Potential role of immunomodulation therapeutic strategies in acute ischemic stroke: what is new

Thromboinflammation implies a novel concept in stroke pathophysiology that has opened up the possibility of immunotherapeutic approaches which could become promising strategies for targeted stroke therapies in the future. Many studies have shown an immune cascade following ischemic stroke or acute traumatic brain injury which leading to more tissue damage and long-term disability. Presence of autoreactive T-cell and elevated levels of autoantibodies within hours to days after stroke, suggests the expansion of naturally occurring autoantibodies and autoreactive T cells and B cells immunity in all stages of stroke. Proposed immunomodulatory therapies targeting pro-inflammatory cytokines, matrix metalloproteinases and leukocyte infiltration to reduce initial brain cell toxicity. To date, different therapeutic strategies including monoclonal antibodies, sphingosine-1-phosphate (S1P) receptors, Beta-Interferons, have been introduced with different results. Here, we are going to review the most recent studies in this controversial concept, promising a mastermind in acute ischemic stroke treatment in future. Nevertheless, most authors believe that it is too early to judge the novel strategy of immunotherapy in general.