BACKGROUND: Brain edema is a serious complication of ischemic stroke that can lead to secondary neurological deterioration and death. Glyburide is reported to prevent brain swelling in preclinical rodent models of ischemic stroke through inhibition of a non-selective channel composed of sulfonylurea receptor 1 and transient receptor potential cation channel subfamily M member 4. However, the relevance of this pathway to the development of cerebral edema in stroke patients is not known. METHODS: Using a case-control design, we retrospectively assessed neuroimaging and blood markers of cytotoxic and vasogenic edema in subjects who were enrolled in the glyburide advantage in malignant edema and stroke-pilot (GAMES-Pilot) trial. We compared serial brain magnetic resonance images (MRIs) to a cohort with similar large volume infarctions. We also compared matrix metalloproteinase-9 (MMP-9) plasma level in large hemispheric stroke. RESULTS: We report that IV glyburide was associated with T2 fluid-attenuated inversion recovery signal intensity ratio on brain MRI, diminished the lesional water diffusivity between days 1 and 2 (pseudo-normalization), and reduced blood MMP-9 level. CONCLUSIONS: Several surrogate markers of vasogenic edema appear to be reduced in the setting of IV glyburide treatment in human stroke. Verification of these potential imaging and blood biomarkers is warranted in the context of a randomized, placebo-controlled trial.
BACKGROUND:Brain edema is a serious complication of ischemic stroke that can lead to secondary neurological deterioration and death. Glyburide is reported to prevent brain swelling in preclinical rodent models of ischemic stroke through inhibition of a non-selective channel composed of sulfonylurea receptor 1 and transient receptor potential cation channel subfamily M member 4. However, the relevance of this pathway to the development of cerebral edema in strokepatients is not known. METHODS: Using a case-control design, we retrospectively assessed neuroimaging and blood markers of cytotoxic and vasogenic edema in subjects who were enrolled in the glyburide advantage in malignant edema and stroke-pilot (GAMES-Pilot) trial. We compared serial brain magnetic resonance images (MRIs) to a cohort with similar large volume infarctions. We also compared matrix metalloproteinase-9 (MMP-9) plasma level in large hemispheric stroke. RESULTS: We report that IV glyburide was associated with T2 fluid-attenuated inversion recovery signal intensity ratio on brain MRI, diminished the lesional water diffusivity between days 1 and 2 (pseudo-normalization), and reduced blood MMP-9 level. CONCLUSIONS: Several surrogate markers of vasogenic edema appear to be reduced in the setting of IV glyburide treatment in humanstroke. Verification of these potential imaging and blood biomarkers is warranted in the context of a randomized, placebo-controlled trial.
Authors: J Marc Simard; Mingkui Chen; Kirill V Tarasov; Sergei Bhatta; Svetlana Ivanova; Ludmila Melnitchenko; Natalya Tsymbalyuk; G Alexander West; Volodymyr Gerzanich Journal: Nat Med Date: 2006-03-19 Impact factor: 53.440
Authors: Joan Montaner; Carlos A Molina; Jasone Monasterio; Sonia Abilleira; Juan F Arenillas; Marc Ribó; Manolo Quintana; José Alvarez-Sabín Journal: Circulation Date: 2003-02-04 Impact factor: 29.690
Authors: Hannah J Irvine; Ann-Christin Ostwaldt; Matthew B Bevers; Simone Dixon; Thomas Wk Battey; Bruce Cv Campbell; Stephen M Davis; Geoffrey A Donnan; Kevin N Sheth; Reza Jahan; Jeffrey L Saver; Chelsea S Kidwell; W Taylor Kimberly Journal: J Cereb Blood Flow Metab Date: 2017-07-21 Impact factor: 6.200
Authors: Thomas W K Battey; Mahima Karki; Aneesh B Singhal; Ona Wu; Saloomeh Sadaghiani; Bruce C V Campbell; Stephen M Davis; Geoffrey A Donnan; Kevin N Sheth; W Taylor Kimberly Journal: Stroke Date: 2014-10-21 Impact factor: 7.914
Authors: Kevin N Sheth; W Taylor Kimberly; Jordan J Elm; Thomas A Kent; Albert J Yoo; Götz Thomalla; Bruce Campbell; Geoffrey A Donnan; Stephen M Davis; Gregory W Albers; Sven Jacobson; Gregory del Zoppo; J Marc Simard; Barney J Stern; Pitchaiah Mandava Journal: Neurocrit Care Date: 2014-08 Impact factor: 3.210
Authors: Ruchira M Jha; Shashvat M Desai; Benjamin E Zusman; Theresa A Koleck; Ava M Puccio; David O Okonkwo; Seo-Young Park; Lori A Shutter; Patrick M Kochanek; Yvette P Conley Journal: J Neurotrauma Date: 2019-02-01 Impact factor: 5.269