[Endogenous neuronal protection: an alternative approach]

Despite a great number of neuroprotective agents have been evaluated successfully in experimental paradigms of brain ischemia and trauma, the results obtained in clinical trials in general do not satisfy the proposed criteria of efficacy. This fact leads to the searching of alternative approaches in order to orient the efforts towards neuronal protection with better perspectives.

By analyzing the brain tissue response after an ischemic insult we could observe that preconditioning with brief periods of ischemia produces tolerance, increasing the resistance against later lethal insults. Other stimuli, such as hypoxia and cortical spreading depression, induce similar responses. All of them, selectively induce specific genes, by acting collectively to increase the surviving potential of the nerve cells, promoting the functional recovery. Administration of some of these genes, or the proteins for which they codify--among them neurotrophic factors are remarkable examples--leads to interesting findings in the global and focal ischemia in rodents, which are mainly related to the inhibition of the ischemia-induced neuronal apoptosis.

These findings also lead to think in an alternative approach for the neuronal protection, which take into consideration the brain endogen response as a promissory choice for a novel therapy.