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A drug to help brain heal itself

A drug usually in the headlines when top athletes are found out as substance cheats could soon be helping people to recover from a traumatic brain injury.

Australian scientists are part of a global effort looking at whether erythropoietin - otherwise known as EPO - can boost the brain's recently discovered ability to heal itself.

The dogma 10 years ago was that the brain was "absolutely unable to generate new neurones ... if they got lost they could never be replaced", explains Associate Professor Cristina Morganti-Kossmann from the National Trauma Research Institute (NTRI) at Melbourne's The Alfred Hospital.

"But it has been shown there is a very small number of new neurones that are generated continuously, even in adult life," she said.

"And that is exactly what a lot of laboratories in the world are trying to understand, and explore, and find ways to increase this endogenous phenomenon."

Morganti-Kossmann's laboratory is about to embark on a three-year study in mice, which will look for signs of brain healing linked to EPO as well as another drug known as brain-derived neurotrophic factor (BDNF).

This work will aim to find whether both drugs in combination have more effect than each alone, while also describing the mechanism for this brain healing.

The hope is to develop a treatment doctors could use in their traumatic brain injury patients - car crash survivors for example - immediately after their accident and through their recovery to reduce the prospect or severity of brain damage.

In 2008, Australia recorded 700 deaths as a result of traumatic brain injury while a further 1700 people were survivors who would require long-term care.

"Unfortunately, so far, there are no efficacious treatments in terms of medication that can inhibit the progression of the brain damage caused by trauma," Morganti-Kossmann said.

"What happens is you have an initial injury but we know that in the following hours, days, weeks and even months there is a progressive degeneration of the brain.

"More neural cells continue to die and this can have a huge impact not only on the physical wellbeing of the patient but on (longer term) psychological aspects, such as mood, depression, substance abuse, memory, lack of concentration."

It is thought the EPO will promote the growth of new neurones needed for healing, as well as stop or slow the degenerative process.

A separate clinical trial is also underway, involving the Alfred Hospital, in which EPO alone is being used experimentally to treat people with traumatic brain injury.

While EPO's effect on the body was well known - it increases the number of circulating red blood cells and therefore oxygen in the body, hence the temptation for its abuse by elite athletes - its effect on the brain was less clear.

Other research had shown EPO could have a role in future treatments for stroke, spinal-cord injury and multiple sclerosis.

"Can you reverse it? No, I don't think so," Morganti-Kossmann also said of the prospect of halting the brain damage altogether.

"But what we hope to do is at least improve the recovery by reducing those detrimental processes which begin from the time of injury and remain ongoing for a long time after trauma."


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