Limiting Secondary Damage of Brain Injury

A new study will seek to determine whether cyclosporin A, a chemotherapy drug, can limit some of the secondary damage, such as swelling, that occurs in patients with severe traumatic brain injury.

Researchers at the University of Florida (Gainesville, FL, US) theorize that head injury damages nerve cells in the brain, which renders them less able to regulate the flow of chemicals, especially calcium, in and out of the cells. A buildup of calcium inside the cell causes progressive damage to the mitochondria and finally kills the nerve cells. By treating the victims of severe brain injury within 12 hours with cyclosporin A, the researchers hope to prevent this delayed response that causes cell death. They say the new treatment may also be effective for stroke, hemorrhage, and tumors.

In animal studies, a low dose of the drug was shown to regulate the flow of calcium into cells, thereby preventing injury to mitochrondia. The drug will be administered through an intravenous catheter to patients who arrive at the hospital within eight hours of the injury. Brain levels will be evaluated through a catheter inserted parallel to the tube routinely used to measure pressure inside the brain. The catheter will also be used to sample substances from the brain to determine whether they contain breakdown products indicative of nerve cell death.

"We're trying to separate the events associated with head injury that are primary—meaning they're a product of the injury itself—from the reactions or misdirected healing attempts by the body that end up being more destructive than the actual injury,” said A. Joseph Layon, M.D., professor of critical care medicine in the department of anesthesiology, who is directing the study.




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