Targeting the Immune System for Ischemic Stroke.

Elsevier Ltd United Kingdom 2021-02-05

Stroke is responsible for almost 6 million deaths and more than 10% of all mortalities each year, and two-thirds of stroke survivors remain disabled. With treatments for ischemic stroke still limited to clot lysis and/or mechanical removal, new therapeutic targets are desperately needed. In this review, we provide an overview of the complex mechanisms of innate and adaptive immune cell-mediated inflammatory injury, that exacerbates infarct development for several days after stroke. We also highlight the features of poststroke systemic immunodepression that commonly leads to infections and some mortalities, and argue that safe and effective therapies will need to balance pro- and anti-inflammatory mechanisms in a time-sensitive manner, to maximize the likelihood of an improved long-term outcome.Copyright © 2020 Elsevier Ltd

disease association; disease severity; down regulation; encephalitis/co [Complication]; encephalitis/dt [Drug Therapy]; encephalitis/pc [Prevention]; endothelium cell; functional status; hormone release; human; immune deficiency; immunoreactivity; immunosuppressive treatment; innate immunity; intracellular signaling; lymphocytopenia/co [Complication]; mechanical thrombectomy; microglia; neuroimaging; neuroprotection; neutrophil lymphocyte ratio; nonhuman; priority journal; protein expression; regulatory T lymphocyte; review; Th1 cell; Th17 cell; Th2 cell; upregulation; 1 (2 bromophenyl) 3 (2 hydroxy 4 nitrophenyl)urea/dt [Drug Therapy]; alteplase/dt [Drug Therapy]; apocynin/dt [Drug Therapy]; beta 2 adrenergic receptor/ec [Endogenous Compound]; CD14 antigen/ec [Endogenous Compound]; CD16 antigen/ec [Endogenous Compound]; chemokine receptor CCR2/ec [Endogenous Compound]; colony stimulating factor 1/ec [Endogenous Compound]; colony stimulating factor receptor/ec [Endogenous Compound]; corticotropin/ec [Endogenous Compound]; corticotropin releasing factor/ec [Endogenous Compound]; CXCL1 chemokine/ec [Endogenous Compound]; CXCL2 chemokine/ec [Endogenous Compound]; disufenton sodium/dt [Drug Therapy]; endothelial leukocyte adhesion molecule 1/ec [Endogenous Compound]; gamma interferon/ec [Endogenous Compound]; heat shock protein/ec [Endogenous Compound]; high mobility group B1 protein/ec [Endogenous Compound]; immunoglobulin enhancer binding protein/ec [Endogenous Compound]; intercellular adhesion molecule 1/ec [Endogenous Compound]; interleukin 1 receptor like 1 protein/ec [Endogenous Compound]; interleukin 10/ec [Endogenous Compound]; interleukin 17/ec [Endogenous Compound]; interleukin 18/ec [Endogenous Compound]; interleukin 1beta/ec [Endogenous Compound]; interleukin 33/ec [Endogenous Compound]; interleukin 37/ec [Endogenous Compound]; interleukin 4/ec [Endogenous Compound]; interleukin 6/ec [Endogenous Compound]; matrix metalloproteinase/ec [Endogenous Compound]; mifepristone/dt [Drug Therapy]; monocyte chemotactic protein 1/ec [Endogenous Compound]; PADGEM protein/ec [Endogenous Compound]; pattern recognition receptor/ec [Endogenous Compound]; propranolol/dt [Drug Therapy]; protein kinase C delta/ec [Endogenous Compound]; reactive oxygen metabolite/ec [Endogenous Compound]; tenecteplase/dt [Drug Therapy]; toll like receptor/ec [Endogenous Compound]; toll like receptor 1/ec [Endogenous Compound]; tumor necrosis factor/ec [Endogenous Compound]; unclassified drug; uridine triphosphate/ec [Endogenous Compound]; vascular cell adhesion molecule 1/ec [Endogenous Compound]; stent retriever; colony stimulating factor 1 receptor/ec [Endogenous Compound]; toll like receptor 13/ec [Endogenous Compound]; immunocompetent cell; adaptive immunity; antigen expression; apoptosis; blood brain barrier; brain blood flow; brain infarction size; brain ischemia/dt [Drug Therapy]; brain ischemia/su [Surgery]; catecholamine release; cell activation; cell infiltration; cell interaction; cellular immunity; complement activation; cytokine release; Review

Open access content. Open access content
Copyright 2021 Elsevier B.V., All rights reserved.

AUSHL oai:repository.monashhealth.org:1/27422
Trends in Pharmacological Sciences. 42 (2) (pp 96-105), 2021. Date of Publication: February 2021.
0165-6147
https://repository.monashhealth.org/monashhealthjspui/handle/1/27422
Monash Health
33341247 [http://www.ncbi.nlm.nih.gov/pubmed/?term=33341247]
2010392514
(Zhang, Sobey) Department of Physiology, Anatomy, and Microbiology, and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, Victoria, Australia (Phan) Clinical Trials, Imaging, and Informatics (CTI) Division, Stroke and Ageing Research (STARC), Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
Sobey C.G.; c.sobey@latrobe.edu.au
(Zhang, Sobey) Department of Physiology, Anatomy, and Microbiology, and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, Victoria, Australia
(Phan) Clinical Trials, Imaging, and Informatics (CTI) Division, Stroke and Ageing Research (STARC), Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
1305127633

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