A promising nasal spray targeting brain inflammation may offer new hope for treating traumatic brain injury (TBI), a leading cause of death and disability worldwide, according to a new study from researchers at Mass General Brigham.
The research, published in the journal Nature Neuroscience, demonstrates that the monoclonal antibody Foralumab, when administered as a nasal spray, reduced damage to the central nervous system and improved behavioral outcomes in mouse models with moderate-to-severe TBI.
"Currently, there is no treatment to prevent the long-term effects of traumatic brain injury," said lead author Saef Izzy, neurologist and head of the Immunology of Brain Injury Programme at Brigham and Women's Hospital (BWH). "Chronic inflammation is one of the key reasons for cognitive decline following TBI."
How the Nasal Spray Works
The research team conducted multiple experiments using mouse models with moderate-to-severe traumatic brain injury to investigate the communication between regulatory cells induced by the nasal treatment and microglial immune cells in the brain.
Their findings revealed that Foralumab, developed by UK-based Tiziana, effectively modulates the immune response in the brain. This modulation led to "improved neurological outcomes, including less anxiety, cognitive decline, and improved motor skills," according to Izzy.
The monoclonal antibody has previously been tested in clinical trials for multiple sclerosis, Alzheimer's disease, and other neurological conditions, suggesting broader applications for the treatment approach.
Significance for TBI Treatment
Traumatic brain injury affects millions globally each year, with limited therapeutic options available to prevent long-term complications. Current TBI management focuses primarily on supportive care and rehabilitation rather than addressing the underlying neuroinflammatory processes.
The study's findings are particularly significant because they target the inflammatory cascade that contributes to secondary brain damage following the initial trauma. By modulating this response, the treatment potentially addresses a key mechanism of ongoing injury.
"Our patients with traumatic brain injury still don't have an effective therapeutic to improve their outcomes, so this is a very promising and exciting time to move forward with something that's backed up with solid science and get it to patients' bedsides," Izzy emphasized.
Potential Applications Beyond TBI
The researchers noted that Foralumab may also prove effective "in intracerebral hemorrhage and other stroke patients with brain injury," expanding the potential applications of this therapeutic approach to other acute forms of brain injury.
This broader application could address significant unmet needs in neurological care, where anti-inflammatory approaches have shown promise but have been challenging to implement effectively due to the blood-brain barrier.
Next Steps in Research
The research team is now focused on translating these findings from preclinical models to human patients. This transition will involve further studies to establish safety profiles, optimal dosing regimens, and timing of administration following injury.
If successful in human trials, this nasal spray could represent a significant advancement in TBI treatment, potentially reducing the long-term disability associated with brain injuries and improving quality of life for millions of patients worldwide.
