Glicoprotein (GP) IIb/IIIa inhibitors for acute stroke treatment

Gene expression profile induced by oral administration of baicalin and gardenin after focal brain ischemia in rats

AIM

To investigate differential gene expression and the pharmacological mechanism of baicalin and gardenin in focal cerebral ischemia in rats with high-density cDNA microarray.

METHODS

Rat left middle cerebral arteries were occluded and treated with either baicalin or gardenin. The pharmacological effects were investigated using the difference in infarction areas before and after treatment, which were determined by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Gene expression was demonstrated using a "Biostar40S" gene microarray. Semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to verify the result of the selected genes.

RESULTS

Both baicalin and gardenin reduced the infarction areas in focal cerebral ischemia rats (P<0.05). The differential genes were 211, 177, and 70 (upregulated or downregulated) in the model group, baicalin, and gardenin treatment groups compared with the sham-operated group, respectively. Gene expression of RpL19 and Csnk2 underwent an approximately 1.9 and 2.1-fold increase, respectively, verified by semiquantitative RT-PCR, which was the same trend as the cDNA microarray.

CONCLUSION

Differential gene expression with respect to the pharmacological effects of baicalin and gardenin on focal cerebral ischemia by cDNA microarray revealed a number of clues with respect to the therapeutic mechanisms of Chinese traditional medicine. In addition, the present study provided theoretical and experimental evidence that will aid future studies examining cerebral ischemia.

Critical care management of acute ischemic stroke

PURPOSE OF REVIEW

To review and examine the efficacy of recently described medical and surgical interventions after acute ischaemic stroke using data from well conducted, clinical trials and systematic reviews. This review will consider recently published or updated articles.

RECENT FINDINGS

As therapeutic options evolve, including thrombolysis and anti-platelet therapy, prevention of secondary insults, becomes increasingly important during periods of acute cerebral ischaemia in order to prevent worsening of the neurological injury. As in other acute medical conditions, urgent management of patients with acute ischaemic stroke should begin with the assessment and treatment of the airway, breathing, circulation, temperature, and blood glucose control.

SUMMARY

It is estimated that there will be 8.5 million patients with acute ischaemic stroke in the European Union and the USA over the next decade, and of these, about one and a half million will die within six months of stroke onset. Of those who survive, about one third will depend on other people for help with their activities of daily living. Future treatment strategies are likely to involve agents that re-canalise vessels and minimise further neuronal damage.