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A 2?×?2 factorial design for the combination therapy of minocycline and remote ischemic perconditioning: efficacy in a preclinical trial in murine thromboembolic stroke model

机译:2?×?2因子设计用于米诺环素和远程缺血性适应症的联合治疗:在小鼠血栓栓塞性中风模型的临床前试验中的功效

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Background After the failure of so many drugs and therapies for acute ischemic stroke, innovative approaches are needed to develop new treatments. One promising strategy is to test combinations of agents in the pre-hospital setting prior to the administration of intravenous tissue plasminogen activator (IV-tPA) and/ or the use of mechanical reperfusion devices in the hospital. Methods We performed a 2?×?2 factorial design preclinical trial where we tested minocycline (MINO), remote ischemic perconditioning (RIPerC) and their combination treatment in a thromboembolic clot model of stroke in mice, without IV-tPA or later treated with IV-tPA at 4 hours post-stroke. Cerebral blood flow (CBF) was measured by laser speckle contrast imaging (LSCI), behavioral outcomes as neurological deficit score (NDS) and adhesive tape removal test, and infarct size measurement were performed at 48 hours post-stroke. Mice within the experimental sets were randomized for the different treatments, and all outcome measures were blinded. Results RIPerC significantly improved CBF as measured by LSCI in both with and without tPA treated mice (P?
机译:背景技术在针对急性缺血性中风的众多药物和疗法失败之后,需要创新的方法来开发新的治疗方法。一种有前途的策略是在静脉内注射纤溶酶原激活剂(IV-tPA)和/或在医院使用机械再灌注设备之前,在院前环境中测试各种药物的组合。方法我们进行了一项2××2因子析因设计的临床前试验,我们在没有静脉输注tPA或以后进行静脉输注的小鼠的血栓栓塞性凝块模型中测试了米诺环素(MINO),远程缺血性过适应(RIPerC)及其组合治疗。 -中风后4小时的-tPA。通过激光散斑对比成像(LSCI)测量脑血流量(CBF),以神经功能缺损评分(NDS)和胶带去除测试作为行为结果,并在卒中后48小时进行梗死面积测量。实验组中的小鼠被随机分配用于不同的治疗,并且所有结果指标均不知情。结果用LSCI测定,在有和没有tPA处理的小鼠中,RIPerC均显着改善了CBF(P << 0.001)。在tPA和非tPA治疗的动物中,MINO和RIPerC单独治疗可有效减少梗塞面积(p 0.0001)和改善短期功能结局(p 0.001)。 MINO和RIPerC的联合治疗显着减少了梗塞面积,大于任何一种单独干预(p <0.05)。 MINO和RIPerC联合治疗后有改善功能预后的趋势。然而,联合治疗组与MINO和RIPERC的单独治疗无显着差异。米诺环素和RIPerC治疗之间没有“统计”相互作用,这表明RIPerC和MINO的作用是加和的,对结果指标没有协同作用。结论将来,将这两种安全且低成本的干预措施结合在救护车中,有可能“冻结”半影并改善中风患者的预后。这种临床前2×2设计可以很容易地转化为院前临床试验。

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