Taizen Nakase, Masahiro Sasaki and Akifumi Suzuki
Background: This study was aimed to explore whether the free radical scavenger, edaravone, can reduce the inflammatory response providing better outcome along with not only conventional therapy but also recombinant tissue plasminogen activator (rt-PA) thrombolytic therapy.
Results: Acute ischemic stroke patients were enrolled (n=64, average 73.3 year-old) for measuring interleukin-6 (IL-6), tumor necrosis factor (TNFα) and malondialdehyde-modified LDL (MDA-LDL) as inflammatory biomarkers at 3 time points: before medication, 5 hrs and 24hs following medication. All patients were classified into four groups depending on the medication: conventional therapy without edaravone (n=15), conventional therapy with edaravone (n=34), rt-PA thrombolytic therapy without edaravone (n=4) and rt-PA thrombolytic therapy with edaravone (n=11). Neurological alteration was assessed by NIH Stroke Scale on admission and at 1 month. As the results, the inflammatory markers were reduced in the edaravone treated group, although it was not significant. While, IL-6 was significantly increased at 24 hrs in the thrombolytic group than the conventional group. Patients treated with rt-PA and edaravone exhibited better outcome than only rt-PA treated patients, although there was no difference of the recanalization rate.
Conclusion: Edaravone may be able to decrease the amplified inflammatory response following brain infarction, providing better outcome.
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