No abstract

Cerebral ischemia/reperfusion injury is an important factor leading to poor prognosis in ischemic stroke patients. Therefore, it is particularly important to find effective remedial measures to promote the health of patients to return to society. Isoflurane is a safe and reliable anesthetic gas with a long history of clinical application. In recent years, its protection function to human body has been widely recognized, and nowadays isoflurane for cerebral protection has been widely studied, and the stable effect of isoflurane has satisfied many researchers. Basic studies have shown that isoflurane’s protection of brain tissue after ischemia/reperfusion involves a variety of signaling pathways and effector molecules. Even though many signaling pathways have been described, more and more studies focus on exploring their mechanisms of action, in order to provide strong evidence for clinical application. This could prompt the introduction of isoflurane therapy to clinical patients as soon as possible. In this paper, several confirmed signaling pathways will be reviewed to find possible strategies for clinical treatment.

D-Serine is thought to be involved in N-methyl-D-aspartate (NMDA)-type glutamate receptor-mediated neurotoxicity and plays a pathophysiologic role in stroke. D-Serine is synthesized by serine racemase (SR), which directly converts L-serine into D-serine. The deletion of SR has been reported to protect against cerebral ischemia damage. Additionally, SR catalytic activity is physiologically regulated by its binding to stargazin. However, whether the stargazin-SR interaction affects the level of stroke damage remains elusive. We showed that cerebral ischemia increased the interaction of stargazin and SR and decreased the levels of D-serine. Disrupting the stargazin-SR interaction by knocking down stargazin aggravated cerebral ischemic insults. We found that cerebral ischemia decreased the phosphorylation of stargazin at the Thr-321 residue, which was phosphorylated by cAMP-dependent protein kinase A (PKA). Treatment with the PKA inhibitor H89 blocked stargazin T321 phosphorylation, augmented the stargazin-SR interaction, decreased D-serine levels, and alleviated focal cerebral ischemic damage in rats subjected to middle cerebral artery occlusion and reperfusion (MCAO/R). Thus, the stargazin-SR interaction is a promising strategy in the treatment of stroke.