Page 17 - ITPS-7-2

INNOSC Theranostics and
Pharmacological Sciences Novel pharmacologic therapies for SAH

4.11. Modified Fisher scale for risk prediction HMGB1, preventing inflammatory responses, alleviating

Recent studies have emphasized the utility of the modified severe blood vessel constriction in the basilar artery, and
Fisher scale in predicting symptomatic vasospasm and ultimately decreasing brain damage caused by insufficient
cerebral infarction post-SAH. This scale enables risk blood flow, thereby improving neurological symptoms.
stratification, allowing for more targeted interventions Clazosentan, an endothelin receptor antagonist, has
in high-risk patients . The development of outcome demonstrated promise in preventing cerebral vasospasm
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prediction models, exemplified by the SAHIT multinational and improving outcomes post-SAH.
cohort study, aids in identifying patients at a higher risk The above-mentioned treatment options are some
of complications, allowing for targeted interventions and of the novel therapies available for the treatment of SAH.
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improved outcomes . Predictably, numerous future therapies may target the
pathophysiology mechanisms mentioned in this review. The
4.12. Clinical trials treatment of SAH can be approached in an individualistic
Table 2 mentions the major clinical trials. manner, involving the use of combinations of newer therapies
with previously available surgical or medical options based
5. Conclusion on patient requirements. Tailoring treatment to each patient’s
SAH is a severe and often fatal condition across all age specific needs could potentially reduce the incidence of
groups, stemming from different causes. The treatment complications and provide exclusively specific treatments.
landscape for SAH is a subject of ongoing discussion, with This approach provides a foundation for future research to
a recognition of the need for tailored treatment options explore these novel therapies and manage different types
to address the specificity of each patient. SAH carries a of patients with unique combinations indicated for specific
high risk of complications, including vasospasm, cerebral patients. Ultimately, this may contribute to the development
infarction, and poor prognosis. of updated guidelines for future reference.
Traditional treatment strategies exhibit limitations, The major limitation of this review lies in the challenge
prompting the exploration of novel approaches to improve of evaluating the combinations of novel therapies
the management of SAH. The two basic categories of mentioned alongside the traditional therapies currently
SAH treatment are surgical and pharmacologic. NCCT available.
has emerged as a rapid, reliable, and accurate diagnostic
method for SAH. Pharmacologic treatments mainly involve Acknowledgments
blood pressure control, the use of tranexamic acid, factor None.
VIII, and antioxidants. Surgical treatments encompass
craniopuncture, craniotomy, hematoma aspiration and Funding
thrombolysis, neuroendoscopy, and evacuation. Novel None.
therapies, such as exosomes, demonstrate the ability to
improve cognitive function, inhibit cell death, reduce Conflict of interest
inflammation, regulate autophagy, and protect BBB. The
utilization of exosomes holds great promise for treating The authors declare that they have no competing interests.
damage to CNS. Author contributions

The ferroptosis inhibitor, liproxstatin-1, has proven Conceptualization: Siddharth Shah, Brandon Lucke-Wold
effective in protecting HT22 cells from hemin-induced Formal analysis: Siddharth Shah
damage by preserving mitochondrial function and Investigation: Siddharth Shah
mitigating lipid peroxidation. These findings suggest Methodology: Siddharth Shah, Abiy Tereda
that NTN-1 exerts neuroprotective effects. Systemic Writing – original draft: Siddharth Shah, Abiy Tereda
treatment with NDP-MSH following SAH significantly Writing – review & editing: Siddharth Shah, Brandon
reduces vasospasm. Glycyrrhizin has been linked to the Lucke-Wold, Pavel S. Pichardo-Rojas
production of PPARs, especially PPAR-γ, and exhibits
anti-inflammatory effects on SAH-induced vasospasm, Ethics approval and consent to participate
suggesting its potential for treating inflammation and
vasospasm in SAH. The use of anti-HMGB1 mAb Not applicable.
contributes to the relaxation of blood vessel constriction Consent for publication
in the context of SAH. This treatment method effectively
interrupts the sequence by neutralizing extracellular Not applicable.

Volume 7 Issue 2 (2024) 11 doi: 10.36922/itps.2019