When a brain injury occurs due to a tumor, stroke or infection, the barrier that covers the cells of this organ is broken, allowing the accumulation of fluid -like water and electrolytes – in the brain tissue, generating an increase in the volume and thus in intracranial pressure. In medical terms, this response is known as cerebral edema.
Luisa Manrique Carmona, specialist in neuroanesthesiology and researcher at the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez (INNN), conducts a research to develop a biological marker for the diagnosis of cerebral edema from the concentrations of taurine in the blood of patients with neurosurgical pathologies: brain tumors of any kind (benign, malignant or metastatic) and strokes, for example.
The swelling in the brain makes the surgical procedure of patients with brain tumors difficult, and puts their life at risk. In the words of Dr. Luisa Manrique, the presence of edema at any time (before, during and after surgery) can prevent the evolution the patient and increase the time of their hospital stay, and even leave life-time sequelae such as paralysis, language problems or even breathe.
“When a surgical procedure is accompanied by edema, we have to take specific measures that allow surgeons to have better results. By not having a biological marker that tells us in real time if the brain is swollen or not, we only have the visual estimation. Our goal is to have something more accurate,” Dr. Manrique shared in an interview with the Agencia Informativa Conacyt.
The precise detection of brain inflammation, she said, requires specialized neuroimaging techniques, but these are often expensive and hospitals often lack of such tools. This is why, the team of researchers proposed taurine as a viable alternative.
Taurine is an amino acid that is present in the human brain and also in animals. Studies conducted by the research group to which Luisa Manrique belongs indicate that the concentration of taurine in patients’ blood would be a marker of the magnitude of cerebral edema.
“We have conducted several studies on different types of central nervous system diseases; and we see that taurine is elevated when there is cerebral edema.”
The future idea of the INNN research group is the development of a test strip similar to the one used to measure blood glucose. “We want the doctor to know at the moment the level of taurine of his patient. Sometimes it is difficult to establish what the magnitude of the edema is, and if it is affecting cellular structures more aggressively than the tumor itself,” she said.
Development of treatment from lidocaine
One purpose in the research is the development of a new treatment for cerebral edema that can be applied during the surgical process and thus reduce its volume. This will allow surgeons more effective interventions and fewer complications for the patient. For this, the scientists propose the administration of lidocaine intravenously. Lidocaine is an anesthetic that stabilizes the cell membrane.
Dr. Manrique explained that since the 60s, corticosteroids are used for the treatment of cerebral edema, as well as some diuretic substances such as mannitol and hypertonic solutions. However, these treatments have side effects that can affect the course of the disease. Side effects can be sodium disorders, rebound cerebral edema, increased kidney work.
In clinical practice, the specialists of the National Institute of Neurology and Neurosurgery have observed a decrease in the volume of cerebral edema once lidocaine was administered intravenously to patients with some type of tumor.
“For now, clinical studies are being carried out to verify these observations. We want to demonstrate the usefulness of lidocaine in the treatment of cerebral edema; this would be a pharmacological, economic and accessible tool with a possible impact on the morbidity and mortality of patients,” Luisa Manrique concluded.
Source: Agencia Informativa CONACYT