Abstract

Background and purposeJ147, a novel neurotrophic compound, was originally developed to treat aging-associated neurological diseases. Based on the broad spectrum of cytoprotective effects exhibited by this compound, we investigated whether J147 has cerebroprotection for acute ischemic stroke and whether it can enhance the effectiveness of thrombolytic therapy with tissue plasminogen activator (tPA).MethodsRats were subjected to transient occlusion of the middle cerebral artery (tMCAO) by insertion of an intraluminal suture or embolic middle cerebral artery occlusion (eMCAO), and treated intravenously with J147 alone or in combination with tPA.ResultsWe found that J147 treatment significantly reduced infarct volume when administered at 2 h after stroke onset in the tMCAO model, but had no effect in eMCAO without tPA. However, combination treatment with J147 plus tPA at 4 h after stroke onset significantly reduced infarct volume and neurological deficits at 72 h after stroke compared with saline or tPA alone groups in the eMCAO model. Importantly, the combination treatment significantly reduced delayed tPA-associated brain hemorrhage and secondary microvascular thrombosis. These protective effects were associated with J147-mediated inhibition of matrix metalloproteinase-9 (MMP9), 15-lipoxygenase-1, and plasminogen activator inhibitor (PAI) expression in the ischemic hemispheres (predominantly in ischemic cerebral endothelium). Moreover, the combination treatment significantly reduced circulating platelet activation and platelet-leukocyte aggregation compared with saline or tPA alone groups at 24 h after stroke, which might also contribute to reduced microvascular thrombosis and neuroinflammation (as demonstrated by reduced neutrophil brain infiltration and microglial activation).ConclusionOur results demonstrate that J147 treatment alone exerts cerebral cytoprotective effects in a suture model of acute ischemic stroke, while in an embolic stroke model co-administration of J147 with tPA reduces delayed tPA-induced intracerebral hemorrhage and confers cerebroprotection. These findings suggest that J147-tPA combination therapy could be a promising approach to improving the treatment of ischemic stroke.

Highlights

  • Since approval in 1996, intravenous administration of recombinant tissuetype plasminogen activator is the only Food and Drug Administration (FDA)—approved medication indicated for the treatment of patients with acute ischemic stroke [3]

  • Our results show that J147 treatment decreased infarct volume in a dose-dependent manner in transient MCAO model (tMCAO)

  • We evaluated the neuroprotective effects of J147 in rats subjected to embolic MCAO models (eMCAO)

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Summary

Introduction

Stroke is a leading cause of morbidity and mortality worldwide [1]. About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked [1, 2]. Only 3–5% of all the patients with acute ischemic stroke in the United States receive IV tPA due to the extremely short timeframe for thrombolysis and the increased risks of intracranial hemorrhage with delayed tPA treatment [3, 4]. It is well-known that IV tPA beyond 3 h of stroke onset significantly increases cerebral bleeding it may be safe and effective in selected patients up to 4.5 h after symptom onset [5, 6]. Based on the broad spectrum of cytoprotective effects exhibited by this compound, we investigated whether J147 has cerebroprotection for acute ischemic stroke and whether it can enhance the effectiveness of thrombolytic therapy with tissue plasminogen activator (tPA)

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