Role of thrombin in CNS damage associated with intracerebral haemorrhage: opportunity for pharmacological intervention?
Intracerebral haemorrhage (ICH) results in high mortality and morbidity. The most important causes of neurological deterioration after ICH are progression of oedema and injury to nerve cells and axons surrounding the haematoma, as well as haematoma enlargement. Recent studies have indicated that thrombin, formed upon clotting of the haematoma, plays an important role in these processes. As opposed to conventional therapeutic approaches, administration of a thrombin inhibitor could effectively limit oedema formation and neuronal damage, improving survival and functional outcome. A small, preliminary clinical trial has suggested that antithrombin therapy with intravenously administered argatroban may be useful in treatment of ICH. Randomised, controlled studies are needed to confirm these initial findings.
Matsuoka
Hideki
H
Division of Neurology, National Hospital Kyushu Cardiovascular Center, 8-1 Shiroyama-cho, Kagoshima City 892-0853, Japan. hmatsuok@jun.ncvc.go.jp
Hamada
Rikuzo
R
D000991:Antithrombins / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D001921:Brain / Q000098:blood supply; D001929:Brain Edema / Q000209:etiology / Q000517:prevention & control*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D009474:Neurons / Q000187:drug effects*; D010865:Pilot Projects; D010875:Pipecolic Acids / Q000627:therapeutic use; D013449:Sulfonamides; D015996:Survival Rate; D013917:Thrombin / Q000037:antagonists & inhibitors / Q000378:metabolism*; D016896:Treatment Outcome
D000991:Antithrombins; D010875:Pipecolic Acids; D013449:Sulfonamides; D001120:Arginine; D013917:Thrombin; C031942:argatroban