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Antibiotic Shows Promise as Stroke Treatment
Date:10/1/2007

Boston. "Clinically, it is the difference between someone who looks almost normal compared to someone with more mild-to-moderate impairment due to stroke."

The findings were published in the Oct. 2 issue of Neurology.

This study focused specifically on ischemic stroke, the kind that is induced by clots that cut off blood flow to parts of the brain. According to Smith, minocycline appears to act as a neuroprotectant -- that is, as a compound that protects the brain from the resulting lack of oxygen and glucose, thereby allowing more brain tissue to survive.

Yet it is not at all clear just how minocycline does this, though several possible mechanisms have been proposed. Lampl suggested the effect "is at least partially dependent" on minocycline's ability to limit inflammation and apoptosis, or cell suicide.

Hillis said she found the results "potentially very exciting," both because of the magnitude of the effect, and because it was observed with a treatment that could be administered as much as a day after a stroke attack.

"They included patients who were eight to 24 hours after onset of stroke, on average 12 hours," she noted. "That's exciting, because that's about when most patients come to the hospital."

Most stroke treatments are now only effective within a few hours of stroke onset, Hillis explained. It's a therapeutic window that is too short to be effective for many patients.

Yet Hillis said she was not yet prepared to change the way she treats her own patients.

"I think this is very promising, very exciting, as a pilot study, but it's not enough to start treating people with minocycline," she said.

Smith concurred, saying, "I think this looks like a promising treatment with pretty big differences in outcome between the minocycline-treated and control groups. However, it is an early-phase study, and the results have to be considered preliminary. The field needs a l
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