More Than Just a Cup of Coffee I
n the search to improve outcomes after the brain injuries that are a hall- mark of recent wars, one answer may be as close as the nearest coffeepot.
Because caffeine is considered the most widely consumed psychoactive drug world- wide, with high use among service members, military researchers have been studying it for several years. A DoD-supported civil- ian team that has been exploring caffeine’s effects on brain injury outcomes recently found that a high dose of caffeine, given immediately after severe brain trauma, reduces the incidence of death.
Dr. Detlev Boison’s project at the Legacy Research Institute was funded by the U.S. Army Medical Research and Materiel Command’s Telemedicine and Advanced Technology Research Center (TATRC). The goal was to gain a comprehensive understanding of the effects of chronic and acute caffeine consumption before and after the full spectrum of brain injury. “Our most exciting finding is that a single acute dose of 25 milligrams per kilogram of caffeine, given immediately following a severe brain injury in rats, can completely prevent acute lethal outcome under con- ditions that otherwise result in a mortality rate of 40 percent,” Boison said.
According to Boison, the team’s data
suggest that caffeine is uniquely able to counteract the effects of a deadly surge in the brain chemical adenosine that is triggered by severe brain injury. The adenosine surge causes prolonged apnea (suspension of breathing), the major cause of immediate deaths following such injury.
Caffeine is an adenosine receptor antago- nist, which means that it opposes the
CAFFEINE AND THE BRAIN
Because caffeine is considered the most widely consumed psychoactive drug worldwide, with high use among service members, a DoD- supported civilian team has been exploring caffeine’s effects on brain injury outcomes. Here, PFC James Russell, a cannon crew member with 4th Battalion, 27th Field Artillery, makes coffee in a kettle over a propane fuel can during the Network Integration Exercise in June 2011 at White Sands Missile Range, NM. (Photo by SPC Latoya Wiggins.)
action of adenosine by blocking its ner- vous system receptors. Boison would like to continue his studies of caffeine by exploring its effects on long-term out- comes after brain injury.
Dr. Brenda Bart-Knauer, who manages this project for TATRC, noted that the study is an excellent example of the early
“proof of concept” work that TATRC sup- ports to encourage new directions that may translate into better care for service
members. According to Bart-Knauer, exploring the role of caffeine and adenos- ine receptors in brain injury could lead to potential applications not only for physical trauma, but also for epilepsy and post-traumatic stress.
“The team has already made a very excit- ing discovery. If further studies confirm that we can safely deliver a high dose of caffeine to stabilize the brain after injury, we’ll have a relatively easy way to mitigate damaging effects,” she said.
Dr. Eugene Golanov, Director of TATRC’s neurotrauma research portfolio, said that this finding opens the possibility of exploring drugs that act on adenosine receptors as an acute treatment for brain trauma, even if the exact compound doesn’t turn out to be caffeine.
Both Bart-Knauer and Golanov pointed out that further research is needed to determine all of the mechanisms whereby caffeine affects injury outcomes. For instance, there are protective (A1) and damaging (A2A) adenosine receptors, and it is not yet clear exactly which are blocked by caffeine. Studying the inter- action of caffeine with sleep restriction would also be important to the military.
Boison is inspired by the possibility of employing a commonly used and safe drug, such as caffeine, to save the life of an injured Soldier. He said that while studies continue, “a caffeine-based rescue approach could immediately be imple- mented to save the lives of warfighters under conditions when lethal outcome is expected otherwise.”
—Courtesy of TATRC
ASC.ARMY.MIL 93
SCIENCE & TECHNOLOGY
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