Péter Hertelendy, József Toldi, Ferenc Fülöp and László Vécsei* Pages 5945 - 5957 ( 13 )
Ischemic stroke is one of the leading causes of mortality and permanent disability in developed countries. Stroke induces massive glutamate release, which in turn causes N-Methyl-D-aspartate (NMDA) receptor over-excitation and thus, calcium overload in neurons leading to cell death via apoptotic cascades. The kynurenine pathway is a complex enzymatic cascade of tryptophan catabolism, generating various neuroactive metabolites. One metabolite, kynurenic acid (KYNA), is a potent endogenous NMDA glutamate receptor antagonist, making it a possible therapeutic tool to decrease excitotoxicity and neuroinflammation. Recently, clinical investigations have shown that during the acute phase of ischemic stroke, kynurenine pathway is activated and peripheral levels of metabolites correlated with worse outcome. In this review, we set out to summarize the current literature on the connection of the kynurenine pathway and ischemic stroke and set a course for future investigations and potential drug development.
Kynurenine, stroke, ischemia, immunomodulation, kynurenine analogue, excitotoxicity.
Department of Neurology, University of Szeged, Semmelweis u. 6, H-6725 Szeged, Department of Physiology, Anatomy and Neuroscience, University of Szeged, Kozep fasor 52, H-6726 Szeged, Institute of Pharmaceutical Chemistry and Research Group for Stereochemistry, Hungarian Academy of Sciences, University of Szeged, Eotvos u. 6, H-6720 Szeged, Department of Neurology, University of Szeged, Semmelweis u. 6, H-6725 Szeged