Lipid Metabolism in Cerebral Ischemia: From Pathogenesis to Therapy

Cerebral ischemia, a leading global cause of death and disability, is marked by multifaceted pathological processes through dysregulation of lipid metabolism. This review examines the pivotal role of lipid metabolism in the pathogenesis of cerebral ischemia, with a particular emphasis on its dual function in neuroinflammation and neuroprotection. It delves into the mechanisms by which Arachidonic Acid (AA) metabolites, such as prostaglandins and Leukotrienes (LTs), drive neuroinflammation through Cyclooxygenase (COX) and Lipoxygenase (LOX) pathways, exacerbating ischemic injury. Conversely, the aim was to review the therapeutic potential of Specialized Pro-resolving Mediators (SPMs), including lipoxins, Resolvins (RVs), and protectins, that resolve inflammation and promote tissue repair. In addition, the roles of Peroxisome Proliferator- Activated Receptors (PPARs) and sphingolipid signaling in modulating oxidative stress, mitochondrial dysfunction, and neuronal survival were also addressed. Integrating recent advances in lipid biology and cerebral ischemia research, this review presents an overview of the role of lipid metabolism in disease progression and its potential as a target for new therapeutic interventions. These findings bridge the gap between basic science and clinical research, opening new doors for the treatment of cerebral ischemia.