Neuroprotective therapy

被引:104
作者
Hickenbottom, SL [1 ]
Grotta, J [1 ]
机构
[1] Univ Texas, Sch Med, Dept Neurol, Stroke Program, Houston, TX 77030 USA
关键词
stroke; neuroprotection; therapy;
D O I
10.1055/s-2008-1040901
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The concept of neuroprotection relies on the principle that delayed neuronal injury occurs after ischemia. The phenomenon of the "ischemic cascade" has been described, and each step along this cascade provides a target for therapeutic intervention. In animal models of global and focal cerebral ischemia, numerous preclinical studies have demonstrated various agents to be neuroprotective at different steps along this cascade. A wide variety of drugs has also been studied in humans. Ten classes of neuroprotective agents have reached phase III efficacy trials but have shown mixed results. They include calcium channel antagonists, NMDA receptor antagonists, lubeluzole, CDP-choline, the free radical scavenger tirilizad, anti-intercellular adhesion molecule-1 (ICAM-1) antibody, GM-I ganglioside, clomethiazole, the sodium channel antagonist fosphenytoin, and piracetam. in the future, clinicians may have an armamentarium of treatments for acute ischemic stroke at their disposal, with a combination of agents directed at different sites in the ischemic cascade being the ultimate goal.
引用
收藏
页码:485 / 492
页数:8
相关论文
共 46 条
  • [1] Albers Gregory W., 1997, Stroke, V28, P233
  • [2] SAFETY, TOLERABILITY, AND PHARMACOKINETICS OF THE N-METHYL-D-ASPARTATE ANTAGONIST DEXTRORPHAN IN PATIENTS WITH ACUTE STROKE
    ALBERS, GW
    ATKINSON, RP
    KELLEY, RE
    ROSENBAUM, DM
    [J]. STROKE, 1995, 26 (02) : 254 - 258
  • [3] ALTER M, 1994, STROKE, V25, P1141
  • [4] ARONOWSKI J, 1993, J CEREBR FLOW METAB, V15, P550
  • [5] CHIU D, 1997, PRIMER CEREBROVASCUL, P731
  • [6] Clark W M, 1996, J Stroke Cerebrovasc Dis, V6, P35, DOI 10.1016/S1052-3057(96)80024-3
  • [7] A randomized dose-response trial of citicoline in acute ischemic stroke patients
    Clark, WM
    Warach, SJ
    Pettigrew, LC
    Gammans, RE
    Sabounjian, LA
    [J]. NEUROLOGY, 1997, 49 (03) : 671 - 678
  • [8] Clark WM, 1998, STROKE, V29, P287
  • [9] Lamotrigine protects hippocampal CA1 neurons from ischemic damage after cardiac arrest
    Crumrine, RC
    Bergstrand, K
    Cooper, AT
    Faison, WL
    Cooper, BR
    [J]. STROKE, 1997, 28 (11) : 2230 - 2236
  • [10] Termination of acute stroke studies involving selfotel treatment
    Davis, SM
    Albers, GW
    Diener, HC
    Lees, KR
    Norris, J
    [J]. LANCET, 1997, 349 (9044) : 32 - 32