Stroke is the second leading cause of death and the leading cause of adult disability worldwide. Although different mechanisms are involved in the pathogenesis of stroke, increasing evidence shows that ischemic injury and inflammation account for its pathogenic progression (1, 2). Ischemic brain injury after stroke is a dynamic process that evolves over a period of hours to several days, particularly in the area surrounding the core of the infarct known as the penumbra (3). This process includes oxidative stress, cell death, and inflammation, as well as the activation of endogenous adaptive and regenerative mechanisms. The regulation of many of these processes occurs at the transcriptional level and involves the concerted activation of various transcription factors, including hypoxia-inducible factor 1␣ (HIF-1␣) 2 (4). Ischemic brain injury is a consequence of a severe reduction in the blood supply to the affected region. The deficits can often be permanent because adult neurons fail to regenerate. After they have been activated by injury, astrocytes and microglia release factors that recruit other astrocytes and microglia to the injury site. This process can lead to glial scar formation, which has the potential to block the growth and maturation of neural progenitors and to impede neovascularization, thus inhibiting recovery after injury (5).Cytokines are up-regulated in the brain in a variety of diseases, including stroke, and are expressed not only in the cells of the immune system, but are also produced by resident brain cells, including glia cells and neurons (6 -8). Chemokine expression precedes inflammatory cell infiltration following cerebral ischemia (9). IL-1 (10, 11), TNF-␣ (12, 13), , and MCP-1 (15) appear to exacerbate cerebral injury; however, TGF- (16) and IL-10 (17) may be neuroprotective.The pleiotropic inflammatory cytokine IL-20, a member of IL-10 family which includes IL-10, IL-19, IL-20, IL-22, 19), is expressed in monocytes, epithelial cells, and endothelial cells and exerts its biological functions on multiple cell types by activating IL-20R1/IL-20R2 or IL-22R1/ . IL-20 is involved in various inflammatory diseases (21), such as psoriasis (18,22,23), rheumatoid arthritis (24), atherosclerosis (25,26), and renal failure (27). Recently, IL-20 has been reported to regulate angiogenesis (28,29). It is also an arteriogenic cytokine based on its actions in remodeling collateral networks and improving the functions of ischemic hind limbs (30).Our previous study showed that hypoxia induced IL-20 in endothelial cells (26). Little is known about the molecular mechanism of gene regulation of IL-20 in hypoxia and its clinical implications. In the present study, we found up-regulation of IL-20 under hypoxic conditions in vitro and in the ischemic brain in vivo. We identified IL-20 promoter regions and the functional response elements of the il20 gene in response to hypoxia. We also demonstrated a pathogenic role of IL-20 in ischemic brain injury in vivo using an animal model of transient middle cerebr...