42716837f8f4345e09540a39482ad128 pmc_10531661.pdf f85847882378e49979c0b7736e9cc7bda80ff000 pmc_10531661.pdf f10130af52496de90bcb62b2d0680eabf8cde44e8f8623ee6bbed64c68cb5063 pmc_10531661.pdf Title: Novel Therapeutic Approaches to Prevent Atherothrombotic Ischemic Stroke in Patients with Carotid Atherosclerosis Subject: Atherothrombotic stroke represents approximately 20% of all ischemic strokes. It is caused by large-artery atherosclerosis, mostly in the internal carotid artery, and it is associated with a high risk of early recurrence. After an ischemic stroke, tissue plasminogen activator is used in clinical practice, although it is not possible in all patients. In severe clinical situations, such as high carotid stenosis (70%), revascularization by carotid endarterectomy or by stent placement is carried out to avoid recurrences. In stroke prevention, the pharmacological recommendations are based on antithrombotic, lipid-lowering, and antihypertensive therapy. Inflammation is a promising target in stroke prevention, particularly in ischemic strokes associated with atherosclerosis. However, the use of anti-inflammatory strategies has been scarcely studied. No clinical trials are clearly successful and most preclinical studies are focused on protection after a stroke. The present review describes novel therapies addressed to counteract inflammation in the prevention of the first-ever or recurrent stroke. The putative clinical use of broad-spectrum and specific anti-inflammatory drugs, such as monoclonal antibodies and microRNAs (miRNAs) as regulators of atherosclerosis, will be outlined. Further studies are necessary to ascertain which patients may benefit from anti-inflammatory agents and how. Keywords: ischemic stroke; atherosclerosis; inflammation; therapies Author: Núria Puig, Arnau Solé, Ana Aguilera-Simon, Raquel Griñán, Noemi Rotllan, Pol Camps-Renom and Sonia Benitez Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Sep 20 09:36:36 2023 CEST ModDate: Wed Sep 20 09:38:37 2023 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 26 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1529248 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XYUBXY+VnURWPalladioL Type 1 Custom yes yes no 10 0 CXQUDM+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 RRGOWR+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 YLKRWR+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 OBEILC+CMSY10 Type 1 Builtin yes yes no 28 0 YUQEMP+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 50 0 CKUPDE+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 53 0 LHCXDL+EURM10 Type 1 Builtin yes yes no 78 0 HDNEAD+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 100 0 HDNEAF+PalatinoLinotype TrueType WinAnsi yes yes no 103 0 HDNEAH+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 106 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2023-12-01 02:34:23 CET RepresentationInformation: pmc_10531661.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-10-18 02:18:51 CEST Size: 1529248 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 713 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Inflammation in Atherothrombotic Ischemic Stroke Destination: section.2 Children: Item: Title: Cytokines Destination: subsection.2.1 Item: Title: MMPs Destination: subsection.2.2 Item: Title: Adhesion Molecules Destination: subsection.2.3 Item: Title: Cell and Soluble Forms of Receptors Destination: subsection.2.4 Item: Title: Biomarkers of Disease Progression Destination: section.3 Item: Title: Pharmacological Therapies Based on Inflammatory Molecules Destination: section.4 Children: Item: Title: Broad-Spectrum Anti-Inflammatory Drugs Destination: subsection.4.1 Children: Item: Title: Colchicine Destination: subsubsection.4.1.1 Item: Title: Other Broad-Spectrum Anti-Inflammatory Treatments Destination: subsubsection.4.1.2 Item: Title: Specific Anti-Inflammatory Drugs Destination: subsection.4.2 Children: Item: Title: TNF- Destination: subsubsection.4.2.1 Item: Title: IL-1 Destination: subsubsection.4.2.2 Item: Title: IL-6 Destination: subsubsection.4.2.3 Item: Title: ICAM-1 Destination: subsubsection.4.2.4 Item: Title: Ischemic Tolerance and Immunomodulation Destination: subsection.4.3 Item: Title: miRNAs as Regulators of Atherosclerosis and Ischemic Stroke Destination: section.5 Item: Title: Putative Strategies Based on miRNA Destination: section.6 Item: Title: Other Putative and Complementary Strategies Destination: section.7 Item: Title: Conclusions and Future Investigations Destination: section.8 Item: Title: References Destination: section.9 Info: Title: Novel Therapeutic Approaches to Prevent Atherothrombotic Ischemic Stroke in Patients with Carotid Atherosclerosis Author: Núria Puig, Arnau Solé, Ana Aguilera-Simon, Raquel Griñán, Noemi Rotllan, Pol Camps-Renom and Sonia Benitez Subject: Atherothrombotic stroke represents approximately 20% of all ischemic strokes. It is caused by large-artery atherosclerosis, mostly in the internal carotid artery, and it is associated with a high risk of early recurrence. After an ischemic stroke, tissue plasminogen activator is used in clinical practice, although it is not possible in all patients. In severe clinical situations, such as high carotid stenosis (70%), revascularization by carotid endarterectomy or by stent placement is carried out to avoid recurrences. In stroke prevention, the pharmacological recommendations are based on antithrombotic, lipid-lowering, and antihypertensive therapy. Inflammation is a promising target in stroke prevention, particularly in ischemic strokes associated with atherosclerosis. However, the use of anti-inflammatory strategies has been scarcely studied. No clinical trials are clearly successful and most preclinical studies are focused on protection after a stroke. The present review describes novel therapies addressed to counteract inflammation in the prevention of the first-ever or recurrent stroke. The putative clinical use of broad-spectrum and specific anti-inflammatory drugs, such as monoclonal antibodies and microRNAs (miRNAs) as regulators of atherosclerosis, will be outlined. Further studies are necessary to ascertain which patients may benefit from anti-inflammatory agents and how. 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Annotation: Subtype: Link Rect: 479, 376, 515, 387 Annotation: Subtype: Link Rect: 459, 353, 497, 364 Annotation: Subtype: Link Rect: 276, 330, 313, 341 Annotation: Subtype: Link Rect: 320, 330, 356, 341 Annotation: Subtype: Link Rect: 447, 307, 484, 318 Annotation: Subtype: Link Rect: 491, 307, 527, 318 Annotation: Subtype: Link Rect: 378, 284, 415, 295 Annotation: Subtype: Link Rect: 421, 284, 457, 295 Annotation: Subtype: Link Rect: 59, 251, 96, 261 Annotation: Subtype: Link Rect: 452, 227, 490, 238 Annotation: Subtype: Link Rect: 168, 205, 205, 215 Annotation: Subtype: Link Rect: 59, 182, 96, 192 Checksum: ad163bfe Type: CRC32 Checksum: 42716837f8f4345e09540a39482ad128 Type: MD5 Checksum: f85847882378e49979c0b7736e9cc7bda80ff000 Type: SHA-1 Checksum: f10130af52496de90bcb62b2d0680eabf8cde44e8f8623ee6bbed64c68cb5063 Type: SHA-256