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首页> 外文期刊>CNS & Neurological Disorders - Drug Targets (Formerly Current Drug Targets - CNS & Neurological Disorders) >Targeting Extracellular Matrix Proteolysis for Hemorrhagic Complications of tPA Stroke Therapy
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Targeting Extracellular Matrix Proteolysis for Hemorrhagic Complications of tPA Stroke Therapy

机译:靶向细胞外基质蛋白水解治疗tPA中风出血性并发症。

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摘要

To date, tPA-based thrombolytic therapy is the only FDA-approved treatment for achieving vascular reperfusion and clinical benefit, but this agent is given to only about 2-5% of stroke patients in the United States of America. This may be related, in part, to the elevated risks of symptomatic intracranial hemorrhage, and the consequently reduced therapeutic time window. Recent efforts have aimed at identifying new combination strategies that might increase thrombolytic efficacy of tPA to benefit reperfusion, while reducing its associated neurotoxicity and hemorrhagic complications. Emerging experimental studies demonstrate that the breakdown of neurovascular matrix initiates blood – brain barrier disruption with edema and/or hemorrhage. Perturbation of extracellular homeostasis triggered by dysregulated extracellular proteases may underlie processes responsible for the hemorrhagic complications of thrombolytic stroke therapy. This short review summarizes experimental investigations of this field in pre-clinical stroke models. The data strongly suggest that targeting the extracellular matrix proteolytic imbalance within the neurovascular unit may provide new approaches for improving the safety and efficacy of thrombolytic reperfusion therapy of stroke.
机译:迄今为止,基于tPA的溶栓治疗是唯一获得FDA批准的实现血管再灌注和临床获益的治疗方法,但是在美国,这种药物仅用于大约2%至5%的中风患者。这可能部分与症状性颅内出血的风险升高以及治疗时间窗缩短有关。最近的努力旨在确定可以提高tPA溶栓疗效以利于再灌注,同时减少其相关的神经毒性和出血并发症的新的联合策略。新兴的实验研究表明,神经血管基质的破坏可引发血液-脑屏障破坏,并伴有水肿和/或出血。细胞外蛋白酶失调引发的细胞外稳态紊乱可能是溶栓性中风治疗出血并发症的过程的基础。这篇简短的综述总结了临床前卒中模型中该领域的实验研究。数据有力地表明,针对神经血管单元内的细胞外基质蛋白水解失衡可能提供改善卒中溶栓再灌注治疗的安全性和有效性的新方法。

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