脳梗塞治療における新たなるアプローチ:－脳虚血障害発症後の耐糖能異常制御の観点から－ [in Japanese] New Therapeutic Strategy for Cerebral Stroke Targeting Post-ischemic Glucose Intolerance [in Japanese]
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Stroke is the third most common cause of death in Japan. Although significant breakthroughs have been made in the development of advanced drugs, the necessity for using them in a limited time window and adverse effects can restrict their application, making it still necessary to explore new therapeutic targets and strategies.<br>It is well known that hyperglycemia can exacerbate ischemic neuronal damage. Also, it has been recently reported that hyperglycemia/glucose intolerance can be induced by cerebral ischemic stress per se, and a clinical study showed that normalization of blood glucose levels during the first 48 h of hospitalization appears to confer a potent survival benefit in patients with thromboembolic stroke. It is therefore important to strictly control blood glucose levels immediately after ischemic stress for neruroprotection. However, the detailed mechanism of post-ischemic glucose intolerance is unknown.<br>Here, we review the progress in research on the mechanism of the development of post-ischemic glucose intolerance focusing on insulin signaling, adiponectin signaling and communication between the brain and peripheral tissues. Furthermore, from the therapeutic viewpoint, we discuss the effect of anti-diabetic drugs, such as insulin, metformin, and the glucose-sensing neuropeptide orexin-A, on the development of post-ischemic glucose intolerance and additional neuronal damage. In our conclusion, we emphasize the importance of focusing on the development of post-ischemic glucose intolerance as a new therapeutic target of stroke.
- Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences)
Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) 37(9), 515-519, 2011
Japanese Society of Pharmaceutical Health Care and Sciences