Advances in the study of mechanism of thrombolysis-induced hemorrhagic transformation and therapeutic drugs
10.16438/j.0513-4870.2018-0296
- VernacularTitle:脑卒中溶栓后出血转化的发生机制及治疗药物研究进展
- Author:
Ling-lei KONG
1
;
Yin-zhong MA
2
;
Li LI
1
;
Yan-xia CHEN
3
;
Guan-hua DU
1
Author Information
1. Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
2. Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
3. BaoTou Medical College, Baotou 014060, China
- Publication Type:REVIEWS
- Keywords:
stroke;
hemorrhagic transformation;
tissue plasminogen activator;
blood-brain barrier
- From:
Acta Pharmaceutica Sinica
2018;53(9):1467-1476
- CountryChina
- Language:Chinese
-
Abstract:
Hemorrhagic transformation (HT) is a common complication of ischemic stroke, especially after thrombolytic therapy, which is associated with increased morbidity and mortality. Thrombolysis with tissue plasminogen activator (t-PA) increases the rate of HT by as much as 10-fold, and the mortality by about 60%. The patients who are eligible for t-PA treatment are still between 3.4% and 5.2% of all patients with acute ischemic stroke because of the narrow therapeutic time window. Due to the unknown mechanism and therapeutic target of HT, there are no effective drugs to decrease the incidence of HT. The main mechanism of HT is disruption of the blood-brain barrier (BBB) integrity and neurovascular homeostasis, involving a variety of molecular signaling pathways. In animal and clinical studies, combining therapeutic agents with t-PA, which may help to minimize BBB perturbations, reduces the incidence of HT and increases the safety of thrombolytic therapy. This article is prepared to review the mechanisms, targets and therapeutic drugs of t-PA induced HT in recent years to provide a reference to the basic research and drug development of HT.
