Pharmacological hypothermia: a potential for future stroke therapy?
Mild physical hypothermia after stroke has been associated with positive outcomes. Despite the well-studied beneficial effects of hypothermia in the treatment of stroke, lack of precise temperature control, intolerance for the patient, and immunosuppression are some of the reasons which limit its clinical translation. Pharmacologically induced hypothermia has been explored as a possible treatment option following stroke in animal models. Currently, there are eight classes of pharmacological agents/agonists with hypothermic effects affecting a multitude of systems including cannabinoid, opioid, transient receptor potential vanilloid 1 (TRPV1), neurotensin, thyroxine derivatives, dopamine, gas, and adenosine derivatives. Interestingly, drugs in the TRPV1, neurotensin, and thyroxine families have been shown to have effects in thermoregulatory control in decreasing the compensatory hypothermic response during cooling. This review will briefly present drugs in the eight classes by summarizing their proposed mechanisms of action as well as side effects. Reported thermoregulatory effects of the drugs will also be presented. This review offers the opinion that these agents may be useful in combination therapies with physical hypothermia to achieve faster and more stable temperature control in hypothermia.
a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA.
Kaiyin
K
Liu
a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA.
Hajra
H
Khan
a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA.|b Department of Neurology, Beijing Luhe Hospital , Capital Medical University , Beijing , China.
Xiaokun
X
Geng
c China-America Institute of Neuroscience, Xuanwu Hospital , Capital Medical University , Beijing , China.
Jun
J
Zhang
a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA.|b Department of Neurology, Beijing Luhe Hospital , Capital Medical University , Beijing , China.
Yuchuan
Y
Ding
D000227:Adenine Nucleotides / Q000494:pharmacology; D000241:Adenosine / Q000494:pharmacology; D000818:Animals; D002186:Cannabinoids / Q000378:metabolism / Q000494:pharmacology; D006801:Humans; D007035:Hypothermia / Q000139:chemically induced*; D007036:Hypothermia, Induced / Q000379:methods*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D009496:Neurotensin / Q000378:metabolism; D011954:Receptors, Dopamine / Q000378:metabolism; D011957:Receptors, Opioid / Q000378:metabolism; D020521:Stroke / Q000628:therapy*; D050916:TRPV Cation Channels / Q000378:metabolism; D013974:Thyroxine / Q000378:metabolism
D000227:Adenine Nucleotides; D002186:Cannabinoids; D018696:Neuroprotective Agents; D011954:Receptors, Dopamine; D011957:Receptors, Opioid; D050916:TRPV Cation Channels; C494482:TRPV1 protein, human; D009496:Neurotensin; D000241:Adenosine; D013974:Thyroxine
Hypothermia; Ischemia–reperfusion injury