Ischemic brain disease treatment
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Advances in Ischemic Brain Disease Treatment
Reperfusion Therapy for Acute Ischemic Stroke
Intravenous Thrombolysis and Mechanical Thrombectomy
Reperfusion therapy remains the cornerstone of acute ischemic stroke treatment. Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rtPA) is effective when administered within 4.5 hours of symptom onset. Mechanical thrombectomy is another critical intervention for patients with large artery occlusion, ideally performed within 6 hours of stroke onset. Recent studies have expanded the therapeutic window for mechanical thrombectomy up to 24 hours in selected patients, particularly those with wake-up strokes or delayed presentation, using advanced imaging techniques to identify candidates.
Neuroprotective Strategies
Baicalein in Subacute Phase
Baicalein, a flavonoid derived from Scutellaria baicalensis, has shown promise in reducing neuroinflammation and neuronal damage when administered in the subacute phase of ischemia-reperfusion (I/R) injury. In animal models, baicalein significantly decreased brain infarct volume and neurobehavioral deficits by modulating microglial activation and reducing pro-inflammatory cytokine release.
Peptide-Templated Nanozymes
Innovative approaches such as peptide-templated MnO2 nanozymes (PNzyme/MnO2) have demonstrated dual thrombolytic and neuroprotective actions. These nanozymes can cross the blood-brain barrier, target ischemic neuronal tissues, and activate thrombolytic functions in the presence of thrombin. They also exhibit anti-inflammatory properties, reducing astrocyte activation and cytokine secretion, thus offering a multifaceted approach to stroke treatment.
Stem Cell Therapy
Regenerative Potential and Delivery Optimization
Stem cell therapy is emerging as a promising treatment for ischemic brain injury. Various stem cell types have been investigated for their ability to release growth factors, protect blood-brain barrier integrity, and promote neurogenesis. Intranasal delivery and hypoxic conditioning are potential strategies to enhance the efficacy and safety of stem cell therapy . Despite promising preclinical results, translating these findings to clinical practice remains challenging.
Nanomedicine in Stroke Treatment
Enhanced Drug Delivery and Efficacy
Nanomedicine offers new possibilities for treating ischemic stroke by improving drug pharmacokinetics, targeting specific brain regions, and reducing side effects. Nanoparticles can enhance the accumulation of therapeutic agents at the ischemic site, providing more effective treatment options compared to traditional methods .
Glial Cell-Related Therapies
Modulating Microglial and Astrocyte Responses
Targeting glial cells, particularly microglia and astrocytes, represents a novel therapeutic approach. Promoting protective phenotypes (M2/A2) while inhibiting neurotoxic profiles (M1/A1) has shown potential in reducing inflammation and supporting recovery in stroke models. This strategy leverages the natural ability of glial cells to switch between detrimental and protective roles.
Conclusion
The treatment landscape for ischemic brain disease is rapidly evolving, with significant advancements in reperfusion therapy, neuroprotective strategies, stem cell therapy, and nanomedicine. These innovative approaches hold promise for improving outcomes in patients with ischemic stroke, although further research and clinical trials are necessary to fully realize their potential.
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