A CDU

Icelandic researchers report identifying a gene that is associated with susceptibility to stroke. Their findings appear in the October issue of Nature Genetics. Co-senior author is medical geneticist and neurologist Kari Stefansson, chairman, chief executive officer and president of deCode Genetics (Reykjavik, Iceland). The basic findings are two in number, Stefansson said, "One is a gene that contains variants predisposed to the common form of stroke. The second, that we have protein made by this gene, which in this instance is a good drug target."

In collaboration with F. Hoffmann-La Roche (Basel, Switzerland), deCode started a drug discovery program on the basis of these molecules. "We have gone to high-throughput screening and are very optimistic that it's going to lead us in the end, years down the road, to a drug that will prevent the genetic predisposition from being turned into stroke," Stefansson said. The other category of implications, he said, "allows us to identify the individuals who have a particular predisposition to the development of stroke." That can help to focus and contain stroke risks like hypertension, Stefansson said, adding that "they would also be the target population for the drugs designed against this particular protein. So these are the two industrial implications: the possibilities of facilitating drug development and of developing diagnoses."

deCode researchers last year mapped the PDE4D stroke-susceptibility gene to the long arm of human chromosome 5. To construct their high-resolution map, deCode geneticists tapped 869 volunteers of Iceland's 277,906 total population. In the present study, working with doctors and researchers at Iceland's National University and its Heart Association, they report a large-scale screening to identify the gene in question, involving sampling 1,800 Icelandic adults who had suffered a stroke both patients and unaffected relatives from across Iceland.

"Within this PDE4D gene," Stefansson said, "our team identified haplotypes (specific sets of genetic markers) that correspond to both increased risk of stroke and significantly decreased risk. Expression and functional analyses of the gene strongly suggest that PDE4D plays an important role in atherosclerosis. This most likely is by influencing the proliferation and migration of smooth muscle cells within arteries, which is central to the biology of ischemic stroke."

A drug that could inhibit PDE4D or one of its specific isoforms (variants) might therefore be useful in counteracting atherosclerosis and thereby reduce the risk of stroke, Stefansson said. "deCode and Roche have initiated medicinal chemistry work on compounds we have identified as active against targets in the PDE4D pathway. Separately, deCode also is developing a DNA-based diagnostic test based upon the at-risk and protective haplotypes within the PDE4D gene."

Stefansson said deCode now is in a drug discovery phase, using the protein made by the gene as a target. "We are also into the development of diagnostic tests based on genes," he said. "That is where we are putting most of our efforts these days."

Scotland focuses on younger stroke victims

A new study into the experiences of younger stroke survivors in Scotland, commissioned and published by the medical charity Chest, Heart & Stroke Scotland (Edinburgh, Scotland) and launched last month at a gathering in Glasgow by Minister of Health Malcolm Chisholm, shows that there are still huge variations in treatment across the country. The report, "Improving services for younger stroke survivors and their families," was written by Drs. Pauline Banks and Charlotte Pearson of the Strathclyde Center for Disability Research at the University of Glasgow.

While stroke is usually seen as an affliction of old age, the report indicates that it strikes more than 4,000 people of working age every year in Scotland, often with devastating effect. It cites gaps in post-discharge and longer-term community support and the need for information and more support in retraining, education, access to employment and welfare benefits. Other problems faced by younger stroke survivors and their families include the impact of being treated largely within services designed for older people and the difficulties experienced by caregivers with family and employment responsibilities.

Chisholm said that stroke is "one of the clinical priorities of the NHS [National Health Service] in Scotland. We are establishing Managed Clinical Networks [MCNs] for stroke services in NHS boards across the country." He said those networks are "a way of designing and integrating services from the perspective of the patient and carer." They join together all health professionals involved and aim to overcome what Chisholm referred to as "traditional barriers between primary and secondary care" so that services can be provided seamlessly.

Noting that the report contains 56 recommendations for action and looks at ways services could be improved to help survivors get back to independent living, CHS Scotland Chief Executive David Clark said, "we are already establishing new support services specifically for younger stroke survivors."

Device coating antibiotic eyed

Researchers from the school of pharmacy at Queen's University Belfast (Belfast, Northern Ireland) reported at last month's British Pharmaceutical Conference on development of a new biodegradable polymer they say has potential application in reducing infection associated with the use of implanted medical devices.

One way of reducing risk of infection caused by bacteria adhering to implanted devices such as urinary stents and catheters is to coat the device with a biodegradable polymer coating, which causes bacteria adhering to the surface to be shed as the polymer degrades.

The next step, as reported by the Queen's University researchers, is to incorporate an antibiotic into the coating to provide added protection. That in essence results in a two-pronged attack the release of antibiotic and the degradation of the substrate onto which the bacteria have adhered.

Clearly this approach will only work if the addition of antibiotic does not affect the mechanical properties of the coating. In order to test whether the addition of the antibiotic does not affect the mechanical properties of the coating, the Belfast experiments involved incorporation of the antibiotic rifampicin into films of polycaprolactone, a biodegradable polymer that has attracted attention as a coating material for implantable devices.

The researchers said that the inclusion of rifampicin did not compromise the physicochemical properties of polycaprolactone. Professor David Jones said the challenge ahead "is to engineer the rate of degradation to equal the rate of bacterial adherence, thereby effectively cleaning the surface of the device."

Cerchiari joins Snia

Dr. Drago Alberto Cerchiari has joined Snia (Milan, Italy) as general manager. He will work with Umberto Rosa, chairman and chief executive officer, in the planning process to restructure and demerge the company's chemicals, fibers and diversified businesses. Upon completion of the demerger process next year and subsequent approval by the board of directors, Cerchiari is expected to assume worldwide responsibility for the Medical Technology Group as chief executive officer of Sorin SpA Group, the newly created entity dedicated to healthcare.

The Sorin Medical Technology Group is a leader in the cardiac surgery sector, with a growing presence in electrophysiology, pacing, interventional cardiology and renal care. It includes Dideco, Carbomedics, COBE Cardiovascular, ELA Medical, Sorin Biomedica, Bellco, Soludia and SorinLifeWatch.