An old antibiotic could prove to be a new treatment for a devastating type of stroke that has no good remedies, said researchers at Georgia Regents University and the University of Georgia College of Pharmacy.
A new pharmacy center at GRU could help foster more collaborations between the two institutions and fund more joint research, the new director said.
Dr. Susan C. Fagan, the assistant dean for the UGA College of Pharmacy campus at GRU, has been named the founding director of the Center for Pharmacy and Experimental Therapeutics at GRU. The UGA College of Pharmacy has had a program at Augusta’s university since 1973. About 60 doctor of pharmacy students complete their final two years of training there, and other postdoctoral and graduate programs and research collaborations take place. That allows them to have a clinical grounding and a ready transition in translating basic research findings into clinical trials, Fagan said.
“I consider myself a translational researcher, so everything I do, even in my laboratory, is with an eye toward how could this work in our patients here,” she said.
Take minocycline, an old antibiotic that Fagan and GRU researchers have studied for 10 years as a potential treatment for stroke. In a clinical trial, they are studying it as a potential treatment for hemorrhagic stroke, caused by bleeding in the brain. That type makes up 10 percent to 15 percent of strokes but results in more deaths and longer hospital stays than strokes caused by clots, said Dr. Jeff Switzer, the director of the Comprehensive Stroke Center at Georgia Regents Medical Center.
“These are less common but more devastating,” he said.
About half of the patients die within 30 days, Fagan said. A clot-busting drug has been approved for those strokes, but doctors can do little to treat the bleeding strokes other than support and treat the complications, Switzer said.
“For patients with brain hemorrhages, for the vast majority we have no evidence of any surgical or pharmacologic treatment,” he said. “We really just support patients and try to get them through those first few days.”
That is why trying minocycline, which has been through safety studies to gain approval, makes sense in those strokes, Fagan said.
“Just seeing all of the hemorrhages untreated, it’s just very frustrating as a pharmacist who cares for stroke patients to have zero to offer these patients,” she said. “I just feel it is urgent. We’ve got to try something. Minocycline at least theoretically has some advantages. We know it is safe. We know it gets into the brain.”
The antibiotic might help in a couple of ways. It has been shown in other studies to reduce the levels of a damaging enzyme known as matrix metalloproteinase-9. That can cause damage by killing some cells and by causing swelling in the brain, Switzer said.
“It weakens the integrity of the blood-brain barrier, and you get more water into the brain tissue,” he said.
The American Heart Association is funding the trial for a small number of patients, but the trial would be expanded if it works, he said. As part of the study, students who are in the doctor of pharmacy program are on call to pick up blood samples at the hospital and analyze them, Fagan said.
“That really enhances their training because other than that they would just be in the lab studying cells or animals,” she said. “They get very excited about seeing what they’re doing help patients as part of a team approach. It’s a unique advantage of a Ph.D. program here at the academic medical center.”
Planning is under way to look at different ideas for new space for the pharmacy center, which includes faculty members from both institutions. The focus, however, is to keep furthering the research teamwork, Fagan said.
“The center is really to promote this kind of collaboration where I think the pharmaceutical scientists can really assist the busy clinician with the design and implementation of clinical trials,” she said.