Minocycline treatment for acute stroke

Lampl Y, Boaz M, Gilad R.Minocycline treatment in acute stroke. An open label, evaluator blinded study.

Patients received 200 mg minocycline orally for five days after stroke, and NIHSS was used. 152 patients were studied (74 received minocycline, 77 placebo). NIHSS and mRS were lower and BI higher in treated group. Deaths, MI, recurrent strokes, and hemorrhagic stroke transformations were no affected.

Study was based on "clear" neuroprotective effect seen in animal models of MS, PD, HD, and ALS. Pyramidal cell survival improved from 10 to 77 % due to "complete prevention of microglia ischemia induced activation." Minocycline prevents infarct volume expansion, inhibits IL 1B converting enzyme, cycklooxygenase 2, PGE 2 expression. Proposals suggests its antiinflammatory, reduces microglial activation, matrix metalloproteinase activation, nitric acid production, and inhibition of apoptosis. In spinal cord its an NMDA antagonist, and prevents activated caspace 3 formation.

Blogger note: The large multicenter phase III trial of minocycline in ALS reported that ALS was HARMED BY minocycline, details at the link below:
http://strokenotes.blogspot.com/2008/02/minocycline-treatment-for-acute-stroke.html