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Table of Contents
Vol. 24, Suppl. 1, 2007
Issue release date: November 2007
Cerebrovasc Dis 2007;24:153–156
(DOI:10.1159/000107391)

Neuroprotection in Cerebral Infarction: The Opportunity of New Studies

Pérez de la Ossa N. · Dávalos A.
Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain

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Abstract

Therapeutic options in the acute phase of a stroke are limited despite a great number of neuroprotectant drugs that have been developed in the last few decades. Although neuroprotection has been proved in animal models, translation of experimental efficacy into clinical benefit in humans is a difficult task. With the aim of bringing closer laboratory and clinical results, a change and unification of the methodology used is needed. Evaluating neuroprotectant capacity to salvage the penumbra using MRI both in animals and humans as a surrogate outcome can help to select drugs more likely to demonstrate clinical benefit. In addition, neuroprotection should enlarge the window of opportunity for reperfusion therapies and protect vascular structures to reduce reperfusion injury and the clinical complications related to thrombolytic treatment. A better understanding of ischemic and restorative brain mechanisms beyond the acute phase of stroke may open new therapeutic options to improve stroke recovery.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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References

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  3. Stroke Therapy Academia Industry Roundtable II (STAIR II): Recommendations for standards regarding preclinical neuroprotective and restorative drug development. Stroke 2001;32:1598–1606.

    External Resources

  4. Lees KR, Zivin JA, Ashwood T, Davalos A, Davis SM, Diener HC, Grotta J, Lyden P, Shuaib A, Hardemark HG, Wasieski WW: NXY-059 for acute ischemic stroke. N Engl J Med 2006;354:588–600.
  5. Shuaib A, Lees KR, Lyden P, Grotta J, Davalos A, Davis SM, Diener HC, Ashwood T, Wasiewski W, Ugochi E: NXY-059 for acute ischemic stroke: results of the SAINT II trial. N Engl J Med 2007;357:562–571.
  6. Savitz SI, Fisher M: Future of neuroprotection for acute stroke: in the aftermath of the SAINT trials. Ann Neurol 2007;61:396–402.
  7. Castillo J, Dávalos A, Naveiro J, Noya M: Excitatory amino acids in relation to infarct size and neurological deficit in ischemic stroke. Stroke 1996;7:1060–1065.
  8. Castellanos M, Sobrino T, Millán M, García M, Arenillas J, Nombela F, Brea D, Perez de la Ossa N, Serena J, Vivancos J, Castillo J, Dávalos A: Serum cellular fibronectin and matrix metalloproteinase-9 as screening biomarkers for the prediction of parenchymal hematoma after thrombolytic therapy in acute ischemic stroke: a multicenter confirmatory study. Stroke 2007;38:1855–1859.
  9. Mallolas J, Hurtado O, Castellanos M, Blanco M, Sobrino T, Serena J, Vivancos J, Castillo J, Lizasoain I, Moro MA, Dávalos A: A polymorphism in the EAAT2 promoter is associated with higher glutamate concentrations and higher frequency of progressing stroke. J Exp Med 2006;203:711–717.
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  13. Hurtado O, Moro MA, Cárdenas A, Sánchez V, Fernández-Tomé P, Leca JC, Lorenzo P, Secades JJ, Lozano R, Dávalos A, Castillo J, Lizasoain I: Neuroprotection afforded by prior citicoline administration in experimental brain ischemia: effects on glutamate transport. Neurobiol Dis 2005;18:336–345.
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  16. www.thelancet.com/journals/lancet/misc/protocol/06PRT-3005.


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