Adjunctive Human Urinary Kallidinogenase Enhances the Cognitive and Hemodynamic Outcomes of Anterior Circulation Stenting.

IF 4.3 2区医学 Q1 CLINICAL NEUROLOGY

Translational Stroke Research Pub Date : 2025-08-05 DOI:10.1007/s12975-025-01375-9

Liuting Hu, Fan Yang, Wenjin Shang, Jing Yang, Xinran Chen, Shuangquan Tan, Hongbing Chen, Jian Zhang, Shihui Xing, Yuhua Fan

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引用次数: 0

Abstract

Chronic cerebral hypoperfusion due to anterior circulation stenosis contributes to cognitive decline. This study examined whether preoperative human urinary kallidinogenase (HUK) administration improves outcomes following percutaneous transluminal angioplasty with stenting (PTAS). In this prospective non-randomized controlled trial, 128 patients with severe anterior circulation stenosis were included in the HUK and control groups, respectively. The primary endpoint was change in Mini-Mental State Examination (MMSE) score at 90 days. Secondary outcomes included changes in Montreal Cognitive Assessment (MoCA) and National Institutes of Health Stroke Scale (NIHSS) scores, perfusion parameters, and inflammatory biomarkers. Propensity score adjustments addressed selection bias. Besides mechanical revascularization by PTAS, HUK pretreatment improved cognitive recovery (ΔMMSE, 5 vs. 2; adjusted p < 0.01) and domain-specific gains in memory, calculation/attention, language, and visuospatial function. HUK significantly promoted postoperative mean transit time (MTT) reduction (1.8 ± 1.3 vs. 0.9 ± 0.6, adjusted p < 0.01), indicating enhanced microcirculatory flow. HUK attenuated ΔIL-6 (18.6 ± 16.2 vs. 26 ± 18, adjusted p = 0.03) and amplified ΔIL-10 (2 ± 0.9 vs. 0.4 ± 0.2, adjusted p < 0.01). Baseline TNF-α predicted cognitive recovery (OR = 0.7, p = 0.03). Safety profiles were comparable (9.4% vs. 10.9% complications, p > 0.05), with no mortality. Collectively, adjunctive HUK administration before PTAS in patients with anterior circulation stenosis was associated with greater cognitive improvement and enhanced microvascular hemodynamics, potentially through anti-inflammatory and perfusion-modulating effects. Larger randomized controlled trials are warranted to validate these associations and elucidate the underlying mechanisms.Trial registration: Chinese Clinical Trial Registry. URL: https://www.chictr.org.cn/ ; unique identifier: ChiCTR2100053351.

查看原文本刊更多论文

辅助人尿钾碱二原酶增强前循环支架置入术的认知和血流动力学结果。

前循环狭窄引起的慢性脑灌注不足导致认知能力下降。本研究探讨术前给药人尿钾碱二原酶（HUK）是否能改善经皮腔内血管成形术伴支架植入术（PTAS）后的预后。在这项前瞻性非随机对照试验中，128例严重前循环狭窄患者分别被纳入HUK组和对照组。主要终点是90天时迷你精神状态检查（MMSE）评分的变化。次要结局包括蒙特利尔认知评估（MoCA）和国立卫生研究院卒中量表（NIHSS）评分、灌注参数和炎症生物标志物的变化。倾向分数调整解决了选择偏差。除了PTAS的机械血运重建术外，HUK预处理还能改善认知恢复(ΔMMSE, 5 vs. 2；校正p0.05)，无死亡率。总的来说，前循环狭窄患者在PTAS前辅助给予HUK与更大的认知改善和微血管血流动力学增强相关，可能通过抗炎和灌注调节作用。需要更大规模的随机对照试验来验证这些关联并阐明潜在的机制。试验注册：中国临床试验注册中心。网址：https://www.chictr.org.cn/；唯一标识符：ChiCTR2100053351。

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来源期刊

Translational Stroke Research CLINICAL NEUROLOGY-NEUROSCIENCES

CiteScore

13.80

自引率

4.30%

发文量

130

审稿时长

6-12 weeks

期刊介绍： Translational Stroke Research covers basic, translational, and clinical studies. The Journal emphasizes novel approaches to help both to understand clinical phenomenon through basic science tools, and to translate basic science discoveries into the development of new strategies for the prevention, assessment, treatment, and enhancement of central nervous system repair after stroke and other forms of neurotrauma. Translational Stroke Research focuses on translational research and is relevant to both basic scientists and physicians, including but not restricted to neuroscientists, vascular biologists, neurologists, neuroimagers, and neurosurgeons.