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Recent Advances in Stroke Therapeutics (Hardcover)
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Recent Advances in Stroke Therapeutics (Hardcover)
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Strokes are a leading cause of brain injury that strike
approximately 800,000 people per year in the US alone, killing
about 150,000 meaning one death in every four minutes. According to
World Health Organization, 15 million people suffer strokes
world-wide each year and out of these, 5 million die and another 5
million are permanently disabled. Despite advances in stroke
research during last decade, current strokes remain a vexing public
health problem. Even with the onset of the 21st century, there is
still no effective therapy for strokes beyond a limited group of
patients who are treated with thrombolytics, which have significant
adverse effects. This situation prevails despite intense research
efforts and numerous clinical trials that have attempted to develop
drugs to reduce morbidity and mortality from strokes. So far, drug
development efforts have targeted modulators of ion channels
(Ca2+and Na+), scavengers of oxygen radicals, and antagonists of
excitotoxic neurotransmitters (primarily glutamate and glycine
receptors). Despite tremendous progress in understanding the
pathophysiology of a stroke, translation of this knowledge into
effective therapies has largely failed, with the exception of
thrombolysis, which only benefits a small proportion of patients.
Systemic and local immune responses have important roles in causing
stroke and are implicated in the primary and secondary progression
of ischaemic lesions, as well as in repair, recovery, and overall
outcome after a stroke. However, potential therapeutic targets in
the immune system and inflammatory responses have not been well
characterised. The development of novel and effective therapeutic
strategies for strokes will require further investigation of these
pathways in terms of their temporal profile (before, during, and
after stroke) and risk-to-benefit therapeutic ratio of modulating
them.
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