Safety and efficacy of glibenclamide combined with rtPA in acute cerebral ischemia with occlusion/stenosis of anterior circulation (SE-GRACE): a randomized, double-blind, placebo-controlled trial

Huang, Kaibin; Zhao, Xiaolin; Zhao, Yunxiao; Yang, Guoshuai; Zhou, Saijun; Yang, Zhi; Huang, Wenguo; Weng, Guohu; Chen, Pingyan; Duan, Chongyang; Lin, Zhenzhou; Wang, Shengnan; Liu, Xiangmin; Huang, Yunqiang; Zhang, Jiangshan; Zhang, Xu; Li, Hao; Ye, Songsheng; Gu, Yong; Zhu, Minzhen; Chen, Weiying; Quan, Weiwei; Liu, Na; Chen, Quanfeng; Chang, Yuan; He, Jinzhao; Ji, Zhong; Wu, Yongming; Pan, Suyue

doi:10.1016/j.eclinm.2023.102305

Cited by 1 publication

(1 citation statement)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the case of SUR1-TRPM4, mid-phase clinical data on patients with large hemispheric infarctions suggest that early treatment with glibenclamide can reduce midline shift, a standard measure of brain swelling [ 41 ]. Ongoing research on drugs for use in humans will determine whether glibenclamide [ 42 ] or other drugs can be advanced for the treatment of patients with stroke whose neurological well-being is adversely affected by brain swelling.…”

Section: Discussionmentioning

confidence: 99%

Brain Swelling versus Infarct Size: A Problematizing Review

Simard,

Wilhelmy,

Tsymbalyuk

et al. 2024

Brain Sciences

View full text Add to dashboard Cite

In human stroke, brain swelling is an important predictor of neurological outcome and mortality, yet treatments to reduce or prevent brain swelling are extremely limited, due in part to an inadequate understanding of mechanisms. In preclinical studies on cerebroprotection in animal models of stroke, historically, the focus has been on reducing infarct size, and in most studies, a reduction in infarct size has been associated with a corresponding reduction in brain swelling. Unfortunately, such findings on brain swelling have little translational value for treating brain swelling in patients with stroke. This is because, in humans, brain swelling usually becomes evident, either symptomatically or radiologically, days after the infarct size has stabilized, requiring that the prevention or treatment of brain swelling target mechanism(s) that are independent of a reduction in infarct size. In this problematizing review, we highlight the often-neglected concept that brain edema and brain swelling are not simply secondary, correlative phenomena of stroke but distinct pathological entities with unique molecular and cellular mechanisms that are worthy of direct targeting. We outline the advances in approaches for the study of brain swelling that are independent of a reduction in infarct size. Although straightforward, the approaches reviewed in this study have important translational relevance for identifying novel treatment targets for post-ischemic brain swelling.

show abstract

Section: Discussionmentioning

confidence: 99%