Developing Intravenous Delivery of Water-Soluble Prodrugs of Idebenone for the Treatment of Acute Ischemic Stroke.

ACS Chem Neurosci

National Key Laboratory of Lead Druggability Research, Shanghai Institute of Pharmaceutical Industry Co., Ltd., China State Institute of Pharmaceutical Industry, Shanghai 201203, China.

Published: August 2025


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Article Abstract

Ischemic stroke (IS) represents a substantial global health threat, but only a few effective medicines exist to treat IS, with a huge unmet clinical need. Idebenone (IDB), a coenzyme Q10 analogue, has multitarget effects, including enhancing mitochondrial energy metabolism, scavenging free radicals, and anti-inflammation, which is approved in Europe for treating Leber's hereditary optic neuropathy (LHON). However, IDB has poor water solubility and oral bioavailability, resulting in insufficient therapeutic plasma concentrations, even following high-dose oral administration, and limiting its use for brain diseases and acute-phase interventions. To address these challenges, we synthesized and identified novel water-soluble IDB prodrugs and found that compound could adopt intravenous delivery for treating acute IS (AIS) with excellent plasma and brain exposure in normal and IS rats. Besides, significantly alleviated brain infarct and edema and improved motor function and cerebral blood flow in acute and chronic IS rat models. Compound is currently undergoing comprehensive evaluation as a preclinical candidate for anti-AIS.

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http://dx.doi.org/10.1021/acschemneuro.5c00340DOI Listing

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