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Immune interventions in stroke.

TitleImmune interventions in stroke.
Publication TypeJournal Article
Year of Publication2015
AuthorsFu Y, Liu Q, Anrather J, Shi F-D
JournalNat Rev Neurol
Volume11
Issue9
Pagination524-35
Date Published2015 Sep
ISSN1759-4766
KeywordsAnimals, Brain, Brain Ischemia, Cerebral Hemorrhage, Clinical Trials as Topic, Humans, Immunotherapy, Multiple Sclerosis, Stroke
Abstract

Approaches for the effective management of acute stroke are sparse, and many measures for brain protection fail. However, our ability to modulate the immune system and modify the progression of multiple sclerosis is increasing. As a result, immune interventions are currently being explored as therapeutic interventions in acute stroke. In this Review, we compare the immunological features of acute stroke with those of multiple sclerosis, identify unique immunological features of stroke, and consider the evidence for immune interventions. In patients with acute stroke, microglial activation and cell death products trigger an inflammatory cascade that damages vessels and the parenchyma within minutes to hours of the ischaemia or haemorrhage. Immune interventions that restrict brain inflammation, vascular permeability and tissue oedema must be administered rapidly to reduce acute immune-mediated destruction and to avoid subsequent immunosuppression. Preliminary results suggest that the use of drugs that modify disease in multiple sclerosis might accomplish these goals in ischaemic and haemorrhagic stroke. Further elucidation of the immune mechanisms involved in stroke is likely to lead to successful immune interventions.

DOI10.1038/nrneurol.2015.144
Alternate JournalNat Rev Neurol
PubMed ID26303850
PubMed Central IDPMC4851339
Grant ListR01NS081179 / NS / NINDS NIH HHS / United States
R01 NS081179 / NS / NINDS NIH HHS / United States
R01 AI083294 / AI / NIAID NIH HHS / United States
R01NS34179 / NS / NINDS NIH HHS / United States
R01AI083294 / AI / NIAID NIH HHS / United States