Every year, 55,000 Australians suffer a stroke, and many are left with life-changing disabilities. A macroscope could help change that.
Currently, there is only one emergency drug treatment for stroke available. This ‘clot-busting’ drug, called tissue plasminogen activator (TPA), can be very effective – but it carries a high risk of dangerous side effects, including severe bleeding and further clotting.
This means it is only used for a small minority of stroke patients, to avoid bleeding on the brain that can be as deadly as the original clot. TPA must also be administered within just 4.5 hours of a stroke to be effective, making it a race against time for stroke patients to reach hospital in time.
In short, TPA can only be administered to around 10 per cent of ischaemic stroke patients.
Up to 90 per cent of people who suffer an ischaemic stroke today cannot receive this emergency treatment – they are at risk of suffering the full devastating consequences of the stroke.
The Heart Research Institute (HRI) is conducting innovative work to help protect people from these terrible strokes and other cardiovascular diseases. Donations to support this life-saving research can be made here.
The search for safer, more effective treatments for ischaemic stroke
Pioneering research by the Thrombosis Group at HRI, led by Professor Shaun Jackson and lab members Associate Professor Simone Schoenwaelder and Dr Jessica Maclean, is focused on finding safer, more effective therapies to treat ischaemic stroke.
“We’re working to couple the existing TPA drug with something else that targets the blood clotting cells,” explains Dr Maclean. “We’re looking for a precise combination of therapies that will dissolve blood clots without causing bleeding or secondary clotting. Specifically, we’re targeting the bigger clots that block the arteries and cause stroke, without stopping the normal, essential clotting process.
“Right now, because of the risks and the limited timeframe for administering TPA, up to 90 per cent of people who experience an ischaemic stroke cannot receive this treatment.
“We urgently need a way to extend that treatment window and to make the treatment safer, so that more people can receive medication to break down the clot as quickly as possible.
“That is vital because with stroke, ‘time is brain’ – the more time you wait or you’re delayed in getting treatment, the more brain cells will die, increasing the risk of life-altering disability or death.”
The macroscope: “a new way of seeing”
Vital to the success of the team’s research is a state-of-the-art macroscope – a unique piece of imaging technology that allows the team to mark clot components with fluorescence, allowing live-cell observation without the need for toxic and time-consuming staining processes.
Not only does this speed up the research dramatically, but it also enables the team to monitor, for the very first time, the whole process of a clot formation from start to finish – including how it builds and rearranges itself over time.
Crucially, the team can also test ‘clot-busting’ treatments and see the effects in real time.
“The macroscope allows us to see what’s happening in a totally different way, and to explore so many things we have never been able to test before,” says Dr Maclean.
“By seeing the clot actually move and form, we can observe how it responds to treatment. Critically, we can see not only whether the clot is successfully broken down, but whether it does so in a way that is safe – ie, into lots of tiny fragments rather than a few larger pieces which can potentially cause deadly blockages elsewhere in the brain.”
Header image: Macroscope image shows build-up of occlusive blood clot in carotid artery following injury. Clot “built” of platelets acting as “bricks” (green) and fibrin acting as “cement” (red)