Neural Regeneration Research ›› 2021, Vol. 16 ›› Issue (12): 2401-2402.doi: 10.4103/1673-5374.313027

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A 3R-Tau-mediated mechanism in oligodendrocytes: could it be the key for neuroprotection after stroke?

Mario Villa Gonzalez, Maria José Pérez-Álvarez*   

  1. Departamento de Biología (Fisiología Animal), Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, Spain (Villa Gonzalez M, Pérez-Álvarez MJ);Centro de Biología Molecular “Severo Ochoa”, Departamento de Neuropatología Molecular CSIC-UAM, Madrid, Spain (Villa Gonzalez M, Pérez-Álvarez MJ);Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain (Pérez-Álvarez MJ)

  • Online:2021-12-15 Published:2021-05-14
  • Contact: Maria José Pérez-Álvarez, PhD, mj.perez@uam.es.
  • Supported by:
    This work was supported by grants from Spanish Ministry of Economy and Competitiveness (BFU-2008-03980, BFU2016-77885-P), from Comunidad de Madrid (S2017/BMD-3700) and from Departamento de Biología, Facultad de Ciencias-UAM (BIOUAM03-2020). 

Abstract: Cerebrovascular accident or stroke have a high global incidence. The most common types of stroke are ischemic, accounting for 87% of the total number, and they are triggered by a reduction or interruption of blood flow to the central nervous system, usually caused by a thrombus, embolus or atherosclerotic plaque. The severity of brain damage caused by this kind of stroke is directly related to the size of the vessel that is occluded and the duration of occlusion. Stroke is currently the leading cause of long-term disability worldwide and as such it has an enormous socioeconomic impact (Benjamin et al., 2019). In fact, between 30–50% of stroke patients do not recover functional independence and need personal assistance to carry out normal everyday activities. Also, according to statistics issued by the World Health Organization (WHO), ischemic stroke is the second cause of death worldwide. This year (2020) has witnessed a new cause of stroke related to coronavirus disease 2019 (COVID-19), with devastating consequences for the prognosis of this disease across all ages (García-Moncó et al., 2020). Given that the incidence of stroke increases with age and life expectancy is rising worldwide, the WHO predicts an increase in the prevalence and incidence of this condition in the coming years (Benjamin et al., 2019). The only therapeutic strategy currently used to reduce ischemic brain damage is early reperfusion using surgical methods (mechanical thrombectomy), or more frequently, the administration of a thrombolytic agent, namely the recombinant tissue plasminogen activator. However, the last approach has a therapeutic window limited to 4.5 hours after the first symptoms appear (Biggs et al., 2019). This temporal restriction implies that reperfusion is not a suitable strategy for a significant number of stroke patients due to the high risk of cerebral hemorrhage. Statistics in different countries reflect that only 10–20% of patients in acute phase of stroke, receive thrombolysis treatment (Lees et al., 2010). The remaining patients do not receive any pharmacological therapy, thus precluding the opportunity to reduce the disability and cognitive dysfunction caused by ischemia. An extension of the time window up to 24 hours has been reported for mechanical thrombectomy in certain patients (Dmytriw et al., 2019). Although reperfusion enhances the prognosis of stroke, it does not prevent the neurodegenerative processes that occur after damage. Therefore, to improve the beneficial effects of reperfusion and to enable pharmacological intervention in patients for whom this approach is not suitable, it is critical to explore alternative therapeutic strategies.