Immunomodulators and microRNAs as neurorestorative therapy for ischemic stroke

Most of all strokes are ischemic due to occlusion of a vessel, and comprise two main types, thrombotic and embolic. Inflammation and immune response play an important role in the outcome of ischemic stroke. Pharmaceutical and cell-based therapies with immunomodulatory properties could be of benefit in treating ischemic stroke. Possible changes in micro RNAs brought about by immunomodulatory treatments may be important. The pharmaceutical studies described in this review have identified several differentially regulated mi RNAs associated with disregulation of m RNA targets or the upregulation of several neuroprotective genes, thereby highlighting the potential neuroprotective roles of specific mi RNAs such as mi R-762,-1892,-200 a,-145. Mi R-124,-711,-145 are the strongly associated mi RNAs predicted to mediate anti-inflammatory pathways and microglia/macrophage M2-like activation phenotype. The cell-based therapy studies reviewed have mainly utilized mesenchymal stem cells or human umbilical cord blood cells and shown to improve functional and neurological outcomes in stroke animals. Mi R-145 and mi R-133 b were implicated in nerve cell remodeling and functional recovery after stroke. Human umbilical cord blood cells decreased proinflammatory factors and promoted M2 macrophage polarization in stroke diabetic animals.