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Arockiam S, Staniforth B, Kepreotis S, Maznyczka A, Bulluck H. A Contemporary Review of Antiplatelet Therapies in Current Clinical Practice. Int J Mol Sci 2023; 24:11132. [PMID: 37446310 DOI: 10.3390/ijms241311132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Antiplatelet therapy plays a crucial role in a number of cardiovascular disorders. We currently have a range of antiplatelet agents in our armamentarium. In this review, we aim to summarise the common antiplatelet agents currently available, and their use in clinic practice. We not only highlight recent trials exploring antiplatelet therapy in atherosclerotic cardiovascular disease, but also in trials related to transcatheter aortic valve implantation and coronavirus disease 2019. Inevitably, the antithrombotic benefits of these drugs are accompanied by an increase in bleeding complications. Therefore, an individualised approach to weighing each patient's thrombotic risk versus bleeding risk is imperative, in order to improve clinical outcomes.
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Affiliation(s)
- Sacchin Arockiam
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS2 3AX, UK
| | - Brittany Staniforth
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS2 3AX, UK
| | - Sacha Kepreotis
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS2 3AX, UK
| | - Annette Maznyczka
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS2 3AX, UK
| | - Heerajnarain Bulluck
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS2 3AX, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK
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Ling S, Jin L, Li S, Zhang F, Xu Q, Liu M, Chen X, Liu X, Gu J, Liu S, Liu N, Ou W. Allium macrostemon Saponin Inhibits Activation of Platelet via the CD40 Signaling Pathway. Front Pharmacol 2021; 11:570603. [PMID: 33584257 PMCID: PMC7874237 DOI: 10.3389/fphar.2020.570603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022] Open
Abstract
Allium macrostemon saponin is a traditional Chinese medicine that exhibits anti-atherosclerosis effects. However, the mechanism of its action has not been fully clarified. Platelet activation induced by CD40L plays an important role in the process of atherosis. In the present study, we demonstrate for the first time that A. macrostemon saponin inhibits platelet activation induced by CD40L. Moreover, the effects of saponin on platelet activation were achieved by activation of the classical CD40L-associated pathway, including the PI3K/Akt, MAPK and NF-κB proteins. In addition, the present study further demonstrated that saponin exhibited an effect on the TRAF2-mediated ubiquitination degradation, which contributed to the inhibition of the CD40 pathway and its downstream members. The findings determine that A. macrostemon saponin inhibits activation of platelets via activation of downstream proteins of the CD40 pathway. This in turn affected TRAF2-associated ubiquitination degradation and caused an anti-thrombotic effect.
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Affiliation(s)
- Sisi Ling
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijun Jin
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shizheng Li
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Fangcheng Zhang
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiong Xu
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingke Liu
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuke Chen
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaolin Liu
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jielei Gu
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shiming Liu
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ningning Liu
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenchao Ou
- Department of Cardiology, Guangdong Key Laboratory of Vascular Diseases, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Bourazana A, Xanthopoulos A, Skoularigis J, Triposkiadis F. Preoperative Antiplatelet Therapy and Bleeding Risk in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A Fine Balance. Angiology 2020; 71:701-703. [PMID: 32431160 DOI: 10.1177/0003319720925973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - John Skoularigis
- Department of Cardiology, Larissa University Hospital, Larissa, Greece
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Ray A, Najmi A, Khandelwal G, Sadasivam B. A Cost Variation Analysis of Drugs Available in the Indian Market for the Management of Thromboembolic Disorders. Cureus 2020; 12:e7964. [PMID: 32523821 PMCID: PMC7273361 DOI: 10.7759/cureus.7964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction Cardiovascular diseases (CVDs) have become one of the major causes of mortality among the Indian population. The costs of anticoagulant, antiplatelet, and fibrinolytic drugs that are used to treat various thromboembolic disorders and used as prophylactics for individuals at high risk of CVDs vary widely in the Indian pharmaceutical market. The aim of this study was to evaluate the cost variation of different brands of drug formulations and to compare the branded prices of the formulations with their corresponding generic and ceiling prices. Materials and methods This study followed an analytical method. Costs of various drugs were obtained from the October - December 2019 edition of the Current Index of Medical Specialities (CIMS) and December 2019 edition of the Monthly Index of Medical Specialities (MIMS) India. Cost ratio and percentage variation in cost per tablet/capsule/injection of different drugs available in the Indian market and manufactured by different pharmaceutical companies were calculated. Comparison of the branded prices with generic and ceiling prices was also performed for different drugs by using information available from official websites. Results Percentage variation in cost among the commonly prescribed drugs for the management of thromboembolic disorders was found to be highest for prasugrel 10 mg tablet (1,408.44%) while it was lowest for fondaparinux 2.5 mg / 0.5 ml injection (20%). Among the commonly prescribed drugs that are under Drugs Prices Control Order (DPCO) price control, streptokinase 1.5 MIU injection had the highest cost variation (132.02%) while enoxaparin 60 mg / 0.6 ml injection had the lowest (4.99%). Among some of the important formulations under the Jan Aushadhi scheme (JAS), acenocoumarol 2 mg tablet had the highest cost variation (680.09%) and cilostazol 50 mg tablet had the lowest (55.46%). Conclusions Wide differences exist in the costs of various anticoagulants, antiplatelets, and fibrinolytics available in the Indian market. The prescribing physician should be aware of theses variations and prescribe medicines accordingly, keeping in mind the financial status of the patients.
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Affiliation(s)
- Avik Ray
- Pharmacology, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Ahmad Najmi
- Pharmacology, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Gaurav Khandelwal
- Cardiology, All India Institute of Medical Sciences Bhopal, Bhopal, IND
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Rengasamy KRR, Khan H, Ahmad I, Lobine D, Mahomoodally F, Suroowan S, Hassan STS, Xu S, Patel S, Daglia M, Nabavi SM, Pandian SK. Bioactive peptides and proteins as alternative antiplatelet drugs. Med Res Rev 2019; 39:2153-2171. [PMID: 31006878 DOI: 10.1002/med.21579] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/28/2019] [Accepted: 03/16/2019] [Indexed: 12/12/2022]
Abstract
Antiplatelet drugs reduce the risks associated with atherothrombotic events and show various applications in diverse cardiovascular diseases including myocardial infarctions. Efficacy of the current antiplatelet medicines including aspirin, clopidogrel, prasugrel and ticagrelor, and the glycoprotein IIb/IIIa antagonists, are limited due to their increased risks of bleeding, and antiplatelet drug resistance. Hence, it is important to develop new effective antiplatelet drugs, with fewer side-effects. The vast repertoire of natural peptides can be explored towards this goal. Proteins and peptides derived from snake venoms and plants represent exciting candidates for the development of novel and potent antiplatelet agents. Consequently, this review discusses multiple peptides that have displayed antiplatelet aggregation activity in preclinical drug development stages. This review also describes the antiplatelet mechanisms of the peptides, emphasizing the signaling pathways intervened by them. Also, the hurdles encountered during the development of peptides into antiplatelet drugs have been listed. Finally, hitherto unexplored peptides with the potential to prevent platelet aggregation are explored.
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Affiliation(s)
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Imad Ahmad
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Devina Lobine
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Fawzi Mahomoodally
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Shanoo Suroowan
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Sherif T S Hassan
- Department of Natural Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Suowen Xu
- Aab Cardiovascular Research Institute, University of Rochester, Rochester, New York
| | - Seema Patel
- Bioinformatics and Medical Informatics Research Center, San Diego State University, San Diego, California
| | - Maria Daglia
- Department of Drug Sciences, Medicinal Chemistry and Pharmaceutical Technology Section, Pavia University, Pavia, Italy
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Adili R, Tourdot BE, Mast K, Yeung J, Freedman JC, Green A, Luci DK, Jadhav A, Simeonov A, Maloney DJ, Holman TR, Holinstat M. First Selective 12-LOX Inhibitor, ML355, Impairs Thrombus Formation and Vessel Occlusion In Vivo With Minimal Effects on Hemostasis. Arterioscler Thromb Vasc Biol 2017; 37:1828-1839. [PMID: 28775075 PMCID: PMC5620123 DOI: 10.1161/atvbaha.117.309868] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/24/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Adequate platelet reactivity is required for maintaining hemostasis. However, excessive platelet reactivity can also lead to the formation of occlusive thrombi. Platelet 12(S)-lipoxygenase (12-LOX), an oxygenase highly expressed in the platelet, has been demonstrated to regulate platelet function and thrombosis ex vivo, supporting a key role for 12-LOX in the regulation of in vivo thrombosis. However, the ability to pharmacologically target 12-LOX in vivo has not been established to date. Here, we studied the effect of the first highly selective 12-LOX inhibitor, ML355, on in vivo thrombosis and hemostasis. APPROACH AND RESULTS ML355 dose-dependently inhibited human platelet aggregation and 12-LOX oxylipin production, as confirmed by mass spectrometry. Interestingly, the antiplatelet effects of ML355 were reversed after exposure to high concentrations of thrombin in vitro. Ex vivo flow chamber assays confirmed that human platelet adhesion and thrombus formation at arterial shear over collagen were attenuated in whole blood treated with ML355 comparable to aspirin. Oral administration of ML355 in mice showed reasonable plasma drug levels by pharmacokinetic assessment. ML355 treatment impaired thrombus growth and vessel occlusion in FeCl3-induced mesenteric and laser-induced cremaster arteriole thrombosis models in mice. Importantly, hemostatic plug formation and bleeding after treatment with ML355 was minimal in mice in response to laser ablation on the saphenous vein or in a cremaster microvasculature laser-induced rupture model. CONCLUSIONS Our data strongly support 12-LOX as a key determinant of platelet reactivity in vivo, and inhibition of platelet 12-LOX with ML355 may represent a new class of antiplatelet therapy.
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Affiliation(s)
- Reheman Adili
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Benjamin E Tourdot
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Katherine Mast
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Jennifer Yeung
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - John C Freedman
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Abigail Green
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Diane K Luci
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Ajit Jadhav
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Anton Simeonov
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - David J Maloney
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Theodore R Holman
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.)
| | - Michael Holinstat
- From the Department of Pharmacology (R.A., B.E.T., K.M., J.Y., M.H.) and Department of Internal Medicine, Division of Cardiovascular Medicine (M.H.), University of Michigan, Ann Arbor; Chemistry and Biochemistry, University of California Santa Cruz (J.C.F., A.G., T.R.H.); and National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Rockville, MD (D.K.L., A.J., A.S., D.J.M.).
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Vorapaxar in the long-term secondary prevention of atherothrombotic events: a profile of its use in the USA. DRUGS & THERAPY PERSPECTIVES 2017. [DOI: 10.1007/s40267-017-0407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vorapaxar: a review of its use in the long-term secondary prevention of atherothrombotic events. Drugs 2016; 75:797-808. [PMID: 25895464 DOI: 10.1007/s40265-015-0387-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Vorapaxar (Zontivity®) is a first-in-class, potent and orally-active protease-activated receptor 1 (PAR-1) antagonist that blocks thrombin-mediated platelet activation without interfering with thrombin-mediated fibrin deposition. The long-term efficacy of once-daily vorapaxar added to standard antiplatelet therapy (aspirin with or without clopidogrel) in the secondary prevention of atherothrombotic events in patients with a history of myocardial infarction (MI), ischaemic stroke or peripheral arterial disease was investigated in the large, multinational TRA 2°P-TIMI 50 trial. Compared with placebo, vorapaxar significantly reduced the risk of the composite endpoints of cardiovascular (CV) death, MI or stroke, and CV death, MI, stroke or urgent coronary revascularization in the overall trial population. Vorapaxar also significantly reduced the risk of these composite endpoints in the subgroup of patients with prior MI (the largest qualifying disease cohort) and the subset of post-MI patients with no history of stroke or transient ischaemic attack (TIA). Vorapaxar significantly increased the risk of GUSTO moderate and/or severe bleeding in the overall trial population and all key subgroups (including post-MI patients with no history of stroke or TIA). Vorapaxar also significantly increased the risk of intracranial haemorrhage (ICH) in the overall trial population and the subgroup of patients with prior stroke, but not the subgroup of post-MI patients or the subset of post-MI patients with no history of stroke or TIA. Based on these results, vorapaxar has been approved in the EU as an adjunctive treatment for the secondary prevention of atherothrombotic events in patients with prior MI who do not have a history of stroke, TIA or ICH.
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Luo Y, Yang Y, Zhang H, Zhang T, Wang Y, Tan S, Xu Y, Li D, Ye L, Chen P. Effect of Inducible Co-Stimulatory Molecule siRNA in Cerebral Infarction Rat Models. Med Sci Monit 2015; 21:3003-7. [PMID: 26436531 PMCID: PMC4599179 DOI: 10.12659/msm.894477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background T cell-induced inflammatory response and related cytokine secretion at the injury site may participate in the pathogenesis of cerebral infarction. Recent studies established inducible co-stimulatory molecule (ICOS) as a novel T cell-related factor for its activation and functions. We thus investigate the role of ICOS in cerebral infarction. Material/Methods The siRNA of ICOS was first used to suppress the gene expression in cultured lymphocytes. An in vivo study was then performed by intravenous application of ICOS siRNA in cerebral infarction rats. Survival rates, neurological scores, serum tumor necrosis factor (TNF)-α, interleukin (IL)-1, and IL-17 levels were observed. Results The expression of ICOS in cultured lymphocytes was significantly suppressed by siRNA. In the in vivo study, the application of siRNA effectively lowered mortality rates of rats, in addition to the improvement of neurological behaviors and amelioration of cerebral tissue damage. Serum levels of TNF-α, IL-1 and IL-17 were all significantly suppressed after siRNA injection. Conclusions ICOS siRNA can protect brain tissues from ischemia injuries after cerebral infarction, improve limb movement and coordination, lower the mortality rate of rats, and inhibit T cell-induced cytokines. These results collectively suggest the potential treatment efficacy of ICOS siRNA against cerebral infarction.
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Affiliation(s)
- Yingquan Luo
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Yu Yang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Hui Zhang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Ting Zhang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Yina Wang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Shengyu Tan
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Yan Xu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Dan Li
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Ling Ye
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Ping Chen
- Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
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11
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Arif SA, D’Souza J, Gil M, Gim S. Vorapaxar for reduction of thrombotic cardiovascular events in myocardial infarction and peripheral artery disease. Am J Health Syst Pharm 2015; 72:1615-22. [DOI: 10.2146/ajhp140758] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Sally A. Arif
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, and Clinical Pharmacist, Department of Pharmacy, Rush University Medical Center, Chicago, IL
| | | | - Monika Gil
- Department of Pharmacy, Rush University Medical Center
| | - Suzanna Gim
- Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY, and Drug Information Specialist, Brookdale University Hospital and Medical Center, Brooklyn
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Abstract
Vorapaxar [Zontivity(®) (US)], an orally active protease-activated receptor-1 (PAR-1) receptor antagonist, has been developed by Merck & Co for the reduction of thrombotic cardiovascular events in patients with a history of myocardial infarction (MI) or peripheral arterial disease (PAD). Vorapaxar has received its first global approval for this indication in the US. This article summarizes the milestones in the development of vorapaxar leading to this first approval for the reduction of thrombotic cardiovascular events in patients with a prior MI or PAD.
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13
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Ofosu FA. Effective, selective and specific inhibition of COX-1 may overcome the “aspirin paradox”. Thromb Res 2013; 132:1-2. [DOI: 10.1016/j.thromres.2013.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 04/08/2013] [Accepted: 04/14/2013] [Indexed: 11/15/2022]
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Kling MA, Trojanowski JQ, Wolk DA, Lee VMY, Arnold SE. Vascular disease and dementias: paradigm shifts to drive research in new directions. Alzheimers Dement 2013; 9:76-92. [PMID: 23183137 PMCID: PMC3640817 DOI: 10.1016/j.jalz.2012.02.007] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 02/23/2012] [Accepted: 02/29/2012] [Indexed: 12/31/2022]
Abstract
Vascular disease was once considered the principal cause of aging-related dementia. More recently, however, research emphasis has shifted to studies of progressive neurodegenerative disease processes, such as those giving rise to neuritic plaques, neurofibrillary tangles, and Lewy bodies. Although these studies have led to critical insights and potential therapeutic strategies, interest in the role of systemic and cerebrovascular disease mechanisms waned and has received relatively less attention and research support. Recent studies suggest that vascular disease mechanisms play an important role in the risk for aging-related cognitive decline and disorders. Vascular disease frequently coexists with cognitive decline in aging individuals, shares many risk factors with dementias considered to be of the "Alzheimer type," and is observed more frequently than expected in postmortem material from individuals manifesting "specific" disease stigmata, such as abundant plaques and tangles. Considerable difficulties have emerged in attempting to classify dementias as being related to vascular versus neurodegenerative causes, and several systems of criteria have been used. Despite multiple attempts, a lack of consensus remains regarding the optimal means of incorporating vascular disease into clinical diagnostic, neurocognitive, or neuropathologic classification schemes for dementias. We propose here an integrative, rather than a strictly taxonomic, approach to the study and elucidation of how vascular disease mechanisms contribute to the development of dementias. We argue that, instead of discriminating between, for example, "Alzheimer's disease," "vascular dementia," and other diseases, there is a greater need to focus clinical and research efforts on elucidating specific pathophysiologic mechanisms that contribute to dementia phenotypes and neuropathologic outcomes. We outline a multitiered strategy, beginning with clinical and public health interventions that can be implemented immediately, enhancements to ongoing longitudinal studies to increase their informative value, and new initiatives to capitalize on recent advances in systems biology and network medicine. This strategy will require funding from multiple public and private sources to support collaborative and interdisciplinary research efforts to take full advantage of these opportunities and realize their societal benefits.
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Affiliation(s)
- Mitchel A Kling
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Yoshida H, Ashikawa Y, Itoh S, Nakagawa T, Asanuma A, Tanabe S, Inoue Y, Hidaka H. K-134, a phosphodiesterase 3 inhibitor, prevents brain damage by inhibiting thrombus formation in a rat cerebral infarction model. PLoS One 2012; 7:e46432. [PMID: 23110051 PMCID: PMC3479105 DOI: 10.1371/journal.pone.0046432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 08/29/2012] [Indexed: 11/30/2022] Open
Abstract
Background K-134 is a more potent antiplatelet drug with a selective inhibitory effect on phosphodiesterase 3 (PDE3) compared with its analogue, cilostazol. Objectives This study was performed to compare the ameliorating effects of K-134 and cilostazol on brain damage in an experimental photothrombotic cerebral infarction model. Methods and Results We investigated the effects of oral preadministration of PDE3 inhibitors in a rat stroke model established by photothrombotic middle cerebral artery (MCA) occlusion. K-134 significantly prolonged MCA occlusion time at doses >10 mg/kg, and reduced cerebral infarct size at 30 mg/kg in the stroke model (n = 12, 87.5±5.6 vs. 126.8±7.5 mm3, P<0.01), indicating its potent antithrombotic effect. On the other hand, the effects of cilostazol on MCA occlusion time and cerebral infarct size are relatively weak even at the high dosage of 300 mg/kg. Furthermore, K-134 blocked rat platelet aggregation more potently than cilostazol in vitro. Also in an arteriovenous shunt thrombosis model, K-134 showed an antithrombotic effect greater than cilostazol. Conclusions These findings suggest that K-134, which has strong antithrombotic activity, is a promising drug for prevention of cerebral infarction associated with platelet hyperaggregability.
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Affiliation(s)
- Hideo Yoshida
- Tokyo New Drug Research Laboratories, Kowa Company, Ltd., Tokyo, Japan.
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Mazur P, Frołow M, Niżankowski R, Sadowski J, Undas A. Impaired responsiveness to clopidogrel and aspirin in patients with recurrent stent thrombosis following percutaneous intervention for peripheral artery disease. Platelets 2012; 24:151-5. [DOI: 10.3109/09537104.2012.676220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Antiplatelet therapy: Controversial aspects. Thromb Res 2012; 129:225-9. [DOI: 10.1016/j.thromres.2011.10.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 10/27/2011] [Accepted: 10/30/2011] [Indexed: 11/19/2022]
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The potential of tetrandrine as a protective agent for ischemic stroke. Molecules 2011; 16:8020-32. [PMID: 21926947 PMCID: PMC6264536 DOI: 10.3390/molecules16098020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 12/31/2022] Open
Abstract
Stroke is one of the leading causes of mortality, with a high incidence of severe morbidity in survivors. The treatment to minimize tissue injury after stroke is still unsatisfactory and it is mandatory to develop effective treatment strategies for stroke. The pathophysiology of ischemic stroke is complex and involves many processes including energy failure, loss of ion homeostasis, increased intracellular calcium level, platelet aggregation, production of reactive oxygen species, disruption of blood brain barrier, and inflammation and leukocyte infiltration, etc. Tetrandrine, a bisbenzylisoquinoline alkaloid, has many pharmacologic effects including anti-inflammatory and cytoprotective effects. In addition, tetrandrine has been found to protect the liver, heart, small bowel and brain from ischemia/reperfusion injury. It is a calcium channel blocker, and can inhibit lipid peroxidation, reduce generation of reactive oxygen species, suppress the production of cytokines and inflammatory mediators, inhibit neutrophil recruitment and platelet aggregation, which are all devastating factors during ischemia/reperfusion injury of the brain. Because tetrandrine can counteract these important pathophysiological processes of ischemic stroke, it has the potential to be a protective agent for ischemic stroke.
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