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| A drug that increases survival chances |
| Press Trust of India / Washington Jan 29, 2010, 14:07 IST |
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In what could be a medical boon, American doctors have found a drug that can turn an injured person into a "super-survivor" by preventing certain biological mechanisms from shutting down.
The researchers from Massachusetts General Hospital in Boston, who have tested the drug — valproic acid — in animals, said if it has a similar effect in humans, it could vastly improve survival from horrific injuries, particularly in soldiers, by allowing them to live long enough to make it to a hospital.
Loss of blood is the main problem with many battlefield injuries, and a blood transfusion the best treatment, although replacing lost fluid with saline can help. But both are difficult to transport in sufficient quantities.
"You can't carry a blood bank into the battlefield," said lead author Hasan Alam.
"What we're looking for is a pill or a shot that would keep a person alive for long enough to get to them to a hospital."
When the body loses a lot of blood, it tries to compensate by going into shock. This is a set of emergency measures to raise blood pressure and conserve energy, such as increasing heart rate and shutting down expression of some proteins.
However, if the body stays in shock for more than a short time, it can lead to organ failure, and death soon follows, journal Surgery reported.
Recent studies have suggested that around 6 or 7 per cent of genes change their expression in response to shock, via the removal of "epigenetic", chemical additions to the genome called acetylations.
As histone deacetylase (HDAC) inhibitors can prevent the removal of such acetylations, Alam wondered if these drugs might improve survival after blood loss.
His team showed that valproic acid, an HDAC inhibitor already used to treat epilepsy, increased survival rates in pigs. It seemed to be doing this by preventing acetylation, causing certain "survival pathways" to remain switched on.
He anaesthetised the animals, drained 60 per cent of their blood, and subjected them to other injuries before giving them a saline transfusion.
He then injected some of the pigs with valproic acid, gave others a blood transfusion and left the remainder untreated.
Just 25 per cent of the pigs receiving only saline survived for 4 hours - the typical time it takes to get hospital treatment - while 86 per cent of those injected with valproic acid survived. All those that had a blood transfusion lived.
Alam is currently repeating the trial to make sure valproic acid does not hinder survival in the longer term. If so, he will apply for permission to do human trials by the end of the year.
"It's exciting," says John Holcomb of the Center for Translational Injury Research at the University of Texas in Houston. "They're looking at resuscitation in a different way."
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