Esketamine is neuroprotective against traumatic brain injury through its modulation of autophagy and oxidative stress via AMPK/mTOR-dependent TFEB nuclear translocation
Abstract
Recent clinical studies highlight the neuroprotective effects of esketamine, but its benefits following traumatic brain injury (TBI) have not been defined. Here, we investigated the effects of esketamine following TBI and its associated neuroprotection mechanisms. In our study, controlled cortical impact injury on mice was utilized to induce the TBI model in vivo. TBI mice were randomized to receive vehicle or esketamine at 2 h post-injury for 7 consecutive days. Neurological deficits and brain water content in mice were detected, respectively. Cortical tissues surrounding focal trauma were obtained for Nissl staining, immunofluorescence, immunohistochemistry, and ELISA assay. In vitro, esketamine were added in culture medium after cortical neuronal cells induced by H 2 O 2 (100μM). After exposed for 12h, neuronal cells were obtained for western blotting, immunofluorescence, ELISA and CO-IP assay. Following administration of 2-8 mg/kg esketamine, we observed that 8 mg/kg esketamine produced no additional recovery of neurological function and ability to alleviate brain edema in TBI mice model, so 4 mg/kg esketamine was selected for subsequent experiments. Additionally, esketamine can effectively reduce TBI-induced oxidative stress, the number of damaged neurons, and the number of TUNEL-positive cells in the cortex of TBI models. Meanwhile, the levels of Beclin 1, LC3 II, and the number of LC3-positive cells in injured cortex were also increased following esketamine exposure. W…
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Autophagy enhancers such as mTOR inhibitors, AMPK activators, and TFEB activators have shown neuroprotective effects in preclinical models.
“While autophagy enhancers (e.g., mTOR inhibitors, such as rapamycin, AMP-activated protein kinase [AMPK] activators, or transcription factor EB [TFEB] activators) have shown neuroprotective effects in preclinical models, broad upregulation can lead to unintended consequences, including excessive degradation or altered immune responses [144].”
From Toward a Unified Framework in Molecular Neurobiology of Alzheimer’s Disease: Revisiting the Pathophysiological Hypotheses (2026) · cites this paper as [144]
Broad upregulation of autophagy can lead to unintended consequences, including excessive degradation or altered immune responses.
“While autophagy enhancers (e.g., mTOR inhibitors, such as rapamycin, AMP-activated protein kinase [AMPK] activators, or transcription factor EB [TFEB] activators) have shown neuroprotective effects in preclinical models, broad upregulation can lead to unintended consequences, including excessive degradation or altered immune responses [144].”
From Toward a Unified Framework in Molecular Neurobiology of Alzheimer’s Disease: Revisiting the Pathophysiological Hypotheses (2026) · cites this paper as [144]
Cites
Chao, X., Wang, S., Zhao, K., Li, Y., Williams, J. A., Li, T., Chavan, H., Krishnamurthy, P., He, X. C., Li, L., et al. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.05.027 · Cited by 342 · see citing works
Autophagy in traumatic brain injury: a new target for therapeutic intervention
Zhang, L., & Wang, H. (2018) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2018.00190 · Cited by 82 · see citing works
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Hein, Z. M., Karikalan, B., Gopalakrishna, P. K., Dhevi, K., Alkatiri, A., Hussan, F., Mohd Moklas, M. A., Jagadeesan, S., Che Ramli, M. D., Che Mohd Nassir, C. M. N., et al. (2026) · Molecular Neurobiology · doi:10.1007/s12035-025-05602-0 · Cited by 43 · see citing works
- Authors
- Tang, Y., Liu, Y., Zhou, H., Lu, H., Zhang, Y., Hua, J., & Liao, X.
- Affiliations
- Chinese People's Liberation Army (CN)
- Xuzhou Medical College (CN)
- Corresponding author
- Liao, Xingzhi
- Venue
- Experimental Neurology
- Publisher
- Elsevier BV
- Published
- 2023-08
- Volume
- 366
- Pages
- 114436
- ISSN
- 0014-4886 (ISSN-L)
- OpenAlex
- W4376505825
- Cited by
- 61
- References
- 2
- Citations by year
- 2026: 16 · 2025: 26 · 2024: 17 · 2023: 2
- FWCI
- 10.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Experimental Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wuhan Science and Technology Project (Y20212046)
- Topics
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Epidemiology › Autophagy in Disease and Therapy
- Keywords
- esketamine, traumatic brain injury, neuroprotection, autophagy, oxidative stress, TFEB nuclear translocation, AMPK/mTOR signaling, Nrf2, Beclin-1, LC3, controlled cortical impact injury, cortical neurons, cerebral edema, apoptosis
- MeSH terms
- Neuroprotection, Brain Injuries, Traumatic, Animals, Autophagy, Hydrogen Peroxide, Ketamine, Oxidative Stress, Neuroprotective Agents, NF-E2-Related Factor 2, Mice, AMP-Activated Protein Kinases, TOR Serine-Threonine Kinases
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