Stroke: A new approach to treatment
07/21/2026Researchers at Würzburg University Hospital have identified a promising target molecule. In experiments, blocking this molecule was shown to slow the progression of strokes even whilst the blood vessel was still blocked.
If a blood vessel in the brain is suddenly blocked, a race against time begins: with every minute that the brain is deprived of sufficient oxygen and nutrients, millions of nerve cells die irretrievably. Although blood clots can now often be dissolved with medication or removed mechanically using a catheter, thereby restoring blood flow, severe permanent damage or death frequently occurs despite successful treatment.
A key reason for this is that the stroke progresses even whilst the blood vessel is blocked. To improve treatment outcomes, additional therapeutic approaches are therefore required that take effect even before the blood vessel is reopened.
At Würzburg University Hospital (UKW), interdisciplinary research groups from the departments of Neurology, Neuroradiology and Experimental Biomedicine have been investigating inflammatory processes that influence the progression of stroke for many years. Among other things, the focus is on the inflammasome, a component of the immune system that responds to stress signals and can regulate immune responses.
Inflammation as a therapeutic target
The NLRP3 inflammasome plays a key role in these inflammatory processes. Until now, its role in the later phases of a stroke was the main focus of research. A study by researchers from the Departments of Neurology and Neuroradiology at the University of Würzburg and the Faculty of Medicine at the University of Bonn now demonstrates that NLRP3 becomes active immediately following vascular occlusion, thereby influencing an early phase of the disease that has previously received little attention.
In experimental models, the research team was able to show that targeted inhibition of the NLRP3 inflammasome significantly attenuates the inflammatory response and slows the progression of the infarct during vascular occlusion. “This opens up new possibilities for therapeutically influencing stroke at a very early stage,” says Professor Michael Schuhmann, Head of the Clinical Laboratory of Neurology, whose professorship is funded by the Hentschel Foundation.
Direct detection in humans
For the first time, the researchers have succeeded in detecting the expression of NLRP3 directly in humans during an acute stroke. This was made possible by a highly specific protocol established at the centre and close collaboration with the interventional neuroradiologists Dr Alexander Kollikowski and Professor Mirko Pham (Director of the Institute for Diagnostic and Interventional Neuroradiology). During routine thrombectomies, it was thus possible to obtain tiny blood samples from the acutely affected area of the brain, the prognostic relevance of which had been demonstrated in earlier studies.
The analyses confirmed the experimental findings and show that NLRP3-mediated inflammatory responses are also pathophysiologically relevant in humans. Furthermore, the clinical course three months after the stroke could be predicted based on the number of NLRP3-positive immune cells.
Outlook: Treatment even before hospital admission
“Our results provide an important starting point for therapies designed to influence stroke even before the vessel is reopened. One possible approach would be to administer NLRP3 inhibitors very early on, for example whilst the patient is still in the ambulance,” says Dr Maximilian Bellut, first author of the study.
“Valuable time is often lost between the occlusion of the blood vessel and successful thrombectomy,” explains Alexander Kollikowski. “If we can succeed in slowing the progression of the infarct during this phase, it could improve the prognosis for many patients.”
Michael Schuhmann adds: “There is still a long way to go before this can be applied clinically in stroke. However, the fact that NLRP3 inhibitors are already being developed for clinical use in other conditions could facilitate future translational studies.”
The findings thus provide an important translational starting point for new, neuroprotective treatments for stroke through the targeted inhibition of inflammatory processes.
A detailed interview with Maximilian Bellut, the study’s first author, can be read here.
Publication
Maximilian Bellut, Alexander M. Kollikowski, Marius L. Vogt, Lukas Rossnagel, Ibrahim Hawwari, Bernardo S. Franklin, Mirko Pham, Guido Stoll and Michael K. Schuhmann. Identifying the role of the NLRP3 inflammasome in stroke progression and outcome before recanalisation. Cell Reports Medicine (2026), https://doi.org/10.1016/j.xcrm.2026.102723
