TITLE:
The Multitarget Synergistic Effect and Clinical Value of Edaravone Dexborneol in Neuroprotection for Acute Ischemic Stroke
AUTHORS:
Zilu Zhang, Junfeng Su
KEYWORDS:
Edaravone Dexborneol, Acute Ischemic Stroke, Neuroprotection, Oxidative Stress, Inflammatory Response
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.8,
August
11,
2025
ABSTRACT: Acute ischemic stroke (AIS), as the second leading cause of death worldwide, involves complex pathophysiological mechanisms including oxidative stress, inflammatory cascade reactions, and blood-brain barrier disruption [1]. Edaravone Dexborneol is a novel dual-effect neuroprotectant composed of the free radical scavenger edaravone and the anti-inflammatory component dexborneol in a 4:1 molar ratio [2]. Preclinical studies have shown that Edaravone Dexborneol can significantly reduce cerebral infarction volume, inhibit the formation of neutrophil extracellular traps, and improve blood-brain barrier permeability by protecting the neurovascular unit—a functional complex that maintains brain function, composed of neurons, vascular endothelial cells, astrocytes, and other components [3]. Its molecular mechanism is associated with regulating the dynamic balance of pro-inflammatory factors (IL-1β ↓ 46.8%, IL-6 ↓ 38.2%) and anti-inflammatory factors (IL-4 ↑ 2.1-fold, IL-10 ↑ 1.8-fold). The pivotal phase III TASTE clinical trial (NCT04119063) demonstrated that intravenous administration of Edaravone Dexborneol within 48 hours of onset significantly improved 90-day functional independence (mRS ≤ 1: 34.6% vs. 24.9%, OR = 1.59, 95%CI 1.21 - 2.08) compared with edaravone monotherapy, with no significant difference in adverse event rates (15.3% vs. 13.8%, P = 0.34). The TASTE-SL subgroup study confirmed that the sublingual preparation has a bioavailability of 82.4% ± 11.6% of intravenous administration, providing a new approach for prehospital emergency care. Future research should explore its synergistic effect with endovascular thrombectomy through multicenter randomized controlled trials (such as the OPTIMAL-AIS study) and clarify the neurovascular unit protection mechanism based on omics technologies. The multitarget regulatory characteristics of Edaravone Dexborneol provide a new paradigm for breaking through the bottleneck of neuroprotective therapy for AIS.