Evidence map›Paper›PMID 41095877›Full record

ReviewJournal of clinical medicine2025

Fingolimod as a Neuroprotective Agent in Ischemic Stroke: A Review of Preclinical and Clinical Evidence.

Alin Ciubotaru, Roxana Covali, Cristina Grosu, Daniel Alexa, Esthir Flavia Pilă, Andrei Ionuț Cucu, Amelian Madalin Bobu, Gabriela Dumachita Sargu, Laura Riscanu, Mihaela Camelia Tirnovanu and 4 more

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Alin CiubotaruDepartment of Neurology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.ORCID 0009-0003-2079-2383
Roxana CovaliDepartment of Radiology, Biomedical Engineering Faculty, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.ORCID 0000-0002-7386-0859
Cristina GrosuDepartment of Neurology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Daniel AlexaDepartment of Neurology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Esthir Flavia PilăDepartment of the Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Andrei Ionuț CucuFaculty of Medicine and Biological Sciences, University Stefan cel Mare of Suceava, 720229 Suceava, Romania.ORCID 0000-0003-1441-1751
Amelian Madalin BobuDepartment of Cardiology, Saint Spiridon Hospital, 700111 Iasi, Romania.ORCID 0009-0002-2874-9227
Gabriela Dumachita SarguDepartment of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.ORCID 0009-0003-8765-7426
Laura RiscanuDepartment of Morphofunctional Sciences, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Mihaela Camelia TirnovanuMother and Child Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Cristina AdamDepartment of Medical Specialties I, Grigore T. Popa University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania.ORCID 0000-0001-7313-3320
Radu PopaDepartment of Vascular Surgery, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Cristiana FilipDepartment of Biochemistry, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Emilian Bogdan IgnatDepartment of Neurology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.ORCID 0000-0002-6952-9741

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ischemic stroke remains a leading cause of mortality and disability worldwide, with current therapies such as intravenous thrombolysis and mechanical thrombectomy benefiting only a limited proportion of patients. Neuroinflammation is a key contributor to secondary brain injury, creating a strong rationale for adjunctive therapies targeting immune modulation. Fingolimod, a sphingosine-1-phosphate receptor (S1PR) modulator originally approved for multiple sclerosis, has shown promising effects in both preclinical and early clinical studies of acute ischemic stroke.

methodsWe conducted a structured narrative review of preclinical and clinical studies published between 2015 and 2024, using PubMed, Scopus, and Web of Science databases. Inclusion criteria were original studies evaluating fingolimod in ischemic stroke models or human patients, either as monotherapy or in combination with reperfusion therapies. Exclusion criteria included conference abstracts without peer review, studies lacking mechanistic insight, and non-English publications.

resultsPreclinical evidence demonstrates that fingolimod reduces infarct size, preserves blood-brain barrier integrity, and modulates neuroinflammation through multiple mechanisms, including T cell sequestration, microglial polarization, and mitochondrial protection. Clinical trials, though limited in size, suggest improved short- and long-term outcomes when fingolimod is used in combination with intravenous thrombolysis or endovascular therapy, with a manageable safety profile. Novel nanotechnology-based delivery systems further enhance central nervous system (CNS) targeting and reduce systemic side effects.

conclusionsFingolimod represents a promising multi-targeted adjunctive strategy for ischemic stroke, acting at the intersection of immune modulation, vascular protection, and neuroprotection. While current findings are encouraging, larger randomized controlled trials and biomarker-driven patient selection are needed to validate its clinical utility. This review highlights the translational potential of fingolimod and outlines key directions for future research.

Indexed as

barrierblood-brainfingolimodischemic strokeneuroinflammationneuroprotectionsphingosine-1-phosphate receptors

Identifiers

PMID41095877
PMCPMC12524549

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.