Cerebrolysin® is a neurotrophic peptidergic drug with multimodal pharmacological properties indicated for the treatment of acute and chronic CNS disorders. The pathophysiological mechanisms targeted by Cerebrolysin® belong to two distinct categories:
- Support of endogenous repair and recovery processes as a consequence of injury or degenerative disease
- Protection against pathological events and cascades caused by an injury or a degenerative disease
The natural repair and recovery processes in the CNS that start immediately upon injury and play an important role in the continuous defense against neurodegeneration in chronic CNS disorders (e.g. Alzheimer’s disease). Cerebrolysin® has shown to modify two major signalling pathways: the neurotrophic factor (NTF) and sonic hedgehog (Shh) signalling pathway. These pathways regulate on a molecular level the cellular processes of neurogenesis, angiogenesis, dendrite arborisation, axonal sprouting, myelination, and remodelling of the neurovascular unit, thereby supporting the maintenance and repair of the neuronal network.
The pathological events and cascades after stroke or trauma lead to secondary injuries, which further compromise motor and cognitive functions of a patient. Among the most relevant molecular processes targeted by Cerebrolysin® in the acute phase of an injury are events of the ischemic cascade, like
- Uncontrolled apoptosis
- Overactivation of proteolytic enzymes
- Overproduction of reactive oxygen species (ROS).
In the early post-acute phase, Cerebrolysin® prevents formation of toxic protein aggregates (amyloidosis) and lowers the level of inflammatory processes, both linked to neurodegeneration if not prohibited.