One of the most dangerous side effects of a stroke or brain injury is uncontrolled brain swelling, which can block blood flow to the brain and lead to further brain damage. Currently, doctors can fight swelling by removing a part of a skull or by installing a shunt to drain cerebrospinal fluid, but both carry risks, primarily of infection. A drug capable of reducing swelling without invasive procedures may potentially also reduce the high morbidity rate of complications caused by brain swelling.
In the study led by the University of Exeter, a group of researchers from around the world discovered that a malfunction in the transportation of key proteins in one brain pathway can lead to the dangerous swelling. The proteins in this pathway regulate water composition in and out of the brain, but the new ZT-1a compound is able to target that specific pathway. In lab tests of mice and rats with stroke or hydrocephalus, ZT-1a was able to stop the enzymes from activating proteins that led to increased water in the brain. This mechanism was able to reduce swelling by 50% in the study. Further human studies are needed to confirm these initial findings.
A previous study examined the potential use of multiple drugs to reduce swelling, but none of those drugs were able to concentrate the reduction of swelling to just the brain, which made the drugs too dangerous to use in humans. The ability of this compound to target specific enzymes in a specific pathway is a unique characteristic that may make the compound a safer alternative to high-risk surgeries and devices, like shunts.
Despite the fact that strokes are a major health concern in the United States, affecting nearly 800,000 people and killing approximately 140,000 each year, treatments are largely outdated, with high rates of complications. Finding ways to improve the treatment of strokes and stroke complications through non-invasive methods could potentially save the life and quality of life of future stroke patients.