Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cerebral stroke is caused by acute interruption of the brain arterial blood supply and is one of the major health problems with no effective treatments so far apart from the thrombolytic recombinant tissue plasminogen activator (rt-PA), which must be administered within 3h of stroke onset. This emerges it as the third leading cause of mortality worldwide. Acidosis and brain edema are the prominent metabolic features of ischemic brain. The combined inhibition of aquaporin-4 (AQP4) and ASIC1a channels may offers a new neuroprotective approach in cerebral stroke management. Moreover, the combined inhibition of AQP4 and ASIC1a with NSAID remains unknown against neuroprotection in animal models of cerebral ischemia. NSAIDs are believed to act as a pharmacological molecule that reported to have an antioxidant and anti-inflammatory properties. Therefore, the target of the present in silico study was to determine the neuroprotective efficacy of Piroxicam, a NSAID in animal model of cerebral ischemia/reperfusion (I/R) injury and efforts were made to analyze its inhibitory effects on aquaporin-4 activation and ASIC1a channels mediated downstream survival/damage mechanisms. Thus we hypothesized that Piroxicam, a NSAID can act as a neuroprotective agent in animal model of cerebral ischemia/reperfusion (I/R) injury due to its inhibitory effects on aquaporin-4 channel and ASIC1a channels. It is indeed vital that we do not give up the fight to develop compounds to treat stroke despite the many years of setbacks. One of the mottos of our proposed hypothesis is to find out a successful modality of effective substantial treatment of brain stroke with other anti stroke therapeutics available till date.
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PMID:Neuroprotective potential of Piroxicam in cerebral ischemia: an in silico evaluation of the hypothesis to explore its therapeutic efficacy by inhibition of aquaporin-4 and acid sensing ion channel1a. 2279 52

Owing to the intricate and multifaceted pathology of cerebral stroke, multiple drug therapy had long been suggested for effective stroke treatment. Therefore, the development of a potential new combination of drug is necessitated which can bring about desirable improved neuroprotection targeting different pathways against ischemic stroke. In this context, we hypothesize the combination effect of Piroxicam, a Non steroidal anti inflammatory drug with Ifenprodil, a NR2b selective NMDAR antagonist in animal model of cerebral ischemia. A few past studies have enumerated the neuroprotective roles of Piroxicam and Ifenprodil administered in singlet against cerebral ischemia in animal model, hence we hypothesized that by using Piroxicam and Ifenprodil in combination would provide additive neuroprotection than either of the agents used alone. In this article, we discuss our hypothesis regarding the possibility of Piroxicam and Ifenprodil as a potent combination which may have a positive therapeutic role in treatment of cerebral ischemia through its anti-inflammatory, anti-apoptotic and anti-oxidative characteristics of Piroxicam with Ifenprodil which has been proved to have neuroprotective, anticonvulsant and antinociceptive effects and has potentials for the treatment of several neuropsychiatric disorders, such as Parkinson's disease alcoholism and drug addiction.
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PMID:Combination therapy of ifenprodil with piroxicam may be an effective therapeutic intervention in cerebral stroke: a hypothesis. 2287 52

Cerebral ischemia is still one of the most confusing and enigmatic neurological disorders with least understood injuries. The EEG measures have been traditionally used to detect residual neural dysfunctions after cerebral ischemia although having several shortcomings, yielding controversial and inconsistent results. It is feasible to hypothesize that advanced EEG research can overcome these shortcomings and provide more clear information regarding the long lasting neural impairment in the subjects suffered from brain stroke. To our understanding, EEG power spectrum density measures can significantly contribute towards intervening drug administered diseased model and give us correct status of neuronal firing after an insult. On the basis of our findings we hypothesize that Piroxicam, a non-steroidal anti-inflammatory drug (NSAID) can protect neurons and improves neuronal firing after ischemia/reperfusion injury in animal model of focal cerebral ischemia. This is the first ever finding which advocates the role of Piroxicam, a NSAID in neuronal firing apart from its other neuroprotective roles. Thus, we consider the possibility of modulation of neuronal firing as a therapeutic strategy to help prevent neuronal dysfunctions in cerebral ischemia.
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PMID:Does Piroxicam really protect ischemic neurons and influence neuronal firing in cerebral ischemia? An exploration towards therapeutics. 3325 70

Matrix metalloproteinases are zinc-containing endopeptidases that are involved in extracellular matrix (ECM) remodeling cascade in many neurological disorders, including cerebral ischemia (CI). Remodeling of the ECM followed by disruption of the blood-brain barrier (BBB) is one of the major factors contributing to the ultimate neurodegeneration in CI. BBB disruption causes a cascade of pathophysiologies that trigger Anoikis-like cell death. While inhibition of MMP-2 and MMP-9 decreases the extent of neuronal damage in CI, MMP-2/9 knock-out mice have reduced infarct volume in experimental animal models of CI. Piroxicam, which is a non-steroidal anti-inflammatory drug (NSAID), has been demonstrated to be protective against aquaporin-4 and acid-sensing ion channel 1a--mediated neurodegeneration in CI. However, no report exists on the inhibitory action of Piroxicam on MMPs. We tested the hypothesis that Piroxicam, with its larger molecular size and more number of interacting pharmacophores, can inhibit MMP-2 and MMP-9. A comparative study on the inhibitory potential of Piroxicam with other reported MMP-inhibitors, viz., Aspirin, Melatonin and Doxycycline, has also been performed. Since the drug has already been reported to be neuroprotective through its inhibitory action in other pathways, it can be the drug of choice in the therapeutic management and prevention of neurodegeneration in CI.
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PMID:Inhibition of matrix metalloproteinase-2 and 9 by Piroxicam confer neuroprotection in cerebral ischemia: an in silico evaluation of the hypothesis. 2545 37

Hyperactivation of GluN2B subunit containing N-methyl-d-aspartate receptors (NMDARs) significantly contributes to the development of several neurodegenerative diseases through a process called excitotoxicity. NMDARs are voltage-gated Ca2+ channels which when activated lead to excessive influx of Ca2+ into neurons thereby exacerbating several calcium-dependent pathways that cause oxidative stress and apoptosis. Several drugs are presently in use to counter the NMDAR-mediated excitotoxic events among which Ifenprodil and its derivatives are GluN2B selective allosteric antagonists. Certain non-steroidal anti-inflammatory drugs (NSAIDs) have also been reported to inhibit NMDARs and the resultant pathologies. Meanwhile, Piroxicam, which is a NSAID, has been reported to be protective in cerebral ischemia-induced neurodegeneration through various pathways. Since Piroxicam has more number of interacting groups as compared to other NSAIDs and also has structural similarities with Ifenprodil, we thought it prudent that Piroxicam may inhibit NMDARs similar to Ifenprodil. By using molecular docking as a tool, we validated the hypothesis and hereby report for the first time that Piroxicam can inhibit GluN2B containing NMDARs through allosteric mode similar to the well known selective antagonist--Ifenprodil; and thus can be a therapeutic drug for the prevention of excitotoxic neurodegeneration.
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PMID:Piroxicam inhibits NMDA receptor-mediated excitotoxicity through allosteric inhibition of the GluN2B subunit: an in silico study elucidating a novel mechanism of action of the drug. 2545 47

Cerebral ischemia (CI), caused by the deprivation of oxygen and glucose to the brain, is the leading cause of permanent disability. Neuronal demise in CI has been linked to several pathways which include cyclooxygenases (COX) - mediated production of prostaglandins (PGs) and subsequently reactive oxygen species (ROS), aquaporin-4 (AQ-4) - mediated brain edema and acidsensing ion channel-1a (ASIC-1a) - mediated acidotoxicity, matrix remodeling, in addition to others. Several non-steroidal antiinflammatory drugs (NSAIDs) are presently in use to prevent these pathways. However, owing to the large number of processes involved, there is high drug load. So, identifying drugs with multimodal role has always been a frequently sought venture. The present in silico study has been performed to find out the relative efficacy of three different NSAIDs (Piroxicam, Aspirin and Nimesulide) in preventing neurodegeneration in CI, with respect to their inhibitory potential on COXs, AQ-4 and ASIC-1a. We find that piroxicam is the most potent inhibitor of these receptors as compared to the NSAIDs under investigation. Since piroxicam has already been reported to inhibit N-methyl-D-aspartate (NMDA) receptor and matrix metalloproteinases (MMPs), which are also linked to CI-induced neurodegeneration, we hereby propose piroxicam to be a gold-standard drug in preventing neurodegeneration in CI.
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PMID:Piroxicam confer neuroprotection in Cerebral Ischemia by inhibiting Cyclooxygenases, Acid- Sensing Ion Channel-1a and Aquaporin-4: an in silico comparison with Aspirin and Nimesulide. 2612 63