Antioxidant Therapy in Ischemic Stroke: Therapeutic Advances

Dear colleagues,

Acute ischemic stroke remains a common and challenging neurological disorder throughout the world.  Research over the last few decades has identified a large number of tissue-injury mechanisms in acute stroke that might be potentially amenable to successful therapeutic intervention.  Among these, reactive oxygen species (ROS), whose generation is favored by ischemia and reperfusion, have been implicated in causing damage to lipid membranes, cellular proteins, and the DNA of the ischemic and post-ischemic brain. These observations, in turn, have led to the exploration of a wide variety of antioxidant strategies with possible therapeutic effects in combating ischemic stroke. These have included the endogenous antioxidant vitamins E and C; dietary antioxidants and natural compounds such as polyphenols (e.g., resveratrol); inhibitors of the xanthine oxidase (e.g., allopurinol) and nitric oxide systems; the endogenous antioxidant, uric acid; and numerous antioxidant pharmaceuticals. Definitive successes of antioxidant therapies in randomized clinical stroke trials, however, have remained sparse and elusive. The present situation is complicated by the fact that thrombolytic strategies and, in particular, mechanical thrombectomy with the latest generations of stent-retrievers have proven remarkably successful in limiting infarct size and restoring neurological function when applied quickly after the onset of ischemic stroke. In contrast, a large number of other putative neuroprotective strategies studied in randomized clinical trials have not. A virtually unexplored research question of particular relevance in the current therapeutic era, therefore, is whether antioxidants or other neuroprotectants might play an adjunctive role in augmenting the therapeutic benefit of clot-removal strategies by reducing reperfusion-related oxidative stress, increasing collateral perfusion, and/or supporting microcirculation.   

The overall goals of this Special Issue are to highlight the most promising and germane basic and clinical work establishing the role(s) of reactive oxygen species in contributing to ischemic brain injury and, in particular, to emphasize promising recent advances in antioxidant-related stroke therapeutics.

Prof. Myron Ginsberg
Guest Editor

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• Antioxidant therapy 
• Ischemic stroke 
• Cerebral ischemia 
• Oxidative stress 
• Reactive oxygen species 
• Neuroprotection 
• Pathophysiology 
• Thrombolysis 
• Reperfusion injury 
• Inflammation 
• Mitochondria 
• Clinical trial