Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437
Acute ischemic stroke (AIS) is the leading cause of disability and one of the top causes of mortality worldwide. The current standard of care is reperfusion therapy including intravenous thrombolysis (IVT) and thrombectomy. However, these treatments have limitations as they have a limited therapeuti...
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| Format: | Article |
| Language: | English |
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Open Exploration Publishing Inc.
2023-02-01
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| Series: | Exploration of Neuroprotective Therapy |
| Subjects: | |
| Online Access: | https://www.explorationpub.com/Journals/ent/Article/100437 |
| _version_ | 1828000997210849280 |
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| author | Grace YY Chia Selvie Yeo Jamie SY Ho Eric Jou Leonard LL Yeo Benjamin YQ Tan |
| author_facet | Grace YY Chia Selvie Yeo Jamie SY Ho Eric Jou Leonard LL Yeo Benjamin YQ Tan |
| author_sort | Grace YY Chia |
| collection | DOAJ |
| description | Acute ischemic stroke (AIS) is the leading cause of disability and one of the top causes of mortality worldwide. The current standard of care is reperfusion therapy including intravenous thrombolysis (IVT) and thrombectomy. However, these treatments have limitations as they have a limited therapeutic window. Hence, there is a vital need to develop neuroprotective agents to prevent brain injury, extend the reperfusion window, improve mortality, and reduce disability in AIS patients. Neuroprotective agents work by counteracting the detrimental biochemical and molecular events that result in irreversible ischemic damage. Numerous preclinical studies and clinical trials have been done on different agents. Thus far, all have been definitively unsuccessful in large trials. Currently, there are several challenges in translation from animal studies to human trials. It is important to understand the current evidence as well as past challenges in the development of neuroprotective strategies in AIS in order for a more strategic selection of agents to be studied, improve study designs and thus contribute to the development of effective neuroprotective agents. Newer agents have shown promise in neuroprotection, and human trials are ongoing. In this review, the mechanisms of action of different families of neuroprotective agents were discussed. The evidence for the efficacy of different drugs in each family of neuroprotective agents was also evaluated and the current research landscape in neuroprotection for AIS was summarized. The past challenges and limitations in clinical trials and proposed possible ways to address these issues were highlighted. |
| first_indexed | 2024-04-10T06:22:37Z |
| format | Article |
| id | doaj.art-41c646378d144f50a1802c5aeeb0006d |
| institution | Directory Open Access Journal |
| issn | 2769-6510 |
| language | English |
| last_indexed | 2024-04-10T06:22:37Z |
| publishDate | 2023-02-01 |
| publisher | Open Exploration Publishing Inc. |
| record_format | Article |
| series | Exploration of Neuroprotective Therapy |
| spelling | doaj.art-41c646378d144f50a1802c5aeeb0006d2023-03-02T02:41:42ZengOpen Exploration Publishing Inc.Exploration of Neuroprotective Therapy2769-65102023-02-0131477010.37349/ent.2023.00037Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437Grace YY Chia0https://orcid.org/0000-0001-5468-7088Selvie Yeo1https://orcid.org/0000-0003-3942-4065Jamie SY Ho2https://orcid.org/0000-0002-1180-6902Eric Jou3https://orcid.org/0000-0002-6259-4874Leonard LL Yeo4https://orcid.org/0000-0002-4249-0402Benjamin YQ Tan5https://orcid.org/0000-0003-1824-9077Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 117597, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 117597, SingaporeDepartment of Medicine, Alexandra Hospital, National University Health System, 159964, SingaporeSchool of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UKDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeAcute ischemic stroke (AIS) is the leading cause of disability and one of the top causes of mortality worldwide. The current standard of care is reperfusion therapy including intravenous thrombolysis (IVT) and thrombectomy. However, these treatments have limitations as they have a limited therapeutic window. Hence, there is a vital need to develop neuroprotective agents to prevent brain injury, extend the reperfusion window, improve mortality, and reduce disability in AIS patients. Neuroprotective agents work by counteracting the detrimental biochemical and molecular events that result in irreversible ischemic damage. Numerous preclinical studies and clinical trials have been done on different agents. Thus far, all have been definitively unsuccessful in large trials. Currently, there are several challenges in translation from animal studies to human trials. It is important to understand the current evidence as well as past challenges in the development of neuroprotective strategies in AIS in order for a more strategic selection of agents to be studied, improve study designs and thus contribute to the development of effective neuroprotective agents. Newer agents have shown promise in neuroprotection, and human trials are ongoing. In this review, the mechanisms of action of different families of neuroprotective agents were discussed. The evidence for the efficacy of different drugs in each family of neuroprotective agents was also evaluated and the current research landscape in neuroprotection for AIS was summarized. The past challenges and limitations in clinical trials and proposed possible ways to address these issues were highlighted.https://www.explorationpub.com/Journals/ent/Article/100437neuroprotectionacute ischemic strokeneuron deaththerapeuticmechanisms |
| spellingShingle | Grace YY Chia Selvie Yeo Jamie SY Ho Eric Jou Leonard LL Yeo Benjamin YQ Tan Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437 Exploration of Neuroprotective Therapy neuroprotection acute ischemic stroke neuron death therapeutic mechanisms |
| title | Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437 |
| title_full | Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437 |
| title_fullStr | Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437 |
| title_full_unstemmed | Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437 |
| title_short | Neuroprotective agents in acute ischemic strokehttps://www.explorationpub.com/Journals/ent/Article/100437 |
| title_sort | neuroprotective agents in acute ischemic strokehttps www explorationpub com journals ent article 100437 |
| topic | neuroprotection acute ischemic stroke neuron death therapeutic mechanisms |
| url | https://www.explorationpub.com/Journals/ent/Article/100437 |
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