THURSDAY, April 10, 2003 (HealthDayNews) -- What started as idle conjecture has produced a promising -- and unconventional -- treatment to prevent the brain damage caused by a stroke, researchers report.
"It really was a serendipitous thing," says Dr. James C. Grotta, director of the stroke program at the University of Texas-Houston Medical School. "One of my laboratory workers, Roger Strong, was musing about the fact that moderate or mild use of alcohol can be effective in reducing the effect of stroke. So we started fooling around with combinations of it with other things, flavonoids and vitamins C and so, and we stumbled on this."
"This" is a mixture that Grotta calls caffeinol. It consists of the amount of caffeine found in one or two strong cups of coffee and the amount of alcohol in one cocktail.
Infusions of caffeinol reduced the brain damage from a stroke in laboratory animals, says a report in the April 10 issue of Stroke, and the first steps toward testing it in human patients have been taken.
Brain damage in rats was reduced by 80 percent when an infusion of caffeinol was given within three hours after a stroke. The stroke was induced by blocking an artery to the brain, the journal report says.
The first human trials have shown that the blood levels effective in rats can be achieved in humans, and steps toward treatment of people have been taken.
The first step was to give intravenous infusions of a low dose of caffeinol -- 6 milligrams of caffeine per kilogram (2.2 pounds) of body weight, 0.2 grams of alcohol per kilogram -- to patients who had just suffered a stroke. That dosage did not achieve the blood levels effective in mice, so the dose was increased to 8 milligrams/kilogram of caffeine and 0.4 milligrams of alcohol for the next group of 19 patients. With that, the target blood level was achieved.
Some of the patients who got caffeinol were being treated with tPA, a clot-busting drug often used for stroke. The combination appears safe, Grotta says; while one patient did have bleeding within the brain, an independent safety officer concluded the hemorrhage was not related to caffeinol.
That is an important finding, because it indicates that caffeinol can be added to standard stroke treatment, Grotta says.
"We are at the phase where we think that the combination is more effective than any other drugs you look at in the laboratory, particular for strokes that affect the cortex, the gray matter of the brain that controls language and other abilities," he says. "Often, it is the part of the brain that hangs in the balance after a stroke."
The next step, being tried now, is to combine caffeinol with hypothermia, or cooling of the body, which is known to help reduce stroke damage. The cooling is done by running cold liquid through a catheter inserted in the femoral vein, "like a refrigerator coil," Grotta explains.
That combination of treatments has been used safely in one patient, and it will be tried in 10 or 20 more to test safety, Grotta says. "If it is feasible to do it urgently, in the first three or four hours after a stroke starts, then our plan is to start a study looking at its efficacy," he adds.
But the caffeine-alcohol combination is for treatment, not prevention, Grotta says.
His studies have found that the treatment does not work in animals that are given regular doses of the drugs, he says.
"Anyone who thinks that having a cup of Irish coffee every day will help prevent stroke will find that it does not work," Grotta says.
This appears to be the first time the idea of using either caffeine or
alcohol to treat stroke has been proposed, says Dr. Philip B. Gorelik, professor of neurology at Rush-Presbyterian Medical Center in Chicago.
"I would congraulate Jim Grotta and his group for doing a
well-directed and important study," says Gorelik, a spokesman for the American Heart Association. "These compounds have the potential for being useful neuroprotective agents in humans. They [the researchers] are taking the appropriate steps to evaluate their concept."
One helpful aspect from a patient's point of view is that "everyone is familiar with caffeine and alcohol," Gorelik says. "Some people get
frightened by fundamental agents because they have unfamiliar names."
More information
You can find additional insight into current treatment of stroke at the American Heart Association or the National Stroke Association.
