A preliminary report on the application of noscapine in the treatment of stroke
Stroke is the third leading cause of death in most developed countries. Therefore, a need exists for its treatment. Considering the role that is played by bradykinin in pathogenesis of neuronal injury, it has been suggested that bradykinin antagonists may be useful in the treatment of neurological patients. As noscapine can act as an antagonist of bradykinin and can effectively reduce brain injury after hypoxic-ischemic insult in neonatal rats, the present work was carried out to investigate its effectiveness in a clinical setting.
Noscapine was administrated orally to ten acute ischemic stroke patients, and the degree of brain injury was evaluated by computed tomography scan and clinical observation. The control group (n=10) did not receive noscapine treatment.
Our study showed that noscapine effectively improved clinical prognosis and reduced the mortality rate down to 20% compared with 80% in the control group. Our patients did not show any specific side effects due to noscapine.
It is concluded that oral noscapine can be an effective drug for reducing the mortality rate in stroke; however, further study with a larger number of patients is needed to determine its full potential in stroke.
KeywordsNoscapine Bradykinin Stroke
The authors would like to thank Dr. S.A. Ebrahimi for his help and Mrs. F. Yazdani for her encouragement during the course of this study.
- 1.Aramori I, Zenkoh J, Morikawa N, Asano M, Hautori C, Sawai H, Kayakiri H, Satoh S, Inoue T, Abe Y, Sawada Y, Mizutani T, Inamura N, Nakahara K, Kojo H, Oku T, Notsu Y (1997) Nonpeptide mimic of bradykinin with long-acting properties at the bradykinin B2 receptor. Mol Pharmacol 52:16–20PubMedGoogle Scholar
- 5.Brott T, Bogousslavsky J (2000) Treatment of acute ischemic stroke. N Engl J Med 343:710–722Google Scholar
- 7.Ebrahimi SA, Zareie MR, Rostami P, Mahmoudian M (2003) Interaction of noscapine with the bradykinin mediation of the cough response Acta Physiologica Hungarica 90:147–155Google Scholar
- 8.Francel CP (1992) Bradykinin and neuronal injury. J Neurotrauma 9[Suppl 1]:827–845Google Scholar
- 9.Karlsoon MO, Dahlstrom B, Eckernas SA, Johansson M, Tufvesson AA Pharmacokinetics of oral noscapine. Eur J Clin Pharmacol 39:275–279Google Scholar
- 12.Mahmoudian M, Mojaverian N (2001) Effects of noscapine, the antitussive opioid alkaloid, on bradykinin-induced smooth muscle contraction in the isolated ileum of the guinea pig. Acta Physiologica Hungarica. 88:231–237Google Scholar
- 13.Mahmoudian M, Siadatpour Z, Ziai SA, Mehrpour M, Benaissa F, Nobakht M (2003) Reduction of the prenatal hypoxic-ischemic brain edema with noscapine. Acta Physiologica Hungarica (in press)Google Scholar
- 14.Martindale (1996) The extra pharmacopeia, 21st edn. Reynold, JEF (ed) The Pharmaceutical Press, London, pp 1072–1073Google Scholar
- 17.Rice JE III, Vannucci RC, Brierley JB, The influence of immaturity on hypoxic-ischemic brain damage in the rat. Ann Neurol 9:131–141Google Scholar