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Potential of immunosuppressive agents in cerebral ischaemia.

The Indian journal of medical research
January 1, 2011
Yogendra Kumar Gupta et al. (2 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the potential of various immunosuppressive agents, including antioxidants, for neuroprotection in experimental models of cerebral ischemia.

Results Summary

The abstract indicates that antioxidants, along with other tested agents, have not provided significant neuroprotection in clinical trials for ischemic stroke management.

Population

Experimental models of cerebral ischemia (not specified if human or animal).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
recombinant tissue plasminogen activator (rtPA)
no change
acute ischaemic stroke
-
-
is the only drug approved for the management
#1
recombinant tissue plasminogen activator (rtPA)
increase
intracranial haemorrhage
-
-
is associated with limitations like narrow therapeutic window and increased risk
#2
N-methyl-D-aspartate (NMDA) receptor antagonist, calcium channel blockers and antioxidants
no change
stroke
clinical trials
-
none has provided significant neuroprotection
#3
Corticosteroids, immunophilin ligands, mycophenolate mofetil and minocycline
increase
neurons
-
-
have shown protective effect
#4
Corticosteroids, immunophilin ligands, mycophenolate mofetil and minocycline
decrease
mediators of inflammation
-
-
attenuating toxic effects
#5
Abstract

Ischaemic stroke is a disorder involving multiple mechanisms of injury progression including activation of glutamate receptors, release of proinflammatory cytokines, nitric oxide (NO), free oxygen radicals and proteases. Presently, recombinant tissue plasminogen activator (rtPA) is the only drug approved for the management of acute ischaemic stroke. This drug, however, is associated with limitations like narrow therapeutic window and increased risk of intracranial haemorrhage. A large number of therapeutic agents have been tested including N-methyl-D-aspartate (NMDA) receptor antagonist, calcium channel blockers and antioxidants for management of stroke, but none has provided significant neuroprotection in clinical trials. Therefore, searching for other potentially effective drugs for ischaemic stroke management becomes important. Immunosuppressive agents with their wide array of mechanisms have potential as neuroprotectants. Corticosteroids, immunophilin ligands, mycophenolate mofetil and minocycline have shown protective effect on neurons by their direct actions or attenuating toxic effects of mediators of inflammation. This review focuses on the current status of corticosteroids, cyclosporine A, FK506, rapamycin, mycophenolate mofetil and minocycline in the experimental models of cerebral ischaemia.

Medical Subject Headings (MeSH)
Brain IschemiaCell DeathFibrinolytic AgentsHumansImmunosuppressive AgentsNerve DegenerationNeuroprotective AgentsSteroidsStrokeTissue Plasminogen Activator
Study Links
PubMed ID21321416
Quality Scores
SafetyNot Assessed
Efficacy20/10
Quality75/10
Citation Metrics
Total Citations16
Citations/Year1.1
Relative Citation Ratio0.47
NIH Percentile25.3%
Research Impact Scores
APT Score0.05
Weight Score0.63
Normalized Score0.43
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