Novel Drug-Based, Emergency Treatment for Ischemic and Hemorrhagic Strokes

Overview

Stroke is the leading cause of disability and the third leading cause of death in the developed world. The two different types of stroke, ischemic and hemorrhagic, are functionally different and currently require unique, primarily surgical treatments. The purpose of this study was to develop a novel drug-based, dual-targeted emergency treatment that can alleviate both ischemic and hemorrhagic strokes by targeting molecular pathways common to both types of stroke—oxidative stress, hemoglobin degradation, and inflammation—as soon as the symptoms of stroke are recognized. The SJ4100 mutant strain of Caenorhabditis elegans exposed to S-Nitroso-N-acetyl-DL-penicillamine (to induce stroke-specific oxidative stress) was administered the treatments (PPAR- γ, Nrf2 Activator, haptoglobin, hemopexin, interleukin-1 receptor antagonist, metastat), and oxidative stress levels were measured using a fluorescence-based assay. All treatment combinations lowered stroke-specific oxidative stress levels at all time points studied (P-value<0.01). After evaluating efficiency, consistency, reliability, and performance over time, it was concluded that individual treatment of metastat, from the inflammation pathway, was most effective in alleviating the harmful effects of stroke. The haptoglobin/hemopexin combination (from the hemoglobin degradation pathway) and the PPAR-γ/Nrf2 Activator combination (from the oxidative stress pathway) were deemed the second and third most effective, respectively. Trends of treatment activity over time and distributions of stroke-specific oxidative stress levels at early time points were analyzed. Applications of this study are paramount in emergency stroke medicine, greatly advancing the development of an emergency, drug-based treatment applicable to both types of stroke—allowing for a greater chance of survival among those afflicted by stroke.