The clots removed from ischaemic stroke patients by mechanical thrombectomy are amyloid in nature, 2024, Douglas B Kell et al

Mij

Mij

Senior Member (Voting Rights)
Abstract
Ischemic stroke due to large vessel occlusion results from the blockage of a major cerebral artery by a clot; however, the origins and molecular composition of these clots remain poorly understood.

Mechanical thrombectomy has become a standard treatment to remove obstructive clots, providing a unique opportunity to analyze their properties. We previously demonstrated that blood can clot into an amyloid-like form, generating fibrinaloid microclots (2 to 200 μm) that are highly resistant to fibrinolysis. In this study, archived clots from eight ischemic stroke patients with large vessel occlusion were examined, using samples stored in the Walton Centre Clot Bank in Liverpool, UK. All clots exhibited strong, heterogeneous amyloid staining, revealing a pervasive amyloid component.

These findings represent a previously unreported characteristic of stroke clots, highlighting the potential for amyloid-targeted therapies to overcome their fibrinolytic resistance and providing a foundational new insight into ischaemic stroke pathophysiology and treatment.
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Had a read, there is no mention of covid-related microclots or covid-induced thrombus causing the strokes they performed thrombectomies on.

Being really overly picky - there is some unusual language in this research paper. Of course, researchers can write with whatever words they like but it struck me as odd the term "massive" and "truly massive" and "striking" So a bit overstated for the results section for a formal scientific paper I am used to reading. (I don't think I would get away with writing such a paper in NZ, using this language but changing it to the more colloquial awesome and truly awesome:laugh:) But seriously and professionally, I would have used the word large and larger and made a comparison to the size of other circulating factors.

Another example: "The chief point is that in every single case, regardless of the thrombus location or of other metadata given in Table 1, the extent of the amyloid staining is truly massive, with in most cases the majority of the clot being amyloid in character. However because of the relatively small numbers of clots studied, we did not perform further statistical analyses, and confine ourselves to the headline message".

In relation to the microclots in LC/ME discussion on another thread, they state in the introduction of this paper. "Some time ago, we discovered (Kell and Pretorius 2017, Pretorius et al 2016) that blood can clot into an anomalous “fibrin amyloid ‘or ‘fibrinaloid’ (Kell et al 2022, Kell and Pretorius 2023, Nunes et al 2022, Turner et all 2023) form that is relatively resistant to fibrinolysis. This of course would explain why such clots are not removed naturally (Desires et al 2022, Ho Tim Noe et al 2023)."

It will be interesting to see, over time, if this is an important scientific discovery. They are talking about the potential use of amyloid targeted therapies which I am presuming are drugs like donanemab and lecanemab that have approval for use in the UK for the early treatment of Alzheimer's dementia (not in the NHS as yet from what I have read). Of course, in NZ we will have to wait for many years to get it approved and publicly funded...
 
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hibiscuswahine said:
(I don't think I would get away with writing such a paper in NZ, using this language but changing it to the more colloquial awesome and truly awesome:laugh:)
Click to expand...

"Heaps", "mega" and "for days, bro" :thumbup: Although to be fair I think "massive" is a perfectly acceptable term, but maybe we just like to use it in imaging.

I had a quick read through. One of the suggestions is that this is a possible explanation for the recognised failure of revascularisation to limit/reverse functional loss via early rescue fibrinolytic therapies (ie tPA), which has seen the development of quick-to-action mechanical clot retrieval services, keeping my neurointerventional colleagues up at night.

The cases discussed here were "mid" pandemic so may or may not be Covid-related. It sounds is as if they think there are other reasons for anomalous clot formation, recognising that they started off looking at diabetes well before 2020.
 
Perhaps worth moving this thread to avoid any confusion. This doesn't have anything to do with covid 19 per se. It just happens to be from Pretorius and Kell.
 
Mij said:
Potential Impact Beyond Stroke: These findings resonate with conditions like Long COVID, where similar amyloid microclots have been identified. More to come as we expand our research!
Click to expand...
Expand our empire might be a more accurate phrase.
 
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