N-butylphthalide: Neuroprotector for Ischemic Stroke
DOI:
https://doi.org/10.55175/cdk.v52i1.1290Keywords:
NBP, N-butylphthalide, neuroprotektor, stroke iskemikAbstract
Stroke, especially ischemic stroke, is still one of the most prioritized health problems in Indonesia with an enormous burden and cost. The main strategy to treat ischemic stroke, which is reperfusion therapy by thrombolytic therapy or thrombectomy, has various challenges in its practices, especially regarding the recommended time window due to facility and infrastructure limitations. N-butylphthalide (NBP) is a neuroprotector with the potential ability to improve cerebral microcirculation, protect the blood-brain barrier, protect neurons from apoptosis, induce neurogenesis, and maintain neuron survivability in the condition of ischemic stroke based on preclinical studies. Clinically, NBP showed benefits mainly in improving post-stroke disability. NBP is a promising neuroprotector for better clinical outcomes.
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References
Khariri, Saraswati RD. Transisi epidemiologi stroke sebagai penyebab kematian pada semua kelompok usia di Indonesia. Prosiding Seminar Nasional Riset Kedokteran. 2021;2:81-6.
Kesuma NMTS, Dharmawan DK, Fatmawati H. Gambaran faktor risiko dan tingkat risiko stroke iskemik berdasarkan stroke risk scorecard di RSUD Klungkung. Intisari Sains Medis. 2019;10:720-9.
Venketasubramanian N, Yudiarto FL, Tugasworo D. Stroke burden and stroke services in Indonesia. Cerebrovasc Dis Extra. 2022;12:53-7. DOI: 10.1159/000524161.
Chugh C. Acute ischemic stroke: Management approach. Indian J Crit Care Med. 2019;23:S140-6. DOI: 10.5005/jp-journals-10071-23192.
Harris S, Sungkar S, Rasyid A, Kurniawan M, Mesiano T, Hidayat R. TOAST subtypes of ischemic stroke and its risk factors: A hospital-based study at Cipto Mangunkusumo Hospital, Indonesia. Stroke Res Treat. 2018;2018:1-6. DOI: 10.1155/2018/9589831.
Bateman K. Medical management of acute ischaemic stroke. SAMJ. 2019;109:72-6. DOI:10.7196/SAMJ.2019.v109i2.00008.
Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare proffesionals from the American Heart Association/American Stroke Association. Stroke 2019;50:e344-418. DOI: 10.1161/STR.0000000000000211.
Rilianto B, Kurniawan RG, Rajab NM, Prasetyo BT. Endovascular thrombectomy for acute ischemic stroke in Indonesia: Challenging and strategic planning. Neuropsychiatr Dis Treat. 2024;20:621-30. DOI: 10.2147/NDT.S453629.
Bang OY. Neuroprotective strategies for acute ischemic stroke: Recent progress and future perspectives. Precis Future Med. 2017;1:115-21. DOI: 10.23838/pfm.2017.00149.
Ghozy S, Reda A, Varney J, Elhawary AS, Shah J, Murry K, et al. Neuroprotection in acute ischemic stroke: A battle against the biology of nature. Front Neurol. 2022;13:870141. DOI: 10.3389/fneur.2022.870141.
Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/394/2019 tentang Pedoman Nasional Pelayanan Kedokteran Tata laksana Stroke. Jakarta; Kemenkes RI; 2019.
Wang S, Ma F, Huang L, Zhang Y, Peng Y, Xing C, et al. Dl-3-n-butylphthalide (NBP): A promising therapeutic agent for ischemic stroke. CNS Neurol Dis Drug Targets 2018;17:338-47. DOI: 10.2174/1871527317666180612125843.
Li J, Li Y, Ogle M, Zhou X, Song M, Yu SP, et al. Dl-3-n-butylphthalide prevents neuronal cell death after focal cerebral ischemia in mice via the JNK pathway. Brain Res. 2010;1359:216-26. DOI: 10.1016/j.brainres.2010.08.061.
Ye ZY, Xing HY, Wang B, Liu M, Lu PY. Dl-3-n-butylphthalide protects the blood-brain barrier against ischemia/hypoxia injury via upregulations of tight junction proteins. Chin Med J (Engl). 2019;132:1344-53. DOI: 10.1097/CM9.0000000000000232.
Li W, Wei D, Lin J, Liang J, Xie X, Song K, et al. Dl-3-n-butylphthalide reduces cognitive impairment induced by chronic cerebral hypoperfusion through GDNG/GFRa1/Ret signaling preventing hippocampal neuron apoptosis. Front Cell Neurosci. 2019;13:351. DOI: 10.3389/fncel.2019.00351.
Zhao Y, Liu D, Li J, Zhang XJ, Wang X. L-NBP, a multiple growth factor activator, attenuates ischemic neuronal impairments possibly through promoting neuritogenesis. 2019;124:94-105. DOI: 10.1016/j.neuint.2019.01.002.
Wang H, Ye K, Li D, Liu Y, Wang D. Dl-3-n-butylphthalide for acute ischemic stroke: An updated systematic review and meta-analysis of randomized controlled trials. Front Pharmacol. 2022;13:963118. DOI: 10.3389/fphar.2022.963118.
Cui L, Zhu Y, Gao S, Wang J, Peng B, Ni J, et al. Ninety-day administration of dl-3-n-butylphthalide for acute ischemic stroke: A randomized, double-blind trial. Chinese Med J. 2013;126:3405-10. DOI: 10.3760/cma.j.issn.0366-6999.20123240.
Wang M, Feng Y, Yuan Y, Gui L, Wang J, Gao P, et al. Use of l-3-n-butylphthalide within 24 h after intravenous thrombolysis for acute cerebral infarction. Complement Ther Med. 2020;52:102442. DOI: 10.1016/j.ctim.2020.102442.
Wang A, Jia B, Zhang X, Huo X, Chen J, Gui L, et al. Efficacy and safety of butylphthalide in patients with acute ischemic stroke. JAMA Neurol. 2023;80:851-9. DOI: 10.1001/jamaneurol.2023.1871.
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