scholarly journals Neurogenesis and Inflammation after Ischemic Stroke: What is Known and Where We Go from Here

2014 ◽  
Vol 34 (10) ◽  
pp. 1573-1584 ◽  
Author(s):  
Matthew K Tobin ◽  
Jacqueline A Bonds ◽  
Richard D Minshall ◽  
Dale A Pelligrino ◽  
Fernando D Testai ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Strategies ◽  
Disease Process ◽  
Brain Repair ◽  
Future Directions ◽  
Close Relationship ◽  
Repair Mechanisms ◽  
New Treatment ◽  
Infarcted Tissue

This review covers the pathogenesis of ischemic stroke and future directions regarding therapeutic options after injury. Ischemic stroke is a devastating disease process affecting millions of people worldwide every year. The mechanisms underlying the pathophysiology of stroke are not fully understood but there is increasing evidence demonstrating the contribution of inflammation to the drastic changes after cerebral ischemia. This inflammation not only immediately affects the infarcted tissue but also causes long-term damage in the ischemic penumbra. Furthermore, the interaction between inflammation and subsequent neurogenesis is not well understood but the close relationship between these two processes has garnered significant interest in the last decade or so. Current approved therapy for stroke involving pharmacological thrombolysis is limited in its efficacy and new treatment strategies need to be investigated. Research aimed at new therapies is largely about transplantation of neural stem cells and using endogenous progenitor cells to promote brain repair. By understanding the interaction between inflammation and neurogenesis, new potential therapies could be developed to further establish brain repair mechanisms.

scholarly journals COVID-19/SARS-CoV-2 Infection: Lysosomes and Lysosomotropism Implicate New Treatment Strategies and Personal Risks

2020 ◽  
Vol 21 (14) ◽  
pp. 4953 ◽  
Author(s):  
Markus Blaess ◽  
Lars Kaiser ◽  
Martin Sauer ◽  
René Csuk ◽  
Hans-Peter Deigner
Keyword(s):  
Viral Entry ◽  
Cathepsin L ◽  
Treatment Strategies ◽  
Disease Process ◽  
Host Cells ◽  
Cytokine Release ◽  
Early Administration ◽  
Lysosomal Ph ◽  
New Treatment ◽  
Exposure Prophylaxis

In line with SARS and MERS, the SARS-CoV-2/COVID-19 pandemic is one of the largest challenges in medicine and health care worldwide. SARS-CoV-2 infection/COVID-19 provides numerous therapeutic targets, each of them promising, but not leading to the success of therapy to date. Neither an antiviral nor an immunomodulatory therapy in patients with SARS-CoV-2 infection/COVID-19 or pre-exposure prophylaxis against SARS-CoV-2 has proved to be effective. In this review, we try to close the gap and point out the likely relationships among lysosomotropism, increasing lysosomal pH, SARS-CoV-2 infection, and disease process, and we deduce an approach for the treatment and prophylaxis of COVID-19, and cytokine release syndrome (CRS)/cytokine storm triggered by bacteria or viruses. Lysosomotropic compounds affect prominent inflammatory messengers (e.g., IL-1B, CCL4, CCL20, and IL-6), cathepsin-L-dependent viral entry of host cells, and products of lysosomal enzymes that promote endothelial stress response in systemic inflammation. As supported by recent clinical data, patients who have already taken lysosomotropic drugs for other pre-existing conditions likely benefit from this treatment in the COVID-19 pandemic. The early administration of a combination of antivirals such as remdesivir and lysosomotropic drugs, such as the antibiotics teicoplanin or dalbavancin, seems to be able to prevent SARS-CoV-2 infection and transition to COVID-19.

Evolving Concepts for Use of Stem Cells and Tissue Engineering for Cardiac Regeneration

2016 ◽  
pp. 279-313
Author(s):  
Jahnavi Sarvepalli ◽  
Rajalakshmi Santhakumar ◽  
Rama Shanker Verma
Keyword(s):  
Tissue Engineering ◽  
Stem Cell ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Basic Research ◽  
Underlying Mechanism ◽  
Repair Mechanisms ◽  
New Treatment

The incidence of cardiovascular disease (CVD) in adults are increasing worldwide with impaired repair mechanisms, leading to tissue and organ failure. With the current advancements, life expectancy has improved and has led to search for new treatment strategies that improves tissue regeneration. Recently, stem cell therapy and tissue engineering has captured the attention of clinicians, scientists, and patients as alternative treatment options. The overall clinical experience of these suggests that they can be safely used in the right clinical setting. Ultimately, large outcome trials will have to be conducted to assess their efficacy. Clinical trials have to be carefully designed and patient safety must remain the key concern. At the same time, continued basic research is required to understand the underlying mechanism of cell-based therapies and cell tissue interactions. This chapter reviews the evolving paradigm of stem cell therapy and tissue engineering approaches for clinical application and explores its implications.

Molecular Pathways of Ischemic Stroke and Advanced Therapeutic Strategies

2018 ◽  
Vol 4 (1-2) ◽  
Author(s):  
Preeti Singh
Keyword(s):  
Ischemic Stroke ◽  
New Technologies ◽  
Treatment Strategies ◽  
Molecular Pathways ◽  
Therapeutic Approaches ◽  
Permanent Disability ◽  
Acute Cerebral Ischemia ◽  
Tremendous Progress ◽  
New Treatment

Ischemic stroke is a leading cause of death and permanent disability. This disease may affect any age group and especially in old age and pregnancy. All the responsible mechanisms are yet not completely understood. There is limited therapeutic intervention beyond prevention, yet tremendous progress in understanding cause of stroke at molecular level has been going on. A lot of advancement has occurred in the prevention and treatment of stroke during the past decade. In this review an update work of causeways of stroke and its therapeutic approaches have been discussed. The relevance of excitotoxicity (role of glutamate receptor), inflammation, ischemic penumbra, apoptosis, to delayed mechanisms and, damage and treatment strategies have been hasted out. Although the results among clinical studies, conflict regarding several experimental data of different therapies, and it may improve neurological outcome after acute cerebral ischemia. Along this several other interventions and new technologies such as stroke detector microwave helmet are being assessed and many other advanced techniques developed by researchers. Even the development of other novel and new treatment strategies (regarding molecular pathways and risk to benefit therapeutic ratio) for stroke are still required in future for better treatment.

scholarly journals Permanent Bilateral Carotid Filters for Stroke Prevention in Atrial Fibrillation

2020 ◽  
Vol 22 (11) ◽  
Author(s):  
Tom De Potter ◽  
Ofer Yodfat ◽  
Guy Shinar ◽  
Avraham Neta ◽  
Vivek Y. Reddy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
High Risk ◽  
Stroke Prevention ◽  
Control Group ◽  
Future Directions ◽  
Mechanical Filter ◽  
Bilateral Carotid ◽  
The Common

Abstract Purpose of Review A novel permanent carotid filter device for percutaneous implantation was developed for the purpose of stroke prevention. In this review, we cover rationale, existing preclinical and clinical data, and potential future directions for research using such a device. Recent Findings The Vine™ filter was assessed for safety in sheep and in 2 observational human studies, the completed CAPTURE 1 (n = 25) and the ongoing CAPTURE 2 (planned n = 100). CAPTURE 1 has shown high procedural and long-term implant safety. A control group was not available for comparison. Summary A mechanical filter for permanent stroke prevention can be implanted bilaterally in the common carotid artery safely and efficiently. A randomized trial is planned for 2021 (n = 3500, INTERCEPT) to demonstrate superiority of a filter + anticoagulation strategy over anticoagulation alone in patients at high risk for ischemic stroke.

Current status of chemotherapy for advanced pancreatic and gastric cancer.

1985 ◽  
Vol 3 (7) ◽  
pp. 1032-1039 ◽  
Author(s):  
M J O'Connell
Keyword(s):  
Gastric Cancer ◽  
Survival Benefit ◽  
Advanced Pancreatic Cancer ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Current Status ◽  
Term Survival ◽  
Clinical Investigator ◽  
New Treatment

There is currently no effective systemic therapy for advanced pancreatic cancer. No definitive controlled data exist that demonstrate a survival benefit for any particular regimen yet developed. A statistically significant short-term survival benefit has been seen in three consecutive GITSG trials using the FAMe regimen in patients with advanced gastric cancer. Occasional long-term responders have been seen with a variety of regimens, but there is no evidence of improved long-term (more than two years) disease-free survival with any regimen reported to date. Continuing research with emphasis on new drug development, innovative alterations in chemotherapy combinations and administration schedules, or entirely new treatment strategies, are clearly required to allow the clinical investigator and the clinical practitioner to achieve their common goal--improved long-term survival for patients with advanced pancreatic and gastric cancer.

Decellularization Strategies to Engineer Fibrocartilage Bioscaffolds: A Review

2021 ◽  
Vol 11 (8) ◽  
pp. 1435-1451
Author(s):  
F. Yusof ◽  
M. Sha’ban ◽  
A. Azhim
Keyword(s):  
Treatment Strategies ◽  
Meniscal Repair ◽  
Long Term Results ◽  
Biological Scaffolds ◽  
Advantages And Disadvantages ◽  
Pros And Cons ◽  
Short And Long Term ◽  
New Treatment ◽  
Cellular Components

Fibrocartilage or known as meniscus tissues located in between the tibia and femur always subjected to extreme forces that can lead to injury especially for the sportsperson. The meniscal injury mean incidence in the general population is 66 per 100,000. The principal methods for the surgical management of fibrocartilage injury have been improvised from meniscectomy to meniscal repair and meniscal reconstruction that portrays different advantages and disadvantages in the short and long-term results. The inability to treat meniscus injury without osteoarthritis development in long-term results also motivates to find new treatment strategies. In this current era, the development of the multidisciplinary fields of tissue engineering and regenerative medicine provides new alternatives for the treatment approaches. This field involves the regeneration of the required tissue using scaffolds such as synthetic, natural, and biological scaffolds to restore the damaged one. Biological scaffolds are preferable because it tremendously mimics the native anatomical structure and has similar ratios and concentration of the proteins and growth factors that influence tissue repair and remodeling. The development of biological scaffolds with low immunogenic levels involves the decellularization process that eliminates all the cellular components while preserved the extracellular matrix (ECM) integrity and mechanics. In this review, the pros and cons of the recent decellularization strategies to engineer fibrocartilage scaffolds have been discussed. We believed that the ideal decellularization methods still need to be explored to develop suitable biological scaffolds that structurally and functionally mimic native tissue as a replacement for new tissue regeneration.

scholarly journals Hyper-acute EEG alterations predict functional and morphological outcomes in thrombolysis-treated ischemic stroke: a wireless EEG study

2020 ◽  
Author(s):  
Miloš Ajčević ◽  
Giovanni Furlanis ◽  
Marcello Naccarato ◽  
Aleksandar Miladinović ◽  
Alex Buoite Stella ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Infarct Volume ◽  
Treatment Strategies ◽  
Alpha Power ◽  
Prognostic Information ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Pre Treatment ◽  
Wireless Eeg

AbstractOwing to the large inter-subject variability, early post-stroke prognosis is challenging, and objective biomarkers that can provide further prognostic information are still needed. The relation between quantitative EEG parameters in pre-thrombolysis hyper-acute phase and outcomes has still to be investigated. Hence, possible correlations between early EEG biomarkers, measured on bedside wireless EEG, and short-term/long-term functional and morphological outcomes were investigated in thrombolysis-treated strokes. EEG with a wireless device was performed in 20 patients with hyper-acute (< 4.5 h from onset) anterior ischemic stroke before reperfusion treatment. The correlations between outcome parameters (i.e., 7-day/12-month National Institutes of Health Stroke Scale NIHSS, 12-month modified Rankin Scale mRS, final infarct volume) and the pre-treatment EEG parameters were studied. Relative delta power and alpha power, delta/alpha (DAR), and (delta+theta)/(alpha+beta) (DTABR) ratios significantly correlated with NIHSS 7-day (rho = 0.80, − 0.81, 0.76, 0.75, respectively) and NIHSS 12-month (0.73, − 0.78, 0.74, 0.73, respectively), as well as with final infarct volume (0.75, − 0.70, 0.78, 0.62, respectively). A good outcome in terms of mRS ≤ 2 at 12 months was associated with DAR parameter (p = 0.008). The neurophysiological biomarkers obtained by non-invasive and portable technique as wireless EEG in the early pre-treatment phase may contribute as objective parameters to the short/long-term outcome prediction pivotal to better establish the treatment strategies.Graphical abstract

scholarly journals Phase I and Phase II Therapies for Acute Ischemic Stroke: An Update on Currently Studied Drugs in Clinical Research

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Cesar Reis ◽  
Onat Akyol ◽  
Wing Mann Ho ◽  
Camila Araujo ◽  
Lei Huang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Molecular Mechanisms ◽  
Injury Severity ◽  
Treatment Strategies ◽  
Tissue Perfusion ◽  
Pathological Process ◽  
Acute Ischemia ◽  
Stroke Therapy ◽  
New Treatment

Acute ischemic stroke is a devastating cause of death and disability, consequences of which depend on the time from ischemia onset to treatment, the affected brain region, and its size. The main targets of ischemic stroke therapy aim to restore tissue perfusion in the ischemic penumbra in order to decrease the total infarct area by maintaining blood flow. Advances in research of pathological process and pathways during acute ischemia have resulted in improvement of new treatment strategies apart from restoring perfusion. Additionally, limiting the injury severity by manipulating the molecular mechanisms during ischemia has become a promising approach, especially in animal research. The purpose of this article is to review completed and ongoing phases I and II trials for the treatment of acute ischemic stroke, reviewing studies on antithrombotic, thrombolytic, neuroprotective, and antineuroinflammatory drugs that may translate into more effective treatments.

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