Researchers at The University of Manchester have discovered that a potential new drug reduces the number of brain cells destroyed by stroke and then helps to repair the damage.
A reduction in blood flow to the brain caused by stroke is a major cause of death and disability, and there are few effective treatments.
A team of scientists at The University of Manchester has now found that a potential new stroke drug not only works in rodents by limiting the death of existing brain cells but also by promoting the birth of new neurones (so-called neurogenesis).
This finding provides further support for the development of this anti-inflammatory drug, interleukin-1 receptor antagonist (IL-1Ra in short), as a new treatment for stroke. The drug is already licensed for use in humans for some conditions, including rheumatoid arthritis. Several early stage clinical trials in stroke with IL-1Ra have already been completed in Manchester, though it is not yet licensed for this condition.
In the research, published in the biomedical journal Brain, Behavior and Immunity, the researchers show that in rodents with a stroke there is not only reduced brain damage early on after the stroke, but several days later increased numbers of new neurones, when treated with the anti-inflammatory drug IL-1Ra.
Previous attempts to find a drug to prevent brain damage after stroke have proved unsuccessful and this new research offers the possibility of a new treatment.
Importantly, the use of IL-1Ra might be better than other failed drugs in stroke as it not only limits the initial damage to brain cells, but also helps the brain repair itself long-term through the generation of new brain cells.
The results lend further strong support to the use of IL-1Ra in the treatment of stroke, however further large trials are necessaryProfessor Stuart Allan
These new cells are thought to help restore function to areas of the brain damaged by the stroke. Earlier work by the same group showed that treatment with IL-1Ra does indeed help rodents regain motor skills that were initially lost after a stroke. Early stage clinical trials in stroke patients also suggest that IL-1Ra could be beneficial.
‘Halo-like’ device fits on head to quickly bust clots
A new device developed by a physician at the University of Arkansas for Medical Sciences and a researcher at the University of Arkansas at Little Rock could soon be available to treat stroke more effectively.
The ClotBust ER® fits on the head like a halo and delivers therapy to quickly bust clots that cause stroke.
It was developed by William Culp, M.D., professor of radiology, surgery and neurology and vice chairman of research at UAMS, and Doug Wilson, assistant director at the Graduate Institute of Technology at UALR.
Culp has spent many years studying therapy for stroke. One element of Culp’s work included using ultrasound in combination with the clot-busting drug tissue plasminogen activator (t-PA).
While looking into the treatment to dissolve clots in blood vessels, Culp realized one problem is getting the ultrasound to operate through the skull. Ultrasound can be delivered anywhere in a patient’s body unless the waves hit something hard like bone or something very soft, like air.
“We realized we had trouble delivering ultrasound to the vessels at the base of the brain,” Culp said. “The skull stopped the ultrasounds.”
He teamed with Wilson to brainstorm ideas about how to get the ultrasound waves to reach the clot in stroke patients.
“This is a great example of how faculty at both schools can partner to develop new technologies. The success of this research will foster ties between the two campuses,” Wilson said.
“It makes me extremely proud to have contributed to a product with potential to help many people,” he said.
Culp received an $8,000 grant from UAMS that provided him with the materials he needed to experiment. Wilson and Culp completed their first patent for “ultrasound for augmented clot lysis” in 2005. The patent was licensed in 2006 and has been in development by Cerevast Therapeutics.
The ClotBust ER® has 16 transducers scattered around the inside – designed to line up with the thin points in the skull: the temples and the foramen magnum in the base of the skull.
This allows the ultrasound waves to move through the brain without interruption. After the patient is administered an IV containing t-PA, the circular device is placed onto the patient’s head like a sports visor or halo.
“The idea is to deliver ultrasound wherever the clot is and where the IV t-PA is working,” Culp said. “It makes t-PA work better – improving the clot-busting drug by 40 or 50 percent. It’s like taking a cooking pot and stirring it. The ultrasound stirs the drug around, making it work better.”
The clot disappears more quickly. “If we resupply blood, we resupply oxygen. The brain recovers quicker. Quicker is, of course, better,” Culp said.