AIDS drug accelerates stroke recovery

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An AIDS drug may become the first pharmaceutical treatment from a human gene discovery to help patients recover from stroke.

Researchers at the University of California Los Angeles discovered that people missing a certain gene recover from stroke well.

Reams Freedman had a severe stroke 21 years ago.

"It was like I was run over by a truck," said Freedman, the director of the Stroke Association of Southern California. "So, I went from a fully functioning man to someone who essentially couldn't do anything."

Using physical and occupational therapies that were available, he got back most of his function and now runs a stroke recovery group.

Now, his friend and UCLA Dr. Tom Carmichael believes a missing gene may speed up stroke recovery, and that may lead to a medication that helps.

"It's tempered hope, but it's a pathway, and we haven't had a lot of those," Carmichael said.

In a study in Tel Aviv, stroke survivors without a functioning CCR5 gene showed significantly better improvements in motor skills, language, sensory function, memory and attention.

The drug maraviroc blocks CCR5 and slows HIV progression. Carmichael hopes the same mechanism will accelerate stroke recovery.

"Our hope is that it does enhance recovery, even a little bit, and lets many stroke patients know there's a possibility if you can get enhanced recovery a little bit and increase brain plasticity, you may be able to do more with a very aggressive rehabilitation program," he said.

Carmichael says maraviroc worked in mouse trials. Human trials are beginning now.

The maraviroc trial will be run at UCLA, Yale and Burke Rehabilitation Institute. Since the drug is already Food and Drug Administration-approved for safety in HIV patients, the trial is already in Phase 2.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: AIDS DRUG ACCELERATES STROKE RECOVERY
REPORT: MB #4593

BACKGROUND: A stroke is a "brain attack". It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost. How a person is affected by their stroke depends on where the stroke occurs in the brain and how much the brain is damaged. For example, someone who had a small stroke may only have minor problems such as temporary weakness of an arm or leg. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. Some people recover completely from strokes, but more than two-thirds of survivors will have some type of disability. (Source: https://www.stroke.org/understand-stroke/what-is-stroke/)

RECOVERY: Recovery time after a stroke is different for everyone. It can take weeks, months, or even years. Stroke rehabilitation can include working with speech, physical, and occupational therapists. Speech therapy helps people who have problems producing or understanding speech. Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke. Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing. Therapy and medicine may help with depression or other mental health conditions following a stroke. (Source: https://www.cdc.gov/stroke/recovery.htm)

NEW RESEARCH: S. Tom Carmichael, MD, PhD, Professor, Chair of Neurology at Geffen School of Medicine, UCLA talked about a potential new drug to help with stroke recovery, "The mice made about 30 to 50 percent enhanced recovery. And the thing that is an advantage there is that we know in humans with movement or motor recovery that if you get a 10 percent improvement in motor function that actually translates to a meaningful change in your interaction to community. That's what's known as a minimal clinically important difference or MCID. It's about 10 percent in humans. And so the mouse recovery was far better than that and it allows us some hope that it was a meaningful thing we hit in the mouse." (Source: S. Tom Carmichael, MD, PhD)