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THE NEW APPROACH
Introduction
For a long period of time it was state of the art
to design drugs displaying one defined
pharmacological mode of action.
These drugs failed in the approach to cure
complex diseases!
Recently the medical community postulated the
need for drugs displaying a mode of action
resulting in pleiotropic effects for treatment of
complex diseases like CNS injury or
neurodegeneration
.
Introduction
The mature central nervous system has limited capacity for selfrenewal and repair after injury or neurodegeneration, therefore
therapeutic strategies with effects similar to neurotrophic factors
resulting in pleiotropic effects are required.
Cerebrolysin acts similar to neurotrophic factors and is
therefore an optimal treatment strategy after CNS injury or
neurodegeneration.
neurogenesis
neuroplasticity
neuroprotection
neuronal survival
Cerebrolysin
NEUROTROPHIC MECHANISM
Cerebrolysin – Indications
DEMENTIA
STROKE
TBI
Cerebrolysin – Characterisation
Protein powder
Starting material
Enzymatic hydrolysis
Ethanol precipitation
Molecular weight cut-off filtration
Addition of amino acids
Cerebrolysin Concentrate
Active Pharmaceutical Ingredient
Cerebrolysin – Mode of action
Cerebrolysin, a balanced peptide preparation acting
like neurotrophic factors.
 General Pharmacodynamics (PD)
 Special Pharmacodynamics (PD)
Cerebrolysin – General PD
The neurotrophic mechanism of Cerebrolysin results in
pleiotropic effects:
• neuronal survival
• neuroprotection
• neuroplasticity
• neurogenesis
Cerebrolysin – General PD
Neuronal survival
Neurotrophic factors exert survival-promoting and trophic
actions on neuronal cells to avoid neuronal atrophy,
hypofunction and cell death.
Cerebrolysin – General PD
Neuroprotection
Neurotrophic factors limit neuronal dysfunction and attempt
to maintain the highest possible integrity of cellular
interactions in the brain under detrimental conditions.
Cerebrolysin – General PD
Neuroplasticity
Neurotrophic factors enable neuroplasticity, a process which
allows the brain to adapt by "re-wiring" in response to
changes in the environment and which allows the regrowth
of damaged neuronal processes.
Cerebrolysin – General PD
Neurogenesis
Neurotrophic factors induce differentiation of progenitor cells
to form neurons, which become functionally integrated into
the surrounding brain tissue during pre-natal development
but also throughout adulthood.
Cerebrolysin – General PD
Cerebrolysin – General PD
Cerebrolysin – Special PD
Efficacy of Cerebrolysin has been proven in several invitro and in-vivo experiments with model systems for
• Dementia
• Stroke
• TBI
Cerebrolysin – Special PD
Model systems for diseases:
 STROKE
 DEMENTIA
 TBI
Cerebrolysin – Special PD
Findings in Dementia Models:
- Cerebrolysin decreases A deposition by regulating APP maturation.
- Cerebrolysin acts as a synaptic modulator to promote integrity of neuronal
circuits.
- Cerebrolysin restores neuronal cytoarchitecture resulting in improved
behavioral performance.
- Cerebrolysin stimulates neurogenesis in the dendate gyrus, which might
provide a basis for neuronal replacement therapy in neurodegenerative
diseases.
Cerebrolysin – Special PD
Findings in Stroke Models:
- Cerebrolysin stabilizes cytoskeleton by inhibition of calpain.
- Cerebrolysin stimulates neurogenesis to promote integrity of neuronal
circuits, a potential mechanisms for self-repair after stroke.
- Cerebrolysin decreases infarct volume.
- Cerebrolysin limits edema formation.
- Cerebrolysin promotes functional recovery.
Cerebrolysin – Special PD
Findings in TBI Models:
- Cerebrolysin prevents apoptosis of lesioned motoneurons.
- Cerebrolysin promotes functional recovery.
Cerebrolysin – Summary
Cerebrolysin, a balanced peptide preparation acting like
neurotrophic factors.
Cerebrolysin – Summary
The neurotrophic mechanism of Cerebrolysin results in
pleiotropic effects:
•
neuronal survival
•
neuroprotection
•
neuroplasticity
•
neurogenesis
Cerebrolysin – Summary
Efficacy of Cerebrolysin has been proven in several invitro and in-vivo experiments with model systems for
• Dementia
• Stroke
• TBI
Cerebrolysin – Conclusion
Cerebrolysin is an optimal treatment strategy after
CNS injury or neurodegeneration.