Remyelination is critical for stroke recovery

Abstract

Stroke is a major cause of worldwide death and disability. Numerous events are triggered in the brain after stroke onset, which together lead to irreversible non-selective brain cells death, including neurons, endothelial cells, oligodendrocytes etc. The only sufficient clinical treatment, recombination tissue plasminogen activator (tPA), limits its administration in patients due to its very narrow treatment window and the risk of hemorrhage. Many studies have been carried out to find new therapeutic treatments, which are generally categorized into drugs/chemokine/cytokine treatment, stem cell therapy, gene therapy, stem cell-based gene therapy and other physical therapy. These studies are mainly focused on reduction of inflammatory response, protection of blood-brain barrier (BBB) integrity, and promotion of angiogenesis and neurogenesis. After stroke, white matter is more vulnerable to deprivation of glucose and oxygen. A very vital component of whiter matter is oligodendrocytes, which ensheath the axons to form myelin and ensure proper pulse signal transduction. However, the studies on how to protect the integrity of white matter myelin, and promote the remyelination after stroke are much fewer than those for angiogenesis and neurogenesis. Angiogenesis, neurogenesis, and remyelination are indispensable for neurobehavioral function recovery after stroke. The therapeutic treatments for remyelination should be treated as important as those for angiogenesis and neurogenesis during stroke recovery phase.