Cerebrolysin
Clinical data
Other namesFPF-1070
Identifiers
CAS Number
DrugBank
UNII

Cerebrolysin (developmental code name FPF-1070) is a mixture of enzymatically treated peptides derived from pig brain whose constituents can include brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF), and ciliary neurotrophic factor (CNTF).

Cerebrolysin has also been studied for potential use with a wide variety of neurodegenerative disorders, though research is preliminary.[1] No benefit in the treatment of acute stroke has been found and an increased rate of spontaneous adverse events requiring hospitalization is reported.[2] Some positive effects have been reported when cerebrolysin is used to treat vascular dementia.[3]

Research

Stroke

Reviews emphasize the need for further high quality studies.[2] In addition, use might be associated with a higher rate of spontaneous adverse events requiring hospitalization.[2] Studies of ischemic stroke in Asian subpopulations found an absence of benefit.[4]

A 2020 study suggested a lack of benefit in hemorrhagic stroke related to cerebral aneurysm.[5]

Dementia

Reviews of preliminary research indicate a possible improvement in cognitive function using cerebrolysin for vascular dementia and Alzheimer's disease, although further high-quality research is needed.[3][6]

Other

Early studies have suggested potential use of cerebrolysin with a wide variety of neurodegenerative disorders, including traumatic brain injury,[7][8] schizophrenia,[9] multiple sclerosis,[10] cerebral palsy[11] and spinal cord injury[12][13] though research is still preliminary.

Adverse effects

In trials studying the use of cerebrolysin after acute stroke, there was no increased risk of "serious adverse events" requiring hospitalization. These were specifically defined as:

"...any untoward medical occurrence that, at any dose, resulted in death, [was] life‐threatening, required inpatient hospitalisation or resulted in prolongation of existing hospitalisation, resulted in persistent or significant disability/incapacity, [was] a congenital anomaly/birth defect, or [was] a medically important event or reaction”.[14]

Mechanism of action

In vitro and animal studies suggest neurotrophic effects of cerebrolysin similar to endogenous neurotrophic factors, though its specific molecular pharmacodynamics are not clear.[15] Studies of dementia suggest decreased beta-amyloid deposition.[16]

Regulatory

Cerebrolysin is not a scheduled drug in the United States.[17][18]

References

  1. ^ Windisch M, Gschanes A, Hutter-Paier B (1998). "Neurotrophic activities and therapeutic experience with a brain derived peptide preparation". Ageing and Dementia. Journal of Neural Transmission. Supplementa. Vol. 53. pp. 289–98. doi:10.1007/978-3-7091-6467-9_25. ISBN 978-3-211-83114-4. PMID 9700665.
  2. ^ a b c Ziganshina LE, Abakumova T, Nurkhametova D, Ivanchenko K, et al. (Cochrane Stroke Group) (October 2023). "Cerebrolysin for acute ischaemic stroke". The Cochrane Database of Systematic Reviews. 2023 (10): CD007026. doi:10.1002/14651858.CD007026.pub7. PMC 10565895. PMID 37818733.
  3. ^ a b Cui S, Chen N, Yang M, Guo J, Zhou M, Zhu C, He L (November 2019). "Cerebrolysin for vascular dementia". The Cochrane Database of Systematic Reviews. 2019 (11). doi:10.1002/14651858.CD008900.pub3. PMC 6844361. PMID 31710397.
  4. ^ Heiss WD, Brainin M, Bornstein NM, Tuomilehto J, Hong Z (March 2012). "Cerebrolysin in patients with acute ischemic stroke in Asia: results of a double-blind, placebo-controlled randomized trial". Stroke. 43 (3): 630–636. doi:10.1161/STROKEAHA.111.628537. PMID 22282884. S2CID 26004422.
  5. ^ Woo PY, Ho JW, Ko NM, Li RP, Jian L, Chu AC, et al. (November 2020). "Randomized, placebo-controlled, double-blind, pilot trial to investigate safety and efficacy of Cerebrolysin in patients with aneurysmal subarachnoid hemorrhage". BMC Neurology. 20 (1): 401. doi:10.1186/s12883-020-01908-9. PMC 7607674. PMID 33143640.
  6. ^ Fan F, Liu H, Shi X, Ai Y, Liu Q, Cheng Y (2022). "The Efficacy and Safety of Alzheimer's Disease Therapies: An Updated Umbrella Review". Journal of Alzheimer's Disease. 85 (3): 1195–1204. doi:10.3233/JAD-215423. PMID 34924395. S2CID 245311001.
  7. ^ Ghaffarpasand F, Torabi S, Rasti A, Niakan MH, Aghabaklou S, Pakzad F, et al. (2019). "Effects of cerebrolysin on functional outcome of patients with traumatic brain injury: a systematic review and meta-analysis". Neuropsychiatric Disease and Treatment. 15: 127–135. doi:10.2147/NDT.S186865. PMC 6311329. PMID 30643411.
  8. ^ El Sayed I, Zaki A, Fayed AM, Shehata GM, Abdelmonem S (April 2018). "A meta-analysis of the effect of different neuroprotective drugs in management of patients with traumatic brain injury". Neurosurgical Review. 41 (2): 427–438. doi:10.1007/s10143-016-0775-y. PMID 27539610. S2CID 3980956.
  9. ^ Xiao S, Xue H, Li G, Yuan C, Li X, Chen C, et al. (February 2012). "Therapeutic effects of cerebrolysin added to risperidone in patients with schizophrenia dominated by negative symptoms". The Australian and New Zealand Journal of Psychiatry. 46 (2): 153–160. doi:10.1177/0004867411433213. PMID 22311531. S2CID 206397952.
  10. ^ Khabirov FA, Khaybullin TI, Granatov EV, Shakirzianova SR (2016). "[Effect of cerebrolysin on remyelination processes in multiple sclerosis patients in stage of relapse regression]". Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova. 116 (12): 48–53. doi:10.17116/jnevro201611612148-53. PMID 28139626.
  11. ^ Nasiri J, Safavifar F (June 2017). "Effect of cerebrolysin on gross motor function of children with cerebral palsy: a clinical trial". Acta Neurologica Belgica. 117 (2): 501–505. doi:10.1007/s13760-016-0743-x. PMID 28074392. S2CID 3805375.
  12. ^ Allam AF, Abotakia TA, Koptan W (July 2018). "Role of Cerebrolysin in cervical spondylotic myelopathy patients: a prospective randomized study". The Spine Journal. 18 (7): 1136–1142. doi:10.1016/j.spinee.2017.11.002. PMID 29155000. S2CID 23283518.
  13. ^ Menon PK, Muresanu DF, Sharma A, Mössler H, Sharma HS (February 2012). "Cerebrolysin, a mixture of neurotrophic factors induces marked neuroprotection in spinal cord injury following intoxication of engineered nanoparticles from metals". CNS & Neurological Disorders Drug Targets. 11 (1): 40–49. doi:10.2174/187152712799960781. PMID 22229324.
  14. ^ Ziganshina LE, Abakumova T, Hoyle CH (July 2020). "Cerebrolysin for acute ischaemic stroke". The Cochrane Database of Systematic Reviews. 7 (7): CD007026. doi:10.1002/14651858.CD007026.pub6. PMC 7387239. PMID 32662068.
  15. ^ Plosker GL, Gauthier S (2009). "Cerebrolysin: a review of its use in dementia". Drugs & Aging. 26 (11): 893–915. doi:10.2165/11203320-000000000-00000. PMID 19848437.
  16. ^ Masliah E, Díez-Tejedor E (April 2012). "The pharmacology of neurotrophic treatment with Cerebrolysin: brain protection and repair to counteract pathologies of acute and chronic neurological disorders". Drugs of Today. 48 (Suppl A): 3–24. doi:10.1358/dot.2012.48(Suppl.A).1739716. PMID 22514792. S2CID 23181962.
  17. ^ Rogers S (29 October 2020). "Nicholasville compounding pharmacy, owner plead guilty to distribution". ABC 36 News.
  18. ^ "Nicholasville Compounding Pharmacy and Its Owner Sentenced for Unlawful Distribution of Prescription Drugs Unlawful Distribution of Prescription Drugs". www.justice.gov. 24 February 2021.
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