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The 1027th target candidate in stroke: Will NADPH oxidase hold up?

Kim A Radermacher1, Kirstin Wingler1, Pamela Kleikers1, Sebastian Altenhöfer1, Johannes JR Hermans1, Christoph Kleinschnitz2 and Harald HHW Schmidt1*

Author Affiliations

1 Department of Pharmacology & Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands

2 Neurologische Klinik und Poliklinik, Universität Würzburg, Würzburg, Germany

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Experimental & Translational Stroke Medicine 2012, 4:11  doi:10.1186/2040-7378-4-11

Published: 24 May 2012


As recently reviewed, 1026 neuroprotective drug candidates in stroke research have all failed on their road towards validation and clinical translation, reasons being quality issues in preclinical research and publication bias. Quality control guidelines for preclinical stroke studies have now been established. However, sufficient understanding of the underlying mechanisms of neuronal death after stroke that could be possibly translated into new therapies is lacking. One exception is the hypothesis that cellular death is mediated by oxidative stress. Oxidative stress is defined as an excess of reactive oxygen species (ROS) derived from different possible enzymatic sources. Among these, NADPH oxidases (NOX1-5) stand out as they represent the only known enzyme family that has no other function than to produce ROS. Based on data from different NOX knockout mouse models in ischemic stroke, the most relevant isoform appears to be NOX4. Here we discuss the state-of-the-art of this target with respect to stroke and open questions that need to be addressed on the path towards clinical translation.

NADPH oxidases (NOX); Oxidative stress; Stroke therapy