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Perspective

Neuroprotection: where to now?

    Geoffrey A Donnan

    † Author for correspondence

    National Stroke Research Institute, 300 Waterdale Road, Heidelberg Heights, Victoria, Australia and, University of Melbourne, Department of Medicine, Austin Health, Victoria, Australia.

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    Email the corresponding author at gdonnan@unimelb.edu.au

    &
    David W Howells

    University of Melbourne, Department of Medicine, Austin Health, Studley Rd, Heidelberg Heights, Victoria, Australia.

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    Email the corresponding author at dwh@davidhowells.net

    Published Online:23 Aug 2007https://doi.org/10.2217/14796708.2.5.513

    Abstract

    Neuroprotection is an attractive potential therapy for acute ischemic stroke and is based on the concept of the ischemic cascade. However, therapeutic use of neuroprotectants in human stroke has proved more difficult than initially realized. The turning point was the finding that an apparently ideal neuroprotectant, NXY-059, was not neuroprotective in human stroke following a number of well-conducted clinical trials. In spite of these difficulties, research in neuroprotection should continue but in a greatly modified form. A number of important issues need to be addressed, ranging from the quality of experimental studies through to the demonstration of compounds reaching the target ischemic penumbra. An incremental approach to neuroprotection research is outlined, including the demonstration of efficacy in human cell cultures and tissues.

    Papers of special note have been highlighted as either of interest (•) or of considerable interest (••) to readers.

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