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Vascular Targets for Ischemic Stroke Treatment

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Translational Stroke Research

Part of the book series: Springer Series in Translational Stroke Research ((SSTSR))

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Abstract

The vast majority of studies on stroke therapy have focused on protecting the neuron from hypoxic/ischemic injury. While undoubtedly important, stroke is a vascular disorder affecting not only neurons, but numerous other cell types in the brain including astrocytes, microglia, and vascular cells (endothelium and smooth muscle). In fact, the only effective treatment for ischemic stroke is a vascular one—dissolution of the clot with tissue plasminogen activator and rapid recanalization of an occluded vessel. The failure of every neuroprotective agent to make it into clinical trials highlights the complexity of ischemic stroke pathophysiology that involves inflammation, oxidative stress, and both macro- and micro-vascular dysregulation that causes brain injury itself and exacerbates the primary insult (i.e., secondary brain injury). The vasculature in the brain has a central role in defining stroke injury since the core infarction is dependent on the depth and duration of ischemia. In addition, any neuroprotective therapy for stroke depends on a patent and functional vasculature, further highlighting the importance of vascular protection as an important therapeutic approach to limiting stroke damage.

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Acknowledgments

We gratefully acknowledge the support of the NIH, NINDS grants RO1 NS043316, RO1 NS 045940, The Neural Environment Cluster Supplement 3RO1 NS045940-06S1, ARRA Supplement 3RO1 NS045940-05S1, and NHLBI grant PO1 HL095488.

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  1. Departments of Neurology, Obstetrics, Gynecology and Reproductive Sciences and Pharmacology, University of Vermont, 89 Beaumont Ave, Given C454, Burlington, VT, 05405, USA

    Sara Morales Palomares PhD & Marilyn J. Cipolla PhD

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  1. Sara Morales Palomares PhD
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  2. Marilyn J. Cipolla PhD
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Correspondence to Marilyn J. Cipolla PhD .

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  1. , Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, 90048, California, USA

    Paul A. Lapchak

  2. Loma Linda University, 11234 Anderson Street, Room 2562B, Loma Linda, 92354, California, USA

    John H. Zhang

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Palomares, S.M., Cipolla, M.J. (2012). Vascular Targets for Ischemic Stroke Treatment. In: Lapchak, P., Zhang, J. (eds) Translational Stroke Research. Springer Series in Translational Stroke Research. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9530-8_1

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