In this issue of Blood, Goncalves et al1 demonstrate that targeting phosphorylation of ocdudin in the endothelium of the cerebrovasculature significantly reduces the risk of intracranial hemorrhage (ICH) after treatment with recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke (AIS). Intravenous administration of rtPA improves the functional outcome of patients who present at any time up to 4.5 hours after suffering an AIS.2'3 Unfortunately, a significant number of patients who receive rtPA develop a hemorrhagic conversion of their ischemic stroke that presents as an ICH. This complication of treatment with rtPA limits its use, with less than 10% of the AIS population receiving treatment. Mitigating the risk of ICH associated with intravenous fibrinolysis can provide increased safety to patients who present with AIS. It may also expand the inclusion criteria for fibrinolysis so that more patients presenting with AIS can receive rtPA therapy.
NSTL
Amer Soc Hematology
