Advances in Translational Medicine 2010

Abstract

Translation from bench to bedside is a tremendous challenge for stroke researchers. Effective neuroprotection from ischemia in humans is elusive despite a number of encouraging results in the laboratory. However, the lessons obtained so far might pave the way to better research strategies and more fruitful translational results. Rapid reperfusion within ischemic brain is essential to prevent further neuronal cell death. What else can be done to minimize brain damage once blood flow is re-established? Various interventions and drugs can prevent further cell death after reperfusion in animals. However, the challenge remains to be beneficial in humans. Adequate selection of patients is critical and there have been advances in identification of biomarkers, including gene expression signatures1 that may assist to identify stroke subtypes in patients. Several ongoing stroke clinical trials (www.strokecenter.org/) are the results of translation to the clinics of experimental findings. Hypothermia has provided strong preclinical evidence and several clinical trials are ongoing worldwide (Controlled Hypothermia in Large Infarction [CHILI], CHIL, COAST-II, HAIS-SE, and Mild Hypothermia in Acute Ischemic Stroke trial). Clinical trials are also assessing molecules that may decrease hemorrhagic complications and toxicity of recombinant tissue plasminogen activator (Desmoteplase in Acute Ischemic Stroke Trial [DIAS]-3, DIAS-4, TNKilas) and experimental research is ongoing on this subject.2 Other …