ABSTRACT

As part of an inflammatory response, leukocytes appear to potentiate central nervous system (CNS) reperfusion injury by clogging the microcirculation and infiltrating into the brain, where they release free radicals and other substances toxic to neurons. The initial step in these processes is leukocyte to endothelial cell adhesion. Through the use of specific monoclonal antibodies directed against leukocyte adhesion receptors, both the microcirculation obstruction and the brain infiltration can be decreased. Experimental studies have found reduced stroke damage through the use of antibodies that bind to either the CD-18 leukocyte adhesion molecule or its endothelial cell ligand, ICAM-1. In this chapter, we review the components of leukocyte to endothelial adhesion, pre-clinical studies of antiinflammatory agents (anti-leukocyte adhesion), and pre-clinical studies investigating combining anti-adhesion therapy with thrombolytics.