Equivocal roles of tissue-type plasminogen activator in stroke-induced injury
Trends in Neurosciences. 2004-03-01; 27(3): 155-160
DOI: 10.1016/j.tins.2003.12.011
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Stroke represents a major health problem in the ever-ageing population of
industrialized nations. Each year, over three million people in the USA alone
suffer from this affliction. Stroke, which results from the obstruction of an
intra- or extra-cerebral artery, induces irreversible neuronal damage. The
clot-busting drug tissue-type plasminogen activator (tPA) is the only
FDA-approved therapy for acute stroke. Although tPA has been successfully used to
treat myocardial infarction due to clot formation, its use in the treatment of
occlusive cerebrovascular diseases remains controversial. Indeed, tPA is clearly
beneficial as a thrombolytic agent. However, increasing evidence suggests that
tPA could have direct and deleterious effects on neurons and glial cells.