Iron-Chelating Therapy in Stroke

Extensive preclinical and clinical investigations indicate that iron, ­mobilized from serum, body tissues, and brain, causes neurotoxic effects in cerebral ischemia and hemorrhage. Iron plays a role in neuronal injury by catalyzing oxidative reactions that yield highly reactive toxic hydroxyl radicals leading to oxidative stress and cell death, activating lipid peroxidation, and exacerbating excitotoxicity. Deferoxamine (DFO), a powerful iron chelator, has been demonstrated in experimental stroke models as an effective neuroprotective agent by multiple and diverse mechanisms, principally by limitation of iron-mediated neurotoxicity but also by non-iron-mediated effects. This chapter reviews the experimental and clinical data existing about the neuroprotective role of iron chelators, especially DFO, in brain ischemia and hemorrhage.