A modern concept of antihypoxic and antioxidant effects of mexidol

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Abstract
The review article presents a modern concept of the mechanism of antioxidant and antihypoxic action of the original drug mexidol (2-ethyl-6-methyl-3-hydroxypyridine succinate). The direct antioxidant activity of mexidol has been described, which consists in the ability of the drug to inactivate free radicals and increase the activity of the antioxidant enzymes glutathione peroxidase and superoxide dismutase in vitro. The results of the indirect antioxidant activity of mexidol, manifested in the increased expression under the ischemia of the transcription factor Nrf2, responsible for the cell resistance to oxidative stress are presented. The antihypoxic action of mexidol due to the presence of succinic acid in its molecule, which on the one hand supports the work of the Krebs cycle succinate oxidase under oxygen deficiency conditions, and on the other hand, binds to its specific receptors (GPR91), and starts a cascade of biochemical reactions that increases the body's resistance to lack of oxygen is discussed. The results of preclinical and clinical studies confirming the antioxidant and antihypoxic effects of mexidol are summarized.