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A naturally occurring molecule that helps the brain clear away damaged blood cells could open the door to new treatments for one of the deadliest forms of stroke, research led by University of Manchester scientists suggests.

Intracerebral hemorrhage (ICH) occurs when a blood vessel bursts and bleeds directly into the brain, leaking substances such as iron that cause serious damage for which effective treatments remain limited. The researchers have now identified a biological process in humans and mice that appears to help the brain deal with the aftermath of the bleeding and improve recovery.

The study, published in the Journal of Neuroinflammation, focuses on an enzyme called cholesterol 25-hydroxylase (CH25H), which converts cholesterol into a molecule called 25-hydroxycholesterol (25HC).

The team found increased levels of CH25H in brain tissue from people who had suffered ICH, particularly in immune cells surrounding the site of the bleed. CH25H also appeared to help the brain's resident immune cells, called microglia, to engulf and remove red blood cells released into brain tissue following a hemorrhage. And it influenced genes involved in clearing cellular debris and processing fats and cholesterol within the microglia.

The cleanup process can be critical because when red blood cells break down, they can contribute to further brain damage after the initial stroke.

Mice genetically lacking Ch25h experienced greater iron accumulation and tissue damage, alongside worse neurological symptoms following an experimentally induced brain hemorrhage.

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