Inosine attenuates post-stroke neuroinflammation by modulating inflammasome mediated microglial activation and polarization.

To date, various agents and molecules have been developed to treat post-stroke neuroinflammation; however, none of them are clinically successful. Post-stroke neuroinflammation is primarily attributed to microglial polarization as the generation of inflammasome complexes shifts microglia to their M1 phenotype and regulates the downstream cascade. Inosine, an adenosine derivative reported to maintain cellular energy homeostasis in stressed conditions. Although the exact mechanism is still unexplored, various studies have reported that it can stimulate axonal sprouting in different neurodegenerative diseases. Hence, our present study aims to decipher the molecular mechanism of inosine mediated neuroprotection by modulating inflammasome signaling towards altered microglial polarization in ischemic stroke. Inosine was administered intraperitoneally to male Sprague Dawley rats at 1 h post-ischemic stroke and was further evaluated for neurodeficit score, motor coordination and long-term neuroprotection. Brains were harvested for infarct size estimation, biochemical assays and molecular studies. Inosine administration at 1 h post ischemic stroke decreased infarct size, neurodeficit score, and improved motor co-ordination. Normalization of biochemical parameters were achieved in the treatment groups. Microglial polarization towards its anti-inflammatory phenotype and modulation of inflammation were evident by relevant gene and protein expression studies. The outcome provides preliminary evidence of inosine mediated alleviation of post-stroke neuroinflammation via modulation of microglial polarization towards its anti-inflammatory form through regulating the inflammasome activation.

Drug repurposing for stroke intervention.

Despite the availability of advanced interventions, stroke remains one of the most significant causes of mortality and morbidity worldwide. US Food and Drug Administration (FDA)-approved treatment options for stroke include tissue plasminogen activators (tPAs) and mechanical thrombectomy (MT). However, these are limited by a narrow therapeutic time window. Additionally, poststroke rehabilitation therapies can provide functional recovery but take a long time to show benefits. Drug repurposing could be a novel approach to broaden treatment options in this scenario. In this review, we summarize marketed drugs that could be repurposed based on their safety and efficacy data. We also briefly discuss their mechanisms of action and provide a list of repurposed drugs under trials for ischemic stroke therapy.