Targeting Neuroinflammation in Adult Ischemic Stroke: Direct Immunotherapy, Regenerative Cell-Based Strategies, and Translational Challenges-A Systematic Review with Exploratory Meta-analysis
Abstract
Neuroinflammatory and immune-mediated processes are increasingly recognized as important contributors to adult ischemic stroke pathobiology, contributing not only to acute neuronal injury and secondary tissue damage, but also to later phases of repair and recovery. Experimental and early clinical evidence suggests that immunotherapeutic interventions may modulate post-ischemic inflammatory cascades and immune-cell activation, thereby potentially contributing to neuroprotective and neurorestorative responses. However, the clinical efficacy, safety, and translational relevance of these approaches remain incompletely defined. This systematic review aimed to critically synthesize contemporary preclinical and clinical evidence on neuroinflammation-targeted immunotherapeutic strategies in adult ischemic stroke, while distinguishing direct immunotherapy from regenerative cell-based approaches with immunomodulatory relevance. A systematic search of PubMed/MEDLINE and Embase was conducted in October 2025 and updated in January 2026 to identify original English-language studies published between January 2020 and December 2025. Eligible studies included preclinical and clinical investigations evaluating direct immunotherapeutic interventions or regenerative cell-based therapies with immunomodulatory relevance in adult ischemic stroke, compared with placebo, standard care, or control conditions appropriate to study design. In total, 913 records were screened, of which 55 studies met all…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 637 participants or records.
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