Dr. Susan C. Fagan is a Professor of Pharmacy at the University of Georgia and has dedicated her career to the identification of new treatment strategies for acute ischemic stroke patients. As a clinical pharmacy scientist, she was a key member of the federally-funded investigative team that developed the clot busting drug, tPA, as a treatment for stroke in the early 1990s. The manuscript was published in the New England Journal of Medicine in December, 1995, impacting the way in which stroke patients are treated worldwide. This research led to the adoption of tPA as the ONLY US Food and Drug Administration-approved pharmacologic treatment for stroke, in 1996.
Since 1994, Dr. Fagan has been searching for new molecular targets, activated after a patient experiences a stroke, which can be modified by novel treatments to improve patient outcome. Frustrated by the lack of clinical efficacy of the neuroprotective compounds studied extensively in the 1990s, she initiated a 15 year journey to develop vascular protection as a way to first, improve the safety of tPA (reducing brain bleeding) and secondly, to improve recovery after ischemia and reperfusion in the brain. Her landmark manuscript, published in Stroke, in 2004, identified likely targets and was followed by a series of federally-funded investigations (2 NIH RO1s and 2 VA Merit Review) to develop pharmacologic interventions that approach those targets. Many of the compounds are currently under investigation in human stroke patients (minocycline, atorvastatin, and candesartan) by Dr. Fagans’ research team at the Augusta University or by other investigators.
Dr. Fagan has published more than 140 peer reviewed journal articles and 15 book chapters. She is recognized as an international expert in ischemic stroke treatment and is a consultant for the National Institutes of Health (NIH), Washington University, Massachusetts General Hospital (Harvard), and the University of Texas Health Sciences Center San Antonio on issues regarding the development of new treatments for stroke and other neurologic disorders.
Dr. Fagan has been recognized for her unique contributions to “translational research” as evidenced by her appointment as a faculty member on two national clinical research training programs. The first, funded by the National Institutes of Neurologic Disorders and Stroke (NINDS), was for neurologists and neurosurgeons (2008- 2010) and the second, for clinical pharmacy scientists (2009 – 2011) was funded by the American College of Clinical Pharmacy (ACCP) Research Institute. She was elected Chair of the ACCP Research Institute in 2008. She is the current chair of the Research and Development Committee of the Charlie Norwood VA Medical Center in Augusta, GA.
Her status in the field has also been recognized by her appointment to several different NIH study sections and by her invitation to exclusive research conferences, funded by NIH (Princeton Conferences are limited to 100 participants). These honors are only bestowed on those with nationally and internationally recognized leadership in research.
The Next Five Years
The past two years have witnessed an explosion of productivity in the Fagan Stroke Laboratory. Following up on a novel finding of a proangiogenic state in the cerebrospinal fluid of animals treated with a vascular protective medication acutely after stroke (Kozak, 2009), the group reported a differential expression of growth factors in BOTH hemispheres of the brain after unilateral ischemia (Guan, 2011). This challenges the decades-long notion that the contralateral hemisphere is a good “control” for measuring changes in molecular mediators after stroke. The next five years will be focused on determining the mechanisms of accomplishing vascular protection after acute ischemic stroke and the impact of vascular protection on functional outcome. The specific goals are:
- To determine the contribution of acute blood pressure lowering to recovery after ischemic stroke.
- To determine the impact of vascular protection on neuronal survival.
- To determine the contribution of premorbid vascular health to recovery after ischemia and reperfusion
These will be accomplished using both in vitro and in vivo models of cerebral ischemia and reperfusion in combination with both pharmacologic, immunologic and genetic manipulation and state of the art molecular and imaging techniques.