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Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research.

Publication ,  Journal Article
Liu, S; Zheng, H; Yu, W; Ramakrishnan, V; Shah, S; Gonzalez, LF; Singh, I; Graffagnino, C; Feng, W
Published in: Exp Neurol
June 2020

BACKGROUND: S-Nitrosoglutathione (GSNO) is a nitric oxide donor that has been investigated for neuroprotective and neuro-recovery effect. We aimed to conduct a systematic review on the published literatures using GSNO in both pre-clinical and clinical stroke studies. METHODS: We searched PubMed up to June 30, 2019, using the following keywords: S-Nitrosoglutathione, GSNO, stroke, cerebrovascular, carotid arteries, middle cerebral artery, and middle cerebral artery occlusion. Only studies published in the English language providing efficacy results of GSNO on ischemic stroke were included. Stroke Therapy Academic Industry Roundtable (STAIR) score was used to assess the quality of pre-clinical studies and PEDro score for clinical trials. A meta-analysis was conducted to compare the effect size. RESULTS: Of 39 articles identified, 10 (6 for pre-clinical and 4 for clinical studies) met the eligibility criteria and were included. The median STAIR score across the pre-clinical studies was 5.5 (range: 4-7), and the median PEDro score for the 4 clinical trials was 10 (ranged: 6 to 10). Among the 6 pre-clinical studies, GSNO reduced infarct size in 6 studies and improved neurological behavior scales in 5 studies compared to placebo. Inverse-variance weighted linear meta-analysis of standardized mean difference (Hedge's g) on 4 human studies revealed a big effect size (Hedge's g = -0.82, 95% CI: [-1.26, -0.38], P = .0003) favoring the GSNO group in term of reducing embolic signals. I2 value was 0 across the included clinical studies in the meta-analysis. CONCLUSIONS: Pre-clinical studies showed positive benefit of GSNO in animal stroke models. The meta-analysis of clinical studies demonstrated that GSNO is effective in reducing embolic signals in patients with symptomatic internal carotid artery stenosis undergoing carotid endarterectomy or stenting. Further investigation of this molecule is warranted.

Duke Scholars

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Published In

Exp Neurol

DOI

EISSN

1090-2430

Publication Date

June 2020

Volume

328

Start / End Page

113262

Location

United States

Related Subject Headings

  • Stroke
  • S-Nitrosoglutathione
  • Neuroprotective Agents
  • Neurology & Neurosurgery
  • Humans
  • Brain
  • Animals
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 1701 Psychology
 

Citation

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Liu, S., Zheng, H., Yu, W., Ramakrishnan, V., Shah, S., Gonzalez, L. F., … Feng, W. (2020). Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research. Exp Neurol, 328, 113262. https://doi.org/10.1016/j.expneurol.2020.113262
Liu, Shimeng, Haiqing Zheng, Wengui Yu, Viswanathan Ramakrishnan, Shreyansh Shah, Louis Fernando Gonzalez, Inderjit Singh, Carmelo Graffagnino, and Wuwei Feng. “Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research.Exp Neurol 328 (June 2020): 113262. https://doi.org/10.1016/j.expneurol.2020.113262.
Liu S, Zheng H, Yu W, Ramakrishnan V, Shah S, Gonzalez LF, et al. Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research. Exp Neurol. 2020 Jun;328:113262.
Liu, Shimeng, et al. “Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research.Exp Neurol, vol. 328, June 2020, p. 113262. Pubmed, doi:10.1016/j.expneurol.2020.113262.
Liu S, Zheng H, Yu W, Ramakrishnan V, Shah S, Gonzalez LF, Singh I, Graffagnino C, Feng W. Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research. Exp Neurol. 2020 Jun;328:113262.
Journal cover image

Published In

Exp Neurol

DOI

EISSN

1090-2430

Publication Date

June 2020

Volume

328

Start / End Page

113262

Location

United States

Related Subject Headings

  • Stroke
  • S-Nitrosoglutathione
  • Neuroprotective Agents
  • Neurology & Neurosurgery
  • Humans
  • Brain
  • Animals
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 1701 Psychology