After a stroke, cell damage induced by the lack of blood supply causes the release of endogenous cell components to the neuron extracellular medium, triggering central nervous system alarms. One of the primary sensors of these brain damage-associated molecular patterns (DAMPs) is TLR4, a central receptor in innate immunity and expressed on the plasmatic membrane of immune cells such as microglia, neutrophils, monocytes, macrophages, among others. TLR4’s activation initiates a cascade of triggers that ultimately leads to the production and release of pro-inflammatory mediators, causing uncontrolled inflammation, further cell damage, and subsequent worsening of the brain lesion. ApTOLL has a powerful immunomodulatory effect through antagonistic action on TLR4 receptors, inhibiting the inflammatory cascade.
ApTOLL’s anti-inflammatory effect has been linked with a high level of brain protection, reducing infarct volume up to 65% in preclinical studies. Aptamers’ mode of action and short half-life matches perfectly with the ideal time-frame to modulate inflammation and while minimizing the side effects.

Scientific references:

· Caso et al., Circulation 2007.
· Cao et al., Biochem Biophys Res Commun 2007.
· Yang et al., J Cereb Blood Flow Metab 2008.
· Urra et al., J Cereb Blood Flow Metab 2009.
· Brea et al., J Cereb Blood Flow Metab 2011.
· Fernández et al., Mol Therapy 2018.
· Ramirez-Carracedo et al., Biomolecules 2020.
· Olivé-Gadea et al., Stroke 2021.
· Durán-Laforet et al., Pharmacology and Therapeutics 2021.