Blockade of glutamate excitotoxicity and its clinical applications.

Glutamate has long been known to play a vital role in the normal functioning of neurons, serving as the main excitatory neurotransmitter in the central nervous system. The normal function of glutamate, as a means of communication from one neuron to the next, breaks down in certain disease states. Under particular scrutiny has been the etiology of neuronal damage caused by ischemic disease, seen most commonly in cerebrovascular embolic disease, commonly known as a stroke. It has been shown that damage associated with ischemic disease in the brain is not a direct result of hypoxia or deprivation of metabolic intermediates. In fact, the crucial role is played by an excessive efflux of glutamate by ischemic neurons, which then in turn activates pathways in post-synaptic neurons leading to acute cell swelling and later, cell death. An extremely hopeful development in the field of glutamate excitotoxicity has been the application of therapeutic methods aimed at attenuating the damaging action of glutamate, in an effort to decrease morbidity associated with such common diseases as stroke and other neurodegenerative disorders.