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Anti-adhesion molecule strategies as potential neuroprotective agents in cerebral ischemia: A critical review of the literature
- Source :
- Inflammation Research. 53:497-508
- Publication Year :
- 2004
- Publisher :
- Springer Science and Business Media LLC, 2004.
-
Abstract
- Despite recent advances in the understanding of the pathophysiology of cerebral ischemia, current approaches attempting to prevent ischemic brain damage after an acute stroke remain quite inadequate. Today, ischemic stroke remains the third leading cause of death in industrialized nations, and the leading cause of disability requiring long term institutional care in the U.S and other industrialized nations. While one treatment, tissue plasminogen activator, has shown efficacy in clinical trials, safety concerns limit its role in clinical practice to a narrow time window of use. Acute cerebral ischemia has been shown to evoke a profound and deleterious upregulation of the inflammatory response, initiated within the cerebral microvasculature. Recently, research efforts have focused on targeting individual components of the inflammatory cascade, such as leukocyte activation and adhesion, in an attempt to develop potential neuroprotective agents. While these strategies have shown promise preclinically, clinical trials have yet to show clear benefit. Here, we review the current understanding of the pathophysiologic consequences of acute cerebral ischemic injury. Additionally, we discuss the role of the inflammatory cascade, with specific attention given to the deleterious role played by leukocyte activation and adhesion in stroke. Finally, relevant efforts to translate these basic science observations into clinical efficacy in acute stroke trials are critically reviewed.
- Subjects :
- medicine.medical_specialty
Neurology
Basic science
Immunology
Ischemia
Bioinformatics
Models, Biological
Tissue plasminogen activator
Neuroprotection
Brain Ischemia
Cell Adhesion
Leukocytes
medicine
Animals
Humans
Stroke
Cause of death
Inflammation
Pharmacology
Clinical Trials as Topic
business.industry
medicine.disease
Clinical trial
Neuroprotective Agents
Physical therapy
business
medicine.drug
Subjects
Details
- ISSN :
- 1420908X and 10233830
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Inflammation Research
- Accession number :
- edsair.doi.dedup.....545438abb28002c91450cdb1d45716ec