Haptoglobin Binds Free Hemoglobin and Can Prevent Neuron Damage After Brain Hemorrhage; Haptoglobin Not Normally Present at Effective Concentration in Brain, But Direct Administration in Cerebrospinal Fluid Is Protective in Animal Model

Patients who survive a cerebral hemorrhage may suffer delayed severe brain damage caused by free hemoglobin, which comes from red blood cells and damages neurons. Researchers at the University of Zurich and the University Hospital Zurich have now discovered a protective protein in the body called haptoglobin, which prevents this effect. Bleeding in the narrow space between the inner and middle meninges is life-threatening. This type of cerebral hemorrhage is normally caused by small protrusions in the major arteries at the base of the brain (aneurysms) that can burst without warning. A third of patients suffering such a hemorrhage, who are often still young, die as a result of the massive increase of pressure inside the skull. "Even if we manage to stop the bleeding and to stabilize the patients, in the first two weeks after bleeding there can be delayed brain damage. This often leads to severe impairments or can even be fatal," explains Luca Regli, MD, Director of the Department of Neurosurgery at the University Hospital Zurich (USZ). Despite great research efforts, until now, it has not been possible to prevent these serious consequences of bleeding in the subarachnoid space. An interdisciplinary team of researchers from the University of Zurich (UZH), USZ, and the Veterinary Teaching Hospital Zurich have now discovered a promising strategy: haptoglobin, a protective protein found in the blood, binds the hemoglobin that has been released in the cerebrospinal fluid before it can cause damage. The results of their work were published online on August 27, 2019 in the Journal of Clinical Investigation. The open-access article is titled “Haptoglobin Administration into the Subarachnoid Space Prevents Hemoglobin-Induced Cerebral Vasospasm.”
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