Cerebrolysin (Cere) is a peptidergic nootropic drug with neurotrophic properties 
which has been used to treat dementia and sequelae of stroke. Use of Cere 
prevents nuclear structural changes typical of apoptosis and significantly 
reduces the number of apoptotic cells after several apoptotic stimuli. Cerebral 
Autosomal Dominant Arteriopathy with Subcortical Infarcts and 
Leukoencephalopathy (CADASIL) is a hereditary disease caused by mutations of the 
Notch3 gene encoding the Notch3 protein. Notch3 is involved in the regulation of 
apoptosis, modulating Fas-Ligand (Fas-L)- induced apoptosis. The aim of this 
study was to evaluate the in vitro protective effects of Cere against oxidative 
stress-induced apoptosis in cells from CADASIL patients. We used peripheral 
blood lymphocytes (PBLs) from 15 CADASIL patients (age range 34-70 years); 
2-deoxy-D-ribose (dRib), a highly reducing sugar, was used as paradigm 
pro-apoptotic stimulus. Apoptosis was analyzed by flow cytometry and 
fluorescence microscopy. Administration of Cere to PBLs from CADASIL patients 
cultured under standard conditions had no effect on the percentage of apoptotic 
cells. Administration of Cere to PBLs cultured with dRib caused a significant 
decrease in apoptosis after 48 h of culture in only 5 patients, whereas in the 
other 10 patients, Cere treatment was not associated with any significant 
difference in the percentage of apoptosis. This result showed a protective 
effect of Cere against oxidative stress-induced apoptosis only in 30 % of the 
CADASIL patients, suggesting that the Notch3 gene probably does not influence 
the anti-apoptotic properties of Cere in vitro.