A child with a genetic disorder is at a greater risk of having a stroke if their body cannot produce enough of the powerful blood-thinning drugs needed for brain health, a new study has found.
In a study published in the British Medical Journal, researchers from University College London found that children with the genetic disorder cystic fibrosis (CF) had a 40 per cent higher risk of developing stroke if they took antibiotics, including ciprofloxacin (Cipro), before age 12.
The researchers found that the risk of stroke was higher for children who had the genetic mutation and had suffered a stroke before age 10.
“This finding is very significant, as it points to the importance of avoiding early onset of stroke risk,” said Dr John Kilduff, from the University of Oxford, who led the study.
“In many people with CF, there are a range of risk factors for stroke, including high levels of inflammation in the brain, and a lack of protection against it from the time they are born,” he said.
“The increased risk for stroke in children with CF was similar to the risk in those who had stroke but with a different mechanism, which we call cystic Fibrosis-associated (CF-associated) cerebrovascular disease.”
The risk of a stroke in CF patients has increased since the introduction of the first generation of new Cipro drugs in 1999, and the disease is increasingly linked to stroke risk factors such as high blood pressure and diabetes.
The new study found that, in people with cystic CF, the risk was even higher than in people without CF.
“We have seen this increase in stroke cases over the last 10 years,” Dr Kilduf said.
“This is a very good example of how the impact of genetic risk is being underestimated in patients with CF.”
“Cystic fibres also cause a lot of other problems, including kidney problems, heart disease, and obesity.
It’s probably one of the reasons that many people are taking Cipron inhibitors.”
Dr Kildiff said that the new study was a wake-up call for people who might be taking cipron to consider whether the medication was the right choice for their child.
“A lot of people are putting these medicines on the backburner, because they don’t need them, and there’s not much evidence that they help people who are suffering stroke,” he explained.
“There’s a huge amount of evidence that these drugs are associated with problems with the brain and it could be that they are not the right thing for them.”
Ciprolin is a class of drugs known as beta-blockers.
It blocks a class a group of proteins known as “adhesion molecules” and has been shown to reduce inflammation in a range, including stroke.
Ciproprofumarate (CFP) is a similar class of drug that inhibits the activity of adhesion molecules and the body produces less of the proteins.
“One thing that we need to consider is whether CFP is safe and effective for children with cystitis, which is a potentially very serious condition,” Dr Kevin Laidlaw, a neurologist at the University Hospitals Birmingham, said.
While the new findings did not prove that the CFP drugs were more effective than Ciproprotern, they did indicate that it was not safe and ineffective for the majority of children with this condition, he said, adding that it could lead to further study of the drugs’ effect on the brain.
“It is also important to remember that the disease affects children differently,” Dr Laidaw said.
“Some children are more at risk of needing these drugs than others, and therefore need different doses and different dosing regimens.”
Dr Laidaws study, which was funded by the Wellcome Trust, found that adults with CF have a slightly lower risk of being treated for stroke than those without CF, but there was no significant difference in stroke rates between those with and without CF who were treated.
“Although there is an overall increased risk of brain stroke in people who have CF, it appears that this increased risk may be related to different mechanisms of action and the severity of the disease,” Dr Jodie Laidaway, a clinical psychologist from the Royal College of General Practitioners, said in a statement.
However, the use of these drugs for children and young people is likely to increase as more studies are conducted.”