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Meftahi GH, Bayat M, Zarifkar AH, Akbari S, Borhani Haghighi A, Naseh M, Yousefi Nejad A, Haghani M. Treatment with edaravone improves the structure and functional changes in the hippocampus after chronic cerebral hypoperfusion in rat. Brain Res Bull 2021; 174:122-130. [PMID: 34116172 DOI: 10.1016/j.brainresbull.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 02/08/2023]
Abstract
This study aimed to find out cellular and electrophysiological effects of the edaravone (EDR) administration following induction of vascular dementia (VaD) via bilateral-carotid vessel occlusion (2VO). The rats were randomly divided into control, sham, 2VO + V (vehicle), and 2VO + EDR groups. EDR was administered once a day from day 0-28 after surgery. The passive-avoidance, Morris water-maze, and open-field tests were used for evaluation of memory, locomotor, and anxiety. The field-potential recording was used for assessment of electrophysiological properties of the hippocampus; and after sacrificing, the cerebral hemispheres were removed for stereological study and evaluation of MDA levels. The long-term potentiation (LTP), paired-pulse ratio (PPR), and input-output (I/O) curves were evaluated as indexes for long-term and short-term synaptic plasticity, and basal-synaptic transmission (BST), respectively. The 2VO led to increases in MDA level with considerable neuronal loss and decreases in the volume of the hippocampus, along with a reduction in the BST and LTP induction which was associated with a decrement in PPR and ultimate loss in memory with higher anxiety behavior. However, administration of EDR caused a decline in MDA and prevented the neural loss and volume of the hippocampus, rescued BST and LTP depression, improved memory and anxiety without any effects on PPR. Therefore, most likely through the improvement of MDA level, and the hippocampal cell number and volume, EDR leads to recovery of synaptic plasticity and behavioral performance. Because of the LTP rescue, without recovery of PPR, it is likely that the EDR improved LTP through the post-synaptic neurons.
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Affiliation(s)
- Gholam Hossein Meftahi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mahnaz Bayat
- Clinical Neurology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Amir Hossein Zarifkar
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Somaye Akbari
- Department of Physiology, the Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Maryam Naseh
- Histomorphometry and Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Amirhossein Yousefi Nejad
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Islamic Azad University of Kazeroon, Shiraz, Iran.
| | - Masoud Haghani
- Histomorphometry and Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
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Herbet M, Natorska-Chomicka D, Ostrowska M, Gawrońska-Grzywacz M, Izdebska M, Piątkowska-Chmiel I, Korga A, Wróbel A, Dudka J. Edaravone presents antidepressant-like activity in corticosterone model of depression in mice with possible role of Fkbp5, Comt, Adora1 and Slc6a15 genes. Toxicol Appl Pharmacol 2019; 380:114689. [DOI: 10.1016/j.taap.2019.114689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 12/16/2022]
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Sifat AE, Vaidya B, Abbruscato TJ. Blood-Brain Barrier Protection as a Therapeutic Strategy for Acute Ischemic Stroke. AAPS JOURNAL 2017; 19:957-972. [PMID: 28484963 DOI: 10.1208/s12248-017-0091-7] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/18/2017] [Indexed: 02/07/2023]
Abstract
The blood-brain barrier (BBB) is a vital component of the neurovascular unit (NVU) containing tight junctional (TJ) proteins and different ion and nutrient transporters which maintain normal brain physiology. BBB disruption is a major pathological hallmark in the course of ischemic stroke which is regulated by the actions of different factors working at different stages of cerebral ischemia including matrix metalloproteinases (MMPs), inflammatory modulators, vesicular trafficking, oxidative pathways, and junctional-cytoskeletal interactions. These components interact further to disrupt maintenance of both the paracellular and transport barriers of the central nervous system (CNS) to worsen ischemic brain injury and the propensity for hemorrhagic transformation (HT) associated with injury and/or thrombolytic therapy with tissue-type plasminogen activator (tPA). We propose that these complex molecular pathways should be evaluated further so that they could be targeted alone or in combination to protect the BBB during cerebral ischemia. These types of novel interventions should be guided by advanced imaging techniques for better diagnosis of BBB damage which may exert significant therapeutic benefit including the extension of therapeutic window of tPA. This review will focus on the different stages and mechanisms of BBB damage in acute ischemic stroke and novel therapeutic strategies to target those pathways for better therapeutic outcome in stroke.
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Affiliation(s)
- Ali Ehsan Sifat
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 S. Coulter, Amarillo, Texas, 79106, USA
| | - Bhuvaneshwar Vaidya
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 S. Coulter, Amarillo, Texas, 79106, USA
| | - Thomas J Abbruscato
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 S. Coulter, Amarillo, Texas, 79106, USA.
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Lakhan SE, Kirchgessner A, Tepper D, Leonard A. Matrix metalloproteinases and blood-brain barrier disruption in acute ischemic stroke. Front Neurol 2013; 4:32. [PMID: 23565108 PMCID: PMC3615191 DOI: 10.3389/fneur.2013.00032] [Citation(s) in RCA: 245] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/21/2013] [Indexed: 12/17/2022] Open
Abstract
Ischemic stroke continues to be one of the most challenging diseases in translational neurology. Tissue plasminogen activator (tPA) remains the only approved treatment for acute ischemic stroke, but its use is limited to the first hours after stroke onset due to an increased risk of hemorrhagic transformation over time resulting in enhanced brain injury. In this review we discuss the role of matrix metalloproteinases (MMPs) in blood-brain barrier (BBB) disruption as a consequence of ischemic stroke. MMP-9 in particular appears to play an important role in tPA-associated hemorrhagic complications. Reactive oxygen species can enhance the effects of tPA on MMP activation through the loss of caveolin-1 (cav-1), a protein encoded in the cav-1 gene that serves as a critical determinant of BBB permeability. This review provides an overview of MMPs' role in BBB breakdown during acute ischemic stroke. The possible role of MMPs in combination treatment of acute ischemic stroke is also examined.
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Affiliation(s)
- Shaheen E Lakhan
- Biosciences Department, Global Neuroscience Initiative Foundation Beverly Hills, CA, USA ; Neurological Institute, Cleveland Clinic Cleveland, OH, USA
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Ergenoglu M, Erbas O, Akdemir A, Yeniel AÖ, Yildirim N, Oltulu F, Aktug H, Taskiran D. Attenuation of Ischemia/Reperfusion-Induced Ovarian Damage in Rats: Does Edaravone Offer Protection. Eur Surg Res 2013; 51:21-32. [DOI: 10.1159/000353403] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/02/2013] [Indexed: 12/14/2022]
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Sharma P, Sinha M, Shukla R, Garg RK, Verma R, Singh MK. A randomized controlled clinical trial to compare the safety and efficacy of edaravone in acute ischemic stroke. Ann Indian Acad Neurol 2012; 14:103-6. [PMID: 21808471 PMCID: PMC3141471 DOI: 10.4103/0972-2327.82794] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 10/12/2010] [Accepted: 12/18/2010] [Indexed: 11/29/2022] Open
Abstract
Background and Objective: Edaravone has potent antioxidant and free radical scavenger properties. Few Japanese studies had demonstrated its neuroprotective role in acute ischemic stroke (AIS). This study aims to evaluate the efficacy of edaravone in terms of functional outcome in a group of Indian patients of AIS. Materials and Methods: Fifty patients of AIS were randomly divided into two groups. The study group received 30 mg of edaravone twice daily for 14 days by infusion, while control group received normal saline infusion as placebo. Outcome assessment was done by the Modified Rankin Scale (MRS). MRS score ≤2 at 90 days was considered as a favorable outcome. Results: Of 25 patients, 18 (72%) had favorable outcomes (MRS ≤2) at 90 days in edaravone group, while 10 (40%) of 25 patients in placebo group had favorable outcome (P < 0.005). Two patients expired (one in each group) during treatment. The mean Barthel index increased from 41.20 ± 32.70 at baseline to 82.40 ± 18.32 at day 90 in edaravone group as compared with placebo group in which scores were 44.20 ± 22.76 at baseline and 68.20 ± 21.30 at day 90 (P < 0.005). Conclusions: We therefore conclude that edaravone effectively improves functional outcome in AIS.
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Affiliation(s)
- Pawan Sharma
- Department of Neurology, CSM Medical University, Lucknow, U.P., India
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Kara M, Daglioglu YK, Kuyucu Y, Tuli A, Tap O. The effect of edaravone on ischemia–reperfusion injury in rat ovary. Eur J Obstet Gynecol Reprod Biol 2012; 162:197-202. [DOI: 10.1016/j.ejogrb.2012.02.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/07/2012] [Accepted: 02/28/2012] [Indexed: 01/07/2023]
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Lapchak PA. Translational stroke research using a rabbit embolic stroke model: a correlative analysis hypothesis for novel therapy development. Transl Stroke Res 2010; 1:96-107. [PMID: 20539748 PMCID: PMC2881325 DOI: 10.1007/s12975-010-0018-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Revised: 01/28/2010] [Accepted: 03/11/2010] [Indexed: 12/29/2022]
Abstract
Alteplase (tissue plasminogen activator, tPA) is currently the only FDA-approved treatment that can be given to acute ischemic stroke (AIS) patients if patients present within 3 h of an ischemic stroke. After 14 years of alteplase clinical research, evidence now suggests that the therapeutic treatment window can be expanded 4.5 h, but this is not formally approved by the FDA. Even though there remains a significant risk of intracerebral hemorrhage associated with alteplase administration, there is an increased chance of favorable outcome with tPA treatment. Over the last 30 years, the use of preclinical models has assisted with the search for new effective treatments for stroke, but there has been difficulty with the translation of efficacy from animals to humans. Current research focuses on the development of new and potentially useful thrombolytics, neuroprotective agents, and devices which are also being tested for efficacy in preclinical and clinical trials. One model in particular, the rabbit small clot embolic stroke model (RSCEM) which was developed to test tPA for efficacy, remains the only preclinical model used to gain FDA approval of a therapeutic for stroke. Correlative analyses from existing preclinical translational studies and clinical trials indicate that there is a therapeutic window ratio (ARR) of 2.43-3 between the RSCEM and AIS patients. In conclusion, the RSCEM can be used as an effective translational tool to gauge the clinical potential of new treatments.
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Affiliation(s)
- Paul A. Lapchak
- Department of Neurology, Cedars-Sinai Medical Center, 8730 Alden Drive, Thalians E216, Los Angeles, CA 90048 USA
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Connell BJ, Saleh TM. A novel rodent model of reperfusion injury following occlusion of the middle cerebral artery. J Neurosci Methods 2010; 190:28-33. [PMID: 20435065 DOI: 10.1016/j.jneumeth.2010.04.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 04/22/2010] [Accepted: 04/23/2010] [Indexed: 11/17/2022]
Abstract
We have developed a novel rodent animal model of reperfusion injury following stroke. In this model, blood flow through the middle cerebral artery (MCA) is temporarily occluded by placing gentle pressure on sutures behind the artery along three separate branches. The sutures remain in place for a period of time (occlusion), and are then removed for an additional amount of time (reperfusion) to study the effects of drug treatment on the ischemic core and/or reperfusion injury. This approach resulted in a highly reproducible focal infarct restricted to the prefrontal cerebral cortex with an intra-operative mortality rate of less than 1%. To validate this new model of reperfusion injury, we used two well characterized neuroprotectants, estrogen and edaravone. Estrogen and edaravone have been studied extensively in many animal models, and our lab as well as others have consistently demonstrated significant reductions in infarct size following edaravone or estrogen pretreatment. In this novel model, intravenous pretreatment of animals with either estrogen or edaravone resulted in significant, dose-dependent, reduction in infarct size following reperfusion. In conclusion, our results demonstrate the validity of using this novel model to study the mechanism of neuroprotection following stroke. Based on the low mortality rate and reproducibility of the focal infarct volume, this novel rodent model is ideal for preclinical studies to screen drugs for potential therapy against reperfusion injury following stroke.
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Affiliation(s)
- Barry J Connell
- Dept. of Biomedical Sciences, Atlantic Veterinary College, University of Prince Edward Island, 550 University Ave, Charlottetown, PEI, Canada
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Lapchak PA. Efficacy and safety profile of the carotenoid trans sodium crocetinate administered to rabbits following multiple infarct ischemic strokes: A combination therapy study with tissue plasminogen activator. Brain Res 2010; 1309:136-45. [DOI: 10.1016/j.brainres.2009.10.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 10/25/2009] [Accepted: 10/27/2009] [Indexed: 01/01/2023]
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Higashi Y. Edaravone for the treatment of acute cerebral infarction: role of endothelium-derived nitric oxide and oxidative stress. Expert Opin Pharmacother 2009; 10:323-31. [PMID: 19236202 DOI: 10.1517/14656560802636888] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Thrombolytic therapy is the most effective therapeutic strategy for the prevention of brain injury and reduction of mortality in patients with acute cerebral infarction. A combination of established thrombolytic therapy and effective neuronal protection therapy has more beneficial effects for patients with acute cerebral infarction. Edaravone (chemical name: 3-methyl-1-phenyl-2-pyrazolin-5-one) is a strong, novel scavenger of free radicals. Several lines of evidence have shown that edaravone has preventive effects on brain injury following ischaemia and reperfusion in patients with brain attack. This review focuses on putative mechanisms underlying the beneficial effects of edaravone on the atherosclerotic process in patients with stroke and on the possibility of edaravone-induced extension of the therapeutic time window in patients with acute cerebral infarction.
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Affiliation(s)
- Yukihito Higashi
- Hiroshima University, Graduate School of Biomedical Sciences, Department of Cardiovascular Physiology and Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
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Lapchak PA, Zivin JA. The lipophilic multifunctional antioxidant edaravone (radicut) improves behavior following embolic strokes in rabbits: A combination therapy study with tissue plasminogen activator. Exp Neurol 2009; 215:95-100. [DOI: 10.1016/j.expneurol.2008.09.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 09/12/2008] [Accepted: 09/16/2008] [Indexed: 01/17/2023]
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