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Dysregulation of GABAergic signaling, particularly involving the cotransporters NKCC1 and KCC2, has been implicated in various pathologies, including epilepsy, schizophrenia, autism spectrum disorder, Down syndrome, and ischemia. NKCC1 facilitates chloride influx, whereas KCC2 mediates chloride efflux via potassium gradient. Altered expression and function of these cotransporters have been associated with excitotoxicity, inflammation, and cellular death in ischemic events characterized by reduced cerebral blood flow, leading to compromised tissue metabolism and subsequent cell death. NKCC1 inhibition has emerged as a potential therapeutic approach to attenuate intracellular chloride accumulation and mitigate neuronal damage during ischemic events. Similarly, targeting KCC2, which regulates chloride efflux, holds promise for improving outcomes and reducing neuronal damage under ischemic conditions. This review emphasizes the critical roles of GABA, NKCC1, and KCC2 in ischemic pathologies and their potential as therapeutic targets. Inhibiting or modulating the activity of these cotransporters represents a promising strategy for reducing neuronal damage, preventing excitotoxicity, and improving neurological outcomes following ischemic events. Furthermore, exploring the interactions between natural compounds and NKCC1\/KCC2 provides additional avenues for potential therapeutic interventions for ischemic injury.<\/jats:p>","DOI":"10.1002\/jnr.25355","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T06:38:43Z","timestamp":1716964723000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["<scp>GABAergic<\/scp>\n                    system and chloride cotransporters as potential therapeutic targets to mitigate cell death in ischemia"],"prefix":"10.1002","volume":"102","author":[{"given":"A. A.","family":"Nascimento","sequence":"first","affiliation":[{"name":"Neurobiology of the Retina Laboratory, Department of Neurobiology and Graduate Program of Neurosciences, Institute of Biology Fluminense Federal University  Niter\u00f3i Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Pereira\u2010Figueiredo","sequence":"additional","affiliation":[{"name":"Graduate Program in Biomedical Sciences (Physiology and Pharmacology) Fluminense Federal University  Niter\u00f3i Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. P.","family":"Borges\u2010Martins","sequence":"additional","affiliation":[{"name":"Laboratory of Neuropharmacology, Department of Physiology and Pharmacology, Biomedical Institute Fluminense Federal University  Niter\u00f3i Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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