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This chapter will review the evidence for selected novel neuroprotective therapies, providing background information, in vitro and in vivo data for safety, efficacy, clinical feasibility and where available, a review of clinical studies. Examples of growth factors (erythropoietin), cell-based therapies and inhaled agents (xenon) will be discussed. We aim to give an overview of therapies that may be added to our armamentarium in the next decade. Ideally, in the future, the approach to neuroprotection will be integrated, with combined therapies timed to target specific mechanisms of injury and repair.
Erythropoietin (Epo) is a 34-kDa glycoprotein originally identified for its role in erythropoiesis, but which has since been found to have other functions. During embryologic and fetal development, Epo receptors (EpoR) are widespread  and Epo appears to have trophic effects on the vascular and nervous systems among others [2,3]. As the fetus develops, EpoR become increasingly regionally and cell-specific . The nonhaematopoietic function of Epo as it interacts with these receptors has been the subject of extensive investigation over the past 15 years. In particular, the neuroprotective effects of Epo and the mechanisms by which these effects occur have been researched in experimental paradigms ranging from cell culture to knockout mice, to small and large animal models of brain injury.
In recent years our understanding of molecular mechanisms of drug action and interindividual variability in drug response has grown enormously. Meanwhile, the practice of anesthesiology has expanded to the preoperative environment and numerous locations outside the OR. Anesthetic Pharmacology: Basic Principles and Clinical Practice, 2nd edition, is an outstanding therapeutic resource in anesthesia and critical care: Section 1 introduces the principles of drug action, Section 2 presents the molecular, cellular and integrated physiology of the target organ/functional system and Section 3 reviews the pharmacology and toxicology of anesthetic drugs. The new Section 4, Therapeutics of Clinical Practice, provides integrated and comparative pharmacology and the practical application of drugs in daily clinical practice. Edited by three highly acclaimed academic anesthetic pharmacologists, with contributions from an international team of experts, and illustrated in full colour, this is a sophisticated, user-friendly resource for all practitioners providing care in the perioperative period.
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