Minocycline May Enter Haemorrhagic Stroke Treatment Scheme
Researchers at the Georgia Regents University are leading a study to see if a broad spectrum antibiotic, minoclycline, can reduce the degree of disability produced by the hemorrhagic stroke. Results so far are promising and show that minocycline is a safe and effective drug in treating damage caused by the other type of stroke, that is ischemic stroke, which is the most common.
Although hemorrhagic stroke counts for about 10% of all strokes, however, the consequences are often more serious. It is worth mentioning that the mortality rate is much higher in the hemorrhagic stroke than in the ischemic stroke. However, an early intervention is associated with higher chances of recovery. Dr. Jeffrey A. Switzer, stroke specialist at the Medical College of Georgia at Georgia Regents University, said that they hope that minocycline, administered early, would reduce bleeding and the cerebral lesions caused by stroke. He said: “If we could give something in the field before we can confirm the type of stroke because we know it’s safe for both, that would be a novel strategy to help patients.”
It seems that minocycline reduces inflammation and the level of enzymes involved haemorrhage, called matrix metalloproteinases, or MMPs. MMPs destroy the basement membrane of blood vessels which make the blood vessel to be more prone to bleeding. Previous studies have shown that patients with a certain type of stroke have elevated blood levels of MMPs and inflammatory cells, which is correlated with a negative prognostic factor. One mechanism by which minocycline works is to collect iron, which is an essential component in the structure of hemoglobin (oxygen transport) but very harmful when it comes in contact with brain tissue.
Switzer hopes this antibiotic will reduce bleeding and the cerebral damage caused by hemorrhagic stroke. Because patients condition worsens usually in the first hours after stroke, early intervention may improve the prognosis. If studies show that minocycline is a safe drug in patients with hemorrhagic stroke, then this drug may be administered before reaching the hospital. In addition it is also possible that this antibiotic to bring benefits in patients with ischemic stroke (ie to increase the window in which can be administered tPA).
Before being given intravenous minocycline, patients will receive a brain CT confirming the hemorrhagic stroke. Also, patients will be investigated several times to see what is their level of MMPs and inflammatory proteins in the blood: at 24 hours, at 7 days and at 90 days after stroke.