Human tissue kallikrein in the treatment of acute ischemic stroke

Since nothing is useful from the abstract, you'll have to assume your doctor is following this up with researchers to get clinical trials done.  But then you know that your doctor is failing in two possible ways;

S/he doesn't even know the article exists.

S/he having read the article did NO followup.

Either of which should be a fireable offense.

Either way your doctors incompetence results in a lesser chance of your children and grandchildren getting efficacious treatment for their strokes.

Human tissue kallikrein in the treatment of acute ischemic stroke

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Michelle Alexander-Curtis, Rick Pauls, Julie Chao, ...

First Published January 20, 2019 Review Article

https://doi.org/10.1177/1756286418821918

Article information

Abstract

Acute ischemic stroke (AIS) remains a major cause of death and disability throughout the world. The most severe form of stroke results from large vessel occlusion of the major branches of the Circle of Willis. The treatment strategies currently available in western countries for large vessel occlusion involve rapid restoration of blood flow through removal of the offending blood clot using mechanical or pharmacological means (e.g. tissue plasma activator; tPA). This review assesses prospects for a novel pharmacological approach to enhance the availability of the natural enzyme tissue kallikrein (KLK1), an important regulator of local blood flow. KLK1 is responsible for the generation of kinins (bradykinin and kallidin), which promote local vasodilation and long-term vascularization. Moreover, KLK1 has been used clinically as a direct treatment for multiple diseases associated with impaired local blood flow including AIS. A form of human KLK1 isolated from human urine is approved in the People’s Republic of China for subacute treatment of AIS. Here we review the rationale for using KLK1 as an additional pharmacological treatment for AIS by providing the biochemical mechanism as well as the human clinical data that support this approach.