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Abstract

INFLAMMATION AND ANTI-INFLAMMATORY STRATEGIES IN STROKE

Manzoor A Mir and Raid S Albaradie

ABSTRACT

Stroke is an important public health issue due to high rates of
disability, morbidity/ mortality and is now the third leading cause of
death after heart disease and cancer affecting 15 million people
worldwide each year. In spite of extensive research in the field of
stroke during past decade the current therapeutic strategies have been
largely unsuccessful. One possible explanation is that research and
pharmacological management have focused on very early events in
brain ischemia. Two important pathophysiological mechanisms
involved during ischemic stroke are oxidative stress and inflammation.
Brain tissue is not well equipped with antioxidant defenses, so reactive
oxygen species and other free radicals/oxidants, released by inflammatory cells, threaten
tissue viability in the vicinity of the ischemic core. Recent studies have shown that brain
ischemia and trauma elicit strong inflammatory reactions driven by both external and brain
cells. Clinical observations suggest that patients with stroke have higher plasma levels of
inflammatory cytokines or soluble adhesion molecules and anti-inflammatory therapy is
effective at reducing stroke incidence in not only animal models, but in humans as well. This
suggests that inflammation might directly affect the onset of stroke. The recognition of
inflammation as a fundamental response to brain ischemia provides novel opportunities for
new anti-inflammatory therapies. Currently, little is known about endogenous counter
regulatory immune mechanisms. Statins have been shown to decrease the stroke incidence
via anti-inflammatory effects that are both dependent and independent of their cholesterollowering
effects. Here in this review we will discuss the molecular aspects of oxidative stress
and inflammation in ischemic stroke. We will also present the latest findings about the
cellular and humoral aspects of immune and inflammatory reactions in the brain. This will increase our understanding regarding neuro-injuries and role immune reactions play in the brain milieu. This all may have an impact on the potential therapeutic strategies that target neuro-inflammation and the innate immune system.

Keywords: Neuroinflammation, antioxidant, macrophages, Ischemia, cytokines, ischemic, statins, brain, immune reactions.


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