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Fractalkine receptor antagonists: Novel approaches to stroke

Stroke is a common cardiovascular disorder affecting 600,000 Americans each year. The treatment of ischemic stroke remains one of the most challenging areas of medicine today. At present, only one agent is approved (Alteplase, rt-PA), and for only a brief window of time (onset of symptoms, for less than three hours). Alteplase acts as a thrombolytic, allowing reperfusion; however, this re-establishment of blood flow can in its own right cause further problems through the infiltration of inflammatory cells and the production of free radicals. Due to the paucity of effective treatments stroke is the most common cause of long-term serious disability in the US, with about 50% of patients suffering moderate or severe hemiplegia. Between 15-30% of ischemic stroke victims are permanently disabled, and 20% require prolonged institutional care. Thus improved treatments of stroke are required and those that target the inflammatory process may be of particular use. In this respect, fractalkine (also known as neurotactin) offers exciting possibilities. This CX(3)C chemokine is upregulated during brain inflammation, and there is accumulating evidence that it induces chemotaxis by binding to its receptor CX(3)CR1 on leukocytes and microglia. Harvard researchers have now generated fractalkine-deficient mice to study its role in post-ischemic brain injury. After transient focal cerebral ischemia, fractalkine-deficient mice had a 28% reduction in infarction size and lower mortality rate, when compared to wild-type littermates. The findings of this study indicate a possible role for fractalkine in augmenting postischemic injury and mortality after transient focal cerebral ischemia and offers direct evidence that the identification of CX(3)CR1 antagonists may contribute to improved treatment of stroke..

Mice deficient in fractalkine are less susceptible to cerebral ischemia-reperfusion injury.

Adapted from Soriano et al, J Neuroimmunol 2002 Apr;125(1-2):59-65

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