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In Slovakia, strokes are among the leading causes of death and long-term disability. Although they were once considered a disease primarily of older adults, they have increasingly affected younger people in recent years. In people of working age, strokes often have a more severe course and lead to serious consequences. At the same time, treatment has improved significantly over the past few decades.

Progress driven by a better care organisation

Advances in rapid diagnostics, thrombolysis, and mechanical thrombectomy now make it possible to save brain tissue that would have been irreversibly damaged just a few years ago. “However, the greatest progress has come from improved organisation of care – rapid patient transport, effective team coordination, and a strong emphasis on time,” says Petra Bonová from the Institute of Neurobiology, BMC SAS. Despite these advances, treatment outcomes still vary. Patients differ in overall health, comorbidities, genetic background, and physiological responses, all of which can significantly influence the effectiveness of standard therapies.

According to Bonová, it is therefore essential to explore new strategies that can support the brain when conventional treatments reach their limits. “One promising approach is remote ischemic conditioning – a simple, non-invasive method based on short, repeated episodes of mild ischemia applied to a limb or another organ distant from the brain. Although the intervention itself is safe and non-damaging, it can activate the body’s natural protective mechanisms. These signals are then transmitted to the brain through the bloodstream and other systemic pathways, where they may support the survival of nerve cells,” she explains.

Focusing on blood-mediated signalling

At the experimental level, this method has shown strong neuroprotective effects, but these have not yet been consistently confirmed in clinical trials. The main reason is the high variability among patients, including differences in comorbidities, medications, age, and metabolic status. What works in a healthy organism does not necessarily translate to patients with conditions such as diabetes, obesity, or chronic inflammation.

“We therefore decided to build on the strongest aspect of this method while eliminating factors that limit its effectiveness in clinical settings. We focused on the humoral, or blood-mediated, pathway of signal transmission,” explains the neurobiologist.

The research team is investigating how blood cells, after targeted stimulation, alter their communication and begin to produce signalling molecules in the form of biogenic proteins that support the survival of nerve cells in the brain affected by stroke.

“When these proteins are isolated from the blood of young, healthy individuals, they can induce a neuroprotective effect at the experimental level even in high-risk groups, where remote conditioning alone is no longer sufficient. This approach has proven effective in obese and ageing individuals, as well as in models simulating infection such as COVID-19. The advantage is that these are natural, endogenous molecules that can be used in a targeted way without the need for invasive interventions,” Bonová explains.

These findings suggest that, even though patients respond differently to treatment, their own cells may serve as a source of a new generation of personalised, safe, and biologically based therapies.“This is where the greatest hope lies – that future stroke treatment will not only be faster and more accessible, but above all more effective for each patient,” concludes Petra Bonová.

Source: Petra Bonová, Institute of Neurobiology, BMC SAS

Edited by: Andrea Nozdrovická

Photo: canva.com