Edaravone: A new therapeutic approach for the treatment of acute stroke
Edaravone: A new therapeutic approach for the treatment of acute stroke
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DOI：
10.1016/j.mehy.2010.07.038
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发表时间：
2010-12-01
影响因子：
4.7
通讯作者：
Shigemori, Minoru
中科院分区：
文献类型：
--
作者：
Kikuchi, Kiyoshi;Kawahara, Ko-ichi;Shigemori, Minoru
急性中风，包括急性缺血性中风（AIS）和急性出血性中风（AHS），是与工业化社会的人口变化特别相关的常见医学问题。近年来，出现了AIS的治疗方法，包括组织纤溶酶原激活剂（t-PA）溶栓。虽然t-PA是目前最有效的治疗方法，但它受到治疗时间窗窄和副作用的限制，只有3%的AIS患者接受溶栓治疗。依达拉奉最初是作为一种有效的自由基清除剂开发的，自2001年以来，在日本已被广泛用于治疗AIS。依达拉奉延长了t-PA在大鼠体内狭窄的治疗时间窗。治疗时间窗对于AIS的治疗非常重要，早期依达拉奉治疗更有效。因此，依达拉奉与t-PA联合给药可挽救更多AIS患者。同时，依达拉奉减轻AHS诱导的大鼠脑水肿、神经功能缺损和氧化损伤。尽管依达拉奉治疗目前仅适用于AIS，但它确实对大鼠AHS具有神经保护作用。因此，我们假设早期给予依达拉奉可以挽救AHS患者以及AIS患者。综上所述，我们的研究结果表明，依达拉奉应立即给予怀疑急性卒中，包括AIS和AHS。(C)2010爱思唯尔有限公司版权所有。
Acute stroke, including acute ischemic stroke (AIS) and acute hemorrhagic stroke, (AHS) is a common medical problem with particular relevance to the demographic changes in industrialized societies. In recent years, treatments for AIS have emerged, including thrombolysis with tissue plasminogen activator (t-PA). Although t-PA is the most effective currently available therapy, it is limited by a narrow therapeutic time window and side effects, and only 3% of all AIS patients receive thrombolysis. Edaravone was originally developed as a potent free radical scavenger and, since 2001, has been widely used to treat AIS in Japan. It was shown that edaravone extended the narrow therapeutic time window of t-PA in rats. The therapeutic time window is very important for the treatment of AIS, and early edaravone treatment is more effective. Thus, more AIS patients might be rescued by administering edaravone with t-PA. Meanwhile, edaravone attenuates AHS-induced brain edema, neurologic deficits and oxidative injury in rats. Although edaravone treatment is currently only indicated for AIS, it does offer neuroprotective effects against AHS in rats. Therefore, we hypothesize that early administration of edaravone can rescue AHS patients as well as AIS patients. Taken together, our findings suggest that edaravone should be immediately administered on suspicion of acute stroke, including AIS and AHS. (C) 2010 Elsevier Ltd. All rights reserved.