Macrae I Mhairi, Allan Stuart M
Institute of Neuroscience and Psychology, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Brain Neurosci Adv. 2018;2:2398212818810689. doi: 10.1177/2398212818810689.
Since the inception of the British Neuroscience Association, there have been major advances in our knowledge of the mechanistic basis for stroke-induced brain damage. Identification of the ischaemic cascade led to the development of hundreds of new drugs, many showing efficacy in preclinical (animal-based) studies. None of these drugs has yet translated to a successful stroke treatment, current therapy being limited to thrombolysis/thrombectomy. However, this translational failure has led to significant improvements in the quality of animal-based stroke research, with the refinement of rodent models, introduction of new technologies (e.g. transgenics, in vivo brain imaging) and improvements in study design (e.g. STAIR, ARRIVE and IMPROVE guidelines). This has run in parallel with advances in clinical diagnostic imaging for detection of ischaemic versus haemorrhagic stroke, differentiating penumbra from ischaemic core, and improved clinical trial design. These preclinical and clinical advances represent the foundation for successful translation from the bench to the bedside in the near future.
自英国神经科学协会成立以来，我们对中风所致脑损伤的机制基础的认识取得了重大进展。缺血级联反应的发现催生了数百种新药，其中许多在临床前（基于动物的）研究中显示出疗效。然而，这些药物均未成功转化为有效的中风治疗方法，目前的治疗仅限于溶栓/血栓切除术。不过，这种转化失败促使基于动物的中风研究质量有了显著提高，包括改进啮齿动物模型、引入新技术（如转基因技术、体内脑成像）以及改善研究设计（如STAIR、ARRIVE和IMPROVE指南）。这与临床诊断成像在检测缺血性与出血性中风、区分半暗带与缺血核心方面的进展以及改进的临床试验设计同步进行。这些临床前和临床进展为在不久的将来成功地将基础研究成果转化为临床应用奠定了基础。
