Combination therapy with normobaric oxygen (NBO) plus thrombolysis in experimental ischemic stroke |
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| Authors: | Norio Fujiwara Yoshihiro Murata Ken Arai Yasuhiro Egi Jie Lu Ona Wu Aneesh B Singhal and Eng H Lo |
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| Institution: | (1) Neuroprotection Research Laboratory, Departments of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA;(2) Neuroprotection Research Laboratory, Departments of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA |
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| Abstract: | Background The widespread use of tissue plasminogen activator (tPA), the only FDA-approved acute stroke treatment, remains limited by
its narrow therapeutic time window and related risks of brain hemorrhage. Normobaric oxygen therapy (NBO) may be a useful
physiological strategy that slows down the process of cerebral infarction, thus potentially allowing for delayed or more effective
thrombolysis. In this study we investigated the effects of NBO started simultaneously with intravenous tPA, in spontaneously
hypertensive rats subjected to embolic middle cerebral artery (MCA) stroke. After homologous clot injection, animals were
randomized into different treatment groups: saline injected at 1 hour; tPA at 1 hour; saline at 1 hour plus NBO; tPA at 1
hour plus NBO. NBO was maintained for 3 hours. Infarct volume, brain swelling and hemorrhagic transformation were quantified
at 24 hours. Outcome assessments were blinded to therapy. |
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