The role of endothelin and endothelin antagonists in traumatic brain injury: a review of the literature

Objectives: To date, there is increasing evidence for the role of endothelins in the pathophysiological development of cerebral vasospasms associated with a variety of neurological diseases, e. g., stroke and subarachnoid hemorrhage. In contrast, only little is known regarding the role of endothelins in impaired cerebral hemodynamics after traumatic brain injury. Therapeutic work in blocking the endothelin system has led to the discovery of a number of antagonists potentially useful in restoring cerebral blood flow after traumatic brain injury, potentially reducing the detrimental effects of secondary brain injury. Therefore, the present work provides an overview of background topics such as structures and biosynthesis of endothelins, different types as well as potential mechanisms and sites of action. In addition, the role of age for the effects of endothelins on cerebral hemodynamics after traumatic brain injury is discussed. Results: Description of data supporting the role of the endothelins play in a host of neurological deficits. Conclusions: Endothelin antagonists may be effective as novel treatments for various neuropathologies.