GJBRC Stroke Research

Tuesday marked #WorldStrokeDay, the GJBRC team is proud to celebrate our amazing stroke researchers working across Greater Manchester in discovery science, experimental medicine, and clinical roles.

Each year 100,000 people in the UK will suffer a stroke. Strokes are either “haemorrhagic” – caused by a bleed in the brain, or “ischaemic” – caused by a blockage of blood vessels in the brain. Both can be devastating and need more treatment options.

Our research into #haemorrhagicstroke, also known as ICH or #IntracerebralHaemorrhage accounts for around 15% of all strokes, but is one of the most deadly forms, with a devastating one-third of ICH sufferers not surviving to 30 days post-stroke.

On the discovery science side, the Kasher Lab is using #zebrafish to help better understand how haemorrhagic strokes happen, how brain cells respond to blood and to identify new potential drug targets for developing new treatments for patients. paul kasher 's lab specialises in using zebrafish, which the team have developed to create models of haemorrhagic stroke - check out their work here:

Nima Geemon is using zebrafish to understand how a specific protein is involved in haemorrhagic stroke, and if drugs can be made to target this protein to improve post-ICH outcome.

Emily McMahon is studying an immune response called the "NLRP3 inflammasome”, to understand its role in brain damage after haemorrhagic stroke and to identify new drugs that could protect the brain and improve recovery.

daisy flatman ?is developing new zebrafish models for cerebral small vessel disease. She is using these zebrafish to understand the biological mechanisms leading to haemorrhagic stroke, and how we could use drugs to protect against them.

In other stroke models, Joe is investigating how changes to the blood vessels within the brain and immune cells surrounding them influence outcomes following ICH, with the aim of discovering new targets for treatments in the future.

Mary Newland investigating drugs which block the cytokine Interleukin-1 after haemorrhagic stroke, aiming to see whether these drugs can reduce brain swelling linked to poor outcomes in patients.

Chiara Ramponi is studying how a newly developed drug influences the immune system's response to intracerebral haemorrhage.

Our researchers are also looking at ICH in patients. Olivia A Jones and Adrian Parry-Jones recently completed analysis of a multimodal imaging study exploring inflammation in the brain after acute haemorrhagic stroke. The results can be found here:

Meanwhile, Olivia M. is developing an AI tool to predict long term motor recovery after haemorrhagic stroke from diagnostic CT brain scans.???

From all our #HaemorrhagicStroke team, we'd like to also highlight the The Natalie Kate Moss Trust , a charity which supports much of our work in ICH, and works to #PreventThePreventable by raising awareness of haemorrhage and funding research to find new treatments ??

#IschaemicStroke is the more common type of stroke. Many of our researchers are working on a large clinical study, Stroke IMPaCT funded by fondationleducq.org Professors Craig Smith, Stuart Allan , Laura Parkes as well as John Grainger and other colleagues in the US and Europe are studying how immune cells and thromboinflammation in the blood change after a stroke and how these relate to later cognitive decline and changes in the brain using MRI scans As part of the Stroke Impact network.

Harry Deijnen studying how immune cells and other blood-based factors may contribute to post-stroke cognitive decline. He is currently looking at how early changes in cell metabolism may affect later cognitive function. Rachel Jones is researching how platelets and blood clotting mechanisms change after a stroke and how they may contribute to a later decline in memory, concentration, and problem-solving skills, collectively known as #CognitiveDecline.?

Ellen Gray is investigating the role of peripheral and central inflammation, in particular within the eye following a stroke and its impact in the development of post stroke dementia.

An add-on study, led by Olivia A Jones , and Professors Laura Parkes, Craig Smith and Stuart Allan, is investigating the longitudinal relationship between blood-brain barrier leakage and cognitive decline after ischaemic stroke using advanced MRI methods.

Read more about Stroke IMPaCT here:

Professor Craig Smith is also leading a multicentre phase 3 clinical trial with colleagues in Glasgow and Manchester to see whether addition of an anti-inflammatory antibiotic, clarithromycin, improves outcomes for patients with stroke and pneumonia #CLASP trial NIHR (National Institute for Health and Care Research)

Professor Smith is leading research looking at whether improving oral healthcare in people with swallowing problems after a stroke can prevent pneumonia from developing. In the first stage, oral healthcare treatment with chlorhexidine and powered brushing, combined with training for stroke unit nursing staff, was feasible, well-tolerated and acceptable #CHOSEN trial

Amit Kishore and Professor Smith and colleagues are using electronic healthcare records at Manchester Centre for Clinical Neurosciences to investigate the real-world impact of pneumonia in people after a stroke. Follow the link below for the first published paper from the #SALSAP study:

In other ischaemic stroke work, researchers are looking at understanding the biology of stroke and testing new drugs to combat inflammation and detrimental processes in the brain.

Lucy Roberts is assessing a new ischaemic stroke drug that targets and breaks down platelet-rich components of blood clots. This makes the new drug effective against blood clots that are not broken down by the current stroke drugs, providing another treatment option for patients.

Alba Grayston Morales is investigating the specific role of two cytokines, interleukin-1 alpha and beta (IL-1α and IL-1β), that are released after ischaemic stroke by brain-resident immune cells called microglia. This will advance the understanding of specific IL-1 mechanisms to develop more effective therapies for stroke. The first results on the role of microglial IL-1α are available here:

Ivy and Miruna are looking at a protein-sugar structure that coats the inside of blood vessels, called the glycocalyx, that sheds in states of inflammation. They investigate how the glycocalyx of the brain responds to stimuli such as stroke, obesity, hypertension, and dementia.

Professors Stuart Allan, Craig Smith and Dr Ioana - Emilia Mosneag are investigating medications which block the effects of the inflammatory cytokine interleukin-1 combined with clot-busting thrombolytic drugs in stroke due to a blocked artery in the brain Brain Research UK .

Whilst some of our research is focussed on acute hospital treatments, we have an excellent #Rehabilitation theme here at the GJBRC, led by Professor Audrey Bowen and Claire Mitchell

Professor Audrey Bowen is excited to start work developing a Core Outcome Set for post-stroke psychological problems, to measure what actually matters to people after stroke. Funded by the TMRP Mental health Mission project and led by Alex Wright-Hughes from the Clinical Trials Research Unit at 英国利兹大学 .

Lauren Lucas is speaking to healthcare professionals and stroke survivors about their experiences working together in the community. She's interested in their working relationship (or therapeutic alliance) and how this relates to self-management and long-term recovery after stroke

Claire Howard is currently exploring the best types of assessments for loss of peripheral vision after stroke.? The results of this research will feed into a larger study to develop new treatments for post stroke visual field loss.

Havva Sumeyye EROGLU and Facial Palsy After Stroke (@Facialpalsyuom) / X is working to improve care for stroke survivors with facial palsy/weakness by developing better ways to assess and measure recovery, tracking how facial movement changes over time, and understanding its impact on patients' daily lives and wellbeing.

Emma Patchwood Ann Bamford & all on the Wellbeing After Stroke study @StrokeWaters are excited to begin a new phase of the project where they will test the online group support for adjustment after stroke. Learn more about the study here:

Everyone on the Wellbeing After Stroke study are grateful to the following community groups & health champions for guiding us in working respectfully with people from minoritised ethnic communities & those with cognitive and communication difficulties like aphasia:

Hulme Moss Side Neighbourhood Health Champions, Deeplish Community Centre Kashmiri Youth Project. The Big Life group , Bolton Aphasia self help group (BASH), Stockport Stroke Association Communication group.

An ongoing study to explore speech and facial weakness recovery after stroke @Dysarthrialife with 200 recruits many thanks to stroke survivors and research nurses involved. This is funded by Stroke Association . Learn more about this study here

In the SAYS study, we're diving into the recovery journeys of #StrokeSurvivors facing both dysarthria & facial palsy, uncovering how these challenges shape their well-being and resilience. Find out more:

And to end on a high note, Professor Audrey Bowen will be part of the SIGHT team, starting January 2025, led by Associate Professor Stephanie Rossit . ?This is the largest clinical trial to address a disability cognitive condition affecting one third of stroke survivors. ?

If you want to read more about our research, head to our website or get in touch at [email protected]