The science of cerebral ischemia and the quest for neuroprotection: navigating past failure to future success.

Abstract:

:Ischemic stroke remains a leading cause of morbidity and death for which few therapeutic options are available. The development of neuroprotective agents, a once promising field of investigation, has failed to translate from bench to bedside successfully. This work reviews the ischemic cascade, agents targeting steps within the cascade, and potential reasons for lack of translation. Additional therapeutic targets are highlighted and areas requiring further investigation are discussed. It is clear that alternative targets need to be pursued, such as the role glia play in neurological injury and recovery, particularly the interactions between neurons, astrocytes, microglia, and the vasculature. Similarly, the biphasic nature of many signaling molecules such as matrix metalloproteinases and high-mobility group box 1 protein must be further investigated to elucidate periods of detrimental versus beneficial activity.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Turner RC,Dodson SC,Rosen CL,Huber JD

doi

10.3171/2012.11.JNS12408

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

1072-85

issue

5

eissn

0022-3085

issn

1933-0693

journal_volume

118

pub_type

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