title: Drug repurposing for vascular protection after acute ischemic stroke.
abstract: The attempts to develop new treatments for acute ischemic stroke have been fraught with costly and spectacularly disappointing failures. Repurposing of safe, older drugs provides a lower risk alternative. Vascular protection is a novel strategy for improving stroke outcome. Promising targets for vascular protection after stroke have been identified, and several of these targets can be approached with "repurposed" old drugs, including statins, angiotensin receptor blockers (ARBs), and minocycline. We tested the vascular protection (ability to reduce hemorrhagic transformation) of three marketed drugs (candesartan, minocycline, and atorvastatin) in the experimental stroke model using three different rat strains [Wistar, spontaneously hypertensive rats (SHR) and type 2 diabetic Goto-Kakizaki (GK) rats]. All agents decreased the infarct size, improved the neurological outcome and decreased bleeding. Mechanisms identified include inhibition of MMP-9, activation of Akt, and increased expression of proangiogenic growth factors. Premorbid vascular damage (presence of either diabetes or hypertension) increased the likelihood of vascular injury after ischemia and reperfusion and improved the response to vascular protection.
authors: Program in Clinical and Experimental Therapeutics, University of Georgia College of Pharmacy, Charlie Norwood VA Medical Center, Augusta, GA, USA.
authors: Weihua
authors: W
authors: Guan
authors: Anna
authors: A
authors: Kozak
authors: Susan C
authors: SC
authors: Fagan
mesh_terms: D000818:Animals; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D001562:Benzimidazoles / Q000627:therapeutic use; D001713:Biphenyl Compounds; D020520:Brain Infarction / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology; D004195:Disease Models, Animal; D004656:Enalapril / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D007839:Functional Laterality; D006454:Hemoglobins / Q000378:metabolism; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006538:Heptanoic Acids / Q000627:therapeutic use; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D011758:Pyrroles / Q000627:therapeutic use; D051381:Rats; D011918:Rats, Inbred SHR; D017208:Rats, Wistar; D015424:Reperfusion; D020521:Stroke / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D013777:Tetrazoles / Q000627:therapeutic use; D057772:Vascular System Injuries / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D006454:Hemoglobins; D006538:Heptanoic Acids; D011758:Pyrroles; D013777:Tetrazoles; D004656:Enalapril; D000069059:Atorvastatin; D020780:Matrix Metalloproteinase 9; C081643:candesartan