49 -8 (82) 2025 - Ramazanova Z.F., Ibragimov N.K. - HORIZONS IN THE TREATMENT OF ACUTE CEREBRAL INSUFFICIENCY

HORIZONS IN THE TREATMENT OF ACUTE CEREBRAL INSUFFICIENCY

Ramazanova Z.F. - Tashkent State Medical University, Uzbekistan

Ibragimov N.K. - Tashkent State Medical University, Uzbekistan

Boymurodov H.A. - Tashkent State Medical University, Uzbekistan

Resume

Lipid peroxidation (LPO) is considered one of the key mechanisms of secondary neuronal damage in acute cerebral insufficiency (ACI), which includes ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury. The initiation of LPO occurs due to excessive generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) under conditions of ischemia and reperfusion, leading to the damage of polyunsaturated fatty acids in the membranes of neurons, glial cells, and endothelium. The resulting toxic products — malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), and isoprostanes — disrupt barrier functions, enhance neuroinflammation, and trigger apoptosis and ferroptosis cascades. Modern therapeutic approaches aim at pharmacological suppression of LPO and stabilization of cell membranes. The most studied drugs are free radical scavengers, in particular edaravone, which has demonstrated neuroprotective effects and improvement of functional outcomes in a number of clinical studies on acute cerebral insufficiency, especially when administered early as part of combination therapy. Promising directions include anti-ferroptotic strategies such as iron chelators (deferoxamine), lipoxygenase inhibitors, and mitochondria-targeted antioxidants, which are currently undergoing preclinical and early clinical evaluation. The integration of LPO biomarkers into risk stratification and therapy monitoring algorithms, optimization of the timing of antioxidant therapy initiation, and combined interventions targeting oxidative stress and inflammation open new horizons in the treatment of ACI. The comprehensive use of antioxidants together with standard reperfusion therapy may improve survival and functional outcomes in patients with severe cerebral pathology.

Keywords: lipid peroxidation, acute ischemic stroke, antioxidant therapy, edaravone, reactive oxygen species, neuroprotection.

First page

277

Last page

284

For citation:Ramazanova Z.F., Ibragimov N.K., Boymurodov H.A. - HORIZONS IN THE TREATMENT OF ACUTE CEREBRAL INSUFFICIENCY//New Day in Medicine 8(82)2025 277-284 https://newdayworldmedicine.com/en/new_day_medicine/8-82-2025

List of References

  1. Ахмедов, А.Ш., Каримов, Х.Х. (2020). Применение антиоксидантов в комплексной терапии черепно-мозговой травмы. // Вестник нейрохирургии Узбекистана, 2020;4(2):45-52.
  2. Гусев, Е.И., Скворцова, В.И. (2017). Ишемия мозга. М.: Медицина.
  3. Касумов, М.М., Алиев, З.К. (2019). Эдаравон: фармакологические свойства и клиническое применение. // Журнал клинической фармакологии и терапии, 2019;28(3):67–73.
  4. Куликов, В.П., Лебедев, В.В. (2016). Черепно-мозговая травма: современные подходы к лечению. СПб.: СпецЛит.
  5. Скворцова, В.И., Стаховская, Л.В., Морозова, С.Б. (2018). Антиоксидантная терапия при острой церебральной ишемии. // Неврология, нейропсихиатрия, психосоматика, 2018;10(2):4–12.
  6. Smith, M., Maas, A. (2018). Traumatic brain injury: Pathophysiology and treatment strategies. // Lancet Neurology, 2018;17(12):951–964.
  7. Zhang, H., et al. (2020). Edaravone in acute ischemic stroke and traumatic brain injury: Mechanisms and clinical outcomes. // Neuropharmacology, 2020;171:107-113.

    file

    download