EUSTROKE – Giving stroke patients new reason for hope
Disturbances in the blood supply to the brain can lead to rapid loss of brain function, causing a stroke. While potentially fatal, this can have life-changing consequences for survivors. Two EU projects aim to ensure that for thousands of patients, there is life - and hope - after such a trauma.
Thousands of European stroke patients live with disabilities, which often severely impact their quality of life and cost taxpayers billions in health care. Substantial sums have been dedicated to developing effective therapies but, to date, these remain limited.
This is why leading European stroke researchers and clinicians have teamed up with small businesses involved in cutting-edge R&D to push for promising new therapies. In fact, two such EU-funded projects are currently under way: the 'European Stroke Research Network' (EUSTROKE) and the 'Affording Recovery in Stroke' (ARISE) consortia.
The European Stroke Network
The EUSTROKE team aims to improve our understanding of the neurovascular system to enable better prevention and treatment of stroke. ARISE, meanwhile, is developing and trialling new therapies to induce repair of lost function, which will potentially bring relief and new hope to thousands of sufferers.
"From the beginning, the European Commission encouraged us to work closely together," explains EUSTROKE coordinator Stephen Meairs. "We first formed common platforms for conducting clinical trials and training young scientists. We decided to use the same stroke models and methods, and also to share imaging advances. The ultimate co-operation, however, was the total merging of the two consortia to form the European Stroke Network (ESN). This allows us to optimally use European resources and brings the best minds in stroke research together to combat this devastating disease."
This unique ESN co-operation has led to a number of breakthroughs, such as the development of novel concepts for the treatment of life-threatening brain swelling after stroke. Interestingly, ESN researchers have learned that stroke outcome can be improved by enriching the treatment environment. This can be accomplished, for example, if patients play games or pursue interesting activities in the recovery phase. By employing sophisticated imaging techniques, scientists in the ESN have been able to show how such activities lead to a remarkable formation of new brain connections.
In another attempt to enhance the therapy of acute stroke, ultrasound physicists and stroke researchers have joined forces to develop new ways to break up blood clots in brain vessels with acoustic energy. An exciting addition to acute stroke therapy is an innovative immunotherapy to prevent the delayed neurotoxic effects of the thrombolytic 'tissue Plasminogen Activator' (tPA). The first human trials using this approach are planned.
The complex role of inflammation in stroke has also been examined. It was discovered that chronic systemic infection increases ischemic and blood-brain barrier damage, leading to sustained cerebrovascular inflammation. Novel therapeutic targets have since been identified, and a clinical trial based on this research is being planned.
Further innovative research by the ESN has involved the integration of pioneers in nanoparticle drug delivery for treating stroke with substances that were not previously suitable for this purpose. Such advances have led to recently established co-operation with the Canadian Stroke Network to study novel ways for supporting functional recovery and the regeneration of brain tissue after stroke. Importantly, multi-disciplinary research has also led to unexpected observations that challenge old dogmas.
Meeting of minds
A particular strength of the EUSTROKE network, says Prof. Meairs, is the fact that it brings together people from different fields. A multiple sclerosis expert, for example, can view tissue inflammation in a different way, which can help lead to new ideas and discoveries.
"The various impacts of a stroke and the subsequent reorganisation and repair of the brain are highly complex," explains ARISE coordinator Professor Ulrich Dirnagl. "Developing successful strategies for brain protection and repair therefore requires a joint effort involving experts in basic neuroscience, vascular biology, neuro-immunology, neuro-protection, neuro-regeneration, drug delivery and clinical stroke neurology." Furthermore, the project has involved stroke patients from the beginning, and they are included in discussions through the Stroke Alliance for Europe, an important member of the network.
Through co-operation and innovative thinking, ESN research has the potential to substantially contribute to improving the quality of lives of stroke sufferers. "A stroke can be devastating," says Prof. Meairs. "And there is simply nothing else that absorbs so many billions of euros in care. Stroke is the biggest cause of disability and it's getting worse. So we have very good reasons for attacking this problem."
The European Stroke Network is bringing a wide range of resources and expertise to develop solutions to this growing issue, and is becoming a hub for the recruitment of additional European centres within and outside the consortium. It is also enhancing the trans-European flow of information on stroke research from stroke patients to governmental agencies. Recently, the ESN has expanded its co-operation with projects across the Atlantic, underlying the global impact of this field of research.
Participants: Germany (Coordinator), Italy, Switzerland, Hungary, France, the Netherlands, Spain, Sweden, United Kingdom, Finland, Belgium
Project N° 202213
costs: € 12 971 601
contribution: € 9 953 915
Duration: March 2008 to August 2013
ARISE - Affording recovery in stroke
Participants: Germany (Coordinator), Belgium, Denmark, Spain, Finland, France, Poland, Sweden, United Kingdom