Modulation of Apoptosis in Acute Ischemic Stroke As Treatment Challenges
Current Immunology Reviews, 2012, 8, 39-49 39 Modulation of Apoptosis in Acute Ischemic Stroke as Treatment Challenges Joaquin Jordan1, Laura Moreno-Parrado1,2, David Anton-Martinez1,3, Kurt A. Jellinger4 and Maria F. Galindo*,5 1Grupo de Neurofarmacología, Dpto Ciencias Médicas, Fac de Medicina, Universidad de Castilla La Mancha, Avenida Almansa, 14, Albacete 02006, Spain 2Sección de Microbiologia, Complejo Hospitalario Universitario de Albacete, Albacete, Spain 3Sección de Bioquímica, Complejo Hospitalario Universitario de Albacete, Albacete, Spain 4Institute of Clinical Neurobiology, Kenyongasse 18; A-1070 Vienna, Austria 5Unidad de Neuropsicofarmacología Translacional, Complejo Hospitalario Universitario de Albacete, Albacete, Spain Abstract: Stroke is a major cause of death and disability throughout the world. Its pathophysiology is complex and includes excitotoxity, inflammatory pathways, oxidative damage, ionic imbalances, apoptosis and other cell death mechanisms, angiogenesis, and neuroprotection. The ultimate result of the complex ischemic cascade is neuronal death with irreversible loss of neuronal functions. New developments in stroke pathophysiology have induced significant advances in acute stroke management. Among the extracellular signals, inflammation, microglia and cytokines as major consequences of hypoxia may be targets for future therapies. Among the intracellular signals, calcium-induced cell death and oxidative stress as most important factors of ischemic cell death and for dysfunctions of the blood-brain barrier
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