In preparation, they are looking at recipients of the largest minocycline dose in the small trial to measure the impact on levels of stroke-associated inflammatory factors. They are also studying the drug's effect on matrix metalloproteinases, or MMPs, which are released during stroke and destroy the basement membrane of blood vessels and cause bleeding. Bleeding can significantly worsen stroke damage and is a major side effect of tPA.
Hess and Fagan believe the drugs can work synergistically to improve stroke outcomes.
Sixty percent of the patients in their study also received tPA. While they know these patients had lower MMPs levels because of minocycline treatment, the study was too small to accurately assess outcomes, Fagan said. Researchers suspect that tPA's bleeding risk is a major reason why nearly 15 years after FDA approval, fewer than 5 percent of hospitalized stroke patients get the clot buster.
In related research, MCG scientists have shown minocycline may be beneficial even before a stroke. Work led by Dr. Adviye Ergul, physiologist in the MCG Schools of Medicine and Graduate Studies, showed in diabetic rats that a daily dose of the drug reduces remodeling of blood vessels in the brain that increases stroke risk. The drug also helps stop bleeding that often follows a stroke. Diabetes dramatically increases stroke and heart attack risk. The work was published in August in the Journal of Cerebral Blood Flow and Metabolism.
While antibiotic resistance resulting from overuse has become a major health concern in the country, Fagan noted minocycline's use in stroke wouldn't contribute to the problem since it will only be given for a few days. In fact, the researchers found the drug remained active in the body longer in their older stroke patients than in younger patie
|Contact: Toni Baker|
Medical College of Georgia