Abstract TP105: Investigation of S-nitrosoglutathione in Stroke: A Systematic Review of Literature in Pre-Clinical and Clinical Research

Abstract

Background: S-Nitrosoglutathione (GSNO) is a nitric oxide donor that that has been investigated for neuroprotective and neuro-recovery effect. We aimed to conduct a systematic review on the published literature using GSNO in both human and animal stroke studies. Methods: We searched PubMed up to June 30, 2018, using the following keywords: S-Nitrosoglutathione, GSNO, stroke, cerebrovascular, carotid arteries, middle cerebral artery, and MCA. Only studies published in the English language providing efficacy results of GSNO on ischemic stroke were included. STAIR Score was used for the quality assessment of preclinical studies and PEDro Score was used to evaluate clinical trials. A meta-analysis was conducted to compare the effect size. Results: Of 39 articles identified, 10 (6 for preclinical and 4 for clinical studies) met eligibility criteria and were included (Fig. 1a). Meta-analysis was done for the 4 clinical studies. The median STAIR Score across the preclinical studies was 5.5 (range: 4-7)(Fig.1b) and the PEDro Score for the 4 clinical trials ranged from 6 to 10 (Fig.1c). Among the included 6 preclinical studies, 5 studies found that GSNO reduced infarct size, while 4 studies demonstrated improved neurological behavior (Fig.1d). Inverse-variance weighted linear meta-analysis of standardized mean difference (Hedge’s g) on 4 human studies revealed a big effect size (Hedge’s g=-0.82, 95% CI: [-1.26, -0.38], P=0.0003) favoring the GSNO group in term of reducing embolic signals (Fig. 1e&1f). Conclusions: There are positive signs from both preclinical and clinical studies that GSNO has potential application in human strokes.