Mode of Action

Anti-Inflammatory Effect
Reduction of Post-Stroke Dementia
Neuroplasticity
Neurogenesis
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Cerebrolysin® is a neurotrophic peptidergic drug with multimodal pharmacological properties indicated for the treatment of acute and chronic CNS disorders. See all proven effects of Cerebrolysin® below.

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 excitotoxicity, uncontrolled apoptosis,…

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.

Neurotrophic Support

Neurotrophic factors (NTFs) are signaling molecules that maintain, protect, and restore the neuronal network and ensure proper functioning of the brain.
Cerebrolysin® mimics and modulates the level of such endogenous NTFs.
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Regeneration Pathways

Studies confirm the important role of the sonic hedgehog pathway in post-stroke brain repair and functional recovery, and suggest the Shh pathway to be a possible target for prolongation of the therapeutic window after stroke.
Cerebrolysin® shows effects on neurogenesis and oligodendrogenesis via the Shh signalling pathway.
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Protection against
excitotoxicity

Excitotoxicity is a pathological process caused by overstimulation of neuronal cells by excitatory neurotransmitters (e.g. glutamate).
Cerebrolysin® has shown to reduce glutamate-induced injury of cultured neurons.
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Reduction of free radicals

Free radicals accumulate during many pathological processes such as the ischemic cascade and are thought to be a basic pathway leading to neurodegeneration in Alzheimer’s disease.
Cerebrolysin® reduces the production of free radicals.
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Reduction of pro-
apoptotic encymes

Apoptosis occurs as the result of acute or chronic cellular damage. Overactivation of calpains, a group of key enzymes involved in cellular apoptosis, results in degradation of microtubules and thus of the cytoskeleton. 
Cerebrolysin® inhibits calpain, which results in less tissue damage!
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Modulation of
inflammatory response

An ischemic stroke occurs when a blood vessel is blocked by clots which have developed slowly over time and consist of substances transported through the blood stream. Fibrin fibers, with their adhesive properties, attach to the vessel walls and enable other components to form a thrombus. This thrombus is growing and can partly or completely block the flow of blood in a blood vessel. Due to a downstream deficiency and undersupply of oxygen and nutrients, endothelial cells become procoagulant, prothrombotic and inflammatory. 
Cerebrolysin® reduces the release of pro-inflammatory cytokines.

Improvement of BBB
integrity

Cerebral endothelial cells play an important role in maintaining the blood brain barrier (BBB) – an adjustable barrier between the blood vessel and the extravascular space. 
Cerebrolysin® significantly reduces tPA or fibrin augmented permeability and makes the BBB tighter again!
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Neuroplasticity

Ischemic stroke leads to a reduced blood flow or a complete blockage of the vessel and causes an ischemic condition. Due to this undersupply, blood vessels and capillaries atrophy, causing the vessels to contract and dissolve.
One of the most important properties of Cerebrolysin® is the initiation and promotion of neuroplasticity. So, Cerebrolysin® enhances new neural networks.

Neurogenesis

Ischemia provokes a cascade of vascular and neurodegenerative processes that cause atrophy of blood vessels, whereby the vessels contract and dissolve. Neurons as well, deteriorate their neuronal functions and communication pathways with neighboring nerve cells or die in the worst case.
Cerebrolysin® amplifies multiple processes of protection and neurovascular recovery and increases neurogenesis.

Reduction of post-stroke
dementia

Cerebrolysin® is indicated for the treatment of all forms of vascular cognitive impairments and consists of small molecules with anti-inflammatory properties.
After ischemic stroke the fragments of the thrombus can lead to micro-clots in smaller vessels which can release pro-inflammatory cytokines and swelling of endothelial cells of the capillary walls. 
The arriving Cerebrolysin® molecules reduce inflammation and reverse swelling. Normal blood flow is restored and activated endothelial cells stop their cytokine release. The affected micro-vasculature returns to normal function.

Source

TENG, Hua, et al. Therapeutic effect of Cerebrolysin® on reducing impaired cerebral endothelial cell permeability. Neuroreport, 2021, 32. Jg., Nr. 5, S. 359-366
FREY, William H., et al. Quantitative and qualitative distribution of 125l-labeled Cerebrolysin® peptides in the CNS following IV delivery, not published, 2004
Gschanes, A., V. Valoušková, and M. Windisch. „Ameliorative inuence of a nootropic drug on motor activity of rats after bilateral carotid artery occlusion.“Journal of neural transmission 104.11-12 (1997): 1319-1327.
Beghi, Ettore, et al. “European Academy of Neurology and European Federation of Neurorehabilitation Societies guideline on pharmacological support in early motor rehabilitation after acute ischaemic stroke.” European Journal of Neurology (2021).
Zhang, Li, et al. „Sonic hedgehog signaling pathway mediates cerebrolysin-improved neurological function after stroke.“ Stroke 44.7 (2013): 1965-1972.
TENG, Hua, et al. Therapeutic effect of Cerebrolysin® on reducing impaired cerebral endothelial cell permeability. Neuroreport, 2021, 32. Jg., Nr. 5, S. 359-366.
FREY, William H., et al. Quantitative and qualitative distribution of 125l-labeled Cerebrolysin® peptides in the CNS following IV delivery, not published, 2004
Gschanes, A., V. Valoušková, and M. Windisch. „Ameliorative inuence of a nootropic drug on motor activity of rats after bilateral carotid artery occlusion.“Journal of neural transmission 104.11-12 (1997): 1319-1327.
Beghi, Ettore, et al. “European Academy of Neurology and European Federation of Neurorehabilitation Societies guideline on pharmacological support in early motor rehabilitation after acute ischaemic stroke.” European Journal of Neurology (2021).
Zhang, Li, et al. „Sonic hedgehog signaling pathway mediates cerebrolysin-improved neurological function after stroke.“ Stroke 44.7 (2013): 1965-1972.

Notice to U.S. Visitors

Please be advised that Cerebrolysin is not registered with the U.S. Food and Drug Administration (FDA) and is not approved for sale or distribution in the United States.

Cerebrolysin is a prescription medication for use under the supervision of an authorized health care professional. For any medical inquiries, please consult with a healthcare professional.