Table 1.

Therapeutic interventions targeting lipids and lipid mediators in the prevention and treatment of ischemic stroke.

Therapeutic Intervention 1	Effect	Application 2	Reference
Lipid-lowering therapies for stroke prevention
Lowering cholesterol with statins	Anti-atherogenic: LDL cholesterol decrease	Clinical use	[91,92,97]
Lowering cholesterol with PCSK9 inhibitors, siRNAs, mimetic peptides, adnectins, vaccinations	Anti-atherogenic: increased LDL-C clearance from circulation	Experimental	[99,100,101,102,103,104,105]
Reduction of hypertriglyceridemia with fibric acid and derivatives	Anti-atherogenic: triglyceride decrease; HDL cholesterol increase	Clinical use	[106,107]
Lowering Lp(a) levels with niacin, PCSK9 or CETP inhibitors, or antisense oligonucleotides	Anti-atherogenic: reduced Lp(a) in circulation	Experimental	[108,109]
Eicosanoid-targeted therapies for post-ischemic brain tissue rescue
Lowering prostaglandins level with COX inhibitors	Anti-atherogenic: anti-platelet effect of aspirin Neuroprotection: anti-inflammatory actions	Clinical use Experimental	[152,153,170]
Increasing prostacyclin levels with intravenous infusions	Vasodilation of cerebral microvessels	Experimental	[156]
Lowering TXA2 levels with statins	Anti-thrombogenic: TXA2 level decrease, anti-platelet activity	Experimental	[157]
Decreasing leukotriene B4 synthesis with 5-LOX inhibitors, microRNAs, FLAP inhibitors, or CysLT receptors antagonists	Neuroprotection: anti-inflammatory and anti-apoptotic actions, reduced neuronal loss	Experimental	[133,134,135,136,158,159,160]
Increasing lipoxin A4 levels with LXA4 or LXA4ME analogues	Neuroprotection: anti-inflammatory action, blood–brain barrier rescue	Experimental	[164,165]
Lowering 20-HETE levels with inhibitors or antagonists	Neuroprotection: improved microcirculation	Experimental	[147,161,162,163]
Increasing EETs levels with sEH inhibitors	Neuroprotection: anti-apoptotic, anti-inflammatory, pro-angiogenic, astrogliosis-preventive actions	Experimental	[166,167,168,169]

¹ Abbreviations: 20-HETE, 20-hydroxyeicosatetraenoic acid; 5-LOX, 5-lipoxygenase; CETP, cholesterylester transfer protein; COX, cyclooxygenase; CysLT, cysteinyl leukotriene; EETs, epoxyeicosatrienoic acids; FLAP, 5-LOX-activating protein; Lp(a), lipoprotein(a); LXA₄, lipoxin A₄; LXA₄ME, lipoxin A₄ methyl ester; PCSK9, proprotein convertase subtilisin/kexin type-9; sEH, soluble epoxide hydrolase; TXA₂, thromboxane A₂. ² Clinical use: therapeutic interventions used as a standard prevention or treatment for stroke patients. Experimental: therapeutic interventions tested in preclinical or clinical studies, but currently not translated into the clinic.