Wayne Clark, MD, Director of the Oregon Stroke Center at Oregon Health & Science University talks about a new stem cell treatment that could potentially benefit patients suffering a stroke.
Interview Conducted by Ivanhoe Broadcast News in October 2017.
What is the problem with current stroke treatment, it’s a timing issue?
Dr. Clark: Yeah and we do have a couple of treatments for stroke now. First, is a medication called tPA, it dissolves the blood clot. It works great, but you’ve got to get it in the first three hours. And less than five percent of patients with a stroke get there in time for the medication. Then, we have some new things that we can pull the clot out of the brain, but that’s only at very specialized stroke centers in major cities. So we really have trouble getting therapies to where the patients are in time.
So then this is a huge development the trial and the stem cell treatment that you’re working on?
Dr. Clark: Right. So if this does pan out and is proven to work we are talking about a 36 hour window. Really every patient would probably qualify for that and also this is something you don’t need specialized training to give it to them. It can be easily stored in a refrigerator, mixed up quickly and then given via IV. So no specialized facilities will have to be created, and this is within a thirty six hour window. It could really allow a lot of patients to potentially benefit.
What is it?
Dr. Clark: Stem cell therapy is a special type where they’re kind of growing the cells themselves. It’s bone marrow derived and then they’ve found a technique that they can have it grow rapidly, so one donor can give thousands of potential application treatments.
And it would be compatible with everybody, no rejection or anything like that?
Dr. Clark: Correct, correct. And no risk of any viruses or anything else, it’s you know pure grown in a culture media.
How is it actually working in the body?
Dr. Clark: Good question. It’s one of those many things in science you know we have some theories. If you think about it when you’re very young and you have some injury to your brain you can recover fairly well. It’s called plasticity, the brain can recover nicely. As we get older our brains just don’t recover as quickly. What this does is stem cells are from very, very young cells and they bathe the brain in this environment that makes it act like it’s young again. So the idea that the injury now because of the chemicals, called cytokines, that are being released; it will give the plasticity back to the brain. The hope is an old brain will now act like a young person’s brain in terms of recovery.
Is it actually the treatment or does it just buy them more time to get to the hospital to get a different treatment?
Dr. Clark: No it actually would be the treatment. When you’ve had a stroke there may be a small area that’s completely dead, but then you have the larger area around it that’s just kind of hanging on, could go either way. So a treatment like this could allow the brain to go to the recovery pathway and not the cell dying pathway.
Where are we in the trial for this?
Dr. Clark: We did in a fairly large, about a hundred and forty patients, trial and in that trial significant benefit was seen at three months and especially at a year. It looked like it might even work a little better after three months. But any time you have a new potential treatment you have to make sure it really did work and do a second larger trial and that’s the next phase, the next plan is to do a larger trial.
So for numbers are we going from one to two or two to three, which would this next one be considered?
Dr. Clark: The next one would be a phase three trial to confirm efficacy, and it would be larger trial with a larger number of patients.
Many centers across the country or just this one?
Dr. Clark: Oh no, you know we were actually the top enrolling center but I think there was about 40 sites around the nation.
So clinicaltrials.gov they could find it?
Dr. Clark: Correct, correct. And I suspect this next one pretty much every state will probably have a representative hospital in it.
It’s pretty tremendous the fact that you can not have to take action within that first couple of hours.
Dr. Clark: Yeah, again a stroke doesn’t hurt, so a lot of people don’t go in right away or maybe they don’t recognize the common symptoms. So you know you get there a day later, well as of now it’s too late, but with this option we would still have something we could offer them.
How did you come across Sharon to get into the trial?
Dr. Clark: Well the Oregon Stroke Center has a network of hospitals around the state of Oregon where we can beam in; it’s kind of like a special secure Skype. So I could see her there on the computer screen and see that she wasn’t talking, wasn’t moving the right side at a facility that’s two hours away. And we were able to bring her here by helicopter and so that’s how she got here, it’s called Telestoke Network.
How did she respond to the treatment?
Dr. Clark: When she got here she had some mild weakness, but her big problem was she really couldn’t talk. She could not communicate, was not following commands, very impaired by her language being really shot. It didn’t happen right away and this type of therapy, if it does work, it’s not you know overnight they’re going to be 100 percent better. But as the brain recovers, every time I saw her, she showed improvement. In a month and then 6 months and a year and now she’s back to work and doing all her activities. It’s very gratifying whenever you see patients have a great recovery.
Who wouldn’t be a candidate for this treatment?
Dr. Clark: Potentially someone that maybe has a cancer, because if this is helping the brain regenerate and regrow, if you have a cancer you don’t want that to grow faster. So that might be one area we would have to be real careful about.
What haven’t I asked you about the trial that you think is important to put in the story?
Dr. Clark: Again I just want to emphasize for this study and as well as the current treatments what the warning signs of stroke are that people need to know of. Sharon showed trouble with language; so either slurred speech or you can’t get any words out, and then one side of the body feels weak, paralyzed or very numb. You know if you have those symptoms, don’t think you’ve slept on your arm funny and go back to bed. Go in get evaluated right away.
And she seems very young, how much is age a factor in what you should look for?
Dr. Clark: The traditional 60 to 70-year-old still is the largest area of stroke. But we see stroke in a lot of people; even 30 year olds having stroke. A lot of very younger ones may have to do with some drug abuse, but you know healthy people in their 40’s have a lot of them. They come with a heart condition called A-fib; which is a big cause of stroke. And people don’t have that diagnosed until they’re had their stroke. All ages it can impact.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Wayne Clark
Scott Stachowiak
Stachowiak@russopartnersllc.com
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