Non-invasive intranasal insulin-like growth factor-I reduces infarct volume and improves neurologic function in rats following middle cerebral arteryocclusion

Insulin-like growth factor-I (IGF-I) has been proposed as a treatment for s troke. However, it does not efficiently cross the blood-brain barrier (BBB) . Intracerebroventricular injection of IGF-I has been shown to offer protec tion against cerebral ischemic damage in rats although this invasive method of administration may not be practical in humans, Non-invasive intranasal (IN) delivery of IGF-I to the brain is a promising alternative. We have ass essed the therapeutic effect of IN IGF-I in rats following middle cerebral artery occlusion (MCAO). Treatment was initiated 10 min after the onset of MCAO and then again 24 and 48 h later. Intranasal dosing of 75 mug IGF-I (2 25 mug total IGF-I over 48 h) significantly reduced corrected infarct volum es by 60% vs. control (P < 0.01) and hemispheric swelling by 45.6% vs. cont rol (P < 0.05). Neurologic function, assessed by the postural reflex, flexo r response and adhesive tape tests, was also improved by IN IGF-I as compar ed to control. Our study indicates IN delivery of IGF-I holds significant p romise as a non-invasive and efficacious method of bypassing the BBB for th e treatment of stroke. (C) 2001 Elsevier Science Ireland Ltd. All rights re served.