Abstract

Stroke is a major cause of mortality and disability. No effective neuroprotection therapy other than thrombolysis with tissue plasminogen activator (t-PA) or thrombectomy exists for acute management of stroke. Clearly, a new investigative direction aimed at prevention and treatment of ischemic brain damage is highly desirable. Previous research demonstrates that exercise not only reduce the stoke incidence but also enhances resistance to brain insults, including ischemia/reperfusion injury in stroke through a variety of mechanisms. These findings suggest that exercise preconditioning is able to produce neuroprotection in ischemic stroke, and that this protection correlates with the angiongenesis and neurogenesis.  Studies have shown that exercise gradually up-regulates hypoxic induced factor 1α(HIF-1α)in brain and increases ATP consumption, leading to a hypoxic condition. These changes induce angiongenesis and neurogenesis in which “neurovascular unit” (a construct consisting of microvascular endothelium, astroglia, neurons and the extracellular matrix including the basal lamina)is strengthened. Knowledge obtained from these studies would offer important clues for novel strategies to improve neuronal survival after stroke.HIF-1may have a casual relationship in maintaining and enhancing the angiongenesis and neurogenesis, leading to neuroprotection. Individulazed or precision conditioning medicine, a future study, is also discussed.