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Leading UK Stroke Research NO DM199 in Acute Neuroprotection

The clinical investigation of DM199, a recombinant human tissue kallikrein-1 (KLK1), represents a sophisticated pharmacological approach to the management of acute ischaemic stroke by targeting the microcirculatory environment of the brain. The University Hospitals of North Midlands NHS Trust (UHNM) has marked a significant milestone in British neuro-vascular research by recruiting the UK’s first patient into the ReMEDy2 global study at the Royal Stoke University Hospital. This phase 2/3 trial evaluates the therapeutic potential of DM199, which is designed to replenish the endogenous KLK1 protein that is often depleted during and after a stroke event. KLK1 plays a critical role in the regulation of local blood flow and the inflammatory response; by administering a recombinant version, researchers aim to promote vasodilation and enhance collateral circulation to the penumbra—the salvageable brain tissue surrounding the core of the infarct.

The pharmacological profile of DM199 is distinct from traditional thrombolytic agents, as it focuses on supporting the physiological mechanisms that naturally protect neural tissue rather than solely focusing on clot dissolution. In the context of an acute ischaemic event, the restoration of microvascular perfusion is essential to prevent the secondary cascade of neuronal death. The ReMEDy2 trial specifically targets patients who are not candidates for mechanical thrombectomy or those who have already received standard-of-care treatments but remain at risk of significant disability. By utilising the expertise of the North Midlands Clinical Research Delivery Centre (CRDC) in collaboration with the UHNM stroke service and research teams, the study seeks to determine if DM199 can significantly reduce the neurological deficit and improve long-term functional independence in stroke survivors.

This international collaboration is particularly vital because current treatments for acute ischaemic stroke are strictly limited by narrow therapeutic windows. The introduction of DM199 into the UK clinical landscape through the Royal Stoke University Hospital provides a unique opportunity to evaluate a therapy that may extend or complement existing protocols. Beyond the immediate vascular effects, DM199 is theorised to exert neuroprotective benefits by modulating the immune response and reducing the detrimental effects of reperfusion injury. As the ReMEDy2 study progresses, the data collected from the North Midlands site will contribute to a global understanding of whether this recombinant protein can redefine the standard of care for acute stroke patients worldwide. The integration of such high-level research into the NHS infrastructure ensures that UK survivors remain at the forefront of access to emerging biotechnological interventions.


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