Therapeutic Agents and Targets to Minimize Ischemic Brain Injury

Worldwide, ischaemic stroke affects over 13 million people annually, and is a major cause of death and life-long disability. Furthermore, despite extensive research over many years, there are still no clinically effective therapies capable of reducing the severity of brain injury following thromboembolic ischemic stroke or other forms of cerebral ischaemia. The situation is further exacerbated by the perception of some researchers, clinicians and pharmaceutical companies that pursuing the development of neuroprotective therapies for ischemic stroke will ultimately be met with failure at the clinical level. Whereas it is generally accepted that undertaking research and development into neuroprotective drugs is a high-risk endeavor, the potential rewards in terms of improving patient outcomes are enormous and far outweigh the risks. In addition, the effectiveness of mechanical thrombectomy in ischemic stroke has highlighted the importance of developing an early neuroprotection therapy, which can be administered by ambulance paramedics or medical personnel in remote locations, as a way of preserving salvageable tissue and slowing infarct growth prior to recanalisation therapy.

In terms of strategies for increasing the prospects of success in developing clinically effective neuroprotective therapies there are a number of avenues that could be explored. First and foremost are further experimental and clinical studies to improve our understanding of the pathophysiological processes involved in ischemic brain injury and cerebral reperfusion injury. These may help us identify new therapeutic targets within the ischemic cascade. The second approach is to identify new compounds or improve the efficacy of existing experimental molecules with neuroprotective properties. Furthermore, another consideration in order to enhance the prospect of success in terms of translational clinical effectiveness, is the development of combination therapies or design of compounds with multiple mechanisms of action targeting different neurodamaging and/or neuroprotective pathways.

Ultimately, a better understanding of the pathophysiology of ischemic brain injury and the identification of novel therapeutic targets and compounds will be essential for the development of new and effective forms of neuroprotective therapy. Hence, the aim of this Research Topic is to encourage the publication of new experimental and clinical findings that advance our understanding of pathogenic processes in cerebral ischemia, and that identify novel neuroprotective compounds and strategies for ischemic stroke and other forms of cerebral ischaemia.

Conflicts of Interest Declaration:

BM would like to declare that he has filed patents for the application of arginine-rich peptide as neuroprotective agents for stroke and other neurological disorders. RRR patents licensed by Neuronasal Inc., a company that he also consults for and has equity interest in. All other Topic Editors declare no competing interests with regards to the Research Topic subject.