Liu JH, Wang TW, Lin YY, et al. - Given that neuronal damage in stroke patients has been suggested to be mainly caused by acrolein, an α,β-unsaturated aldehyde, researchers intended to shed light on the mechanism by which acrolein causes neuronal damage during ischemic stroke. They correlated disease severity and prognosis of stroke patients vs controls by evaluating urinary 3-hydroxypropyl mercapturic acid, an acrolein-glutathione (GSH) metabolite, plasma acrolein-protein conjugates and plasma GSH levels. For determining the underlying mechanisms, they used in vivo middle cerebral artery occlusion animal models and an in vitro oxygen glucose deprivation stroke model. Findings revealed that acrolein causes neuronal damage through GSH depletion in stroke patients. Via spermidine/spermine N1-acetyltransferase-induced polyamine oxidation by NF-kB pathway activation, the mechanism underlying the role of acrolein in stroke-associated neuronal damage happened. These findings offer a new mechanism of neurotoxicity in stroke patients and provide assistance in the development of neutralizing or preventive measures.