Neuronal autophagy in cerebral ischemia--a potential target for neuroprotective strategies?

Although many attempts have been made, stroke treatment options are still extremely limited and brain ischemia remains the leading cause of death and disability worldwide. Two major strategies for ischemic stroke, reperfusion and neuroprotection, are currently being evaluated. Autophagy is a bulk protein degradation system that is involved in multiple cellular processes. Increasing data suggest that activation of autophagy in ischemic brain may contribute to neuroprotection. However, it should also be noted that there are evidences that autophagy is a process involved in neurodegeneration. Targeting signaling pathways related to autophagy might be a promising option in the treatment of cerebral ischemia, but the exact role of autophagy activation due to ischemic episodes and its potential applications in pharmacotherapy are still to be determined. In this paper we review recent evidences for cerebral ischemia-induced autophagy, briefly discuss mechanisms and signaling pathways that lead to this activation and we analyze its potential roles.