Title:Vascular Protection to Increase the Safety of Tissue Plasminogen Activator for Stroke
VOLUME: 18 ISSUE: 25
Author(s):Tauheed Ishrat, Sahar Soliman, Weihua Guan, Mihaela Saler and Susan C. Fagan
Affiliation:Program in Clinical and Experimental Therapeutics, University of Georgia College of Pharmacy, HM 1200; 1120 15th St., Augusta, GA 30912.
Keywords:Ischemic stroke, vascular protection, tissue plasminogen activator (tPA), matrix metalloproteinases (MMPs), hemorrhagic transformation (HT), thrombolysis, blood–brain barrier, edema formation, vascular damage, clinical trials.
Abstract:Thrombolytic therapy with tissue plasminogen activator (tPA) remains the most effective treatment for acute ischemic stroke,
but can cause vascular damage leading to edema formation and hemorrhagic transformation (HT). In this review, we discuss how tPA
contributes to the pathogenesis of vascular damage and highlight evidence to support combination therapy of tPA with pharmacological
agents that are vascular protective. There is an unmet need to develop therapeutic interventions which target the underlying mechanisms
of vascular damage after acute ischemic stroke in order to prevent HT and improve the safety and impact of tPA.
