Thrombo-Inflammation in Ischemic Stroke - Pathophysiologic Concept and Translational Relevance

Only a few years ago ischemic stroke has been pathophysiologically classified as a prototype of a merely thrombotic disease. This assumption changed step-wise after the surprising finding that immune cells do not only infiltrate ischemic brain parenchyma but even play a fundamental pathophysiologic role. Meanwhile it is widely accepted that various components of the immune system contribute to ischemic stroke development. Of utmost importance, thrombotic and inflammatory processes influence each other, a phenomenon in recent literature called thrombo-inflammation. Data regarding thrombo-inflammation in ischemic stroke mainly derive from experimental rodent studies but according to the results of first clinical trials a pathophysiological relevance of thrombo-inflammatory mechanisms can be assumed also in human stroke. Therefore, anti-thrombo-inflammatory strategies could become novel treatment approaches in the future. This review aims to address the most important mechanisms of thrombo-inflammation in ischemic stroke. In addition, the first translational results, i.e. clinical trials, will be outlined.