Edaravone: a new therapeutic approach for the treatment of acute stroke.
Acute stroke, including acute ischemic stroke (AIS) and acute hemorrhagic stroke, (AHS) is a common medical problem with particular relevance to the demographic changes in industrialized societies. In recent years, treatments for AIS have emerged, including thrombolysis with tissue plasminogen activator (t-PA). Although t-PA is the most effective currently available therapy, it is limited by a narrow therapeutic time window and side effects, and only 3% of all AIS patients receive thrombolysis. Edaravone was originally developed as a potent free radical scavenger and, since 2001, has been widely used to treat AIS in Japan. It was shown that edaravone extended the narrow therapeutic time window of t-PA in rats. The therapeutic time window is very important for the treatment of AIS, and early edaravone treatment is more effective. Thus, more AIS patients might be rescued by administering edaravone with t-PA. Meanwhile, edaravone attenuates AHS-induced brain edema, neurologic deficits and oxidative injury in rats. Although edaravone treatment is currently only indicated for AIS, it does offer neuroprotective effects against AHS in rats. Therefore, we hypothesize that early administration of edaravone can rescue AHS patients as well as AIS patients. Taken together, our findings suggest that edaravone should be immediately administered on suspicion of acute stroke, including AIS and AHS.
Kikuchi
Kiyoshi
K
Department of Neurosurgery, Yame Public General Hospital, 540-2 Takatsuka, Yame 834-0034, Japan. kkikuchi@m2.kufm.kagoshima-u.ac.jp
Kawahara
Ko-ichi
K
Miyagi
Naohisa
N
Uchikado
Hisaaki
H
Kuramoto
Terukazu
T
Morimoto
Yoko
Y
Tancharoen
Salunya
S
Miura
Naoki
N
Takenouchi
Kazunori
K
Oyama
Yoko
Y
Shrestha
Binita
B
Matsuda
Fumiyo
F
Yoshida
Yoshihiro
Y
Arimura
Shinichiro
S
Mera
Kentaro
K
Tada
Ko-ichi
K
Yoshinaga
Narimasa
N
Maenosono
Ryuichi
R
Ohno
Yoshiko
Y
Hashiguchi
Teruto
T
Maruyama
Ikuro
I
Shigemori
Minoru
M
D000818:Animals; D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077553:Edaravone; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D051381:Rats; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D016166:Free Radical Scavengers; D018696:Neuroprotective Agents; D010959:Tissue Plasminogen Activator; D000077553:Edaravone; D000983:Antipyrine