Hypoxia Mimetic Agents for Ischemic Stroke

2019 
Every year stroke claims more than 6 million lives worldwide. The majority of them are ischemic strokes. Small molecule-based therapeutics for ischemic stroke have attracted a lot of attention but none has been shown to be effective clinically so far. Hypoxia-inducible factor-1 (HIF-1) plays a crucial role in the transcriptional adaptation of cells to hypoxia. Small molecule-based hypoxia-mimetic agents inhibit HIF-prolyl hydroxylases (PHDs), stabilize HIF-1α and have been shown to confer ischemic neuroprotection. These agents are mainly classified into iron chelators, iron competitors, and 2 oxoglutarate (2OG) analogs. This review discusses HIF structure and key players in the HIF degradation pathway as well as the genes, proteins and chemical molecules that are connected to HIF-1 and how they affect cell survival following ischemic injury. Furthermore, this review gives a summary of studies that used PHD inhibitors as hypoxia mimetic agents for the treatment of ischemic injury.
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