Rationale and Current Evidence for Testing Iron Chelators for Treating Stroke

Curr Cardiol Rep. 2019 Mar 4;21(4):20. doi: 10.1007/s11886-019-1106-z.

Abstract

Purpose of review: To discuss the mechanisms of iron regulation in the brain and the pathophysiological role of deregulation of iron homeostasis following a stroke, and to review existing evidence supporting the potential role of iron chelators in the treatment of ischemic and hemorrhagic stroke.

Recent findings: In recent years, accumulating evidence has highlighted the role of neuroinflammation in neurological injury after ischemic and hemorrhagic stroke, and that free iron is central to this process. Via the Fenton reaction, free iron catalyzes the conversion of superoxide ion and hydrogen peroxide into hydroxyl radicals, which promote oxidative stress. Advances in our understanding of changes in brain iron metabolism and its relationship to neuronal injury in stroke could provide new therapeutic strategies to improve the outcome of stroke patients. Pharmacological agents targeting brain iron regulation hold promise as potentially effective treatments in both ischemic and hemorrhagic stroke.

Keywords: Cerebral hemorrhage; Chelators; Inflammation; Iron; Ischemic stroke; Neuroprotection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain Ischemia* / drug therapy
  • Humans
  • Intracranial Hemorrhages / drug therapy
  • Iron
  • Iron Chelating Agents* / therapeutic use
  • Stroke* / drug therapy

Substances

  • Iron Chelating Agents
  • Iron