The gospel of stroke patients! Combination therapy restores cognitive abilities in stroke patients and extends the duration of treatment

Reperfusion therapy is the gold standard for stroke treatment and helps restore blood flow after a stroke caused by a blood clot and prevents brain tissue damageHowever, only about 10% of stroke patients qualify, in part because of the narrowness of the treatment window for reperfusion therapyA recent study by the Medical University of South Carolina showed that the treatment is safe and effective for exercise and cognitive recovery if a specific compound blocks the immune responseA May 13 article in the journal Neuroscience reported the team's preclinical findings that reducing the brain's immune response may be a strategy for improving cognitive recoveryIt could also expand the treatment window, allowing stroke specialists to help more stroke patients
"With reperfusion therapy, we are restoring blood flow, which is necessary to save tissue, but the immune system is responding to inflammation, and that is not a target for re-injection," said DrStephen Tomlinson, interim chair of Musk's Department of Microbiology and Immunology and senior author of the paper"This may explain why, although mechanical reperfusion has a 90 percent success rate in returning blood to the brain, only about 40 percent of the patients treated have regained sufficient motor and reasoning skills within three months to handle daily needs independently." Even those who do regain motor function will face cognitive challenges after a few months
DrAli Alawieh, a graduate student at MUSC and now a resident of neurosurgery at Emory University School of Medicine and lead author of the study, said, "I've seen patients with almost no movement disorders in follow-up, but they do have memory, behavioral consequences, and language disorders in their daily lives." A family of special immune proteins called complementary proteins helps guide and promote this immune response in damaged areas
In an article published in Science Translation Medicine in 2018, Tomlinson and Allawi said the supplement proteins labeled dead tissues and oppressed brain cells to remove them
The oppressed brain cells are not yet dead, but are damaged by lack of oxygen and lack of energySince the goal of stroke treatment is to preserve as much brain tissue as possible to reduce overall damage, this is a worrying result because it means that the recoverable tissue is destroyed by the immune system
So Tomlinson and his team developed a complement protein blocker called B4Crry, which only works in the area of stroke damageIn preclinical stroke models, this compound causes the supplement protein to lose its effect on the signals of stressed brain cells, preserving stress tissue and reducing overall brain damage
In the current study, Tomlinson and Allawi hypothesized that combined therapy with reperfusion therapy and B4Crry significantly improved stroke recovery compared to single reperfusion therapy Most importantly, they hypothesized that this combination of therapy could improve cognitive recovery
As Tomlinson's team predicted, in preclinical stroke models, individual reperfusion therapies do improve the recovery of coordinated movement, such as walking With The addition of B4Crry, the coordinated movement improved faster and recovered well after 3 days of stroke Improvements in learning and memory are even greater than in motor function
For learning and memory recovery after stroke, reperfusion therapy alone is equivalent to complete treatment However, when B4Crry was added to their treatment, the mice's cognitive recovery improved dramatically, with three times fewer errors in learning and memory tasks
Tomlinson's team went on to explore why B4Crry's addition, and the subsequent decline in the brain's immune response, could help cognitive recovery so much They found that after a stroke, brain immune cells called small glial cells began to devour the connections between stress editing brain cells Immune system supplement proteins label these connections for destruction because they show signs of stress cells Without these connections, brain cells cannot communicate effectively and the whole brain function will decline B4Crry hides the cell's stress signals from the complement protein, thus preserving the connections between neurons Maintaining connectivity can improve learning and memory after stroke Complementary inhibitors such as B4Crry can also help stroke specialists overcome the biggest barrier to reperfusion therapy: a short treatment window Tomlinson's team showed that adding B4Crry to reperfusion therapy, even within six hours of a stroke after a blood clot was removed, can reduce the likelihood of bleeding or excessive bleeding These results suggest that supplemental inhibition can no longer only make perfusion treatment safer, but can expand its range of treatment seisphons to make it available to more stroke patients
"I'm excited about the clinical use of supplementsuppression, and the next step we need to do is look at how complementary inhibitors interact with co-conditions such as old age, smoking, and diabetes in preclinical studies," Alavech explained Overall, this information will help us design the best clinical trials for use in humans "We have shown that we can use complementary inhibitors two months after traumatic brain injury and see improvements in cognitive recovery, " says Mr Tomlinson It makes me very excited This means that supplements may still be beneficial for cognitive recovery after brain injury, including stroke, months after a stroke Introduction: .1: 2 Source: Translational Medicine Network