Treatment for ischemic changes in the brain
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Treatment for Ischemic Changes in the Brain
Thrombolytic and Neuroprotective Strategies
Thrombolytic Therapy with Nanozymes
Recent advancements in nanomedicine have introduced innovative approaches to treat ischemic stroke (IS). A novel peptide-templated MnO2 nanozyme (PNzyme/MnO2) has shown promising results by integrating thrombolytic activity with reactive oxygen species (ROS) scavenging capabilities. This nanozyme can cross the blood-brain barrier, accumulate in ischemic neuronal tissues, and activate thrombolytic functions in the presence of thrombin. In animal models, PNzyme/MnO2 demonstrated prolonged blood circulation, strong thrombolytic action, and reduced ischemic brain damage, while also inhibiting astrocyte activation and pro-inflammatory cytokine secretion 1.
Neuroprotective Effects of Baicalein
Baicalein, a flavonoid derived from the root of Scutellaria baicalensis, has been studied for its neuroprotective effects in the subacute phase of ischemic stroke. Administered 24 hours after reperfusion, baicalein significantly reduced neurobehavioral deficits and brain infarct volume in rat models. It also modulated microglia/macrophage polarization, reduced neuroinflammation, and decreased neuronal apoptosis and autophagy, suggesting its potential as a therapeutic agent for cerebral ischemia-reperfusion injury 2.
Stem Cell Therapy
Regenerative Potential of Stem Cells
Stem cell therapy has emerged 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 mitigate ischemic injury through exosome release. Intranasal delivery and hypoxic conditioning are potential strategies to optimize stem cell therapy. Preclinical studies have shown that stem cells can down-regulate inflammatory phenotypes and promote tissue regeneration, although clinical trials are still in early phases 36.
Anti-Inflammatory and Antioxidative Therapies
Nanozyme Therapy for Inflammation and Oxidative Stress
A neutrophil-like cell-membrane-coated mesoporous Prussian blue nanozyme (MPBzyme@NCM) has been developed to target ischemic brain damage noninvasively. This nanozyme improves delivery to the damaged brain and is taken up by microglia, promoting M2 polarization, reducing neutrophil recruitment, and decreasing neuronal apoptosis. This approach shows potential for long-term neurological recovery after ischemic stroke 4.
Polyphenolic Compounds
Polyphenolic compounds have shown potential in animal models of ischemic stroke due to their biocompatibility and ability to target multiple ischemic cascade signaling pathways. However, their low bioavailability remains a challenge. Strategies to improve bioavailability are being explored to enhance the therapeutic efficacy of polyphenols in clinical settings 9.
Emerging Nanomedicine Approaches
Advances in Nanomedicine
Nanomedicine offers new possibilities for treating ischemic stroke by improving drug pharmacokinetics, achieving effective drug accumulation at target sites, and enhancing therapeutic effects while reducing side effects. Recent research has focused on overcoming barriers to nanomedicine delivery to ischemic lesions and developing new nanomedicine-based treatments 5.
Conclusion
The treatment of ischemic changes in the brain involves a multifaceted approach, including thrombolytic and neuroprotective strategies, stem cell therapy, and innovative nanomedicine applications. Advances in these areas hold promise for improving outcomes in ischemic stroke patients by targeting various aspects of the ischemic cascade, reducing inflammation, and promoting tissue regeneration. Continued research and clinical trials are essential to translate these promising therapies into effective treatments for patients.
Sources and full results
Most relevant research papers on this topic
A Thrombin‐Activated Peptide‐Templated Nanozyme for Remedying Ischemic Stroke via Thrombolytic and Neuroprotective Actions
The PNzyme/MnO2 nanozyme effectively reduces ischemic brain damage and thrombosis by combining thrombolytic and neuroprotective actions, offering a promising treatment for ischemic stroke.
Highly CitedBaicalein administered in the subacute phase ameliorates ischemia-reperfusion-induced brain injury by reducing neuroinflammation and neuronal damage.
Baicalein reduces neuroinflammation and neuronal damage in the subacute phase of cerebral ischemia-reperfusion injury by inhibiting M1 transformation and promoting M2 transformation of microglia/macrophages.
Non-RCT
Animal Study
Rigorous JournalHighly CitedOptimizing Stem Cell Therapy after Ischemic Brain Injury
Stem cell therapy shows potential in ischemic brain injury treatment, with intranasal delivery and hypoxic conditioning offering potential optimization strategies.
Systematic Review
Very Rigorous JournalNeutrophil-like Cell-Membrane-Coated Nanozyme Therapy for Ischemic Brain Damage and Long-Term Neurological Functional Recovery.
MPBzyme@NCM shows potential as a noninvasive active-targeting therapy for ischemic stroke by improving delivery and long-term neurological functional recovery.
Highly CitedRecent advances in nanomedicines for the treatment of ischemic stroke
Nanomedicines show promise in improving ischemic stroke treatment by enhancing drug accumulation, reducing side effects, and enhancing therapeutic effect while minimizing transport barriers.
Highly Cited