Exploration of the Effect of Stress Hyperglycemia on Therapeutic Efficacy for Acute Cerebral Infarction based on TLR4/NF-κB Pathway，Blood Brain Barrier and Oxidative Stress

Shengkun CAO; Zhenzhen MA; Hui JIANG; Xiaorui ZHOU; Yanling ZHOU

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Shengkun CAO, Zhenzhen MA, Hui JIANG, Xiaorui ZHOU, Yanling ZHOU. Exploration of the Effect of Stress Hyperglycemia on Therapeutic Efficacy for Acute Cerebral Infarction based on TLR4/NF-κB Pathway，Blood Brain Barrier and Oxidative Stress[J]. Journal of Kunming Medical University.

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Exploration of the Effect of Stress Hyperglycemia on Therapeutic Efficacy for Acute Cerebral Infarction based on TLR4/NF-κB Pathway，Blood Brain Barrier and Oxidative Stress

1.
Department of Pharmacy，Suqian Hospital，Jiangsu Province Hospital，Suqian Jiangsu 223800
2.
Department of Pharmacy，Nanjing Drum Tower Hospital Group Suqian Hospital，Suqian Jiangsu 223800，China

Received Date: 2026-03-05
Available Online: 2026-10-29

Abstract

Abstract

Objective To investigate the impact of stress hyperglycemia on the efficacy of edaravone and dexborneol combined with recombinant tissue plasminogen activator （rt-PA） in the treatment of acute cerebral infarction （ACI）, and to analyze the influence of this regimen on TOLL-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB ） inflammatory pathway, the blood-brain barrier and oxidative stress. Methods A prospective study was conducted on 197 patients with ACI admitted to Suqian Hospital of Jiangsu Provincial People’s Hospital from September 2021 to June 2023. Patients were divided into SHG group （n = 90） and non-SHG group （n = 107） according to the presence or absence of stress hyperglycemia （SHG）. Clinical efficacy, and pre- and post-treatment levels of the TLR4/NF-κB inflammatory pathway [TLR4, NF-κB, interleukin-6 （IL-6）], blood-brain barrier [matrix metalloproteinase-9 （MMP-9）, occludin （OCLN）], oxidative stress [advanced oxidation protein product （AOPP）, reactive oxygen species （ROS）, superoxide dismutase （SOD）] were compared between the two groups. The prognosis and safety during treatment were also compared between the two groups. . After 1 week and 2 weeks of treatment, serum MMP-9 levels decreased and OCLN levels increased first and then decreased in both groups （P<0.05）, with no significant difference between groups （P > 0.05）. After 1 week and 2 weeks of treatment, the levels of serum AOPP and ROS in the two groups were decreased, while the level of SOD was increased （P < 0.05）, and there was no significant difference between the two groups （P > 0.05）. The rate of good prognosis showed no significant difference between the SHG group and the non-SHG group （P > 0.05）. The incidence of intracranial hemorrhage in SHG group was higher than that in non SHG group （P < 0.05）. There were no statistically significant differences in gastrointestinal reactions, mild liver biochemical abnormalities and fever between SHG group and non SHG group （P > 0.05）. Conclusion In ACI patients with or without SHG, treatment with edaravone and borneol combined with rt-PA demonstrates comparable therapeutic effects and mechanisms of action, including modulation of the TLR4/NF-κB inflammatory pathway, protection of the blood brain barrier, and anti-oxidant effects . SHG does not affect short-term efficacy, but significantly increases the risk of intracranial hemorrhage.
- Acute cerebral infarction,
- Stress hyperglycemia,
- Edaravone and dexborneol,
- Alteplase,
- Therapeutic effect,
- Blood-brain barrier

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References(25)

References

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