The Role of Matrix Metalloproteinases in Hemorrhagic Transformation in the Treatment of Stroke with Tissue Plasminogen Activator
Ischemic stroke is a leading cause of disability and mortality worldwide. The only approved treatment for ischemic stroke is thrombolytic therapy with tissue plasminogen activator (tPA), though this approach often leads to a severe complication: hemorrhagic transformation (HT). The pathophysiology o...
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| Veröffentlicht in: | Journal of personalized medicine 2023-07, Vol.13 (7), p.1175 |
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| creator | Babenko, Valentina A Fedulova, Ksenia S Silachev, Denis N Rahimi-Moghaddam, Parvaneh Kalyuzhnaya, Yulia N Demyanenko, Svetlana V Plotnikov, Egor Y |
| description | Ischemic stroke is a leading cause of disability and mortality worldwide. The only approved treatment for ischemic stroke is thrombolytic therapy with tissue plasminogen activator (tPA), though this approach often leads to a severe complication: hemorrhagic transformation (HT). The pathophysiology of HT in response to tPA is complex and not fully understood. However, numerous scientific findings suggest that the enzymatic activity and expression of matrix metalloproteinases (MMPs) in brain tissue play a crucial role. In this review article, we summarize the current knowledge of the functioning of various MMPs at different stages of ischemic stroke development and their association with HT. We also discuss the mechanisms that underlie the effect of tPA on MMPs as the main cause of the adverse effects of thrombolytic therapy. Finally, we describe recent research that aimed to develop new strategies to modulate MMP activity to improve the efficacy of thrombolytic therapy. The ultimate goal is to provide more targeted and personalized treatment options for patients with ischemic stroke to minimize complications and improve clinical outcomes. |
| doi_str_mv | 10.3390/jpm13071175 |
| format | Article |
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The only approved treatment for ischemic stroke is thrombolytic therapy with tissue plasminogen activator (tPA), though this approach often leads to a severe complication: hemorrhagic transformation (HT). The pathophysiology of HT in response to tPA is complex and not fully understood. However, numerous scientific findings suggest that the enzymatic activity and expression of matrix metalloproteinases (MMPs) in brain tissue play a crucial role. In this review article, we summarize the current knowledge of the functioning of various MMPs at different stages of ischemic stroke development and their association with HT. We also discuss the mechanisms that underlie the effect of tPA on MMPs as the main cause of the adverse effects of thrombolytic therapy. Finally, we describe recent research that aimed to develop new strategies to modulate MMP activity to improve the efficacy of thrombolytic therapy. The ultimate goal is to provide more targeted and personalized treatment options for patients with ischemic stroke to minimize complications and improve clinical outcomes.</description><identifier>ISSN: 2075-4426</identifier><identifier>EISSN: 2075-4426</identifier><identifier>DOI: 10.3390/jpm13071175</identifier><identifier>PMID: 37511788</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Bats ; Blood vessels ; Drug therapy ; Enzymatic activity ; Enzymes ; FDA approval ; Health aspects ; Hemorrhage ; Ischemia ; Matrix metalloproteinase ; Mortality ; Neurophysiology ; Neurosciences ; Neurotoxicity ; Permeability ; Polypeptides ; Precision medicine ; Reteplase ; Review ; Stroke ; Stroke (Disease) ; t-Plasminogen activator ; Tenecteplase ; Thrombolysis</subject><ispartof>Journal of personalized medicine, 2023-07, Vol.13 (7), p.1175</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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The only approved treatment for ischemic stroke is thrombolytic therapy with tissue plasminogen activator (tPA), though this approach often leads to a severe complication: hemorrhagic transformation (HT). The pathophysiology of HT in response to tPA is complex and not fully understood. However, numerous scientific findings suggest that the enzymatic activity and expression of matrix metalloproteinases (MMPs) in brain tissue play a crucial role. In this review article, we summarize the current knowledge of the functioning of various MMPs at different stages of ischemic stroke development and their association with HT. We also discuss the mechanisms that underlie the effect of tPA on MMPs as the main cause of the adverse effects of thrombolytic therapy. Finally, we describe recent research that aimed to develop new strategies to modulate MMP activity to improve the efficacy of thrombolytic therapy. 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Fedulova, Ksenia S ; Silachev, Denis N ; Rahimi-Moghaddam, Parvaneh ; Kalyuzhnaya, Yulia N ; Demyanenko, Svetlana V ; Plotnikov, Egor Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-1e5c88ef16cdfe0ae5f8e5b00536418532e4fd4787f03ab6e0e4bd908ac802b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Bats</topic><topic>Blood vessels</topic><topic>Drug therapy</topic><topic>Enzymatic activity</topic><topic>Enzymes</topic><topic>FDA approval</topic><topic>Health aspects</topic><topic>Hemorrhage</topic><topic>Ischemia</topic><topic>Matrix metalloproteinase</topic><topic>Mortality</topic><topic>Neurophysiology</topic><topic>Neurosciences</topic><topic>Neurotoxicity</topic><topic>Permeability</topic><topic>Polypeptides</topic><topic>Precision medicine</topic><topic>Reteplase</topic><topic>Review</topic><topic>Stroke</topic><topic>Stroke (Disease)</topic><topic>t-Plasminogen activator</topic><topic>Tenecteplase</topic><topic>Thrombolysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Babenko, Valentina A</creatorcontrib><creatorcontrib>Fedulova, Ksenia S</creatorcontrib><creatorcontrib>Silachev, Denis N</creatorcontrib><creatorcontrib>Rahimi-Moghaddam, Parvaneh</creatorcontrib><creatorcontrib>Kalyuzhnaya, Yulia N</creatorcontrib><creatorcontrib>Demyanenko, Svetlana V</creatorcontrib><creatorcontrib>Plotnikov, Egor Y</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of personalized medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Babenko, Valentina A</au><au>Fedulova, Ksenia S</au><au>Silachev, Denis N</au><au>Rahimi-Moghaddam, Parvaneh</au><au>Kalyuzhnaya, Yulia N</au><au>Demyanenko, Svetlana V</au><au>Plotnikov, Egor Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Role of Matrix Metalloproteinases in Hemorrhagic Transformation in the Treatment of Stroke with Tissue Plasminogen Activator</atitle><jtitle>Journal of personalized medicine</jtitle><addtitle>J Pers Med</addtitle><date>2023-07-23</date><risdate>2023</risdate><volume>13</volume><issue>7</issue><spage>1175</spage><pages>1175-</pages><issn>2075-4426</issn><eissn>2075-4426</eissn><abstract>Ischemic stroke is a leading cause of disability and mortality worldwide. The only approved treatment for ischemic stroke is thrombolytic therapy with tissue plasminogen activator (tPA), though this approach often leads to a severe complication: hemorrhagic transformation (HT). The pathophysiology of HT in response to tPA is complex and not fully understood. However, numerous scientific findings suggest that the enzymatic activity and expression of matrix metalloproteinases (MMPs) in brain tissue play a crucial role. In this review article, we summarize the current knowledge of the functioning of various MMPs at different stages of ischemic stroke development and their association with HT. We also discuss the mechanisms that underlie the effect of tPA on MMPs as the main cause of the adverse effects of thrombolytic therapy. Finally, we describe recent research that aimed to develop new strategies to modulate MMP activity to improve the efficacy of thrombolytic therapy. 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| subjects | Bats Blood vessels Drug therapy Enzymatic activity Enzymes FDA approval Health aspects Hemorrhage Ischemia Matrix metalloproteinase Mortality Neurophysiology Neurosciences Neurotoxicity Permeability Polypeptides Precision medicine Reteplase Review Stroke Stroke (Disease) t-Plasminogen activator Tenecteplase Thrombolysis |
| title | The Role of Matrix Metalloproteinases in Hemorrhagic Transformation in the Treatment of Stroke with Tissue Plasminogen Activator |
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