Potential of immunosuppressive agents in cerebral ischaemia.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.