Time of action of neuroprotectors plays a role?

摘要

I have read with great interest the review by Zhang et al. [1]. The review gives the opportunity to explore the pharmacological approach to acute (ischemic) stroke, and poses the question whether reperfusion is the only realistic treatment to stroke, or if other approaches might work. The maturation of ischemic brain damage is a complex process, triggered by hypoperfusion and self-perpetuating through crucial steps that are considered targets for putative protective drugs. With further research, our understanding of the process deepens and widens, and ever more possible targets are discovered that might protect the brain from ischemic damage. Nonetheless, clinical trials still fail to show any effectiveness of drugs based on these targets [2]. What is the reason for the lack of clinical translation in neuroprotection for acute stroke?