ScienceDaily (Oct. 21, 2009) — As doctors begin to test progesterone for traumatic brain injury at sites across the country, researchers are looking ahead to optimizing the hormone's effectiveness.

Two abstracts summarizing Emory research on progesterone are being presented at the 2009 Society for Neuroscience (SFN) meeting in Chicago.

A multisite phase III clinical trial called ProTECT III will begin to evaluate progesterone's effectiveness for treating traumatic brain injury early next year. The trial grows out of years of research by Donald Stein, PhD, Asa G. Candler Professor of Emergency Medicine at Emory School of Medicine, demonstrating that progesterone can protect damaged brain tissue. Stein is director of the Department of Emergency Medicine's Brain Research Laboratory.

One of the SFN abstracts reports on progesterone analogues that are more water-soluble. This work comes from Stein and his colleagues in collaboration with the laboratory of Dennis Liotta, PhD, Emory professor of chemistry.

Currently, the lack of water solubility limits delivery of progesterone, in that the hormone must be prepared hours ahead and cannot be kept at room temperature. Small chemical modifications may allow similar compounds with the same effects as progesterone to be given to patients closer to the time of injury.

According to the results, two compounds similar to progesterone showed an equivalent ability to reduce brain swelling in an animal model of traumatic brain injury.

The second abstract describes evidence that adding vitamin D to progesterone enhances the hormone's effectiveness when applied to neurons under stress in the laboratory. Like progesterone, vitamin D is a steroid hormone that is inexpensive, has good safety properties and acts on many different biochemical pathways.

The authors showed that a low amount of vitamin D boosted the ability of progesterone to protect neurons from excito-toxicity , a principal cause of brain injury and cell death.

http://www.sciencedaily.com/releases/2009/10/091019122636.htm

By Bill Rankin - The Atlanta Journal-Constitution

Emergency room doctors make rapid-fire, life-or-death decisions in a chaotic environment, often without knowing the medical histories of their patients.

The Georgia Supreme Court’s justices were reminded of that Tuesday by lawyers defending a key provision of the state’s tort reform law. It requires a plaintiff to establish by “clear and convincing evidence” that an ER doctor committed “gross negligence” — an almost insurmountable legal threshold — to prove medical malpractice.

An injectable biomaterial gel may help brain tissue grow at the site of a traumatic brain injury, according to findings by a Clemson University bioengineer.

Research by assistant professor of bioengineering Ning Zhang shows that the biomaterial gel made up of both synthetic and natural sources has the potential to spur the growth of a patient's own neural stem cells in the body, structurally repairing the brain injury site. In previous lab studies, Zhang has demonstrated the reconstruction of a complete vascular network at the injury site as an initial step toward brain tissue regeneration.

Zhang presented her findings Wednesday, Sept. 2, at the Military Research Forum in Kansas City. The conference is geared toward improving the overall health and welfare of the U.S. armed forces, their families, veterans and the American public.

 "We have seen an increase in brain injuries due to combat, but our strategy can also potentially be applied to head injuries caused by car accidents, falls and gunshot wounds," said Zhang. "These results that we are seeing in adult lab rats are the first of its kind and show a sustained functional recovery in the animal model of TBI (traumatic brain injury). It also represents one of very few in the traumatic brain injury field that attempts structural repair of the lesion cavity using a tissue-engineering approach."

Zhang predicts the procedure may be ready for human testing in about three years.

The researcher says current approaches to traumatic brain injury have been focused on managing the primary injury using hypothermia or neuroprotection with pharmacological agents, all with limited success. With this new procedure, the hydrogel is injected into the lesion site to direct the response of neural stem cells in the brain to regenerate normal brain tissue at the lesion site.

The current research is supported by a $220,000 grant from the U.S. Department of Defense.

Susan Polowczuk - This e-mail address is being protected from spambots. You need JavaScript enabled to view it - 864-656-2063