Abstract
Stroke is the leading cause of morbidity and mortality worldwide. About 87% of stroke cases are ischemic, which disrupt the physiological activity of the brain, thus leading to a series of complex pathophysiological events. Despite decades of research on neuroprotectants to probe for suitable therapies against ischemic stroke, no successful results have been obtained, and new alternative approaches are urgently required in order to combat this pathological torment. To address these problems, drug repositioning/reprofiling is explored extensively. Drug repurposing aims to identify new uses for already established drugs, and this makes it an attractive commercial strategy. Nuclear factor-kappa beta (NF-κB) is reported to be involved in many physiological and pathological conditions, such as neurodegeneration, neuroinflammation, and ischemia/reperfusion (I/R) injury. In this study, we examined the neuroprotective effects of atorvastatin, cephalexin, and mycophenolate against the NF-κB in ischemic stroke, as compared to the standard NF-κB inhibitor caeffic acid phenethyl ester (CAPE). An in-silico docking analysis was performed and their potential neuroprotective activities in the in vivo transient middle cerebral artery occlusion (t-MCAO) rat model was examined. The percent (%) infarct area and 28-point composite neuro score were examined, and an immunohistochemical analysis (IHC) and enzyme-linked immunosorbent assay (ELISA) were further performed to validate the neuroprotective role of these compounds in stroke as well as their potential as antioxidants. Our results demonstrated that these novels NF-κB inhibitors could attenuate ischemic stroke-induced neuronal toxicity by targeting NF-κB, a potential therapeutic approach in ischemic stroke.
Highlights
Ischemic stroke is characterized by a decrease in cerebral blood flow (CBF) and deprivation of both glucose and oxygen, which are required to maintain the metabolic demands of the brain (Siniscalchi et al, 2014)
We performed a comparative analysis of three FDA-approved drugs—atorvastatin, cephalexin, and mycophenolate—in ischemic brain injury, to evaluate their possible neuroprotective role based on drug repurposing
We observed that different oxidative damage parameters are the critical determinants in I/R brain injury, which causes a significant increase in Lipid Peroxidation (LPO) and protein oxidation accompanied by significant depletion in brain GSH as well as a decrease in GST and catalase
Summary
Ischemic stroke is characterized by a decrease in cerebral blood flow (CBF) and deprivation of both glucose and oxygen, which are required to maintain the metabolic demands of the brain (Siniscalchi et al, 2014). Ischemia-induced brain detriment may be partially recovered if appropriate treatment is given within a certain time frame, i.e., approximately 3–4.5 h Thrombolytics, such as tissue-type plasminogen activator (t-PA), and embolectomy, such as craniectomy, are the approved treatments for ischemic stroke (Drieu et al, 2018). A long list of perplex factors, such as complex brain structure, longer time window, diverse or different outcome strategies, no precise target, heterogeneity of stroke, and a lack of optimal duration of drug administration, are among the major variants of drug failure in clinical trials (Cheng et al, 2004). NF-κB is composed of several subunits, such as p65 (RelA), RelB, c-Rel, p105/p50 (NF-κB1), and p100/p52 (NFκB2), which, upon activation, assemble to form homo- or heterodimerized transcription factor complexes (Chen et al, 2007) It is present in the cytoplasm as an inactive dimer with the inhibitory subunit of κB (IκB), a pro-inflammatory mediator. Our results suggested that drug repurposing could be a safe and time and cost-effective option for drug development in ischemic stroke
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