Role of Inflammation and Its Mediators in Acute Ischemic Stroke

Abstract

Inflammation plays an important role in the pathogenesis of ischemic stroke and other forms of ischemic brain injury. Increasing evidence suggests that inflammatory response is a double-edged sword, as it not only exacerbates secondary brain injury in the acute stage of stroke but also beneficially contributes to brain recovery after stroke. In this article, we provide an overview on the role of inflammation and its mediators in acute ischemic stroke. We discuss various pro-inflammatory and anti-inflammatory responses in different phases after ischemic stroke and the possible reasons for their failures in clinical trials. Undoubtedly, there is still much to be done in order to translate promising pre-clinical findings into clinical practice. A better understanding of the dynamic balance between pro- and anti-inflammatory responses and identifying the discrepancies between pre-clinical studies and clinical trials may serve as a basis for designing effective therapies.

Microglia and Monocyte-Derived Macrophages in Stroke

“…However, a growing body of evidence indicates the importance of immune-mediated responses for central nervous system (CNS) injury repair and recovery [7], revealing the controversial complexity of inflammatory responses in ischemic stroke. Besides microglia, a host of immune cells, including neutrophils, monocytes/macrophages, natural killer cells, and lymphocytes, infiltrate into the stroked hemisphere.…”

Anti-inflammatory, Antinociceptive Activity of an Essential Oil Recipe Consisting of the Supercritical Fluid CO2 Extract of White Pepper, Long Pepper, Cinnamon, Saffron and Myrrh in vivo

“…Inflammation is a basic reaction to irritation, infection or other injury 11 . It is an essential step in the mechanisms of ischemic stroke and other forms of ischemic brain injury 12,13 .…”

“…Clinical studies suggested that systemic inflammation could influence the susceptibility of patients to stroke and subsequent prognosis 12,13 . Therefore test of the anti-inflammatory and antinociceptive effect of the essential oil recipe named OR consisting of white pepper, long pepper, cinnamon, saffron and myrrh may help us to understand the traditional theory.…”

Ischemic Stroke Mechanisms, Prevention, and Treatment: The Anesthesiologist’s Perspective

“…After an ischemic insult, several key transcriptional factors, such as hypoxia inducible factor 1 (HIF-1), nuclear factor-κB (NF-κB), interferon regulatory factor 1 (IRF1), and STAT3, are up-regulated via calcium-induced signaling pathways, increased oxygen free radicals, and hypoxia (30)(31)(32). These transcriptional factors induce the expression of numerous pro-inflammatory genes, including tumor necrosis factor α (TNFα), interleukin 1α (IL-1α) and 1β (IL-1β), intercellular adhesion molecule 1 (ICAM-1), and selectins (11,30,33). Circulating leukocytes interact with these adhesion molecules to adhere to brain endothelium, transmigrate through the vascular wall, and enter the brain parenchyma.…”