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Four months after treating them, Yasuhiro Shiga, MD, PhD, checked on his rats. Walking into the lab, he carried minimal expectations. Treating spinal cord injuries with stem cells had been tried by many people, many times before, with modest success at best. The endpoint he was specifically there to measure — pain levels — hadn’t seemed to budge in past efforts.

“Well, it doesn’t seem to be working. I don’t see any real change in pain behavior in any of the groups,” said Shiga, a visiting scholar at University of California San Diego School of Medicine, apologetically, as he walked into the office of his supervisor, Wendy Campana, PhD, professor in the Department of Anesthesiology and Program in Neuroscience.

But, to Campana’s surprise, he continued, almost as an after-thought.

“Although … some rats are actually really moving.”

The difference for those rats was this: Before delivering them into the spinal cord injury site, Shiga and Campana had conditioned stem cells with a modified form of tissue-type plasminogen activator (tPA), a drug commonly used to treat non-hemorrhagic stroke.

Full story at Science Daily

A study led by Massachusetts General Hospital (MGH) investigators may lead to a significant expansion in the number of stroke patients who can safely be treated with intravenous tPA (tissue plasminogen activator), the “clot busting” drug that has greatly reduced stroke-related disability and deaths in eligible patients. The report, published online in Annals of Neurology, describes the results of a trial using MR-based imaging technologies to identify patients likely to be within 4.5 hours of stroke onset, even though their initial symptoms had not been witnessed.

“In up to 25 percent of stroke patients, the start of their symptoms is unwitnessed, preventing them from receiving tPA,” says Lee Schwamm, MD, executive vice chair of the MGH Department of Neurology and director of the MGH Comprehensive Stroke Center, co-lead and corresponding author of the paper. “For many of these patients, the first time anything is noticed is when they get up from sleeping. Our study showed — for the first time — that tPA could be given safely to patients with stroke of unwitnessed onset if their imaging suggested the stroke was very early in its progression and they met other treatment criteria. These results pave the way for a large randomized trial of tPA in patients with unwitnessed strokes.”

Full story at Science Daily

Adult patients with sickle cell disease (SCD) who experience a stroke caused by a clot (i.e., ischemic strokes or IS) can be treated safely with tissue plasminogen activator (tPA) if they qualify, report investigators at the Medical University of South Carolina (MUSC) and elsewhere in the March 2017 issue of Stroke.

Tissue plasminogen activator (tPA), which has been the established therapy for treating IS since 1996, speeds up the body’s ability to dissolve clots, thus improving blood flow to the brain. When administered in the requisite time window, tPA can help prevent some of the disability associated with IS.

The use of tPA in SCD patients is not well established, although it has never been contraindicated. Stroke has a different pathophysiology in those with SCD — it is caused by the enhanced adhesion of the red blood cells to the endothelium. People with SCD also have an increased risk of intracranial hemorrhage, an uncommon but potentially fatal complication of tPA.

Full story of tPA om stroke patients at Science Daily

In a meta-analysis of randomized clinical trials for the treatment of acute ischemic stroke, an endovascular intervention (such as use of a very small catheter to remove a blood clot) compared to standard medical care (administration of a clot dissolving agent) was associated with improved functional outcomes and higher rates of functional independence at 90 days, but no significant difference in symptomatic intracranial hemorrhage (bleeding in the brain) or all-cause mortality, according to a study in the November 3 issue ofJAMA.

The current standard therapy for acute ischemic stroke is intravenous administration of tissue plasminogen activator (tPA). Although intravenous tPA improves survival and functional outcomes when administered as early as possible after onset of ischemic stroke, its use is limited by the narrow therapeutic time window (<4.5 hours), and by several contraindications. As few as 10 percent of patients presenting with ischemic stroke can be eligible for treatment with intravenous tPA. The limitations of its use have led to interest in endovascular therapy for acute ischemic stroke. Endovascular intervention improves blood flow but clinical studies examining this therapy have yielded variable results, warranting further examination, according to background information in the article.

Full story of endovascular intervention for stroke treatment at Science Daily