Biochemistry & Analytical Biochemistry

Abstract

Potential Benefit of Uric Acid for Thrombolytic Therapy in Acute Ischemic Stroke

Kiyoshi Kikuchi, Motohiro Morioka, Yoshinaka Murai and Eiichiro Tanaka

Alteplase (recombinant tissue plasminogen activator) is the only licensed drug for acute ischemic stroke (AIS) treatment, but only 3–5% of patients with AIS receive thrombolytic treatment using alteplase. Further breakthroughs are needed for thrombolysis in AIS because thrombolytic therapy does not benefit all patients equally. Alteplase administration can induce intracerebral hemorrhage or a low rate of recanalization for occlusion of major cerebral arteries (e.g., internal carotid artery). Recently, the effect of alteplase–uric acid (UA) combination therapy was demonstrated in a clinical trial of AIS patients. UA administration resulted in a significant improvement in functional outcome in patients with hyperglycemia, female patients, and patients who had suffered a moderate stroke. Oxidative stress and antioxidant properties would be differ in each AIS patients after reperfusion. Therefore, the optimal dose of UA may vary according to sex, age, body weight, ethnicity and medical history (e.g., diabetes mellitus). Hence, various study arms may be needed in future, large clinical trials. In the future, if levels of oxidative stress or antioxidant properties can be determined rapidly in AIS patients before treatment, the optimal dose of antioxidant may be ascertained.