The immune system and stroke: from current targets to future therapy

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Date
2018-07-19
Authors
Malone, Kyle
Amu, Sylvie
Moore, Anne C.
Waeber, Christian
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John Wiley & Sons, Inc.
Published Version
10.1111/imcb.12191
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Abstract
Stroke is a major cause of morbidity and mortality worldwide. Despite the intensive search for new therapies, hundreds of agents targeting various pathophysiological mechanisms have failed clinical trials, and the thrombolytic agent tissue plasminogen activator is currently the only FDA-approved medication for the treatment of acute ischaemic stroke (AIS). The immune system is involved in all stages of stroke, from the pathogenesis of risk factors to neurotoxicity, to tissue remodelling and repair. There is a bi-directional interaction between the brain and the immune system, with stroke-induced immunosuppression and subsequent infection a principal source of patient mortality. Newer work also points to a role for the gut microbiota in the immune response to stroke, while clinical sequelae such as dementia might now also be explained in immune terms. However, the exact roles of innate and adaptive components have not been fully elucidated, with studies reporting both detrimental and beneficial functions. Time is a key determinant in defining whether immunity and inflammation are neuroprotective or neurotoxic. The local inflammatory milieu also has a clear influence on many proposed treatments. This review examines the individual components of the immune response to stroke, highlighting the most promising future stroke immunotherapies.
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Keywords
Stroke , Ischaemia , Immunity , Neuroinflammation
Citation
Malone, K., Amu, S., Moore, A. C. and Waeber, C. (2018) 'The immune system and stroke: from current targets to future therapy', Immunology and Cell Biology. doi:10.1111/imcb.12191
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https://hdl.handle.net/10468/6507
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Pharmacology and Therapeutics - Journal Articles
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© 2018, John Wiley & Sons Inc. This is the peer reviewed version of the following article: Malone, K., Amu, S., Moore, A. C. and Waeber, C. (2018) 'The immune system and stroke: from current targets to future therapy', Immunology and Cell Biology. doi:10.1111/imcb.12191, which has been published in final form at https://doi.org/10.1111/imcb.12191. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.