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The underlying mechanism of cerebral injury occurring in patients with acute ischemic stroke involves a key
pathophysiological role of oxidative stress. Thus, reactive oxygen species are related to the development of brain edema,
calcium overload, mitochondrial dysfunction, excitotoxicity, iron release and inflammation. Nevertheless, although experimental studies have tested the use of antioxidants as an adjuvant therapy in this setting, clinical data and randomized trials
are still lacking. Current approved pharmacological therapy is aimed at reperfusion strategies; however, the therapeutic window is limited and also challenged by the injury known to result from the reperfusion. We have recently defined a timecourse occurrence of pathological events triggered by reperfusion-dependent increased reactive oxygen species, thus suggesting the beneficial role of the pertinent use of antioxidants. The present study was aimed to support the hypothesis that an
enhanced antioxidant neuroprotection could be achieved by the use of two or more antioxidants opportunely provided to ischemic stroke patients focused against the specific mechanism occurring throughout the pathophysiological process. From
this paradigm,using an underexplored therapeutic principle, it could be suggested that antioxidant-based therapy is a novel,
promising, safe, available and cost-effective strategy against the deleterious effects of ischemic stroke that needs to be further studied in clinical protocols.
Development of a reactive oxygen species-sensitive nitric oxide synthase inhibitor for the treatment of ischemic stroke
