Glyburide is associated with attenuated vasogenic edema in stroke patients.
Glyburide is associated with attenuated vasogenic edema in stroke patients.
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DOI：
10.1007/s12028-013-9917-z
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发表时间：
2014-04
影响因子：
3.5
通讯作者：
Sheth KN
中科院分区：
文献类型：
--
作者：
Kimberly WT;Battey TW;Pham L;Wu O;Yoo AJ;Furie KL;Singhal AB;Elm JJ;Stern BJ;Sheth KN
脑水肿是缺血性中风的严重并发症，可导致继发性神经功能恶化和死亡。据报道，格列本脲可通过抑制由磺酰脲受体 1 (SUR1) 和瞬时受体电位阳离子通道亚家族 M 成员 4 (TRPM4) 组成的非选择性通道来预防缺血性中风临床前啮齿动物模型中的脑肿胀。然而，该途径与中风患者脑水肿发生的相关性尚不清楚。采用病例对照设计，我们回顾性评估了参加格列本脲在恶性水肿和中风试点 (GAMES-Pilot) 试验中的受试者的神经影像学和细胞毒性和血管源性水肿的血液标志物。我们将连续脑磁共振图像（MRI）与具有类似大体积梗塞的队列进行了比较。我们还比较了大面积半球卒中时血浆基质金属蛋白酶 9 的水平。我们报道，IV 格列本脲与脑部 MRI 上 T2 液衰减反转恢复 (FLAIR) 信号强度比减弱相关，降低第 1 天和第 2 天之间的病变水扩散率（伪正常化），并降低血液基质金属蛋白酶 9 (MMP-9) 水平。在人类中风的静脉注射格列本脲治疗中，血管源性水肿的几种替代标志物似乎有所减少。在随机、安慰剂对照试验的背景下，有必要验证这些潜在的成像和血液生物标志物。
Brain edema is a serious complication of ischemic stroke that can lead to secondary neurological deterioration and death. Glyburide is reported to prevent brain swelling in preclinical rodent models of ischemic stroke through inhibition of a non-selective channel composed of sulfonylurea receptor 1 (SUR1) and transient receptor potential cation channel subfamily M member 4 (TRPM4). However, the relevance of this pathway to the development of cerebral edema in stroke patients is not known. Using a case control design, we retrospectively assessed neuroimaging and blood markers of cytotoxic and vasogenic edema in subjects who were enrolled in the Glyburide Advantage in Malignant Edema and Stroke-Pilot (GAMES-Pilot) trial. We compared serial brain magnetic resonance images (MRIs) to a cohort with similar large volume infarctions. We also compared matrix metalloproteinase-9 plasma level in large hemispheric stroke. We report that IV glyburide was associated with attenuated T2 fluid attenuated inversion recovery (FLAIR) signal intensity ratio on brain MRI, diminished the lesional water diffusivity between days 1 and 2 (pseudo-normalization), and reduced blood matrix metalloproteinase-9 (MMP-9) level. Several surrogate markers of vasogenic edema appear to be reduced in the setting of IV glyburide treatment in human stroke. Verification of these potential imaging and blood biomarkers is warranted in the context of a randomized, placebo-controlled trial.
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DOI：
10.1097/00002142-200010000-00006
发表时间：
2000-10-01
期刊：
Topics in magnetic resonance imaging : TMRI
影响因子：
--
作者：
Schaefer, P W
通讯作者：
Schaefer, P W
影响因子：
8.3
作者：
CROCKARD, A;IANNOTTI, F;SYMON, L
通讯作者：
SYMON, L
影响因子：
8.3
作者：
Castellanos, Mar;Sobrino, Tomas;Davalos, Antoni
通讯作者：
Davalos, Antoni
影响因子：
--
作者：
Hacke, W;Schwab, S;vonKummer, R
通讯作者：
vonKummer, R
影响因子：
5.3
作者：
Chen, MK;Simard, JM
通讯作者：
Simard, JM