Author: Kimberly Johnston ’26

Drug repurposing is a strategy that aims to find new applications for drugs that have already been proven safe and effective in humans. Lacunar stroke, characterized by reduced blood flow to the deep structures of the brain, can significantly impair a person’s movement, speech, and cognitive functions. Preventative treatments typically focus on managing hypertension, diabetes, and high cholesterol as these conditions can cause stiffening and narrowing of blood vessels in the brain. A team of researchers led by L. Zhang et al. hypothesized that specific medications for these risk factors could be identified and prioritized for use in preventing lacunar stroke. 

Mendelian randomization (MR), the primary method utilized in this study, uses genetic variants as variables to estimate the causal effect of an exposure on an outcome. A two-sample MR analysis identified hypertension, hyperlipidemia, and type 2 diabetes as the predominant risk factors for lacunar stroke. Given the genetic correlation between blood pressure and lipid-related traits, multivariable MR was conducted to determine the independent causal effect of antihypertensive, lipid-lowering, antidiabetic drugs in reducing the risk of lacunar stroke. Drug-target MR demonstrated that calcium channel blockers, statins, ezetimibe, and anti-apoC3 agents had the greatest potential for preventing lacunar stroke due to their respective roles in lowering blood pressure and lipid levels.

Drug repurposing is a faster and less costly approach than traditional processes that require the discovery and development of new therapeutics. It can make treatment more accessible to patients at risk of conditions such as lacunar stroke. This study demonstrated that certain medications for conditions associated with the risk factors of lacunar stroke could be used to prevent this type of stroke. A further understanding of the mechanisms in which lacunar stroke develops is necessary to provide doctors with sufficient knowledge to implement the drugs in clinical practice.

Figure 1: New applications for pre approved medications can be explored as a faster and less costly alternative of developing treatments.

Works Cited

[1] Zhang, L., Wang, F., Xia, K., Yu, Z., Fu, Y., Huang, T., & Fan, D., “Unlocking the medicinal mysteries: Preventing lacunar stroke with drug repurposing.” MDPI (2023). doi: 10.3390/biomedicines12010017

[2] Image retrieved from: https://www.piqsels.com/en/public-domain-photo-froej