Intra-arterial Stroke Management

Prince, Ethan A.; Ahn, Sun Ho; Soares, Gregory M.

doi:10.1055/s-0033-1353481

Cited by 7 publications

(1 citation statement)

References 19 publications

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“…Alternative surgical procedures may be used to remove the clot or enhance delivery of tPA but require dedicated stroke teams. Both tPA administration and surgical intervention have a limited window for efficacy and act to prevent additional damage, contributing little to neurorestoration (Doberstein et al, 2017; Prince et al, 2013). Hemorrhagic strokes are limited to surgical interventions, which are often of necessity.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of stem cell-based therapies for stroke

et al. 2019

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Stroke remains a prevalent disease with limited treatment options. Available treatments offer little in the way of enhancing neurogenesis and recovery. Because of the limitations of available treatments, new therapies for stroke are needed. Stem cell-based therapies for stroke offer promise because of their potential to provide neurorestorative benefits. Stem cell-based therapies aim to promote neurogenesis and replacement of lost neurons or protect surviving neurons in order to improve neurological recovery. The mechanism through which stem cell treatments mediate their therapeutic effect is largely dependent on the type of stem cell and route of administration. Neural stem cells have been shown in pre-clinical and clinical trials to promote functional recovery when used in intracerebral transplantations. The therapeutic effects of neural stem cells have been attributed to their formation of new neurons and promotion of neuroregeneration. Bone marrow stem cells (BMSC) and mesenchymal stem cells (MSC) have been shown to enhance neurogenesis in pre-clinical models in intracerebral transplantations, but lack clinical evidence to support this therapeutic approach in patients and appear to be less effective than neural stem cells. Intravenous and intra-arterial administration of BMSC and MSC have shown more promise, where their effects are largely mediated through neuroprotective mechanisms. The immune system has been implicated in exacerbating initial damage caused by stroke, and BMSC and MSC have demonstrated immunomodulatory properties capable of dampening post-stroke inflammation and potentially improving recovery. While still in development, stem cell therapies may yield new treatments for stroke which can improve neurological recovery.

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Section: Introductionmentioning

confidence: 99%

Efficacy of stem cell-based therapies for stroke

et al. 2019

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Extracranial vascular disease

Qasabian¹,

Sandhu²

2019

Textbook of Surgery

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An optimized dosing regimen of cimaglermin (neuregulin 1β3, glial growth factor 2) enhances molecular markers of neuroplasticity and functional recovery after permanent ischemic stroke in rats

Iaci

Parry

Huang

et al. 2015

J of Neuroscience Research

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Cimaglermin (neuregulin 1b3, glial growth factor 2) is a neuregulin growth factor family member in clinical development for chronic heart failure. Previously, in a permanent middle cerebral artery occlusion (pMCAO) rat stroke model, systemic cimaglermin treatment initiated up to 7 days after ischemia onset promoted recovery without reduced lesion volume. Presented here to extend the evidence are two studies that use a rat stroke model to evaluate the effects of cimaglermin dose level and dose frequency initiated 24 hr after pMCAO. Forelimb-and hindlimb-placing scores (proprioceptive behavioral tests), body-swing symmetry, and infarct volume were compared between treatment groups (n 5 12/group). Possible mechanisms underlying cimaglermin-mediated neurologic recovery were examined through axonal growth and synapse formation histological markers. Cimaglermin was evaluated over a wider dose range (0.02, 0.1, or 1.0 mg/kg) than doses previously shown to be effective but used the same dosing regimen (2 weeks of daily intravenous administration, then 1 week without treatment). The dose-frequency study used the dose-ranging study's most effective dose (1.0 mg/kg) to compare daily, once per week, and twice per week dosing for 3 weeks (then 1 week without treatment). Dose-and frequency-dependent functional improvements were observed with cimaglermin without reduced lesion volume. Cimaglermin treatment significantly increased growth-associated protein 43 expression in both hemispheres (particularly somatosensory and motor cortices) and also increased synaptophysin expression. These data indicate that cimaglermin enhances recovery after stroke. Immunohistochemical changes were consistent with axonal sprouting and synapse formation but not acute neuroprotection. Cimaglermin represents a potential clinical development candidate for ischemic stroke treatment. Early results with cimaglermin, a neuregulin isoform, demonstrated functional improvements when initiated up to 7 days after middle cerebral artery occlusion in preclinical animal models of stroke. The studies presented here extend these observations to show that functional improvements in a rat stroke model using cimaglermin initiated within a 24-hr poststroke window are dose and frequency dependent, with 1 mg/kg cimaglermin significantly improving all functional measures vs. vehicle. Results from markers of new neuronal axon growth and contact formation were consistent with promoting neurologic recovery.

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Intra-arterial Stroke Management

Cited by 7 publications

References 19 publications

Efficacy of stem cell-based therapies for stroke

Efficacy of stem cell-based therapies for stroke

Extracranial vascular disease

An optimized dosing regimen of cimaglermin (neuregulin 1β3, glial growth factor 2) enhances molecular markers of neuroplasticity and functional recovery after permanent ischemic stroke in rats

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