After discussion on Monday, I realized that I had not brought up the concept of a prenumbra, "a constrained area of blood flow with partially preserved energy metabolism...that surrounds the lethally damaged core of the ischemic infarct". Having no idea what a prenumbra looked like, I googled it, and was surprised at the extent of viable tissue surrounding the ischemic core. It got me thinking that if medical professionals could shunt the constrained flow to the most ischemic tissue, damage could be minimilized (I was thinking of it as an almost focal reprofusion). I guess the rub lies in how to reperfuse the area without subsequent reperfusion injury. I just found it interesting that this study, which investigated a T-cell mediated approach as a prophylactic therapy, would be the first (and only) of our papers to address the matter.
The results of the study were promising but it was difficult to be convinced because of what has been brought up in class - that the doses for the nasal vs oral MOG were different. I think the way to improve the study is to use a biomarker for MOG, and report the results, as adjusted for biomarker levels (kind of like how Western blots are adjusted for protein concentration before well loading and reported as sample density per density of a standard protein).
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