Brain injuries no match for sPIF treatment

New Haven, Conn. — Researchers at Yale School of Medicine and their colleagues have uncovered a new pathway to help treat perinatal brain injuries. This research could also lead to treatments for traumatic brain injuries and neurodegenerative disorders such as Alzheimer’s and Parkinson’s.

 

The findings are published in the Sept. 8 issue of Proceedings of the National Academy of Sciences.

 

The microRNA let-7 is known to cause the death of neurons in the central nervous system. The research team found that a synthetic molecule derived from the embryo called PreImplantation Factor (sPIF) protects against neuronal death and brain injury by targeting let-7.

 

“We would never have connected the dots between PIF and let-7 without prior knowledge and experience with let-7 and H19, a developmentally regulated gene that is highly expressed in the developing embryo,” said senior author Yingqun Huang, M.D., associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine.

 

Using a rat perinatal brain injury model, Huang and the team found that sPIF rescued damaged neurons and reduced inflammation. The team performed a series of in vivo and in vitro experiments and found that sPIF helped to stop the production of let-7. “We showed that sPIF works by destabilizing the key microRNA processing protein called KH-type splicing regulatory protein,” said Huang.

 

Lead author Martin Mueller, who helped develop the rat perinatal brain injury model, was surprised at the consistency of the results from both the in vivo and in vitro studies. “Collectively, our findings suggest that sPIF mitigates brain damage through a novel pathway,” said Mueller. “We saw more cortical brain volume and more neurons restored in brain-damaged animals receiving sPIF.”

 

“For the first time, we have clear indication to pursue a new line of investigation in the treatment of perinatal brain injury, and possibly traumatic brain injury,” said co-author Michael Paidas, M.D., professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine.

 

Paidas, who is also vice chair of obstetrics at Yale, has helped to identify PIF’s effects with co-author Eytan R. Barnea, founder of the Society for the Investigation of Early Pregnancy (SIEP) and chief scientific officer of BioIncept, LLC. Barnea discovered and characterized the peptide and described key elements of PIF’s mode of action.

 

Based on this promising data, the FDA has awarded sPIF fast-track designation and allowed a phase 1 sPIF clinical trial to treat patients with autoimmune liver disease at the University of Miami.

 

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In addition to Huang, Paidas, Mueller, and Barnea, other authors on the study include Jichun Zhou, Lihua Yang, Yuan Gao, and Fuju Wu of Yale; and Andreina Schoeberlein and Daniel Surbek of the University of Bern, Switzerland.

 

Citation: Proceedings of the National Academy of Sciences www.pnas.org/cgi/doi/10.1073/pnas.1411674111

Food Therapy for TBI

Most neurologists agree that the omega acids in fish oil are beneficial to the brain. Therefore, I would recommend that all TBI victims try to include that in their everyday supplements. However, there is also a new and more organic option available, Purslane.
 

Purslane is a common succulent vine that grows plentifully and easily in most climates. Astonishingly, purslane has an extraordinarily high level of omega 3 acids, second only to eating fish. All this in a tasty plant. Purslane can be purchased in nurseries, grown in pots, and can be grown easily in one’s backyard.
 

I would recommend for anyone who has suffered a TBI to plant and consume as much purslane as possible on a daily basis. Many recipes for purslane can be found on the internet. It is excellent in salads, stir-fries, or on sandwiches.
 

People that live near a beach or a man-grown swamp can enjoy “Sea Purslane,” which actually picks up a salty flavor from the ocean. A pre-salted snack! Purslane contains more omega-3 fatty acids than any other leafy vegetable plant. Research showed that it contains .01mg/g of EPA, an important omega-3 acid found mostly in fish, some algae and flax seeds, one cup of fresh purslane leaves contains 300 to 400 mg of alpha-linolenics, 90mg of calcium, 561 mg of potassium and lots of vitamin A.
 

“Purslane I Collected Growing at the Seashore. Eaten in a Fish
Sandwich. Delicious!”

 
Purslane is commonly eaten in most parts of the world outside of the United States, especially in Greece, the mid east, Asia and Mexico. It is also used in traditional Chinese medicine – used to treat insect or snake bites, sores, pain from bee stings, diarrhea, hemorrhoids and intestinal bleeding.
 

Purslane is an excellent companion plant, which provides grown cover in a humid micro-climate for nearby plants. Plant some now. Let us know your results.

Brain Injury and Fatigue

It is a very common complaint of victims of traumatic brain injury that since the injury they experience extreme bouts of fatigue. Symptoms of “fatigue” are often ignored or downplayed by doctors because  it is considered a “vague” symptom.  It is also a symptom that has not been specifically linked to any known mechanism or area of damage in of the brain.
 
Like many other aspects of brain injury, this symptom of fatigue is now being studied and explained in much greater detail than done before.  This is once again thanks to the sacrifice our soldiers have made in Iraq and Afghanistan and the Army researchers trying to help them.
 
The first thing we know about the creation of fatigue is that in functional MRI testing, TBI victims with frontal lobe injury, when asked to perform spelling or math problems, have a much higher rate of “brain recruitment”.  Brain recruitment means what part of the brain and how much of the brain is activated by doing a given task. By these recent studies we know that the person with the injured brain is forced to recruit a larger percentage of their brain to complete a certain task, whereas an uninjured person would be activating a much lower percentage of their brain.  The brain burns up about 30% of the bodies energy on a given day.  Thus, over-recruitment of the brain because of injury is literally fatiguing, since it is costing a much higher rate of energy to do things that previously cost the body much less energy.  It would be the same of putting 5 lb weights on each hand throughout the day.  It explains nicely why there is such widespread and debilitating fatigue with TBI survivors.
 
In another recent study (Vanzuiden M et al., 2012) soldiers were tested before and after deployment regarding reports of severe fatigue.  It was found that severe fatigue was associated with higher reactivity to IL-1 beta and it was found in higher levels in those with severe fatigue. TBI also plays a part in increasing what is known as pro-inflammatory cytokines in the blood for many months or years after injury.  This can explain the very high level of severe fatigue found in TBI survivors.  If a way can be found to decrease the reactivity to the immune system of the IL-1 beta, treatment can be found.

Brain Rehabilitation Ideas

We know now that the brain is elastic throughout our entire lifetimes. That is, we are able to positively or negatively affect its structure by how we live. Illness and lack of cognitive stimulation result in a shrinking of key parts of the brain while physical exercise, cognitive stimulation, and healthy lifestyle tend to add brain mass.

 

We have been suggesting for clients at braininjury.com to engage in free methods of rehabilitation and to chart whether or not this program works for them. The program is simple:

 

1. Obtain a device capable of downloading and playing audiobooks with headphones.. Download several books to listen to but try to make selections that are not just easy listening. Remember that cognitive challenge is what we are looking for here.

 

2. Walk at least one hour per day while listening to your books through the headphones.

 

3. Take a different route each time if possible. Again, novelty and multi-tasking of the brain during physical exercise is what we are looking for.

 

We know walking itself over and above cardiovascular exercise, as well as exposure to novel situations promote and results in neuro-genesis.

 

We invite you to try this method of rehabilitation either acutely or in chronic situations ad would love to have you report back to braininjury.com on the outcomes.

 

We look forward to hearing from you.

Consciousness Test Will Alter Rehabilitation

A widely publicized study recently published in The Lancet, where three patients in a “vegetative state” showed signs of consciousness on EEG testing, will have important ramifications on brain injury rehabilitation. There are two long held beliefs by both the medical community and the insurance community that are no longer valid. One is that persons in a vegetative state are not “conscious” as we understand it. This study, as well as others, is showing that assumption to be false. Secondly, the long held belief that the brain of a person in a chronic vegetative state cannot be rehabilitated is also untrue.

 

This development will greatly impact the already troubled field of brain injury rehabilitation. Twenty five years ago there were thousands more brain injury rehabilitation centers in the United States than there are now. The reason for the reduction has primarily been that brain injury rehabilitation is slow and expensive. Most medical coverage now in the United States severely limits the amount of brain injury rehabilitation a person can be covered for if they have suffered a severe brain injury. Most patients in a coma or in a vegetative state are simply dumped into nursing homes if they do not show improvement within the first six-months of injury.

 

A recent study in 2011, has shown that long term therapy for patients in a persistent vegetative state or minimally conscious state through sensory stimulation can result in long term improvements. This upsets the apple cart in an expensive way for the insurance companies. This means that common and inexpensive EEG machines can be used to measure the level of consciousness of these patients. That means, for the first time, there will be a way to objectively measure the level of improvement in a coma patient who is undergoing rehabilitation. Until these new findings came out, most patients were assessed using behavioral observations, which, of course, are mostly absent in coma patients. The recent study on rehabilitation shows us that, not only is there a way to measure the improvement in a vegetative patient undergoing therapy, but there is actually sensory stimulation therapy that can help those in a persistent vegetative state. Persistent vegetative state describes a patient who has been in a state of awake unawareness for over a year. Currently, approximately 25,000 people in the United States are in a chronic vegetative state.

 

While certainly larger studies need to be done on some of these issues, the revolutionary idea here is that people who appear to be in a vegetative state may, in fact, be far more conscious than we realized. We now have the tools to help them and allow for movement and communications to return in some patients. The battle over who will pay for these breakthroughs has just begun.