Open AccessProtective Effects of Cilostazol against Transient Focal Cerebral ischemia and Chronic Cerebral Hypoperfusion Injury
Author(s) -
Lee Jeong Hyun,
Park So Youn,
Shin Hwa Kyoung,
Kim Chi Dae,
Lee Won Suk,
Hong Ki Whan
Publication year - 2008
Publication title -
cns neuroscience and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 69
eISSN - 1755-5949
pISSN - 1755-5930
DOI - 10.1111/j.1527-3458.2008.00042.x
Subject(s) - cilostazol , medicine , ischemia , phosphodiesterase 3 , pharmacology , cerebral infarction , cyclic adenosine monophosphate , anesthesia , cerebral edema , phosphodiesterase , cardiology , chemistry , biochemistry , receptor , aspirin , enzyme
Cilostazol increases intracellular cyclic adenosine monophosphate (cyclic AMP) levels by inhibiting type III phosphodiesterase. It was approved by the Food and Drug Administration for the treatment of intermittent claudication. Its principal actions include inhibition of platelet aggregation, antithrombotic action in cerebral ischemia, and vasodilation, mediated by increased cyclic AMP levels. In a multicenter, randomized, placebo‐controlled, double‐blind clinical trial, cilostazol has been shown to protect patients from recurrent cerebral infarction. It has been recently suggested that cilastozol could be useful in the treatment of transient focal cerebral ischemic injury. Beneficial effects of cilostazol in cerebral ischemic infarction and edema formation has been confirmed in rats by the magnetic resonance imaging (MRI). The preventive effect was ascribed to cAMP‐dependent protein kinase (PKA)‐coupled maxi‐K channel activation with additional antioxidant and poly(adenosine diphosphate [ADP]‐ribose) polymerase inhibitory actions. Most recently, cilostazol has been shown to prevent vacuolation and rarefaction in the white matter of the rats subjected to chronic cerebral hypoperfusion in association with suppression of astrocyte and microglial activation. Taken together, recent experimental studies with cilostazol showed promising results in cerebral ischemia and chronic cerebral hypoperfusion.