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The use of recombinant tissue plasminogen activator in in acute ischemic stroke is associated with increased level of BDNF

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Abstract

Much concern was directed towards the crucial role of recombinant tissue plasminogen activator (rt-PA) in improving neuroplasticity in patients with acute ischemic stroke. The aim of the work to investigate the effect of treating patients with acute ischemic stroke with rt-PA, on the level of brain derived neurotrophic factor (BDNF) as a marker of neuroplasticity. This study was conducted on 47 patients presenting with acute ischemic stroke (during the first 4.5 h from stroke onset); 26 patients of them eligible for receiving rt-PA (patient group) and 21 patients having contraindications for treatment with rt-PA (control group). Neurological, radiological and laboratory assessment (including BDNF serum level) were done for both groups at stroke onset (before receiving rt-PA) and at day 7. There was a statistically significant increase in BDNF serum level from day 1 to day 7 in rt-PA treated patients in comparison to control group (P-value˂ 0.001). Serum level of BDNF is significantly higher at the onset of stroke in female patients and non-smokers than males or smokers (P-value = 0.011, 0.01 respectively). There was no effect of either age, body mass index, hypertension, diabetes, drug abuse, past or family history of stroke, valvular heart diseases, atrial fibrillation, cardiomyopathy, ejection fraction, carotid atherosclerotic changes, lipid profile or uric acid, on BDNF serum level measured at the onset of stroke. Treatment of patients with acute ischemic stroke with rt-PA causes significant improvement in neuroplasticity through increasing BDNF serum level.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request with permission of Faculty of Medicine, Beni-Suef University, Egypt.

Abbreviations

AF:

Atrial fibrillation

AHA/ASA:

American heart association and American stroke association

B.P:

Blood pressure

BDNF:

Brain derived neurotrophic factor

CT:

Computed tomography

DM:

Diabetes mellitus

DTN:

Door to needle

FDA:

Food and drug administration

GBD:

Global burden of disease

HDL:

High lipodensity protein

HRP:

Horseradish peroxidase

HTN:

Hypertension

LDL:

Low density lipoprotein

MMP-9:

Matrix metalloproteinases-9

NIHSS:

National institute of health stroke scale

NMDA:

N-methyl-D-aspartate

OD:

Optical density

RBS:

Random blood sugar

rt-PA:

Recombinant tissue plasminogen activator

TG:

Triglycerides

TNF-α:

Tumor necrosis factor -α

TrkB:

Tropomyosin receptor kinase B

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Funding

Authors did not receive any funding for this work.

Author information

Authors and Affiliations

  1. Department of Neurology, Beni-Suef University, Beni Suef, Egypt

    Rasha Soliman & Hend Mamdouh

  2. Department of Biochemistry, Cairo University, Giza, Egypt

    Laila Rashed

  3. Department of Neurology, Beni-Suef University, Beni Suef, 62511, Egypt

    Mona Hussein

Authors
  1. Rasha Soliman
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  2. Hend Mamdouh
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  3. Laila Rashed
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  4. Mona Hussein
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Contributions

RS participated in study design, sequence alignment and helped to draft manuscript. HM participated in study design, collection and analysis of data and helped to draft manuscript. LR participated in study design, performed the laboratory work and helped to draft manuscript. MH participated in study design, sequence alignment and helped to draft manuscript. All authors read and approved the final manuscript with agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Mona Hussein.

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The authors declare that they have no competing interests.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki.

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A written informed consent was obtained from each participant in this study or from one of his family members and the study was approved by local ethical committee in Faculty of medicine, Beni-Suef University.

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Soliman, R., Mamdouh, H., Rashed, L. et al. The use of recombinant tissue plasminogen activator in in acute ischemic stroke is associated with increased level of BDNF. J Thromb Thrombolysis 52, 1165–1172 (2021). https://doi.org/10.1007/s11239-021-02443-1

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  • DOI: https://doi.org/10.1007/s11239-021-02443-1

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