Comparative Study On The Effect Of N-Butylphthalide (NBP) And Human Urinary Kallidinogenase (HUK) On Cerebral Angiogenesis After Ischaemic Stroke

Background:In the research of alternative treatments for ischemic stroke,angiogenesis,a key element in the complex process of Neuroprotection,has always been an attractive therapeutic target.Human urinary kallidinogenase(HUK)and dl-3-n-Butylphthalide(NBP)have shown promising results in the treatment of the acute phase of ischemic stroke.This study aimed to evaluate and quantify the effects of administration of NBP and HUK on the process of post-stroke angiogenesis and inflammation,and to assess and compare their global effects on the patient’s functional outcome.Methods:Seventy ischemic stroke patients in Nanjing Zhongda Hospital were enrolled in this prospective study.Of them,19 received human urinary kallidinogenase(HUK).20 received dl-3-n-Butylphthalide(NBP),while the remaining 31 were selected as control.The National institute health stroke scale(NHISS),modified Rankin Scale(mRS)and activities of daily living(ADL)scores were used to determine functional outcome,whereas their effects on angiogenesis and inflammatory response were assessed through serum levels of tumor necrosis factor alpha(TNF-α)and vascular endothelial growth factor(VEGF),by means of enzyme-linked immunosorbent assay.Results:NBP showed a better enhancement of angiogenic factor VEGF expression and down-regulation of TNF-a after two weeks therapy compared to control.The 2 weeks and 3 months outcomes did not differ between HUK group and NBP group.however,both treatment groups showed a better long-term outcome(3 months)compared to control.Conclusions:NBP and HUK facilitated stroke recovery and greatly improved the long-term outcome.Additionally,NBP exhibited a superior effect on up-regulation of angiogenic factor VEGF expression and down-regulation of pro-inflammatory cytokine TNF-a compared to HUK.