Abstract

Introduction: After analysis of current reviews and research into current clinical tries, a novel combination therapy which is phased to tackle the pathophysiological events in the brain over time may be suggested which may provide more positive results in clinical trials, overcome some of the limits that current therapies in trial are facing, and improve ischemic stroke sufferers long-term recovery and outcome. Method: Only those articles that provide original research were reviewed, such as primary research articles, cohort studies, and animal model studies and phase 1 clinical trial. Multiple electronic databases using a variety of outlined search terms were used to gather suitable papers. The sources used were Google Scholar, Pub Med, Science Direct, Web of Science, Scientific Web Plus etc. Result: The result of this review shows that the number of pre-clinical animal model studies for potential therapies after stroke outnumber clinical human trials on a ratio 2.6:1 (pre-clinical animal: clinical human). Therapies after TIA to prevent major stroke recurrence appear to be more advanced, with all potential therapies in phase 1 clinical trial for safety and efficacy. Discussion: There are many trials which has shown potential for better stroke recovery and results from those studies support the safe and effective use of many chemical derivatives like 2-growth factor therapy initiated 24 to 48 hours after stroke onset, therapy using adenovirus-expressing heparin-binding epidermal growth factor which significantly enhanced recovery after ischemic stroke, human umbilical mesenchymal stem cells transplantation for ischemic stroke, and monocyte-derived Multipotential cells which are potentially effective candidate for use in cell transplantation therapy for cerebral ischemia.

Keywords: Ischemic stroke · Transient ischemic attack (TIA) · Tissue remodeling · Tissue revascularization · Neuroprotection

References

  1. 1.Goldstein, M. et al. Recommendations on stroke prevention, diagnosis, and therapy: Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke, 20 (10), 1407-1431.
  2. 2.NHS.uk NHS Choices - Stroke. 2010 [online] Available at: http://www.nhs.uk/conditions/stroke/pages/ introduction.aspx [Accessed: 16 Apr 2012]
  3. 3.Barnett, H. et al. Stroke: Pathophysiology, Diagnosis, and Management. The Journal of The American Potential Therapies after Ischemic Stroke, Al Baradie RS Medical Association, 1999; 282 (6), p.595 - 596.
  4. 4.Hickey, J. The Clinical Practice of Neurological and Neurosurgical Nursing,. 5th ed. 2003 Philadelphia: Lippincott, Williams & Wilkins.
  5. 5.Candelario-Jalil E. Injury and repair mechanisms in ischemic stroke: considerations for the development of novel neurotherapeutics. Curr Opin Investig Drugs. 2009 Jul;10(7):644-54.
  6. 6.Krupinski, J. et al. (1994) Role of angiogenesis in patients with cerebral ischemic stroke.. Stroke, 25 (9), p.1794 - 1798.
  7. 7.Lyden PD. Thrombolytic Therapy for Acute Stroke. Totowa, NJ: Humana Press; 2005.
  8. 8.Hinkle, J. and Guanci, M. (2007) Acute Ischemic Stroke Review. Journal of Neuroscience Nursing, 39 (5), p.285 - 293, 310.
  9. 9.Slevin, M. et al. (2006) Can angiogenesis be exploited to improve stroke outcome? Mechanisms and therapeutic potential. Clinical Science, 111 (1) p.171 - 183.
  10. 10.Prinz V, Laufs U, Gertz K, Kronenberg G, Balkaya M, Leithner C et al.. Intravenous rosuvastatin for acute stroke treatment: an animal study. Stroke. 2008 Feb;39(2):433-8.
  11. 11.M. Dávalos A, Alvarez-Sabín J, Castillo J, Díez-Tejedor E, Ferro J, Martínez-Vila E, et al.; International Citicoline Trial on acUte Stroke (ICTUS) trial investigators. Lancet. 2012 Jul 28;380(9839):349-57. doi: 10.1016/ S0140-6736(12)60813-7.
  12. 12.Ehrenreich H, Weissenborn K, Prange H, Schneider D, Weimar C, Wartenberg K et al. Recombinant human erythropoietin in the treatment of acute ischemic stroke. Stroke. 2009 Dec;40(12):e647-56.
  13. 13.Zhao LR, Berra HH, Duan WM, Singhal S, Mehta J, Apkarian AV, Kessler JA. Beneficial effects of hematopoietic growth factor therapy in chronic ischemic stroke in rats. Stroke. 2007;38(10):2804-11
  14. 14.Yang J, Guo L, Liu R, Liu H. Neuroprotective effects of VEGF administration after focal cerebral ischemia/ reperfusion: dose response and time window. Neurochem Int. 2012 May;60(6):592-6.
  15. 15.Zhao H, Bao XJ, Wang RZ, Li GL, Gao J, Ma SH et al. Postacute ischemia vascular endothelial growth factor transfer by transferrin-targeted liposomes attenuates ischemic brain injury after experimental stroke in rats. Hum Gene Ther. 2011 Feb;22(2):207-15.
  16. 16.Emerich DF, Silva E, Ali O, Mooney D, Bell W, Yu SJ, Kaneko Y, Borlongan C. Injectable VEGF hydrogels produce near complete neurological and anatomical protection following cerebral ischemia in rats. Cell Transplant. 2010;19(9):1063-71.
  17. 17.Pathipati P, Surus A, Williams CE, Scheepens A. Delayed and chronic treatment with growth hormone after endothelin-induced stroke in the adult rat. Behav 9 Review Article MAJMAAH JOURNAL OF HEALTH SCIENCE, Vol 2, Issue 1, 2014 Brain Res. 2009 Dec 1;204(1):93-101.
  18. 18.Lapergue B, Moreno JA, Dang BQ, Coutard M, Delbosc S, Raphaeli G et al. Protective effect of high-density lipoprotein-based therapy in a model of embolic stroke. Stroke. 2010 Jul;41(7):1536-42.
  19. 19.Zare M, Saadatnia M, Mousavi SA, Keyhanian K, Davoudi V, Khanmohammadi E. The effect of statin therapy in stroke outcome: a double blind clinical trial. Int J Prev Med. 2012 Jan;3(1):68-72.
  20. 20.Jung KH, Chu K, Lee ST, Sunwoo JS, Park DK, Kim JH et al. Effects of long term nitrite therapy on functional recovery in experimental ischemia model. Biochem Biophys Res Commun. 2010 Dec 3;403(1):66-72.
  21. 21.Herz J, Reitmeir R, Hagen SI, Reinboth BS, Guo Z, Zechariah A et al. Intracerebroventricularly delivered VEGF promotes contralesional corticorubral plasticity after focal cerebral ischemia via mechanisms involving anti-inflammatory actions. Neurobiol Dis. 2012 Mar;45(3):1077-85
  22. 22.Cramer SC, Fitzpatrick C, Warren M, Hill MD, Brown D, Whitaker L et al. The beta-hCG+erythropoietin in acute stroke (BETAS) study: a 3-center, single-dose, open-label, noncontrolled, phase IIa safety trial. Stroke. 2010 May;41(5):927-31.
  23. 23.Sugiura S, Kitagawa K, Tanaka S, Todo K, OmuraMatsuoka E, Sasaki T. Adenovirus-mediated gene transfer of heparin-binding epidermal growth factorlike growth factor enhances neurogenesis and angiogenesis after focal cerebral ischemia in rats. Stroke. 2005 Apr;36(4):859-64. Epub 2005 Mar 3.
  24. 24.Lin YC, Ko TL, Shih YH, Lin MY, Fu TW, Hsiao HS et al. Human umbilical mesenchymal stem cells promote recovery after ischemic stroke. Stroke. 2011 Jul;42(7):2045-53.
  25. 25.Hattori H, Suzuki S, Okazaki Y, Suzuki N, Kuwana M. Intracranial transplantation of monocyte-derived multipotential cells enhances recovery after ischemic stroke in rats. J Neurosci Res. 2012 Feb;90(2):479-88
  26. 26.Yu H, Cao B, Feng M, Zhou Q, Sun X, Wu S et al. Combinated transplantation of neural stem cells and collagen type I promote functional recovery after cerebral ischemia in rats. Anat Rec (Hoboken). 2010 May;293(5):911-7. Potential Therapies after Ischemic Stroke, Al Baradie RS
  27. 27.Levy EI, Siddiqui AH, Crumlish A, Snyder KV, Hauck EF, Fiorella DJ et al. First Food and Drug Administrationapproved prospective trial of primary intracranial stenting for acute stroke: SARIS (stent-assisted recanalization in acute ischemic stroke). Stroke. 2009 Nov; 40(11):3552-6.
  28. 28.Warner, G. et al. Secondary stroke prevention best practice recommendations: exploring barriers for rural family physicians. Canadian Journal of Rural Medicine, 2010; 15 (4), p.143-152.
  29. 29.Amareneco, P. et al. Baseline blood pressure, lowand high-density lipoproteins, and triglycerides and the risk of vascular events in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Atherosclerosis, 2009; 204 (1), p.515-520
  30. 30.Bao Dang, Q. et al. High-density lipoproteins limit neutrophil-induced damage to the blood–brain barrier in vitro. Journal of Cerebral Blood Flow & Metabolism, 2013 [Epub ahead of print] Available at: doi: 10.1038/jcbfm.2012.206. doi:10.1038/jcbfm.2012.206
  31. 31.Wang, L. et al. Treatment of Stroke With Erythropoietin Enhances Neurogenesis and Angiogenesis and Improves Neurological Function in Rats. Stroke, 2004; 35 (1), p.1732-1737.
  32. 32.Sahota, P. and Savitz, S. Investigational Therapies for Ischemic Stroke: Neuroprotection and Neurorecovery. Neurotherapeutics, 2011; 8 (1), p.434-451.
  33. 33.Adibhatla, R. Citicoline in stroke and TBI clinical trials. Nature Reviews Neurology, 2013 [Epub ahead of print] Available at: doi:10.1038/nrneurol.2012.166-c1. doi:10.1038/nrneurol.2012.166-c1
  34. 34.Sun, Y. et al. VEGF-induced neuroprotection, neurogenesis, and angiogenesis after focal cerebral ischemia.The Journal of Clinical Investigation, 2003; 111 (12), p.1843-1851.
  35. 35.Ma, Y. et al. Effects of Vascular Endothelial Growth Factor in Ischemic Stroke. Journal of Neuroscience Research, 2012; 90 (1), p.1873-1882.
  36. 36.Elkind, M. (2012) Inflammatory Mechanisms of Stroke. Stroke, 41 (1), p.S3-S8, 10
Majmaah Journal of Health Sciences · eISSN 1658-8223 · Majmaah University · open access