Innovations in stroke care: UI-led study shows promise for protecting brain tissue

Date: Tuesday, March 14, 2023

UI team contributes uric acid treatment as winning approach for improving stroke therapy within the the Stroke Pre-Clinical Assessment Network (SPAN) study.

UI stroke researchers led by Enrique Leira, MD, professor of neurology, and neurosurgery, and Anil Chauhan, PhD, professor of internal medicine, contributed the winning therapy in the rigorous pre-clinical Stroke Preclinical Assessment Network (SPAN) trial for testing cerebroprotective stroke treatments.

The UI-proposed therapy of uric acid supplementation was the only one of six options tested to succeed in minimizing brain tissue damage that can occur at the time of a stroke or when blood flow to the brain is restored (a process referred to as reperfusion.)

To better understand the importance and benefits of this research, Leira and Chauhan collaborated to explain the significance of their research. Both researchers contributed to the following responses.

In your own words, why is stroke research important to UI Health Care?

The University of Iowa stands at the forefront of cerebrovascular research. We’re involved with two major NIH networks testing therapies for advancing stroke treatment both in research animals and in patients, respectively. Stroke is a leading cause of death and disability in the U.S., and because of how quickly stroke can destroy brain cells, speedy access to treatment can make a huge difference in outcomes for patients. It is critically important for us to identify new treatments that can be useful for patients living in rural areas, such as Iowa, where people often live far from a comprehensive stroke center like the one at UI Hospitals & Clinics. We are in an optimal position, both academically and geographically, for advancing stroke care.

How does uric acid help protect brain tissue during stroke?

Uric acid is a natural biological component present in human blood that helps improve flow in the smaller vessels and reduces brain damage by neutralizing damaging chemicals that occur during a stroke. Unfortunately, our own endogenous uric acid levels are rapidly consumed after stroke and are insufficient to prevent brain injury. This is particularly true in women, who have lower uric acid levels than men. We believe that giving an intravenous infusion of uric acid at the time of stroke treatment could compensate for this insufficient natural protection against stroke.

Why is this research important to you?

While we have effective therapies for patients with stroke, they have limitations. Mechanical thrombectomy—the physical removal of clots from within the artery—is a highly effective therapy, but approximately half of the patients treated with thrombectomy do not completely recover from their stroke.

Using uric acid to protect brain tissue during a stroke has the potential to augment the effects of standard treatments that remove blood clots. We believe our method could be a simple and safe therapy that could also be delivered in more rural areas. Increasing access and using treatments that reduce damage to brain tissue could greatly improve outcomes for patients.

What are your next steps in your project?

Based on these results, the UI team hopes to move uric acid into human trials. We anticipate working with the National Institutes of Health to test our methods on a dedicated platform focused on enhancing the effectiveness of traditional therapies for patients with stroke.

It takes a lot of persistence for investigators to find therapies that are effective to help patients. We are truly grateful for the support of patients and their families who participate in clinical trials when they are offered. Clinical trials are the only way to make progress in how we treat patients who have had a stroke.