Inhalation Gases or Gaseous Mediators As Neuroprotectants for Cerebral Ischaemia
2012
Ischaemic stroke is one of the leading causes of morbidity and mortality worldwide. While recombinant tissue
plasminogen activator can be administered to produce thrombolysis and restore blood flow to the ischaemic brain, therapeutic
benefit is only achieved in a fraction of the subset of patients eligible for fibrinolytic intervention. Neuroprotective
therapies attempting to restrict the extent of brain injury following cerebral ischaemia have not been successfully translated
into the clinic despite overwhelming pre-clinical evidence of neuroprotection. Therefore, an adequate treatment for
the majority of acute ischaemic stroke patients remains elusive. In the stroke literature, the use of therapeutic gases has received
relatively little attention. Gases such as hyperbaric and normobaric oxygen, xenon, hydrogen, helium and argon all
possess biological effects that have shown to be neuroprotective in pre-clinical models of ischaemic stroke. There are
significant advantages to using gases including their relative abundance, low cost and feasibility for administration, all of
which make them ideal candidates for a translational therapy for stroke. In addition, modulating cellular gaseous mediators
including nitric oxide, carbon monoxide, and hydrogen sulphide may be an attractive option for ischaemic stroke
therapy. Inhalation of these gaseous mediators can also produce neuroprotection, but this strategy remains to be confirmed
as a viable therapy for ischaemic stroke. This review highlights the neuroprotective potential of therapeutic gas therapy
and modulation of gaseous mediators for ischaemic stroke. The therapeutic advantages of gaseous therapy offer new
promising directions in breaking the translational barrier for ischaemic stroke.
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