If a stroke patient doesn’t get treatment within approximately the first 3 hours of symptoms, there’s not much doctors can do to limit damage to the brain—but researchers report a technique that potentially could restore functions to patients weeks or even months after a stroke.
The technique involves jumpstarting the growth of nerve fibers to compensate for brain cells destroyed by the stroke.
"In the best-case scenario, this would open up the window of time that people could recover and go back to normal functional status," said Gwendolyn Kartje, MD, PhD, a professor in the department of cell biology, neurobiology, and anatomy and the department of neurology at Loyola University Chicago Stritch School of Medicine in Maywood, Ill and chief of neuroscience research at Edward Hines Jr VA Hospital in Hines, Ill.
Kartje and colleagues described the experimental approach, called anti-nogo-A immunotherapy, in a recent review article in the journal Topics in Stroke Rehabilitation.
Anti-nogo has dramatically improved functions in lab animals that have experienced strokes. And an ongoing clinical trial in Europe and Canada is testing anti-nogo in humans who have suffered spinal cord injuries.
Most strokes are caused by clots that block blood flow to one part of the brain, killing brain cells within hours. The drug TPA can minimize damage by dissolving the clot. But TPA is safe and effective only when given within about 3 hours of the onset of symptoms.
Most patients don’t receive treatment within that brief window. Patients typically arrive at the hospital too late, or hospitals do not begin administering TPA soon enough.
Anti-nogo is among several new approaches under study that potentially could reverse stroke damage, researchers wrote. Nogo-A is a protein that inhibits the growth of nerve fibers called axons. It serves as a check on runaway nerve growth that could cause a patient to be overly sensitive to pain, or experience involuntary movements. (The protein is called nogo because it in effect says to axons: "No go.") In anti nogo immunotherapy, an antibody disables the nogo protein.
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