Inflammation in Acute Ischemic Stroke: Translational Barriers and Implications for Treatment.

Dias, Alexandre; Moutinho, Ana; Igreja, Liliana; Moura, João; Wegener, Susanne; Maia, Luís F · Stroke · 2026

review · Level V

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Abstract

Cerebral ischemia triggers a cascade of molecular events over minutes to days, which activate immune cells, inflammation, and coagulation, promoting cell death. These processes critically influence both short- and long-term outcomes in patients with stroke. In this review, we address the role of immune molecular and cellular factors, and the therapeutic approaches predicted to be targetable by specific agents under a timely application. We will focus on translational efforts targeting (thrombo)-inflammatory mechanisms, highlighting past missteps and current opportunities. Finally, we outline key mechanistic and methodological questions that may define a path forward.