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Experimentelle Ansätze zur Therapie des ischämischen Schlaganfalls

Experimental therapy approaches for ischemic stroke

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Zusammenfassung

Der ischämische Schlaganfall ist in Deutschland – ähnlich wie in den meisten anderen Industrieländern – die häufigste Ursache für eine bleibende Behinderung und die dritthäufigste Todesursache. Da ischämische Schlaganfälle mit dem Alter häufiger auftreten, muss aufgrund der demographischen Entwicklung mit einer Zunahme dieser Erkrankung gerechnet werden. Trotz intensiver Bemühungen auf klinischer und experimenteller Ebene fußt die Therapie des ischämischen Schlaganfalls nach wie vor auf allgemein-intensivmedizinischen Verfahren und der Reperfusionstherapie mit rekombinantem Gewebeplasminogenaktivator (rtPA). Die rtPA-Behandlung ist allerdings nicht für alle Patienten geeignet und außerdem aufgrund des zunehmenden Blutungsrisikos auf ein therapeutisches Fenster von 4,5 h beschränkt. Daher besteht ein großer Bedarf an neuen Therapieoptionen zur Behandlung zerebraler Ischämien. Diese Übersichtarbeit diskutiert neue experimentelle Behandlungsprinzipien für den ischämischen Schlaganfall, die möglicherweise klinisches Potenzial besitzen. Der besondere Schwerpunkt liegt hierbei auf neuroprotektiven und immunologischen Ansätzen.

Summary

In Germany, as in most other industrialized countries, ischemic stroke is the leading cause of disability and the third leading cause of death. As the incidence of ischemic stroke increases with age it is expected that this problem will become even more urgent in an aging society. Despite significant research efforts on the clinical as well as on the experimental level, treatment of ischemic stroke is still based on general intensive care measures and on reperfusion therapy with recombinant tissue plasminogen activator (rtPA); however, rtPA is not suitable for a wide range of patients and is restricted to a therapeutic window of 4.5 h due to an increasing risk of bleeding. Accordingly, novel therapeutic options for ischemic stroke are urgently need. The current review discusses novel experimental therapeutic principles for ischemic stroke which may have clinical potential. The main topics are neuroprotection and strategies addressing the immune system.

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Danksagung

Einige der hier referierten Arbeiten wurden durch die Deutsche Forschungsgemeinschaft (DFG), SFB 688 (TP A13 und B1) und DFG KL2323/6-1 unterstützt.

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Authors and Affiliations

  1. Neurologische Klinik und Poliklinik, Universitätsklinik Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland

    C. Kleinschnitz

  2. Institut für Schlaganfall- und Demenzforschung (ISD), Klinikum der Universität München, Max-Lebsche Platz 30, 81377, München, Deutschland

    N. Plesnila

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  1. C. Kleinschnitz
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  2. N. Plesnila
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Correspondence to C. Kleinschnitz or N. Plesnila.

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Kleinschnitz, C., Plesnila, N. Experimentelle Ansätze zur Therapie des ischämischen Schlaganfalls. Nervenarzt 83, 1275–1281 (2012). https://doi.org/10.1007/s00115-012-3536-3

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