Hyperglycemia in acute ischemic stroke: physiopathological and therapeutic complexity

作     者：Federica Ferrari Antonio Moretti Roberto Federico Villa Federica Ferrari;Antonio Moretti;Roberto Federico Villa

作者机构：Department of Biology and BiotechnologyLaboratory of Pharmacology and Molecular Medicine of Central Nervous SystemUniversity of PaviaVia FerrataPaviaItaly 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2022年第17卷第2期

页      面：292-299页

核心收录：

学科分类：0710[理学-生物学] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100204[医学-神经病学] 10[医学] 

基　　金：supported by a grant from Catholic Universitary Center(Centro Universitario Cattolico)-Conferenza Episcopale Italiana Rome Italy(to FF)。 

主　　题：acute ischemic stroke diabetes mellitus DPP-4 inhibitor glucose-like peptide-1 receptor agonist hyperglycemia hypoglycemia insulin physiopathology sodium glucose cotransporter 2 inhibitor 

摘      要：Diabetes mellitus and associated chronic hyperglycemia enhance the risk of acute ischemic stroke and lead to worsened clinical outcome and increased mortality. However, post-stroke hyperglycemia is also present in a number of non-diabetic patients after acute ischemic stroke, presumably as a stress response. The aim of this review is to summarize the main effects of hyperglycemia when associated to ischemic injury in acute stroke patients, highlighting the clinical and neurological outcomes in these conditions and after the administration of the currently approved pharmacological treatment, i.e. insulin. The disappointing results of the clinical trials on insulin(including the hypoglycemic events) demand a change of strategy based on more focused therapies. Starting from the comprehensive evaluation of the physiopathological alterations occurring in the ischemic brain during hyperglycemic conditions, the effects of various classes of glucose-lowering drugs are reviewed, such as glucose-like peptide-1 receptor agonists, DPP-4 inhibitors and sodium glucose cotransporter 2 inhibitors, in the perspective of overcoming the up-to-date limitations and of evaluating the effectiveness of new potential therapeutic strategies.