Autophagy is a strictly regulated process that degrades and recycles long-lived or misfolded
proteins and damaged organelles for the maintenance of energy and function homeostasis of
cells. Insufficient oxygen and glucose supply caused by cerebral ischemia lead to a higher ratio of
AMP/ATP, which will activate the AMPK pathway to initiate the process of autophagy. Accumulating
evidence shows that autophagy participates in the pathogenesis of ischemic stroke as a double-
edged sword. However, the exact role of autophagy in the pathogenesis of ischemic stroke is
controversial and yet to be elucidated. In this review, the autophagy pathway, both in physiological
conditions and in ischemic stroke, is expounded. The focus was also on discussing the doubleedged
sword effect of autophagy in brain ischemia and its underlying mechanisms. In addition, potential
therapeutic strategies for ischemic stroke targeting autophagy pathway were also reviewed.
Keywords: Autolysosome, autophagy, double-edge sword, ischemic stroke, pathogenesis, therapeutic strategies.
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