Preventing Oxygen Deprivation During a Stroke

Oxygen can reduce stroke severity. This is the oxygen stroke connection. There is currently only one treatment for stroke – a clot-busting drug known as tPA (tissue plasminogen activator). It is important to administer tPA at the right time for it to be effective. Usually within 4.5 hours of the onset of symptoms. Therapy can’t commence until after specific medical tests. The tests include a brain scan. The text confirms a clot blocking blood flow to part of the brain is what causes an ischemic stroke. There is good reason to do these time-consuming precautionary tests. Because if patients with hemorrhagic strokes (brain bleeds) receive tPA, it will kill them.

Full Article: Experimental drug could mitigate brain damage caused by strokes.

Less than 10 percent of patients get tPA within 4.5 hours, at which point the brain can suffer permanent damage. As time passes, the loss of oxygen-rich blood creates a chain of chemical reactions that produce toxic free radicals. These radicals kill nerve cells.

An Experimental Drug

The experimental drug – called Tat-NR2B9c – stops this destructive process.

“We’re blocking these reactions, and when you don’t get an accumulation of free radicals, the cells don’t die,” said Dr. Tymianski, who has been developing the drug for more than a decade.

His team’s study, published this week in the journal Nature, showed that the drug prevents brain cell death. And preserves brain function in non-human primates.

Related Article: Added Oxygen During Stroke Reduces Brain Tissue Damage

Scientists have countered the findings of previous clinical trials. They showed that giving supplemental oxygen to animals during a stroke can reduce damage to brain tissue surrounding the clot.

For supplemental oxygen to work, 100% oxygen must be delivered at the right time. It can be administered either by mask or in a hyperbaric chamber.

“The use of supplemental oxygen after blood flow is restored in the brain appears actually to cause harm by unleashing free radicals,” said Savita Khanna, assistant professor of surgery at Ohio State University and principal investigator of the research. “The resulting tissue damage was worse than stroke-affected tissue that received no treatment.”

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Additional Research

Stopping stroke with extra oxygen: NetWellness

…The research showed the way that adding in extra oxygen helped. This discovery had to do with the typical brain molecule glutamate. This molecule is released in excess as the body attempts to keep the brain functioning during a stroke.

The problem is that extra glutamate poisons nerve cells and causes damage. Adding more oxygen helps convert the excess glutamate into much-needed energy for the cells. A particular protective factor, called “GOT” (glutamate oxaloacetate transaminase), supports the conversion of glutamate into fuel for the brain. GOT makes the system work even under lower oxygen conditions. So the brain doesn’t release too much toxic glutamate and damages the nerve cells.

The Ohio State Center for Clinical and Translational Science funded this research at The Ohio State University Medical Center. NIH funding also helped accelerate the process of turning scientific discoveries into cures. This pilot award has added vital information to explain how adding oxygen during a stroke can reduce damage, showing:

1. the correct time frame for giving oxygen, and
2. how oxygen converts toxic glutamate into fuel for brain cells

These two keys have opened the door for the next steps and rapid translation to clinical research and treatment.