Every year, 750,000 Americans suffer a stroke, and more than 150,000 die. Time is life following an attack, so the sooner you get treatment, the better chance you have to survive. A stroke can take away your ability to speak or even move -- functions that may never come back. But now, scientists may have found a new way to stop and even reverse that damage.
50-year-old David Adams used to run a restaurant. Then, five years ago, he had a stroke. His life changed in an instant.
Thanks to years of therapy, David's gotten his independence, and some skills back.
"Reading, writing, talking, driving," David said.
While David and countless others face the daily challenges of life after stroke, LSU researchers have been looking for a way to stop the damage.
A team led by LSU neuroscientist Doctor Nicolas Bazan discovered that one injection of DHA can protect the brain for up to five hours after a stroke and stop the damage.
"In fact, it does both: protection and reversion of cells that are in the process of being severely injured," said Dr. Bazan.
In these experimental models, the red area is the stroke damage without DHA. In the brain with DHA --much less damage. And the injured area continues to shrink from the first day to the seventh.
"This could be the way to protect and minimize the terrible consequences of stroke," said Dr. Bazan.
It's still early, but some are calling it a breakthrough. David calls it something else.
"Beautiful, I mean beautiful," said David.
Administering clot-busting drugs is currently the only treatment for ischemic stroke. But, only three to five percent of stroke patients benefit from these drugs. LSU researchers hope to begin human clinical trials with the new fish oil compound within two or three years.
Meanwhile, David Adams is working as a stroke advocate helping other stroke victims in their recovery.
RESEARCH SUMMARY
BACKGROUND: Every 40 seconds, someone in United States suffers a stroke, and every three to four minutes, someone dies from one. The most common type of stroke is ischemic stroke. Ischemic strokes occur when a blood vessel supplying the brain becomes blocked. This causes significant tissue damage and can affect the tissue surrounding the core known as the penumbra. When injured, the penumbra has a limited lifespan of just a few hours in which blood flow needs to be reestablished and therapy administered to avoid irreversible damage. Ischemic strokes account for 87 percent of all strokes and up to 70 percent of strokes seen in hospitals. (SOURCE: strokecenter.org)
STANDARD TREATMENT: The treatment a stroke patient receives depends on the severity of the stroke. If a stroke victim is diagnosed soon enough after the symptoms start, they may be given a clot-dissolving medicine known as tissue plasminogen activator (t-PA). The drug can increase the patient's chances of survival and recovery. However, the drug is not safe for everyone. The stroke victim may also be given an aspirin or an aspirin in combination with other medicine. Other medicines are often given to control blood sugar levels, fever, and seizures. (SOURCE: WebMD)
NEW TREATMENT? New research on acute ischemic strokes shows that Docosahexaenoic acid (or DHA), an essential Omega-3 fatty acid, can be used to protect brain tissue. DHA can promote the recovery of brain function even when administered up to five hours after the stroke has occurred. Dr. Nicolas Bazan, at the Louisiana State University Health Sciences Center, led the study on DHA and its effectiveness in stroke treatment. DHA treatment has already proved to be beneficial for patients with coronary heart disease, asthma, rheumatoid arthritis, cancer and age-related macular degeneration. This is the first time its potential for stroke has been explored. Dr. Bazan and his team found that DHA treatment is not only able to salvage brain tissue that would have rotted, but its use also renders some of the affected areas indistinguishable from normal tissue within seven days. (SOURCE: Medschool.lsu)
INTERVIEW
Nicolas Bazan, MD, PhD., a neuroscientist at LSU Health Sciences Ctr., discusses how injecting DHA into patients who just suffered from a stroke can ultimately protect against damage and prevent further irreversible injury to susceptible parts of the brain.
What is the main goal of the studies that are currently ongoing for stroke patients as well as the future studies still on the drawing boards?
Dr. Nicolas Guillermo Bazan: Well, the main point of this study was to ask the question: Can we protect the penumbra of the stroke? Because in the stroke, the area of the brain that is without blood supply, that usually so damaged that it is often times difficult to salvage, is an area that we call the penumbra. That is a short-lived area that only stays around for a few hours and then vanishes and then also becomes damaged. So the target of potential therapies is to protect that particular area of the brain called the penumbra.
What happens when that area eventually becomes damaged?
Dr. Nicolas Guillermo Bazan: The consequences of the stroke are even larger in addition to the severity of it. In the United States alone, we have about 750,000 patients every year with stroke. One-third of those aforementioned patients will not survive, one-third of those patients will end up with severe disability, and the last third of those patients will be amenable to some type of rehabilitation therapy.
Can you briefly discuss this novel breakthrough that you have discovered, and what that means for the 750,000 patient each year that are affected by the detrimental consequences of having a stroke?
Dr. Nicolas Guillermo Bazan: It was really a surprise, because we did an experimental therapeutic approach. We did two hours of experimental stroke (no circulation to one side of the brain), and then one hour following the stroke injected an IV of DHA, which is a component of fish oil, and it is moreover a very imperative component of our everyday diet that the human body cannot make on its own. In due course, the DHA ended up in the brain as well as the retina of the eye. What we found was that one-day after we have remarkable protection; however, the main surprise was that if we gave these one hour, two hours, three hours, four hours . . . even five hours later, we still have protection and we actually follow the protection up to seven days later. This is called a therapeutic window, and the riddle for delaying stroke has been to have the medication that protects the brain with a long therapeutic window, because a patient who has a stroke (he or she is brought to the emergency room following the stroke) - the decision has to be made in the emergency room, the type and severity of the stroke has to be determined and then time passes. So here, with this injection, we allow for a five-hour therapeutic window, and the result in protection is utterly remarkable in quite a few levels.
Ultimately, does the protection last and prevent further damage from occurring that could be irreversible?
Dr. Nicolas Guillermo Bazan: We have followed it up to seven days later, and we have actually seen in a multitude of forms (followed via MRI) shows shrinkage. Subsequently, we see the neurological recovery - the motor function as well as the sensorial function responds to the treatment - and then we can actually quantify the neurological recovery. We went into the intimacy of the mechanisms on the level of cells in addition to the level of molecules, and we have identified the changes that have been made in the brain from DHA that we have hulled in neuro-protecting D1. This neuro-protecting D1 made from the DHA injected into the blood circulation, seemed to be the driver of the protection. It is exceptionally interesting and enthralling for all of us in this field.
Does this merely stop the progression of the affects from the stroke, or does in actually reverse the consequences of it?
Dr. Nicolas Guillermo Bazan: What it does is two things. The main being neuro-protection. That is the major benefit of this particular treatment. Secondly, the part of the brain that is already undergoing damage - in the brain is a process called neuroinflammation. Instead of generating an inflammation that leads to damage, 'results' the inflammation in a good way. We call it "resolution of inflammation." So, the fact is, this therapy boasts both protection as well as diversion of cells that are in the process of being severely injured.
It is really true what they say, and I know that this relates to your field especially: Time is life.
Dr. Nicolas Guillermo Bazan: Yes. Time is life . . . after stroke. Time is the most key and furthermore imperative element when dealing with strokes, because having four or five hours of a window to do other things, or just to find even sustained delivery . . . this could nevertheless be the way for protecting and minimizing the appalling consequences that come with having a stroke. You know, we only injected one dose. It was only one injection. In fact, we experimented with myriad doses before finding that one dose actually offers utmost benefit.
How do you think that this particular therapy would be administered to patients with strokes?
Dr. Nicolas Guillermo Bazan: It would be delivered via intravenously, and performed in an emergency room right after the patient arrived. Then the certain diagnosis of stroke is made, and at that time the injection will be made, but we have to always be creative and eventually something like this therapy can be done in ambulances (before they even get to the hospital or emergency room for that matter) as the very first defense against somebody who is suffering from a stroke. We suspect also that head trauma will additionally be protected against these mechanisms. Also, think about accidents where people endure serious head trauma. This can even be used on the football field. The opportunities for this particular treatment are endless. I think that it is an exceptionally exciting mechanism from the scientific point of view, because as I said before, this has allowed us to begin unraveling the neuromolecular protection of the brain, which is one of the biggest riddles in medicine.
FOR MORE INFORMATION, PLEASE CONTACT:
Leslie Capo, Media Relations
LSU Health Sciences Center
(504) 568-4806
LCapo@lsuhsc.edu
