Theranostics · 2017 · 109 citations · 39 references
PharmacyNeurosciencePharmacologyBioavailabilityDrug DeliveryTargeted Drug DeliveryAcute Ischemic StrokeBlood-brain Barrier DeliveryBlood-brain Barrier PenetrationBlood-brain Barrier PharmacologyNeuroprotectionStrokeAcute Ischemic Stroke TreatmentBlood - Brain Barrier UptakeBlood-brain Barrier PermeabilityCerebral Ischemia NeuroprotectionIschemia-induced Barrier DisruptionMicelle EncapsulationNeuroprotective AgentsStroke Neuroprotection
Thrombolysis has been a standard treatment for ischemic stroke. However, only 2-7% patients benefit from it because the thrombolytic agent has to be injected within 4.5 h after the onset of symptoms to avoid the increasing risk of intracerebral hemorrhage. As the only clinically approved neuroprotective drug, edaravone (EDV) rescues ischemic brain tissues by eradicating over-produced reactive oxygen species (ROS) without the limitation of therapeutic time-window. However, EDV's short circulation half-life and inadequate cerebral uptake attenuate its therapeutic efficacy. Here we developed an EDV-encapsulated agonistic micelle (EDV-AM) to specifically deliver EDV into brain ischemia by actively tuning blood-brain barrier (BBB) permeability. The EDV-AM actively up-regulated endothelial monolayer permeability in vitro. HPLC studies showed that EDV-AM delivered more EDV into brain ischemia than free EDV after intravenous injection. Magnetic resonance imaging also demonstrated that EDV-AM more rapidly salvaged ischemic tissue than free EDV. Diffusion tensor imaging indicated the highest efficiency of EDV-AM in accelerating axonal remodeling in the ipsilesional white matter and improving functional behaviors of ischemic stroke models. The agonistic micelle holds promise to improve the therapeutic efficiency of ischemic stroke patients who miss the thrombolytic treatment.
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A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
Olvert A. Berkhemer, Puck Fransen, Debbie Beumer et al. · New England Journal of Medicine · 2014 · 6.6K citations · Full text
Medicine, Neurology, Neurosurgery +14
Junya Aoki, Kazumi Kimura, Kensaku Shibazaki et al. · Cerebrovascular Diseases Extra · 2013 · 1.9K citations · Full text