Promising approaches to ischemic stroke therapy
https://doi.org/10.34680/2076-8052.2024.4(138).573-585
Abstract
The article analyzes data on promising approaches to the treatment of ischemic stroke (IS) presented in peer-reviewed sources indexed in the Pubmed and Russian Science Citation Index databases for the period 2019–2024. It has been demonstrated that the intestinal microbiota enhances neuroprotection through neuronal pathways, suppresses inflammation, and the activity of the hypothalamic-pituitary-adrenal axis. Analysis of the presented data suggests that the intestinal microbiota can serve as a new therapeutic target in the treatment of ischemic stroke. The authors state that melatonin is a promising therapeutic molecule in the treatment of IS. Melatonin is able to inhibit oxidative stress. Melatonin inhibits neuroinflammation in ischemic brain tissue by suppressing the SIRT1 pathway, inhibiting the phenotypic polarization of microglia to M2, and reducing the synthesis of proinflammatory cytokines. The authors noted that melatonin is an active participant in neurogenesis in the ischemic injury zone through activation of MT1 and MT2 receptors, as well as direct activating effect on calmodulin kinase type 2. The analysis reflects the role of stem cells. Stem cells, in particular human neural progenitor cells, are able to restore lost nervous tissue through high neuroregenerative potential, form synaptic connections with intact neurons of the brain. Bone marrow stem cells have a pronounced migration capacity, which allows them to be delivered to the site of ischemic brain damage by intravenous administration; mesenchymal stem cells, in addition to high proliferative potential, modulate neuroinflammation through the synthesis of anti-inflammatory cytokines.
About the Authors
M. V. Osikov
South Ural State Medical University; Chelyabinsk Regional Clinical Hospital
Russian Federation
Russian Federation
Chelyabinsk
A. V. Shelomentsev
South Ural State Medical University; Chelyabinsk Regional Clinical Therapeutic Hospital for War Veterans
Russian Federation
Russian Federation
Chelyabinsk
Yu. S. Shishkova
South Ural State Medical University
Russian Federation
Russian Federation
Chelyabinsk
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Osikov M.V., Shelomentsev A.V., Shishkova Yu.S. Promising approaches to ischemic stroke therapy. Title in english. 2024;(4(138)):573-585. (In Russ.) https://doi.org/10.34680/2076-8052.2024.4(138).573-585
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