Current status and perspectives on the development of neuroprotectants for ischemic cerebrovascular disease.
The concept of neuroprotection is based on the understanding that delayed neuronal damage occurs after ischemia. Each step along the ischemic cascade provides an opportunity for therapeutic intervention. Based on the excellent results obtained in experimental models of ischemia, many clinical trials have been conducted with different neuroprotective drugs. The results obtained in most studies were negative and in some cases the studies were terminated due to safety problems. However, the mechanisms that underlie the development of ischemic damage are still being discovered, creating new therapeutic possibilities for neuroprotection that might be clinically applicable in the future. This article reviews the mechanisms of ischemic neuronal injury, the mechanism of action of neuroprotective agents, current neuroprotective clinical trials, and probable reasons for the failure of clinical neuroprotection. (c) 2003 Prous Science. All rights reserved.
Hong
Hao
H
Department of Pharmacology, China Pharmaceutical University, Nanjing, China. haohongchina@hotmail.com
Liu
Guo-Qing
GQ
D000328:Adult; D017209:Apoptosis / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D020521:Stroke / Q000188:drug therapy / Q000378:metabolism / Q000517:prevention & control
D002121:Calcium Channel Blockers; D018696:Neuroprotective Agents; D016194:Receptors, N-Methyl-D-Aspartate