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Article Dans Une Revue Cardiovascular Diabetology Année : 2022

Protection against stroke with glucagon-like peptide-1 receptor agonists: a comprehensive review of potential mechanisms.

Résumé

Several randomized controlled trials have demonstrated the benefits of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on ischemic stroke in patients with diabetes. In this review, we summarize and discuss the potential mechanisms of stroke protection by GLP-1RAs. GLP-1RAs exert multiple anti-atherosclerotic effects contributing to stroke prevention such as enhanced plaque stability, reduced vascular smooth muscle proliferation, increased nitric oxide, and improved endothelial function. GLP-1RAs also lower the risk of stroke by reducing traditional stroke risk factors including hyperglycemia, hypertension, and dyslipidemia. Independently of these peripheral actions, GLP-1RAs show direct cerebral effects in animal stroke models, such as reduction of infarct volume, apoptosis, oxidative stress, neuroinflammation, excitotoxicity, blood-brain barrier permeability, and increased neurogenesis, neuroplasticity, angiogenesis, and brain perfusion. Despite these encouraging findings, further research is still needed to understand more thoroughly the mechanisms by which GLP-1RAs may mediate stroke protection specifically in the human diabetic brain.
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hal-04013171 , version 1 (03-03-2023)

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Bruno Vergès, Victor Aboyans, Denis Angoulvant, Pierre Boutouyrie, Bertrand Cariou, et al.. Protection against stroke with glucagon-like peptide-1 receptor agonists: a comprehensive review of potential mechanisms.. Cardiovascular Diabetology, 2022, 21 (1), pp.242. ⟨10.1186/s12933-022-01686-3⟩. ⟨hal-04013171⟩
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