Emerging immune and cell death mechanisms in stroke: Saponins as therapeutic candidates

Laura García-Pupo; Emily Van San; René Delgado-Hernández; Tom Vanden Berghe; Wim Vanden Berghe

doi:10.1016/j.bbih.2020.100152

Emerging immune and cell death mechanisms in stroke: Saponins as therapeutic candidates

Brain Behav Immun Health. 2020 Oct 3:9:100152. doi: 10.1016/j.bbih.2020.100152. eCollection 2020 Dec.

Authors

Laura García-Pupo¹, Emily Van San², René Delgado-Hernández³, Tom Vanden Berghe^{4

5

6}, Wim Vanden Berghe⁷

Affiliations

¹ Centro de Investigación y Desarrollo de Medicamentos (CIDEM), Ave 26, No. 1605 Boyeros y Puentes Grandes, CP 10600, La Habana, Cuba.
² VIB-UGent Center for Inflammation Research, Technologiepark 71, 9052, Ghent, Belgium.
³ Centro de Estudios, Investigaciones y Evaluaciones Biológicas (CEIEB), Instituto de Farmacia y Alimentos (IFAL), Universidad de la Habana, Cuba.
⁴ Ferroptosis and Inflammation Research Unit, Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium.
⁵ VIB Center for Inflammation Research, Ghent, Belgium.
⁶ Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Belgium.
⁷ Proteinscience, Proteomics and Epigenetic Signaling (PPES), Department of Biomedical Sciences, University of Antwerp, Belgium.

Abstract

The complexity of the ischemic cascade is based on the integrated crosstalk of every cell type in the neurovascular unit. Depending on the features of the ischemic insult, several cell death mechanisms are triggered, such as apoptosis, necroptosis, ferroptosis/oxytosis, ETosis or pyroptosis, leading to reactive astrogliosis. However, emerging evidence demonstrates a dual role for the immune system in stroke pathophysiology, where it exerts both detrimental and also beneficial functions. In this review, we discuss the relevance of several cell death modalities and the dual role of the immune system in stroke pathophysiology. We also provide an overview of some emerging immunomodulatory therapeutic strategies, amongst which saponins, which are promising candidates that exert multiple pharmacological effects.

Keywords: Cell death; Immunomodulation; Neurovascular; Saponins; Stroke.

Publication types

Review