Abstract | BACKGROUND AND PURPOSE:
Ischemia/ hypoxia induces de novo expression of the sulfonylurea receptor 1-regulated NC(Ca- ATP) channel. In rodent models of ischemic stroke, early postevent administration of the sulfonylurea, glibenclamide, is highly effective in reducing edema, mortality, and lesion volume, and in patients with diabetes presenting with ischemic stroke, pre-event plus postevent use of sulfonylureas is associated with better neurological outcome. However, the therapeutic window for treatment with glibenclamide has not been studied. METHODS: RESULTS:
Glibenclamide reduced total lesion volume by 53% in the thromboembolic MCAo model at 6 hours, reduced corrected cortical lesion volume by 51% in the permanent MCAo model at 4 hours, and reduced corrected cortical lesion volume by 41% in the temporary MCAo model at 5.75 hours (P<0.05 for all 3). Analysis of pooled data from the permanent MCAo and temporary MCAo series indicated a sigmoidal relationship between hemispheric swelling and corrected cortical lesion volume with the half-maximum cortical lesion volume being observed with 10% hemispheric swelling. CONCLUSIONS: Low-dose glibenclamide has a strong beneficial effect on lesion volume and has a highly favorable therapeutic window in several models of ischemic stroke.
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Authors | J Marc Simard, Vladimir Yurovsky, Natalia Tsymbalyuk, Ludmila Melnichenko, Svetlana Ivanova, Volodymyr Gerzanich |
Journal | Stroke
(Stroke)
Vol. 40
Issue 2
Pg. 604-9
(Feb 2009)
ISSN: 1524-4628 [Electronic] United States |
PMID | 19023097
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- ATP-Binding Cassette Transporters
- Hypoglycemic Agents
- Neuroprotective Agents
- Potassium Channels, Inwardly Rectifying
- Receptors, Drug
- Sulfonylurea Compounds
- Sulfonylurea Receptors
- Glyburide
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Topics |
- ATP-Binding Cassette Transporters
(biosynthesis, genetics)
- Animals
- Brain
(pathology)
- Brain Ischemia
(complications)
- Cerebral Infarction
(pathology)
- Data Interpretation, Statistical
- Glyburide
(therapeutic use)
- Hyperglycemia
(blood, complications)
- Hypoglycemic Agents
(therapeutic use)
- Immunohistochemistry
- Infarction, Middle Cerebral Artery
(pathology)
- Male
- Neuroprotective Agents
- Potassium Channels, Inwardly Rectifying
(biosynthesis, genetics)
- Rats
- Rats, Wistar
- Receptors, Drug
(biosynthesis, genetics)
- Stroke
(etiology, pathology, prevention & control)
- Sulfonylurea Compounds
(pharmacology)
- Sulfonylurea Receptors
- Thromboembolism
(drug therapy, pathology)
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