Cells. 2024 May 04. pii: 784. [Epub ahead of print]13(9):
Filippo Annoni,
Elisa Gouvea Bogossian,
Lorenzo Peluso,
Fuhong Su,
Anthony Moreau,
Leda Nobile,
Stefano Giuseppe Casu,
Elda Diletta Sterchele,
Lorenzo Calabro,
Michele Salvagno,
Mauro Oddo,
Fabio Silvio Taccone.
Cardiac arrest survivors suffer the repercussions of anoxic brain injury, a critical factor influencing long-term prognosis. This injury is characterised by profound and enduring metabolic impairment. Ketone bodies, an alternative energetic resource in physiological states such as exercise, fasting, and extended starvation, are avidly taken up and used by the brain. Both the ketogenic diet and exogenous ketone supplementation have been associated with neuroprotective effects across a spectrum of conditions. These include refractory epilepsy, neurodegenerative disorders, cognitive impairment, focal cerebral ischemia, and traumatic brain injuries. Beyond this, ketone bodies possess a plethora of attributes that appear to be particularly favourable after cardiac arrest. These encompass anti-inflammatory effects, the attenuation of oxidative stress, the improvement of mitochondrial function, a glucose-sparing effect, and the enhancement of cardiac function. The aim of this manuscript is to appraise pertinent scientific literature on the topic through a narrative review. We aim to encapsulate the existing evidence and underscore the potential therapeutic value of ketone bodies in the context of cardiac arrest to provide a rationale for their use in forthcoming translational research efforts.
Keywords: anoxic brain injury; cerebral metabolism; heart arrest; ischemia–reperfusion; ketone bodies