Delayed Gene Expression and Ischemic Brain Injury

There is increasing evidence that cerebral ischemic injury occurs at a slower pace than previously believed. Although in areas of severe ischemia tissue damage occurs relatively rapidly, in regions of less-severe ischemia, damage develops over the course of many hours or even days. In this chapter, we review data indicating that inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) are upregulated following focal cerebral ischemia and that the products of their reaction contribute to the delayed progression of ischemic brain damage. Administration of iNOS and COX-2 inhibitors may be a useful therapeutic strategy to selectively target the progression of the brain damage that takes place during the post-ischemic period.