The therapeutic use of ketone bodies (KB) against acute brain injury and neurodegenerative disorders has lately been suggested by many studies. Several mechanisms responsible for the protective action of KB have been described, including metabolic, anti-inflammatory and epigenetic. However, it is still not clear whether a specific mechanism of action can be associated with a particular neurological disorder. Different strategies to induce ketosis including the ketogenic diet (KD), caloric restriction (CR), intermittent fasting (IF), as well as the administration of medium chain triglycerides (MCTs), exogenous ketones or KB derivatives, have been used in animal models of brain injury and in humans. They have shown different degrees of success to prevent neuronal damage, motor alterations and cognitive decline. However, more investigation is needed in order to establish safe protocols for clinical application. Throughout the present review, we describe the different approaches that have been used to elevate blood KB and discuss their effectiveness considering their advantages and limitations, as tested in models of brain injury, neurodegeneration and clinical research. We also describe the mechanisms of action of KB in non-pathologic conditions and in association with their protective effect against neuronal damage in acute neurological disorders and neurodegenerative diseases.

中文翻译：

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诱导酮症的治疗策略及其在治疗急性脑损伤和神经退行性疾病中的潜在功效。

近年来，许多研究提出了酮体（KB）对急性脑损伤和神经退行性疾病的治疗用途。已经描述了负责KB的保护作用的几种机制，包括代谢，抗炎和表观遗传。但是，尚不清楚特定的作用机制是否可以与特定的神经系统疾病相关。在动物模型中，已采用了多种不同的诱导酮症的策略，包括：生酮饮食（KD），热量限制（CR），间歇性禁食（IF）以及中链甘油三酸酯（MCT），外源酮或KB衍生物的给药脑损伤和人类。他们已经显示出不同程度的成功，可以预防神经元损伤，运动改变和认知能力下降。然而，为了建立安全的临床应用方案，还需要进行更多的调查。在本综述中，我们描述了用于升高血液KB的不同方法，并考虑了其优势和局限性来讨论其有效性，这些方法已在脑损伤，神经退行性病变和临床研究模型中进行了测试。我们还描述了KB在非病理性疾病中的作用机制，以及它们在急性神经系统疾病和神经退行性疾病中对神经元损害的保护作用。神经变性和临床研究。我们还描述了KB在非病理性疾病中的作用机制，以及它们在急性神经系统疾病和神经退行性疾病中对神经元损害的保护作用。神经变性和临床研究。我们还描述了KB在非病理性疾病中的作用机制，以及它们在急性神经系统疾病和神经退行性疾病中对神经元损害的保护作用。