Abstract
All human clinical trials of neuroprotection after brain ischemia and reperfusion injury have failed. Brain ischemia is currently conceptualized as an “ischemic cascade” and therapy is directed to treating one or another element of this cascade. This approach conflates the science of cell injury with the development of neuroprotective technologies. Here we review a theory that describes the generic nonlinear dynamics of acute cell injury. This approach clearly demarcates the science of cell injury from any possible downstream technological applications. We begin with a discussion that contrasts the qualitative, descriptive approach of biology to the quantitative, mathematical approach used in physics. Next we discuss ideas from quantitative biology that underlie the theory. After briefly reviewing the autonomous theory, we present, for the first time, a non-autonomous theory that describes multiple injuries over time and can simulate pre- or post-conditioning or post-injury pharmacologics. The non-autonomous theory provides a foundation for three-dimensional spatial models that can simulate complex tissue injuries such as stroke. The cumulative theoretical formulations suggest new technologies. We outline possible prognosticative and neuroprotective technologies that would operate with engineering precision and function on a patient-by-patient basis, hence personalized medicine. Thus, we contend that a generic, mathematical approach to acute cell injury will accomplish what highly detailed descriptive biology has so far failed to accomplish: successful neuroprotective technology.
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DeGracia, D.J., Taha, D., Anggraini, F.T., Huang, Z. (2017). Neuroprotection Is Technology, Not Science. In: Lapchak, P., Zhang, J. (eds) Neuroprotective Therapy for Stroke and Ischemic Disease. Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-319-45345-3_3
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DOI: https://doi.org/10.1007/978-3-319-45345-3_3
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