Antioxidants and stroke: Success and pitfalls

Abstract

Stroke is a problem that affects more than 15 million people worldwide. It is the third most common cause of death and is also an important cause of morbidity and of severe long-term disability. In this chapter, stroke mechanisms are outlined and particular attention is given to the oxidative and nitrosative stress, essentially to the role of the reactive oxygen (ROS) and nitrogen (RNS) species in stroke events. Following this approach, the most recent literature relative to success and pitfalls of the use of antioxidants of natural (including endogenous and those from diet) or synthetic origin in stroke is herein reviewed. Antioxidant therapies have enjoyed general success in preclinical studies, across disparate animal models, but little benefit in human intervention studies or clinical trials. This mismatch has been often attributed both to limitations of the animal models and to pitfalls in the clinical trial design. Finally, some ADME/Tox problems related to a number of drawbacks were also discussed.