Related Research and Recent Progress of Ischemic Penumbra

Ran, Yuncai; Zhu, Ming; Li, Shu-Jian; Zhang, Zan-Xia; Wang, Xiao; Zhang, Yong; Cheng, Jingliang

doi:10.1016/j.wneu.2018.04.193

Cited by 15 publications

(11 citation statements)

References 87 publications

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“…Penumbra was proposed for the first time on the basis of a research conducted by Abstrup 27 . In the early stage of ischaemia, cells in the ischaemic penumbra region will incur irreversible damage if blood flow cannot be recovered in time 28 . Hence, saving the ischaemic penumbra plays a vital role in the management of AIS.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Chen

Lin

et al. 2021

J Clin Pharm Ther

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What is known and objective Edaravone is a new antioxidant and hydroxyl radical scavenger. Although there is evidence that it improves clinical outcomes of patients with acute ischaemic stroke (AIS), it is not yet widely accepted for treatment of AIS in Western countries. We further investigated the efficacy and safety of edaravone through this meta‐analysis of randomized controlled clinical trials (RCTs). Method Pubmed, Embase, Web of Science and Cochrane Library were screened up to December 2020 for original articles from SCI journals that published in English. RCTs that compared edaravone versus placebo or no intervention in adult patients and reported the efficacy or safety of edaravone were regarded as eligible. Mortality was regarded as the primary outcome and the improvement of neurological impairment was regarded as the secondary outcome. Safety evaluation was conducted according to the incidence of adverse events. Review Manager 5.3 was employed to perform the assessment of the risk of bias and data synthesis. The Cochrane risk of bias tool for randomized controlled trials was employed to assess the risk of bias. Results and discussion Seven randomized controlled trials with 2069 patients were included. For the incidence of mortality, the pooled RR for studies that evaluated edaravone after three‐month follow‐up was 0.55 (95% Cl, 0.43‐0.7, I2 = 0, P < 0.01). The pooled RR for improvement of neurological impairment at the three months follow‐up was 1.54 (95% CI, 1.27‐1.87, I2 = 0, P < 0.01) in four RCTs. On subgroup analysis of studies that were conducted in Asia, the RR was 1.56 (95% CI, 1.27‐1.90, I2 = 0%; P < 0.01); the pooled RR for studies that conducted in Europe was 1.32 (95% CI, 0.64‐2.72; P = 0.45); the pooled RR for studies that used edaravone for two weeks was 1.42 (95% CI, 1.10 to 1.83, I2 = 0%; P < 0.01); the pooled RR for studies that used edaravone for one week was 1.64 (95% CI, 1.24‐2.16, I2 = 0%; P < 0.01); the pooled RR for studies that conducted in patients with mean age equal to or over 60 years was 1.52 (95% CI, 1.24‐1.87, I2 = 0%; P < 0.01); and the pooled RR for studies that conducted in patients with mean age less than 60 was 1.80 (95% CI, 1.05‐3.08, I2 = 0%; P = 0.03). For the incidence of any treatment‐related adverse events, the pooled RR for studies that evaluated edaravone during treatment was 0.83 (95% CI, 0.51‐1.34, I2 = 0, P = 0.43). The difference of the incidence of any treatment‐related adverse events between two groups was not statistically significant. What is new and conclusion The limited studies indicate that edaravone can improve neurological impairment with a survival benefit at three‐month follow‐up, regardless of the mean age and course of treatment. It is worthy of promotion in the clinical treatment of AIS in Asian countries. More well‐designed RCTs with larger sample sizes are needed to determine the benefits of edaravone in patients from Western countries.

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Section: Discussionmentioning

confidence: 99%

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Chen

Lin

et al. 2021

J Clin Pharm Ther

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“…Based on the OGD/R studied by other scholars and the laboratory conditions, the OGD 9 h/R 1 h was determined as the nal modeling condition with gas concentration of 37 ℃, 90% N2 and 5% O2. [32][33] The cell proliferation ability can be seen from the cell viability determined by CCK-8 assay. Real-Time Live-Cell Imaging System was used to automatically take pictures at regular intervals to capture changes in the shape and area of cells in each eld of vision.…”

Section: Discussionmentioning

confidence: 99%

Targeted Delivery of Intranasally Administered Cyclovirobuxine D Liposomes to Brain for Treatment Cerebral Ischemia-Reperfusion Injury via Anti-oxidative Stress and Activating Autophagy

Liu

Xiao

Yang

et al. 2021

Preprint

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Background: The lack of effective therapy mandates development of treatment for cerebral ischemia-reperfusion injury (CIRI). The previous study suggested that CVBD encapsulated in Angiopep-conjugated Polysorbate 80-Coated Liposomes showed a better brain targeting by intranasal administration. Therefore, this study focused on the protection and mechanism of CVBD brain-targeted liposomes in treating CIRI.Methods: The CIRI rat model was induced by MCAO. Pharmacological evaluation was assessed in vivo by general indexs, neurobehavioral scores, triphenyl tetrazolium chloride (TTC) staining, histopathological staining (HE staining and Nissl staining), small animal magnetic resonance imaging, biochemical assay and Western blot. Then, the protective effect of CVBD liposomes on OGD/R-injured HT22 cell was investigated by cell fusion degree, cell proliferation curve and cell viability. OGD/R-injured HT22 cell was infected by mRFP-GFP-LC3 adenovirus. The autophagosome and autophagy flow were observed by laser confocal microscopy, and autophagy-related protein expressions (LC3, p62 and Beclin 1) were analyzed by Western blot. Meanwhile, the classic autophagy inhibitor, chloroquine, was used to explore the autophagy- regulated mechanism of CVBD brain-targeted liposomes in treating CIRI. Results: In rat model of CIRI, CVBD liposomes alleviated pathological damage of brain. In cell model of oxygen and glucose deprivation/re-oxygenation, CVBD liposomes increased cell viability and decreased ROS level. CVBD liposomes improved oxidative stress protein expressions and activated autophagy in vitro. Furthermore, CVBD liposomes reversed the decrease of cell viability, increase of ROS level, and reduction of protein expressions associated to anti-oxidative stress and autophagy induced by chloroquine. Conclusions: Therefore, CVBD liposomes inhibited CIRI via regulating oxidative stress and enhancing autophagy level in vivo and in vitro, showing a great potential in treating CIRI in clinic.

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“…However, ischemic tissue surrounding the infarct centre, known as the ischemic penumbra (IP), is short of electrical activity, but can still maintain normal transmembrane potential and voltage. If the supply of blood to the brain can be repaired in time, IP can be recovered to prevent further expansion of the infarct [23]. Therefore, timely and effective neuroprotection of the IP is now the main method of ischemic stroke treatment [24].…”

Section: Discussionmentioning

confidence: 99%

Calycosin-7-O-β-D-Glucoside Treatment Promotes Axonal Regeneration via Rho/ROCK Pathway After Ischemia/Reperfusion Injury

Zhong¹,

Yu²,

Wen³

et al. 2020

Preprint

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Background: As a medical component in Astragalus(AR) ，Calycosin-7- O -β-D-glucoside（CG）defends ischemia/reperfusion(I/R) injury in cerebral ischemia due to its anti-oxidative and anti-inflammatory effects. However, whether CG can facilitate I/R injury by stimulating neuroregeneration and its specific mechanism is remained to be elucidated. Methods: In this study, an animal model of ischemic stroke was established by middle cerebral artery occlusion (MCAO). Seven days after CG, triphenyltetrazolium chloride (TTC) staining was performed to examine the ischemic volume, accompanied by behavioral tests to assess neurological function. Nissl staining and Bielschowsky’s silver staining were used to observe nerve cell damage and axonal loss, while immunofluorescence was used to evaluate axonal regeneration. Results: The expression of proteins associated with the Rho/ROCK pathway was detected by using western blot (WB) and quantitative real-time polymerase chain reaction (qRT-PCR). We showed that CG significantly reduced ischemic volume, facilitated axonal regeneration, improved neurological function, and regulated expression of RGMa, Rho, ROCK, and CRMP2. Conclusions: Our results suggested that CG promotes axonal regeneration by limiting activation of the Rho/ROCK pathway to promote recovery after cerebral ischemia.

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Related Research and Recent Progress of Ischemic Penumbra

Cited by 15 publications

References 87 publications

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Targeted Delivery of Intranasally Administered Cyclovirobuxine D Liposomes to Brain for Treatment Cerebral Ischemia-Reperfusion Injury via Anti-oxidative Stress and Activating Autophagy

Calycosin-7-O-β-D-Glucoside Treatment Promotes Axonal Regeneration via Rho/ROCK Pathway After Ischemia/Reperfusion Injury

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Related Research and Recent Progress of Ischemic Penumbra

Cited by 15 publications

References 87 publications

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Targeted Delivery of Intranasally Administered Cyclovirobuxine D Liposomes to Brain for Treatment Cerebral Ischemia-Reperfusion Injury via Anti-oxidative Stress and Activating Autophagy

Calycosin-7-O-β-D-Glucoside Treatment Promotes Axonal&nbsp;Regeneration via Rho/ROCK Pathway After Ischemia/Reperfusion&nbsp;Injury

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Calycosin-7-O-β-D-Glucoside Treatment Promotes Axonal Regeneration via Rho/ROCK Pathway After Ischemia/Reperfusion Injury