Scientists at North Carolina State University and the University of North Carolina at Chapel Hill have developed a new way of delivering a clot buster and a mitigating drug to limit damage due to reperfusion.
Currently, serious blockages leading to the myocardium are typically broken up in the cath lab, usually with a stent left behind to support the vessel. But, it can take significant time between when a patient is admitted and when the clot is physically removed, often resulting in poor outcomes. Moreover, the removal of a clot can result in reperfusion injury as blood rushes back into vessels that were starving for much too long.
The North Carolina team’s solution is a drug delivery system that places a high concentration of a powerful clot buster right onto the blockage, following the destruction of which a drug that prevents serious reperfusion damage is released. Hopefully, this will lead to a surgery-free standard of care that clears out clots faster and safer.
So far the technology, which involves injecting nanogels covered with fibrin-seeking proteins that also contain the two relevant drugs (tPA clut buster and Y-27632 for reperfusion mitigation), has been already tried on lab animals with promising success.
Since the nanogel targets fibrin, which is found in high concentrations at a blood clot, the drugs are mostly deposited where they should be, minimizing damage to the rest of the body and allowing for more of the drug to be injected.
There’s clearly a lot more left to discover before this research results in a clinically applicable product, but the proof-of-concept has shown impressive results at limiting damage from a heart attack and minimizing the amount of scar tissue that results. Moreover, since the technology does not rely on catheters, it should be possible to address clots that are located in areas otherwise difficult to access.