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Neuroprotective Effects of Phenothiazines on Acute Ischemic Stroke.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Neuroprotective Effects of Phenothiazines on Acute Ischemic Stroke.
Συγγραφείς: Wang Q; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Department of Neurology and China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China., Li W; Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qian Fo Shan Hospital, Jinan, China., Wu D; Department of Neurology and China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China., Xu S; Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China., Ji X; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Department of Neurology and China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.; Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
Πηγή: CNS neuroscience & therapeutics [CNS Neurosci Ther] 2026 Jun; Vol. 32 (6), pp. e70960.
Τύπος έκδοσης: Journal Article; Review; Research Support, Non-U.S. Gov't
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101473265 Publication Model: Print Cited Medium: Internet ISSN: 1755-5949 (Electronic) Linking ISSN: 17555930 NLM ISO Abbreviation: CNS Neurosci Ther Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, UK : Wiley-Blackwell, c2008-
Ιατρικοί όροι (MeSH): Neuroprotective Agents*/therapeutic use , Neuroprotective Agents*/pharmacology , Phenothiazines*/therapeutic use , Phenothiazines*/pharmacology , Ischemic Stroke*/drug therapy , Ischemic Stroke*/metabolism , Brain Ischemia*/drug therapy, Promethazine/therapeutic use ; Humans ; Animals
Περίληψη: Background: Standard therapeutic strategies for acute ischemic stroke (AIS) include endovascular mechanical thrombectomy, intravenous thrombolysis, bridging therapy, and conventional conservative treatment. Despite the implementation of standardized treatments, nearly half of patients still experience significant motor or speech dysfunction, severely impacting their quality of life. Consequently, there is a pressing need for effective neuroprotective adjunctive therapies to further improve functional outcomes and prognosis. Phenothiazines, primarily chlorpromazine and promethazine (C + P), have been proposed as potential neuroprotective agents. Preclinical evidence suggests that phenothiazines may induce mild hypothermic responses, exert anti-inflammatory effects, and promote a hypometabolic state, thereby potentially contributing to improved neurological outcomes.
Methods: We reviewed and synthesized the mechanisms underlying the neuroprotective effects of phenothiazines, with a particular focus on C + P.
Results: This review highlights the neuroprotective mechanisms of phenothiazines related to mild hypothermia, anti-inflammation, and metabolic reduction, along with relevant preclinical and clinical evidence. We also compare the distinct mechanisms of action between C + P and conventional anesthetic sedatives and draw partial comparisons with natural hibernation. Our findings reveal that C + P possesses unique features and advantages in neuroprotection, particularly regarding metabolic suppression and hypothermia.
Conclusions: This review explores the adjunctive role of phenothiazines following AIS and elucidates their modulatory mechanisms, which may exert neuroprotective effects through multiple pathways and potentially improve AIS outcomes. This approach may facilitate the identification of novel specific targets for conventional drugs, thereby offering a new perspective on addressing the challenges associated with AIS.
(© 2026 The Author(s). CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)
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Grant Information: 82027802 National Natural Science Foundation of China; 82071468 National Natural Science Foundation of China; 82201618 National Natural Science Foundation of China
Contributed Indexing: Keywords: chlorpromazine and promethazine; ischemic penumbra; neuroprotective effects; phenothiazines
Substance Nomenclature: 0 (Neuroprotective Agents)
0 (Phenothiazines)
FF28EJQ494 (Promethazine)
Entry Date(s): Date Created: 20260609 Date Completed: 20260611 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13247682
DOI: 10.1002/cns.70960
PMID: 42261637
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1755-5949
DOI:10.1002/cns.70960