Old Drug May Treat Stroke More Effectively

A drug used to treat sepsis may offer a potential way to temper the side effects of tissue plasminogen-activator (TPA) and increase the treatment window in stroke patients beyond the current three-hour limit.

Researchers at the University of Rochester Medical Center (URMC, NY, USA) have developed a potential new treatment for stroke by using activated protein C (APC). In the coming five years, researchers at the University of California (Irvine, USA), Washington University (St. Louis, MO, USA), Mt. Sinai Hospital (New York, NY, USA), and Rochester General Hospital (NY, USA) will test the treatment for the first time on 72 people who have had a stroke within six hours but who decline the use of TPA. The trial has been approved by the U.S. Food and Drug Administration (FDA).

When a stroke happens, part of the brain is immediately shut off from oxygen and other vital nutrients, and a wave of destruction sweeps across a section of the brain. The body's immune system rushes in to try to fix the damage but often makes things worse by causing inflammation. Molecular signals telling damaged brain cells to kill themselves abound, and more and more brain cells die off as the body tries to cope with the damage. APC counters a great deal of this damage, saving most of the brain cells that otherwise die and reducing the impact of stroke by 70%. APC protects brain cells from the toxic effects of TPA and slows down the cascade of signals that causes more brain cells to die, as well as quelling inflammation. APC also blocks the cascade of chemical signaling that enables TPA to disable the blood-brain barrier

"Dozens of drugs have been tested in the last decade, but currently there are no other approved medications available besides TPA to help doctors treat acute stroke,” said team leader Curtis Benesch, M.D., M.P.H., director of the Strong Stroke Center at Rochester.



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