title: Ginsenoside Represses Symptomatic Intracerebral Hemorrhage after Recombinant Tissue Plasminogen Activator Therapy by Promoting Transforming Growth Factor-β1.
abstract: BACKGROUND
  Currently, the most effective treatment for brain ischemic stroke is recombinant tissue plasminogen activator (rt-PA); however, increased incidence of symptomatic intracerebral hemorrhage severely reduced its favorable treatment outcome.
  
  
  METHODS
  We aimed to investigate the effect of ginsenoside (Gs) on symptomatic intracerebral hemorrhage after rt-PA treatment. Stroke patients were randomly divided into 2 treatment groups, one receiving rt-PA + placebo (Pc) and the other rt-PA + Gs. Twenty-four hours after the treatment, outcomes were assessed with transcranial Doppler (TCD) ultrasonography and National Institutes of Health Stroke Scale (NIHSS), and plasma levels of transforming growth factor-β1 (TGF-β1), matrix metalloproteinase (MMP)-2, and MMP-9 were also measured. After initial cotreatment, the patients were continuously administered with either Pc or Gs, and the treatment outcomes at 7 days were assessed with TCD, NIHSS, modified Rankin scale (MRS), and Glasgow outcome scale (GOS).
  
  
  RESULTS
  Cotreatment of rt-PA with Gs significantly improved outcomes in patients compared to the Pc group, as indicated by improved TCD and NIHSS scores and reduced incidence of symptomatic intracerebral hemorrhage, which could be attributed to a Gs-induced increase in TGF-β1 and a decrease in both MMP-2 and MMP-9 serum levels. Seven days of Gs treatment also significantly improved outcomes in patients compared to the Pc group, assessed by TCD, NIHSS, MRS, and GOS.
  
  
  CONCLUSIONS
  Our study supports the clinical use of Gs as a potential supplement with rt-PA treatment, which reduces symptomatic intracerebral hemorrhage, therefore improving the treatment outcome of stroke patients.
authors.affiliation: Department of Neurology, Pudong People's Hospital, Shanghai.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Neurology, Pudong People's Hospital, Shanghai. Electronic address: qkbai2@126.com.
authors.forename: Qingke
authors.initials: Q
authors.lastname: Bai
authors.affiliation: Department of Radiology, Pudong People's Hospital, Shanghai, China.
authors.forename: Zhenguo
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Pudong People's Hospital, Shanghai, China.
authors.forename: Haijing
authors.initials: H
authors.lastname: Sui
authors.affiliation: Department of Radiology, Pudong People's Hospital, Shanghai, China.
authors.forename: Xiuhai
authors.initials: X
authors.lastname: Xie
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D036145:Ginsenosides / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D012720:Severity of Illness Index; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D053773:Transforming Growth Factor beta1 / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D036145:Ginsenosides; D053773:Transforming Growth Factor beta1; D010959:Tissue Plasminogen Activator; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9
keywords: Ginsenoside; brain ischemic stroke; recombinant tissue plasminogen activator (rt-PA); symptomatic intracerebral hemorrhage; transforming growth factor-β1 (TGF-β1)