Novel Stroke Therapeutics: Unraveling Stroke Pathophysiology and Its Impact on Clinical Treatments

Abstract

Stroke remains a leading cause of death and disability in the world. Over the past few decades our understanding of the pathophysiology of stroke has increased, but greater insight is required to advance the field of stroke recovery. Clinical treatments have improved in the acute time window, but long-term therapeutics remain limited. Complex neural circuits damaged by ischemia make restoration of function after stroke difficult. New therapeutic approaches, including cell transplantation or stimulation, focus on reestablishing these circuits through multiple mechanisms to improve circuit plasticity and remodeling. Other research targets intact networks to compensate for damaged regions. This review highlights several important mechanisms of stroke injury and describes emerging therapies aimed at improving clinical outcomes.

Prokineticins are neuroprotective in models of cerebral ischemia and ischemic tolerance in vitro

“…Unfortunately, clinical trials for stroke and related ischemic syndromes with neuroprotective drugs have been generally unsuccessful so far (Green and Shuaib, 2006;George and Steinberg, 2015). Along with the development of more appropriate experimental animal models, drugs with a better therapeutic index and aimed at alternative targets in the excitotoxic cascade are needed for the identification of new and effective neuroprotective therapies for cerebral ischemia.…”

Antioxidant Status of Patients With Atherothrombotic Variant of Ischemic Stroke

“…Одной из важнейших задач современной медицины является детальное изучение пато химических и патофизиологических меха низмов возникновения и развития инсульта [4,6,11]. Это необходимо для разработки новых, более эффективных методик оказания помо щи пациентам с острым нарушением мозгово го кровообращения (ОНМК), особенно в ост рейшем периоде заболевания [3,13].…”

“…Одним из механизмов повреждения ткани головного мозга при развитии ише мического инсульта является интенсифика ция процессов свободнорадикального окис ления [6,7]. Однако в литературе приведены немногочисленные данные об интегратив ной оценке состояния антиоксидантной системы.…”

“…Интенсификация процессов активации свободнорадикального окисления при раз витии ОНМК подтверждена многочислен ными работами [1,6,7]. Вопросам инте гральной оценки состояния антиоксидатной системы посвящено значительно меньшее число работ [10].…”

Optogenetic Approaches to Target Specific Neural Circuits in Post-stroke Recovery

“…The only proven therapies for ischemic stroke are intravenous tissue plasminogen activator (tPA) and intra-arterial thrombectomy, both of which must be administered within 6 h of stroke onset, a scenario that is applicable to very few patients [1][2][3][4]. Increasing attention has therefore focused on understanding how the surviving brain gains new function, and developing potential therapies that promote long-term post-stroke recovery.…”