ISQUEMIA CEREBRAL: MECANISMOS FISIOPATOLÓGICOS Y OPORTUNIDADES TERAPÉUTICAS / Ischemic stroke: Physiopathological mechanisms and therapeutic opportunities
Year: 2016
Type: review
Abstract: Ischemic stroke is a major cause of death and disability worldwide. Thrombolysis by the tissueplasminogen activator (t-PA) is the only pharmacological option approved for clinical practice, but with a narrow therapeutic window of 4,5 h. In this review we aim to describe the most recent advances in the research of pathophysiological mechanisms as well as possible pharmacological targets for ischemic stroke. Ischemic cascade is established immediately after the interruption in the cerebral blood flow, and it include processes like excitotoxicity, oxidative stress, mitochondrial dysfunction, disruption of the blood-brain barrier, inflammation and cell death. The molecular mediators of these processes can act in a biphasic way and concomitantly depending on the postischemic step. The main objectives of the identification and evaluation of therapeutic targets are the revascularization (thrombolysis), the blockade of the deleterious events involved in the ischemic cascade (neuroprotection) or the induction of endogenous processes of brain repair (neurorestoration). For example, new thrombolytic molecules or medical devices aimed to increase the t-PA effectiveness, different classes of compounds with neuroprotective actions, and the induction of neurogenesis and angiogenesis. The accumulated evidence suggest that the combination of these strategies would be more effective than individually, which may increase their potentialities of clinical application.
Language: Spanish
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2375545646