidative stress due to acute CO poisoning causes overproduction of reactive oxygen species (ROS) and finally direct cellular injury [
      • Weaver L.K.
      Clinical practice. Carbon monoxide poisoning.
      ,
      • Wang P.
      • Zeng T.
      • Zhang C.L.
      • Gao X.C.
      • Liu Z.
      • Xie K.Q.
      • Chi Z.F.
      Lipid peroxidation was involved in the memory impairment of carbon monoxide-induced delayed neuron damage.
      ,
      • Guan L.
      • Wen T.
      • Zhang Y.
      • Wang X.
      • Zhao J.
      Induction of heme oxygenase-1 with hemin attenuates hippocampal injury in rats after acute carbon monoxide poisoning.
      ]. Therefore, today, it has been considered that inflammation, white matter demyelination, lipid peroxidation, cytotoxic/vasogenic edema, apoptosis, and finally necrosis are responsible for pathogenesis of brain injury due to CO poisoning [
      • Wang P.
      • Zeng T.
      • Zhang C.L.
      • Gao X.C.
      • Liu Z.
      • Xie K.Q.
      • Chi Z.F.
      Lipid peroxidation was involved in the memory impairment of carbon monoxide-induced delayed neuron damage.
      ,
      • Guan L.
      • Wen T.
      • Zhang Y.
      • Wang X.
      • Zhao J.
      Induction of heme oxygenase-1 with hemin attenuates hippocampal injury in rats after acute carbon monoxide poisoning.
      ,
      • Han S.-T.
      • Bhopale V.M.
      • Thom S.R.
      Xanthine oxidoreductase and neurological sequelae of carbon monoxide poisoning.
      ].
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