Neuronal Death Mechanisms and Therapeutic Strategy in Ischemic Stroke

Ischemic stroke caused by intracranial vascular occlusion has become increasingly prevalent with considerable mortality and disability, which gravely burdens the global economy. Current relatively effective clinical treatments are limited to intravenous alteplase and thrombectomy. Even so, patients...

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Bibliographic Details
Published in:Neuroscience bulletin 2022-10, Vol.38 (10), p.1229-1247
Main Authors: Mao, Rui, Zong, Ningning, Hu, Yujie, Chen, Ying, Xu, Yun
Format: Article
Language:English
Subjects:
Anatomy
Anesthesiology
Biomedical and Life Sciences
Biomedicine
Cell death
Global economy
Health aspects
Human Physiology
Ischemia
Mortality
Neurology
Neurons
Neurosciences
Pain Medicine
Review
Stroke (Disease)
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Summary:Ischemic stroke caused by intracranial vascular occlusion has become increasingly prevalent with considerable mortality and disability, which gravely burdens the global economy. Current relatively effective clinical treatments are limited to intravenous alteplase and thrombectomy. Even so, patients still benefit little due to the short therapeutic window and the risk of ischemia/reperfusion injury. It is therefore urgent to figure out the neuronal death mechanisms following ischemic stroke in order to develop new neuroprotective strategies. Regarding the pathogenesis, multiple pathological events trigger the activation of cell death pathways. Particular attention should be devoted to excitotoxicity, oxidative stress, and inflammatory responses. Thus, in this article, we first review the principal mechanisms underlying neuronal death mediated by these significant events, such as intrinsic and extrinsic apoptosis, ferroptosis, parthanatos, pyroptosis, necroptosis, and autophagic cell death. Then, we further discuss the possibility of interventions targeting these pathological events and summarize the present pharmacological achievements.
ISSN:1673-7067
1995-8218
DOI:10.1007/s12264-022-00859-0