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Brain killers

Nancy RothwellThe brain is the most complex structure we know. It is also essential for every part of our lives - it controls our heart and kidneys, pain and touch, directs release of hormones, integrates how we respond to the environment and allows us to think and feel emotion. Damage even to a small part of the brain can be devastating, all the more so because brain cells, unlike many others in the body. cannot easily repair and are not replaced.

Some of the biggest killers and causes of disability worldwide are stroke, brain injury and haemorrhage, Alzheimer's, Parkinson's and epilepsy. These diseases all seem very different but in each case the ultimate problem is that brain cells (neurones) are damaged or killed. It is, therefore, a huge and important challenge to understand what kills these cells, how the damage occurs and to find treatments to limit or prevent the damage.

It is now clear that these very different diseases have some common features. All have different causes, but in each disease much of the damage is caused by toxins, 'brain killers', released from within our own brain. Indeed our brains contain quite large amounts of potentially deadly chemicals which are normally released in just tiny amounts.

My research has been focused on trying to identify these 'brain killers' and to stop them from acting.

Several 'brain killers' have been identified. Most are molecules that are essential for normal brain function, but which get out of control after an injury or in disease - so blocking them can have serious side-effects. My research group in Manchester has identified a protein, that is normally produced by the immune system, which seems to have no involvement in normal brain function, but is released very soon after brain injury or stroke.

The protein, called interleukin-l (abbreviated to IL-l) is important in other parts of the body in combating infection, but when produced in large quantities can kill cells. The body also produces a natural blocker of IL-l, called IL-l receptor antagonist (lL-l ra), which prevents IL-l from binding to cells. In experimental studies our group showed that IL-l ra dramatically reduces brain damage caused by stroke, injury or toxins. Other means of inhibiting the production, release or action of IL-l are similarly effective in reducing brain damage. So it was established that the protein IL-l is a key cause of death at least in experimental conditions.

The real challenges now are to discover what switches on IL-l , and how it kills brain cells and therefore how we can switch it off or stop its devastating effects. These questions are being addressed by our current research team, but they are also interested in patients.

With local clinicians in Manchester, the group has studied the early production of cytokines like IL- T after strokes in patients and we are trying to determine if high cytokine levels or tiny changes in cytokine genes are risk factors for stroke arid poor outcome after brain haemorrhage and head injury. They have also just completed the first clinical study to test whether IL-l ra can be safely given to patients after strokes.

Experimental and clinical evidence now also implicates IL-l in chronic brain diseases which prove a massive burden in our societies; diseases such as Alzheimer's, Parkinson's, Motor neurone disease and epilepsy.

Nancy Rothwell

(Visiting Delhi, Mumbai and Bangalore in February for the British Council's Ambassadors of Science series is esteemed physiologist Prof Nancy Rothwell. She is the medical research council professor at the School of Biological Sciences in the University of Manchester. She is a renowned popular communicator of science and the author of 'Who Wants to be a Scientist'? She will visit Bangalore 18 February and speak on the subject of her book and choosing science as a career at the Visvesvaraya Industrial and Technological Museum.)

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Published on 17th Feb, 2004

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