title: Human Urinary Kallidinogenase Improves Outcome of Stroke Patients by Shortening Mean Transit Time of Perfusion Magnetic Resonance Imaging.
abstract: BACKGROUND
  Improving cerebral perfusion remains a good option for ischemic stroke for restoring cerebral blood flow. Human urinary kallidinogenase has been shown promising in treating stroke patients. To investigate whether human urinary kallidinogenase's efficacy in treating stroke patients has relationship with improving cerebral perfusion and possible mechanism.
  
  
  METHODS
  Fifty-eight stroke patients in Nanjing Drum Tower Hospital were enrolled in this prospective study. Of them, 29 received human urinary kallidinogenase, while the other 29 were selected as control. National institute health stroke scale, modified Rankin Scale and activities of daily living score were used to determine patient outcome. Cerebral perfusion in patients was determined by perfusion magnetic resonance imaging. Serum apelin and vascular endothelial growth factor were measured by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  We confirmed that human urinary kallidinogenase improved stroke outcome in patients. Cerebral perfusion was elevated by human urinary kallidinogenase 12 days after therapy. Human urinary kallidinogenase enhanced vascular endothelial growth factor and APJ expression in stroke patients. The reduced mean transit time was related with favorable outcome analyzed by univariate logistic regression.
  
  
  CONCLUSIONS
  Human urinary kallidinogenase facilitated stroke recovery and enhanced cerebral reperfusion through up-regulating vascular endothelial growth factor, apelin/APJ pathway.
authors.affiliation: Department of Neurology and Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, PR China; The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, Jiangsu, PR China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, PR China.
authors.forename: Jingwei
authors.initials: J
authors.lastname: Li
authors.affiliation: The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, Jiangsu, PR China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, PR China; Department of Neurology, Drum Tower Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurology and Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, PR China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurology and Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, PR China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Neurology and Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, PR China; The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, Jiangsu, PR China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, PR China. Electronic address: juanzi1986126@163.com.
authors.forename: Meijuan
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Neurology and Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, PR China; The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, Jiangsu, PR China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, PR China; Department of Neurology, Drum Tower Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China. Electronic address: xuyun20042001@aliyun.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007610:Kallikreins / Q000378:metabolism / Q000627:therapeutic use*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015424:Reperfusion; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D055815:Young Adult
chemical_list: D042461:Vascular Endothelial Growth Factor A; D007610:Kallikreins
keywords: Human urinary kallidinogenase; VEGF; angiogenesis; apelin/APJ; cerebral perfusion; ischemic stroke