Journal Article

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

Amarenco, Pierre, Cariou, Bertrand, Hyafil, Fabien, Mohammedi, Kamel, Angoulvant, Denis, Vergès, Bruno, Aboyans, Victor, Boutouyrie, Pierre

2022

Overview

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.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Agonists / Angiogenesis / Angiology / Animal models / Animals / Apoptosis / Arteriosclerosis / Blood pressure / Blood-brain barrier / Brain / Cardiology / Cardiology and cardiovascular system / Clinical trials / Cognitive science / Diabetes / Diabetes mellitus / Diabetes Mellitus, Type 2 - chemically induced / Dyslipidemia / Excitotoxicity / GLP-1 / GLP-1 receptor agonists / Glucagon / Glucagon-like peptide 1 / Glucagon-Like Peptide-1 Receptor - agonists / Glucose / Heart failure / Human health and pathology / Humans / Hyperglycemia / Hyperglycemia - chemically induced / Hypoglycemic Agents - adverse effects / Inflammation / Insulin resistance / Ischemia / Life Sciences / Lipoproteins / Mechanisms / Medicine / Medicine & Public Health / Membrane permeability / Metabolism / Neurogenesis / Neuroplasticity / Neuroprotection / Neuroscience / Nitric oxide / Oxidative stress / Peptides / Pharmaceutical sciences / Pharmacokinetics / Pharmacology / Review / Risk factors / Smooth muscle / Stroke / Stroke - chemically induced / Stroke - prevention & control