Cocktail treatment, a promising strategy to treat acute cerebral ischemic stroke?
Up to now, over 1,000 experimental treatments found in cells and rodents have been difficult to translate to human ischemic stroke. Since ischemia and reperfusion, two separate stages of ischemic stroke, have different pathophysiological mechanisms leading to brain injury, a combination of protective agents targeting ischemia and reperfusion respectively may obtain substantially better results than a single agent. Normobaric hyperoxia (NBO) has been shown to exhibit neuro- and vaso-protective effects by improving tissue oxygenation when it is given during ischemia, however the effect of NBO would diminish when the duration of ischemia and reperfusion was extended. Therefore, during reperfusion drug treatment targeting inflammation, oxidative stress and free radical scavenger would be a useful adjuvant to extend the therapeutic window of tissue plasminogen activator, the only United States Food and Drug Administration (FDA) approved treatment for acute ischemic stroke. In this review, we discussed the neuro- and vaso-protective effects of NBO and recent finding of combining NBO with other drugs.
Children's Hospital of Shanxi Province, Taiyuan, Shanxi Province, China.
Li-Jun
LJ
Liang
Children's Hospital of Shanxi Province, Taiyuan, Shanxi Province, China.
Jin-Ming
JM
Yang
Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and Institute of Neuroscience, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu Province, China.
Xin-Chun
0000-0002-5351-7914
XC
Jin
blood-brain barrier; combination therapy; ischemic stroke; normobaric hyperoxia; tissue plasminogen activator