We have long known that trauma to the brain causes a primary insult and initiates a secondary biochemical cascade as part of the immune and reparative response to injury.
The secondary cascade, although a normal physiological response, can contribute to ongoing neuroinflammation, oxidative stress and axonal injury, continuing in some cases years after the initial insult. There is no clearly effective therapy to mitigate the secondary injury to the central nervous system – to ameliorate the neuroinflammatory response to injury that can cause long term symptoms.
Researchers at Mass General Brigham have recently released a study that provides evidence that this neuroinflammatory response may be moderated by a nasal spray administered shortly after injury. The study is “preclinical,” using animal models. The next step is to translate the study from preclinical models to human patients.
Following a concussive injury to the brain, the researchers administered an anti-CD3 monoclonal antibody through a nasal spray.
They found that doing so reduced central nervous system damage and behavioral deficits following a contusional traumatic brain injury (TBI.) “Traumatic brain injury is a leading cause of death and disability — including cognitive decline — and chronic inflammation is one of the key reasons,” said lead author Saef Izzy, MD, FNCS, FAAN, a neurologist and head of the Immunology of Brain Injury Program at Brigham and Women’s Hospital (BWH), a founding member of the Mass General Brigham healthcare system. “Currently, there is no treatment to prevent the long-term effects of traumatic brain injury.” Modulating the neuroinflammatory response using the nasal spray, Izzy said, “correlated with improved neurological outcomes, including less anxiety, cognitive decline, and improved motor skills.”
The study examines the monoclonal antibody Foralumab, made by Tiziana, which has been tested in clinical trials for patients with multiple sclerosis, Alzheimer’s disease, and other conditions.
“This opens up a whole new area of research and treatment in traumatic brain injury, something that’s almost impossible to treat,” said senior author Howard Weiner, MD, co-director of the Ann Romney Center for Neurologic Diseases at BWH. “It also means this could work in intracerebral hemorrhage and other stroke patients with brain injury.”
