Inflammation and stroke: Putative role for cytokines, adhesion molecules and iNOS in brain response to ischemia

Ischemic stroke is a leading cause of death and disability in developed cou ntries, Yet, in spite of substantial research and development efforts, no s pecific therapy for stroke is available, Several mechnism for neuroprotecti on have been explored including ionchannels, excitatory amino acids and oxy gen raicals yet none has culminated in an effective therapeutic effect, The review article on "inflammation and stroke" summarizes key data in support for the possibility that inflammatory cells and mediators are important co ntributing and confounding factors in ischemic brain injury. In particular, the role of cytokines, endothelial cells and leukocyte adhesion molecules, nitric oxide and cyclooxygenase (COX-2) products are discussed. Furthermor e, the potential role for certain cytokines in modulation of brain vulnerab ility to ischemia is also reviewed,The data suggest that novel therapeutic strategies may evolve from detailed research on some specific inflammatory factors that act in spatial and temporal relationships with traditionally r ecognized neurotoxic factors, The dual nature of some mediators in reformat ting of brain cells for resistance or sensitivity to injury demonstrate the delicate balance needed in interventions based on anti-inflammatory strate gies.