Dr. Cameron Rink points to a picture of a brain that is currently undergoing a stroke, noting in particular the dark, feathery arteries that branch out across grayish brain tissue. Some of that tissue has faded to black around the vessels which are obstructed, and they very much resemble a city block that has lost power as the rest of the city remains well-lit.
“That part of the brain is not getting blood or oxygen and the cells are dying. There’s not much we can do for a patient at this point and that’s frustrating,” Dr. Rink, a professor of surgery at the Ohio State University Wexner Medical Center, said.
It is easy to understand all of his frustration. After more than two and a half decades and the failure of some 1,000 experimental neuroprotective medications, only aspirin and tPA, the so-called “clot-busting” drug, are all that traditional medical science is offering to patients after they’ve suffered a stroke. And of the two, tPA is only used in about 4 percent of all stroke cases, said the university in a press release.
Prevention is the key
But Dr. Rink has long been convinced that such “after the fact” approaches don’t really do much to prevent disability and death. So, for the past dozen years, Rink has focused his research on stroke prevention, and it is finally beginning to pay dividends.
What’s more, one of the most promising of treatments is a natural alternative.
In published studies involving animals, Dr. Rink and fellow researchers write that they have discovered that brain damage during a strike can be prevented by triggering the surrounding blood vessels to dilate, thereby redirecting blood flow around a blockage.
The blood vessel “redirection” is the result of 10 weeks’ worth of supplementation with a little known type of vitamin E called tocotrienol, which appears to stimulate arteriogenesis, or “the remodeling of existing blood vessels that can instantaneously expand in response to a demand for oxygen-rich blood,” the press release states. And the creation of a collateral blood supply can make a huge difference in the outcome of strokes.
“We know that people who have good collaterals have better recovery from strokes. We think that tocotrienol helps improve the function of collaterals, which would offer someone better protection from an initial or secondary stroke,” said Dr. Rink, who is currently participating in a study of stroke survivors to see if the supplement can help prevent or reduce damage from secondary strokes — which can often be more disabling and costly than the first stroke.
More from the university’s release:
To find out exactly how tocotrienol is impacting blood vessel remodeling, Rink pioneered a technique using laser capture microdissection (LCM) to take microscopic pieces of brain tissue and blood vessels from the exact area where collaterals are called into action during a stroke.
The LCM samples also give Rink a chance to study micro-RNA activity during a stroke. Micro-RNAs are tiny snippets of non-coding DNA that turn off the production of proteins created by genes, proteins that give cells a range of different instructions. By identifying the micro-RNAs, Rink will be able to find out what’s happening at a genetic level during a stroke, and how tocotrienol may be influencing those genes.
More funding for more studies
The tocotrienol, which is formed naturally in palm oil, is a vitamin E variant and is currently available as an oral nutritional supplement. And because it does not interfere with other stroke therapies or have any side effects, Dr. Rink says he believes that the vitamin could someday become a common stroke-prevention strategy.
The university said that Dr. Rink’s research was given pilot funding from Ohio State’s Center for Clinical and Translational Science in 2012 to study tocotrienol’s impact on stroke. The center has been studying the supplement for the past two years.
His initial findings also led to an additional funding grant from the American Heart Association, and Dr. Rink would like to apply for an RO1 grant in the next two years after the publication of several more studies on animal and human subjects.
“The animal studies are helping inform the optimal tocotrienol dose and therapeutic window for our human studies, so it’s a great example of how the basic research is informing clinical studies, and helping us move the research forward faster,” Dr. Rink said.