European Journal of Clinical Pharmacology

, Volume 59, Issue 8–9, pp 579–581 | Cite as

A preliminary report on the application of noscapine in the treatment of stroke

  • Massoud Mahmoudian
  • Massoud Mehrpour
  • Faouzya Benaissa
  • Zahra Siadatpour
Clinical Trials

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Noscapine Bradykinin Stroke 

Notes

Acknowledgements

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.

References

  1. 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
  2. 2.
    Asano M, Hatori CH, Inamora N, Sawai H, Hirosumi J, Fujiwara T, Nakahara K (1997) Effect of a nonpeptide bradikinin B2 receptor antagonist, FR167344, on different in vivo animal models of inflammation. Br J Pharmacol 122:1436–1440PubMedGoogle Scholar
  3. 3.
    Bonita R (1992) Epidemiology of stroke. Lancet 339:342–344PubMedGoogle Scholar
  4. 4.
    Bonita R, Beaglehole R (1988) Recovery of motor function after stroke. Stroke 19:1497–1500PubMedGoogle Scholar
  5. 5.
    Brott T, Bogousslavsky J (2000) Treatment of acute ischemic stroke. N Engl J Med 343:710–722Google Scholar
  6. 6.
    Chiu D, Krieger D, Villar-Cordova C, Kasner S, Morgenstern LB, Bratina PRN, Yatsu FM, Grotta JC (1998) Intravenous tissue plasminogen activator for acute ischemic stroke. Stroke 29:18–22PubMedGoogle Scholar
  7. 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. 8.
    Francel CP (1992) Bradykinin and neuronal injury. J Neurotrauma 9[Suppl 1]:827–845Google Scholar
  9. 9.
    Karlsoon MO, Dahlstrom B, Eckernas SA, Johansson M, Tufvesson AA Pharmacokinetics of oral noscapine. Eur J Clin Pharmacol 39:275–279Google Scholar
  10. 10.
    Ke Y, Ye K, Grossniklaus HE, Archer DR, Joshi HC, Kappa JA (2000) Noscapine inhibits tumor growth with little toxicity to normal tissues or inhibition of immune responses. Cancer Immunol Immunother 49:217–25CrossRefPubMedGoogle Scholar
  11. 11.
    Loewen SC, Anderson BA (1990) Predictors of stroke outcome using objective measurement scales. Stroke 21:78–81PubMedGoogle Scholar
  12. 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. 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. 14.
    Martindale (1996) The extra pharmacopeia, 21st edn. Reynold, JEF (ed) The Pharmaceutical Press, London, pp 1072–1073Google Scholar
  15. 15.
    Palmer CH, Vannucci RC, Towfighi J (1990) Reduction of perinatal hypoxic-ischemic brain damage with allopurinol. Pediatr Res 27:332–336PubMedGoogle Scholar
  16. 16.
    Relton JK, Beckey VE, Hanson WL, Whalley ET (1997) CP-0597, a selective bradykinin B2 receptor antagonist, inhibits brain injury in a rat model of reversible middle cerebral artery occlusion. Stroke 28:1430–1436PubMedGoogle Scholar
  17. 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
  18. 18.
    Zausinger SD, Lumenta DB, Pruneau D, Schmid-Elsaesser R, Plesnila N, Baethmann A (2002) Effect of LF16–0687 Ms, a bradykinin B2 receptor antagonist, on brain edema formation and tissue damage in a rat model of temporary focal cerebral ischemia. Brain Res 950:268–278CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Massoud Mahmoudian
    • 1
  • Massoud Mehrpour
    • 2
  • Faouzya Benaissa
    • 2
  • Zahra Siadatpour
    • 1
  1. 1.Razi Institute for Drug ResearchIran University of Medical SciencesTehranIran
  2. 2.Department of NeurologyIran University of Medical SciencesTehranIran

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