Treatment of Human Urinary Kallidinogenase Combined with Maixuekang Capsule Promotes Good Functional Outcome in Ischemic Stroke

Abstract

Aims: To evaluate the clinical efficacy of Human Urinary Kallidinogenase (HUK) and Maixuekang capsule in the treatment of acute ischemic stroke (AIS) patients.Methods: In this study, from January 2016 to July 2016, 60 patients with acute ischemic stroke were enrolled and 56 patients with complete information of whom 21 patients received HUK+ basic treatment (HUK group), 16 patients received HUK+ Maixuekang capsule + basic treatment (HUK+ Maixuekang group), 19 patients received basic treatment (control group). 0.15 PNA unit of HUK injection plus 100 ml saline in intravenous infusion was performed in the HUK group and HUK+ Maixuekang group, with once a day for 14 consecutive days. 0.75 g Maixuekang capsules were taken in HUK+ Maixuekang group, with three times a day for 14 consecutive days. The National Institutes of Health Stroke Scale (NIHSS) scores in three groups were analyzed 7 days after treatment. The modified Rankin Scale (mRS) scores in three groups were analyzed 12 month after the treatment.Results: No difference was found in the NIHSS scores, age, gender, and comorbidities between three groups before treatment (p > 0.05). Seven days after treatment, the NIHSS scores in the HUK group and HUK+ Maixuekang group were significantly decreased than before (p HUK = 0.001, p HUK+Maixuekang < 0.001), and lower than that in the control group (p HUK = 0.032; p HUK+Maixuekang < 0.001). Twelve months after treatment, good functional outcome rate (12 month mRS score ≤ 2) in the HUK group and HUK+ Maixuekang group was significantly higher than that in the control group (p HUK = 0.049, p HUK+Maixuekang = 0.032).Conclusion: The treatment of HUK or HUK combined with Maixuekang capsule can effectively improve the neurological function and promote long-term recovery for AIS patients.

Human Urinary Kallidinogenase Reduces Lipopolysaccharide-Induced Neuroinflammation and Oxidative Stress in BV-2 Cells

“…UK, a tissue kallikrein isolated from human urine, is a widely used drug for the treatment of ischemic stroke in China [11]. However, there is still no evidence for the role of UK play on inflammation and oxidative stress in model of migraine, which is a multifactorial neurodegenerative disease without satisfactory treatment.…”

“…Accumulated studies have reported the function of tissue kallikrein on antiapoptotic, antioxidant, and antiexcitotoxic properties, suggesting that tissue kallikrein could be an effective therapy for neurological disorders [10]. Human urinary kallidinogenase (UK) is a tissue kallikrein derived from human urine, cleaving kininogen to release bradykinin [11]. UK has been considered to be a positive regulatory substance in the kallikrein-kinin system by increasing kallikrein.…”

Effects of Urinary Kallidinogenase on NIHSS score, mRS score, and fasting glucose levels in acute ischemic stroke patients with abnormal glucose metabolism

“…These include a study that randomized 200 patients with acute cerebral infarction after thrombolytic therapy, [25] a study of 58 patients with massive cerebral infarction treated with edaravone, [26] and a study of 47 patients with level 3 hypertension and ischemic stroke. [27] Another study looked at the treatment combination of urinary kallidinogenase with Maixuekang capsule and found that patients with ischemic stroke who received either urinary kallidinogenase in combination with standard treatment or urinary kallidinogenase in combination with standard treatment and Maixuekang capsule had significantly lower NIHSS scores after treatment than the control group. [27] A study using MRI to assess the effect of urinary kallidinogenase in patients with ischemic stroke found that alongside with observed improvements in stroke outcome, cerebral perfusion was enhanced and vascular endothelial growth factor (VEGF) and apelin expression were increased, suggesting a possible mechanism for the action of urinary kallidinogenase.…”

“…[27] Another study looked at the treatment combination of urinary kallidinogenase with Maixuekang capsule and found that patients with ischemic stroke who received either urinary kallidinogenase in combination with standard treatment or urinary kallidinogenase in combination with standard treatment and Maixuekang capsule had significantly lower NIHSS scores after treatment than the control group. [27] A study using MRI to assess the effect of urinary kallidinogenase in patients with ischemic stroke found that alongside with observed improvements in stroke outcome, cerebral perfusion was enhanced and vascular endothelial growth factor (VEGF) and apelin expression were increased, suggesting a possible mechanism for the action of urinary kallidinogenase. [27] These studies all show that further large-scale clinical studies into the use of AIS are needed, [28] but its use clinically shows a benefit to stroke outcome.…”

“…[27] A study using MRI to assess the effect of urinary kallidinogenase in patients with ischemic stroke found that alongside with observed improvements in stroke outcome, cerebral perfusion was enhanced and vascular endothelial growth factor (VEGF) and apelin expression were increased, suggesting a possible mechanism for the action of urinary kallidinogenase. [27] These studies all show that further large-scale clinical studies into the use of AIS are needed, [28] but its use clinically shows a benefit to stroke outcome.…”