Neuroprotective strategies for acute ischemic stroke: recent progress and future perspectives

Stroke is one of the leading causes of death and most common cause of disability in adult. Despite of recent advances in the recanalization therapy for acute ischemic stroke, the need for neuroprotectants is substantial, to extend the window for recanalization therapy and to prevent neuronal death by ischemic brain injury or by reperfusion injury after successful therapy. Herein, the possible reasons for the failure of neuroprotectants trials during the past two decades and current status of neuroprotective strategies for acute ischemic stroke are discussed. This review will also address the recent advances and future perspectives in preclinical and clinical trials of neuroprotective agents, including the efforts of high quality of transition of preclinical results to clinical trial, genetic studies to trigger neuroprotectants development, application of neuroprotectants at optimal time and duration after stroke, adjuvant approaches, and biomarker-based triage