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Ginkgo biloba enhances stroke recovery

gingkoSTROKE IN AMERICA

Stroke is the fourth leading cause of death and a major cause of long-term disability, which inflicts substantial economic and societal burdens. Drug therapies aimed at post-stroke recovery that can enhance a person’s own ability to replenish injured or dead brain cells with new developing brain cells (endogenous neurogenesis) may help minimize the cost related to prolonged hospital stays and rehabilitation. Ginkgo biloba, a widely studied herbal product for the treatment of neurological disorders, offers endogenous neurogenesis-enhancing properties that hold the promise of providing recovery-improving benefits to stroke patients.

EFFECTS OF GINKGO BILOBA

Led by Dr. Zahoor A. Shah, Dr. Shadia E. Nada and graduate student Jatin Tulsulkar, researchers in the College of Pharmacy and Pharmaceutical Sciences have discovered that mice treated with Ginkgo biloba 4 hours after inducing an experimental stroke, and then daily for seven days, had improved recovery and less brain damage than the control mice. It was also observed that Ginkgo biloba-treated mice had enhanced neurogenesis, partly due to the increased protein expression of hemeoxygenase 1, an antioxidant gene that also has a role in neurogenesis. Pertinently, mice lacking the hemeoxygenase 1 gene were observed to have reduced neurogenesis after stroke. An important finding was that in Ginkgo biloba-treated mice the majority of these new cells were found in the proximity of the stroke injury site, suggesting their role in repairing the injured/dead neurons.

Besides prevention, improving recovery following a stroke should become the prime focus of current stroke research. We now know that neurogenesis is not only an ongoing process in adults, but can also be induced by pathological conditions like traumatic brain injury and ischemic stroke, and strategies that promote endogenous neurogenesis as part of the repair and regeneration process should be prioritized. Neurogenesis in the adult brain involves not only the proliferation and migration of precursor cells known as stem cells/neural progenitor cells (NSCs) but also their functional integration into the neural network. Though ischemia is potent in inducing the proliferation and migration of NSCs, it does not provide an environment conducive to their survival, differentiation and integration, and creating an environment with exogenous drugs is paramount to improving the number of NSCs that can result in improved brain repair and regeneration.

The study, first reported in Molecular Neurobiology (Vol. 49, 2014) and then reviewed in Neural Regeneration Research (Vol. 9, 2014), confirmed that Ginkgo biloba, in addition to its antioxidant, neuritogenic and angiogenic properties, provides a conducive environment for the survival and functional integration of NSCs into neural system.

“Controversies and other ethical issues related to stem cell therapies make drug induced, enhanced neurogenesis a promising treatment strategy,” stressed senior author Zahoor A. Shah. “Besides one documented clinical trial recommending the use of Ginkgo biloba after ischemic stroke, further high quality and large-scale randomized controlled trials are warranted to test its efficacy in stroke recovery” he said.


Dr. Shah publishes in Neuroscience journal

Dr. Shah

Dr. Shah

Dr. Zahoor Shah, assistant professor of Medicinal and Biological Chemistry along with Shadia E. Nada and Sylvain Dore, was recently published in Neuroscience journal.

Their article, entitled “Heme oxygenase 1, beneficial role in permanent ischemic stroke and in Gingko biloba (EGb 761) neuroprotection,” details how Gingko biloba shows protective effects against ischemic stroke.