Background: Autophagy is a prosurvival, reparative process that maintainsww cellular
homeostasis through lysosomal degradation of selected cytoplasmic components and programmed
death of old, dysfunctional, or unnecessary cytoplasmic entities. According to growing evidence,
autophagy shows beneficial effects following subarachnoid hemorrhage (SAH). SAH is considered
one of the most devastating forms of stroke.
Methods: In this review lies in revealing the pathophysiological pathways and the effects of autophagy.
Current results from animal studies will be discussed focusing on the effects of inhibitors
and inducers of autophagy. In addition, this review discusses the clinical translation of potential
neuropharmacological targets that can help prevent early brain injury (EBI) following SAH by incorporating
programmed cell death into clinical management.
Results: Published data showed that autophagy mechanisms have a prosurvival effect to reduce
apoptotic cell death after SAH. However, if SAH exceeds a certain stress threshold, autophagy
mechanisms lead to increased apoptotic cell death, more brain injury, and worse outcome.
Conclusion: Future investigation on the differences and molecular switches between protective
mechanisms of autophagy and excessive “self-eating” autophagy leading to cell death is needed to
achieve more insight into the complex pathophysiology of brain injury after SAH. If autophagy
after SAH can be controlled to lead to beneficial effects only, as the physiological self-control
mechanism, this could be an important target for treatment.