지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
이용수
초록· 키워드
오류제보하기
To date, reperfusion with tissue plasminogen activator (tPA) remains the gold standard treatment for ischemic stroke. However, when tPA is given beyond 4.5 hours of stroke onset, deleterious effects of the drug ensue, especially, hemorrhagic transformation (HT), which causes the most significant morbidity and mortality in stroke patients. An important clinical problem at hand is to develop strategies that will enhance the therapeutic time window for tPA therapy and reduce the adverse effects (especially HT) of delayed tPA treatment. We reviewed the pharmacological agents which reduced the risk of HT associated with delayed (beyond 4.5 hours post-stroke) tPA treatment in preclinical studies, which we classified into those that putatively preserve the blood-brain barrier (e.g., minocycline, cilostazol, fasudil, candesartan, and bryostatin) and/or enhance vascularization and protect the cerebrovasculature (e.g., coumarin derivate IMM-H004 and granulocyte colony-stimulating factor). Recently, other new therapeutic modalities (e.g., oxygen transporters) have been reported which improved delayed tPA-associated outcomes by acting through other mechanisms. While the above-mentioned interventions unequivocally reduced delayed tPA-induced HT in stroke models, the long-term efficacy of these drugs are not yet established. Further optimization is required to expedite their future clinical application. The findings from this review indicate the need to explore the most ideal adjunctive interventions that will not only reduce delayed tPA–induced HT, but also preserve neurovascular functions. While waiting for the next breakthrough drug in acute stroke treatment, it is equally important to allocate considerable effort to find approaches to address the limitations of the only FDA-approved stroke therapy.
목차
등록된 정보가 없습니다.
참고문헌 (23)
참고문헌 신청
Adams HP Jr / 2003 / Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association /
Albers GW / 1999 / Expanding the window for thrombolytic therapy in acute stroke. The potential role of acute MRI for patient selection / Stroke 30 : 2230 ~ 2237
Ballabh P / 2004 / The blood?brain barrier: an overview: structure, regulation, and clinical implications / Neurobiol Dis 16 : 1 ~ 13
Blacker DJ / 2013 / Reducing haemorrhagic transformation after thrombolysis for stroke: a strategy utilising minocycline / Stroke Res Treat 2013 : 362961 ~
Fagan SC / 2010 / Minocycline to improve neurologic outcome in stroke (MINOS): a dose-finding study / Stroke 41 : 2283 ~ 2287
Albers GW / 1999 / Expanding the window for thrombolytic therapy in acute stroke. The potential role of acute MRI for patient selection / Stroke 30 : 2230 ~ 2237
Ballabh P / 2004 / The blood?brain barrier: an overview: structure, regulation, and clinical implications / Neurobiol Dis 16 : 1 ~ 13
Blacker DJ / 2013 / Reducing haemorrhagic transformation after thrombolysis for stroke: a strategy utilising minocycline / Stroke Res Treat 2013 : 362961 ~
Fagan SC / 2010 / Minocycline to improve neurologic outcome in stroke (MINOS): a dose-finding study / Stroke 41 : 2283 ~ 2287
함께 읽어보면 좋을 논문
논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!
-
tPA Helpers in the Treatment of Acute Ischemic Stroke: Are They Ready for Clinical Use?
대한뇌졸중학회지
2019 .01
-
Intravenous Tissue Plasminogen Activator Improves the Outcome in Very Elderly Korean Patients with Acute Ischemic Stroke
대한뇌졸중학회지
2015 .01
-
Emergency management of stroke in the era of mechanical thrombectomy
Clinical and Experimental Emergency Medicine
2019 .01
-
Antiplatelet therapy within 24 hours of tPA: lessons learned from patients requiring combined thrombectomy and stenting for acute ischemic stroke
Journal of Cerebrovascular and Endovascular Neurosurgery
2020 .01
-
Mechanisms of Preconditioning Exercise-Induced Neurovascular Protection in Stroke
대한뇌졸중학회지
2021 .09
-
Pneumococcal meningitis complicated by otomastoiditis and pneumocephalus confounding an acute ischemic stroke diagnosis
Journal of Neurocritical Care
2021 .01
-
Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society
대한뇌졸중학회지
2019 .01
-
Organizing Healthcare for Optimal Acute Ischemic Stroke Treatment
Journal of Clinical Neurology
2020 .01
-
Effect of isoflurane post-treatment on tPA-exaggerated brain injury in a rat ischemic stroke model
Korean Journal of Anesthesiology
2015 .01
-
Case Characteristics, Hyperacute Treatment, and Outcome Information from the Clinical Research Center for Stroke-Fifth Division Registry in South Korea
대한뇌졸중학회지
2015 .01
-
Update of the Korean Clinical Practice Guidelines for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke
대한뇌졸중학회지
2016 .01
-
허혈성 뇌졸중 치료의 최신지견
대한의사협회지
2016 .01
-
Cancer-Related Stroke: An Emerging Subtype of Ischemic Stroke with Unique Pathomechanisms
대한뇌졸중학회지
2020 .01
-
Prestroke Antiplatelet Effect on Symptomatic Intracranial Hemorrhage and Functional Outcome in Intravenous Thrombolysis
대한뇌졸중학회지
2016 .01
-
Considerations When Subtyping Ischemic Stroke in Asian Patients
Journal of Clinical Neurology
2016 .01
-
Clinical Variables and Genetic Risk Factors Associated with the Acute Outcome of Ischemic Stroke: A Systematic Review
대한뇌졸중학회지
2019 .01
-
Application of Machine Learning and Deep Learning in Imaging of Ischemic Stroke
Investigative Magnetic Resonance Imaging
2022 .12
-
Treatments to Promote Neural Repair after Stroke
대한뇌졸중학회지
2018 .01
-
Trends in Incident and Recurrent Rates of First-Ever Ischemic Stroke in Taiwan between 2000 and 2011
대한뇌졸중학회지
2016 .01
-
The Comparison of Risk Factors for Ischemic Stroke or Intracranial Hemorrhage in Korean Stroke Patients : A Nationwide Population-based Study
대한의생명과학회지
2018 .12
이 논문의 저자 정보
최근 본 자료
댓글(0)
0