Page 14 - Stuart Exposure - April '24

Page 14, Stuart Exposure

Cleveland CliniC Martin HealtH news

Minor Head Injuries No effective treatment, patients enjoy a faster recovery and a
Small Affair For Seniors lower risk of complications.
To learn more about neurological services at Cleveland

Clinic in Florida, visit ClevelandClinicFlorida.org/Neuro or
New Treatment For Leaky call (877) 463-2010 to make an appointment.
Blood Vessels In The Brain
Cleveland Clinic Researchers
Any knock to the head,
be it from a car accident, slip Uncover How Virus Causes
on the pickleball court, or
fall from a chair, is no small Cancer, Point To Potential
affair. Especially for older
adults who experience head Treatment recipients. In these high-risk groups, the now active virus
trauma. They are at greater can trigger aggressive cancers.
risk of an increasingly Kaposi Sarcoma-Associated Herpesvirus KSHV-induced cancers are fast-acting, aggressive and
common neurological Activates A Specific Pathway To Drive Viral difficult to treat. An estimated 10 percent of people in North
condition caused by leaky Persistent Infection And Cell Growth, Paving America and Northern Europe have KSHV, but this ranges
blood vessels in the brain. The Way For Tumors To Form throughout the globe. More than 50 percent of individuals
Called a subdural in parts of Northern Africa are estimated to have the virus.
hematoma, it occurs when a Cleveland Clinic researchers have discovered a key Experts estimate these rates are higher, as KSHV often goes
blow to the head tears blood mechanism used by Kaposi’s sarcoma-associated herpesvirus undiagnosed because of lack of symptoms. These findings
vessels between the brain Jeffrey Miller, M.D. (KSHV), also known as human herpesvirus 8 (HHV8), to have implications that reach past KSHV; researchers can
and the skull. Blood then induce cancer. The research points to effective new treatment apply knowledge about KSHV to other cancer-associated
leaks, pools and clots in the space below the dura mater, the options for KSHV-associated cancers, including Kaposi’s viruses that might use the same process to cause cancer.
outermost layer of three protective membranes surrounding sarcoma, primary effusion lymphoma, and HHV8-associated To understand the cells’ metabolic processes to uncover
the brain. multicentric Castleman disease. the virus’s vulnerabilities, Zhao collaborated with Michaela
“A recently published study predicts that by 2030, “Our findings have significant implications: Viruses cause Gack, Ph.D., scientific director of the Florida Research &
chronic subdural bleeds will be the most common reason between 10 to 20 percent of cancers worldwide, a number Innovation Center.
for neurosurgical intervention,” said Jeffrey Miller, M.D., that is constantly increasing as new discoveries are made. Rapidly replicating cancer cells reprogram metabolism
a neuro endovascular surgeon at Cleveland Clinic Martin Treating virus-induced cancers with standard cancer therapies to fuel growth. Meanwhile, most viruses cannot produce
Health. can help shrink tumors that are already there, but it doesn’t fix energy or necessary molecules on their own, so they rely
A New Understanding the underlying problem of the virus,” said Jun Zhao, Ph.D., on human cells to do the work for them. The team found
Subdural hematomas occur in up to 25 percent of people of Cleveland Clinic Florida Research & Innovation Center. that the virus takes over the host protein CDK6 and CAD,
with head injuries, and individuals taking blood thinners are “Understanding how pathogens transform a healthy cell into causing the infected cells to produce extra metabolites, which
at increased risk. a cancer cell uncovers exploitable vulnerabilities and allows allows faster replication of the virus and an uncontrolled
Symptoms may include ongoing headache, confusion us to make and repurpose existing drugs that can effectively proliferation of the cells.
and drowsiness, nausea and vomiting, slurred speech and treat virus-associated malignancies.” The research team treated preclinical models with a
changes in vision. If the bleeding occurs slowly enough, The Nature Communications study, led by Dr. Zhao, CDK6-blocking drug, Palbociclib, an FDA-approved breast
the symptoms may not appear for weeks or months. As a reveals that KSHV manipulates two human enzymes called cancer medication, as well as a compound targeting CAD.
result, an older person may not even recall how their head CDK6 and CAD to reshape the way human cells produce new They saw significant decreases in tumor size and increases
injury happened. nucleotides – the building blocks of DNA and RNA – and in cancer survival rates: Most tumors virtually disappeared
“If someone is experiencing any of these symptoms, it process glucose. The changes to how infected cells grow and after about a month of treatment, and remaining tumors
is always best to be evaluated by a professional,” said Dr. how KSHV persists put cells at a much higher risk of forming shrank around 80 percent. Survival increased to 100 percent
Miller. “If left untreated, subdural hematomas can quickly tumors and play a crucial role in causing cancer. for selected lymphoma cell lines.
lead to permanent neurological injury or death.” The team showed the virus activates a specific pathway Zhao and his team are working to better understand the
It is now believed, however, that chronic bleeding into driving cell metabolism and proliferation. Inhibiting this connections among KSHV, CDK6/CAD pathway, and cancer
the site of the hematoma may be instead caused by blood process with existing FDA-approved breast cancer drugs formation. With the knowledge they obtain, they plan to
leaking from fragile arteries that develop after the injury reduced KSHV replication, blocked lymphoma progression implement and refine their experimental drug combinations
and initial blood clot formation. “These new blood vessels and shrunk existing tumors in preclinical models. for clinical trials.
feed the membrane that forms around the clotted blood,” Like other herpesviruses, KSHV often has no symptoms “Cellular metabolism could be hijacked by both viruses
says Miller. initially and remains in the body after primary infection. and cancers for pathogenesis,” said Zhao. “By investigating
Innovative Treatment The virus stays dormant, suppressed by the immune system. these metabolic rewiring mechanisms, we aim to find the
This new understanding has led to the development of However, KSHV can reactivate when immunity is weakened Achilles’ heel of cancer-causing viruses and nonviral cancers.
an innovative endovascular treatment for chronic subdural – as in older people, those with HIV/AIDS, and transplant I’m excited to see what the future of this work holds.”
hematomas called middle meningeal artery (MMA)
embolization.
The middle meningeal artery is a large blood vessel that
supplies oxygen-rich blood to the dura mater surrounding
the brain. A flexible tube called a catheter is used to inject
a small amount of bioadhesive gel into branches of the
artery that lead to the hematoma. This cuts off blood supply
to the membrane surrounding the hematoma and prevents
rebleeding.
The team at Cleveland Clinic Martin Health has
successfully treated more than 100 patients with this
minimally invasive approach. In addition to being an

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