Source: Thailand Medical News Jan 15, 2020 4 years, 11 months, 1 week, 1 day, 3 hours, 23 minutes ago
Many are not aware that it has been almost a quarter century since the first drug was approved for
stroke. But what's even more striking is that only a single drug remains approved today for
stroke treatment. Fortunately a new research by medical scientists at the University Of Georgia is about to change that.
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The medical scientists, funded by the National Institutes of Health, presented brain-imaging data for a new
stroke treatment that supported full recovery in swine, modeled with the same pattern of neurodegeneration as seen in humans with severe
stroke.
Dr Steven Stice, Georgia Research Alliance Eminent Scholar and D.W. Brooks Distinguished Professor in the University of Georgia's College of Agricultural and Environmental Sciences told
Thailand Medical News, "It was eye opening and unexpected that you would see such a benefit after having had such a severe
stroke. Perhaps the most formidable discovery was that one could recover and do so well after the
exosome treatment."
Dr Stice and his colleagues at UGA's Regenerative Bioscience Center report the first observational evidence during a midline shift, when the brain is being pushed to one side, to suggest that a minimally invasive and non-operative
exosome treatment can now influence the repair and damage that follow a severe
stroke.
Typically,
exosomes are considered to be powerful mediators of long-distance cell-to-cell communication that can change the behavior of tumor and neighboring cells. The results of the study echo findings from other recent RBC studies using the same licensed
exosome technology.
Many individuals who suffer
stroke exhibit a shift of the brain past its center line, the valley between the left and right part of the brain. Lesions or tumors will induce pressure or inflammation in the brain, causing what typically appears as a straight line to shift.
Dr Franklin West, Associate Professor of Animal and Dairy Science in the UGA College of Agricultural and Environmental Sciences added, "Based on results of the
exosome treatment in swine, it doesn't look like lesion volume or the effects of a midline shift matter nearly as much as one would think. This suggests that, even in some extremely severe cases caused by
stroke, you're still going to recover just as well."
Often, trauma from an acute
stroke can happen quickly and can cause irreversible damage almost immediately. "Time is brain," a phrase coined by
stroke advocacy organizations in the late 1990s, captures the importance of acting on the first signs of
stroke. In less than 60 seconds, warns the
Stroke Awa
reness Foundation, an ischemic stroke kills 1.9 million brain cells.
Research data from the team showed that non-treated brain cells near the site of the
stroke injury quickly starved from lack of oxygen and died, triggering a lethal action of damage signals throughout the brain network and potentially compromising millions of healthy cells.
It was observed that in brain areas treated with
exosomes that were taken directly from cold storage and administered intravenously, these cells were able to penetrate the brain and interrupt the process of cell death.
Dr Stice, who is also director of the RBC added, "Basically, during a
stroke, these really destructive free radicals are all over the place destroying things. What the
exosome technology does is communicate with jeopardized cells and work like an anti-inflammatory agent to interrupt and stop further damage."
The team's research results also show that
neuroimaging is an essential tool for evaluating brain tissue and managing
stroke recovery.
In the study, the team analyzed brain images taken 24 hours after
stroke. They then applied recovery scores, commonly used in human practice, based on swine gait, cadence, walking speed and stride length. By recording the relationship between brain measurements and functional outcomes, the new assessment scales can better help physicians predict how quickly a person will recover in real time.
Dr Samantha Spellicy, a neuroscience graduate student and first author on the publication added, "What I'm trying to do with this assessment data is come up with something that we can implement in the clinics right today to help with predicting patient outcomes."
Dr Spellicy, who is currently training under Dr Stice, began her first two years at the Medical College of Georgia at Augusta University and has plans to return to MCG after completing her Ph.D. She anticipates a return to
stroke care and one day using the same outcome assessments presented in the study with human patients.
Dr Spellicy further added, "When a patient arrives in emergency with a
stroke, the available clinician would not be left crunching an arbitrary number based on some standardized scale assessment. Instead, the clinician could take more of a personalized approach based on the patient's midline shift measurement, and, say for instance: ‘OK, in three months you're going to get better, but you're going to have issues with your gait. Let's talk to a specialist now to target that exact condition’.”
With regards to the future of the
exosome treatment, Dr Spellicy and the RBC team anticipate that the patented neural
exosome technology, called
AB126, will be filed for clinical trials by late 2020.
Reference : Samantha E. Spellicy et al. Neural Stem Cell Extracellular Vesicles Disrupt Midline Shift Predictive Outcomes in Porcine Ischemic Stroke Model, Translational Stroke Research (2019). DOI: 10.1007/s12975-019-00753-4
