PHOENIX, Ariz. - Dec. 4, 2013 - In an effort to
lower medical costs, identify patients at risk for injury, and
speed patient recovery, scientists will attempt to identify a
molecular signal that indicates severity of brain-injury during a
$4 million, five-year federal grant to Barrow Neurological
Institute at St. Joseph's Hospital and Medical Center, Phoenix
Children's Hospital and the Translational Genomics Research
Institute (TGen).
The molecular profile - comprised of RNA, the body's relay
messenger between DNA and protein - could help identify which
patients are most at risk for vasospasm after hemorrhagic
stroke. Hemorrhagic stroke can occur as:
• Subarachnoid hemorrhage, or the bleeding into
the area between the brain and a thin membrane that covers
it.
• Ruptured brain aneurysm, which is an abnormal
bulge or ballooning in the wall of an artery within the
brain.
By identifying this RNA molecular marker, a new standard of
individualized care could be established, enabling medical teams to
respond more rapidly to quickly changing health conditions, and
allowing earlier intervention to prevent a secondary injury from
occurring.
"We hope this study will lead to less injury, less testing and
cost, and shorter stays in the hospital," said Dr. Yashar Kalani,
M.D. and Ph.D., a resident physician in Neurological Surgery and
assistant professor at the Barrow Neurological Institute and one of
the study's principal investigators. Additional investigators at
Barrow include Drs. Robert Spetzler, Peter Nakaji, Felipe
Albuquerque and Cameron McDougall.
Vasospasms are characterized by bleeding in the brain that causes
irritation and nearby blood vessels to spasm and narrow. This
decreases blood flow to the brain, which can result in damage or
even death to parts of the brain.
Only about half of patients with brain-aneurysm ruptures survive,
and those who do survive often are severely disabled for life. In
the 10 days following such ruptures, blood vessels can narrow,
leading to loss of oxygen, strokes and brain damage.
"If we knew what is happening during this period, we might be able
to intervene and prevent the secondary injury," Dr. Kalani
said.
Barrow will provide patient care and collect blood and spinal
fluid samples that will be analyzed by TGen. A recent TGen study
showed spinal fluid could be sequenced for RNA biomarkers. Samples
will be checked daily to compare and identify changes.
Another part of the study will be conducted at Barrow's
partnership with Phoenix Children's Hospital, where researchers
will investigate the effects of intraventricular hemorrhage -
another form of bleeding in the brain - in newborn babies.
Intraventricular hemorrhage in newborns occurs secondary to
diminished blood flow and oxygen delivery to the brain.
Intraventricular hemorrhage is associated with the development of
hydrocephalus and damage to the brain that can result in cerebral
palsy or other types of motor and cognitive delays.
"This study will get us one step closer to learning what is unique
in pediatric stroke so we can provide the best quality care and
improve the long term outcomes for these children," said Dr. P.
David Adelson, one of the principal investigators of the study at
Barrow Neurological Institute at Phoenix Children's Hospital.
"In addition, as this study progresses, we want to know how to
identify children at risk, and how they differ from adults with
similar conditions, this will not only help us to be more accurate
at providing current treatments but to develop new ones." said Dr.
Jorge Arango, an investigator affiliated with Barrow Neurological
Institute at Phoenix Children's Hospital and with the University of
Arizona College of Medicine-Phoenix.
In the study of both adults and children, TGen researchers will
use state-of-the-art sequencing - to analyze RNA transcripts,
searching for biomarkers that could identify at-risk
patients.
RNAs are cell molecules made from DNA that help create
proteins.
"There has been an explosion over the last several years in our
understanding of the functional and regulatory mechanisms modulated
by RNA" said Dr. Kendall Van Keuren-Jensen, Ph.D., an Assistant
Professor in TGen's Neurogenomics Division and also a principal
investigator in the study funded by the National Institutes of
Health (NIH).
"We are very excited about the potential for extracellular RNAs to
provide us with accessible information about the mechanism of
disease, and in doing so, provide us with pre-symptomatic markers
of disease," said Dr. Matt Huentelman, Ph.D., an Associate
Professor in TGen's Neurogenomics Division and also a principal
investigator on the project. "In the best-case scenario, these
markers can be coupled with an improved clinical management of the
disease, too. In a nutshell, that is what we are exploring under
this new grant award."
This type of study is now possible because of continuing
improvements in optics and computer speed that enables TGen's
cutting-edge technology to sequence at ever-faster rates and at
ever-lower costs. While it took 13 years and $2.7 billion to spell
out the first human genome, such sequencing can now be done in a
matter of days and for less than $5,000.
Additional partners in the study include: University of
California, San Francisco; and Stanford University.
# # #
About Phoenix Children's Hospital
Phoenix Children's Hospital is Arizona's only children's hospital
that is ranked in U.S. News & World Report's Best Children's
Hospitals. Phoenix Children's provides world-class inpatient,
outpatient, trauma, emergency and urgent care to children and
families in Arizona and throughout the Southwest. As one of the
largest children's hospitals in the country, Phoenix Children's
provides care across more than 75 pediatric specialties. The
Hospital is poised for continued growth in quality patient care,
research and medical education. For more information about the
hospital, visit www.phoenixchildrens.org.
Media Contact:
Jane Walton
Media Relations
Phoenix Children's Hospital
(602) 933 5871
jwalton@phoenixchildrens.org
*
About Barrow Neurological Institute
Barrow Neurological Institute at St. Joseph's Hospital and Medical
Center is internationally recognized as a leader in neurological
research, diagnosis and patient care. Its world-renowned physicians
treat patients with a wide range of neurological conditions,
including brain and spinal disorders and injuries. More brain
surgeries are performed at Barrow than any hospital in the United
States and the Institute trains more neurosurgeons than anywhere in
the world. St. Joseph's is consistently voted among the top
hospitals in the United States for neurology and
neurosurgery.
Media Contact:
Carmelle Malkovich
Senior Public Relations Specialist
St. Joseph's Hospital and Medical Center
Barrow Neurological Institute
602-406-3319
Carmelle.Malkovich@DignityHealth.org
*
About TGen
Translational Genomics Research Institute (TGen) is a Phoenix,
Arizona-based non-profit organization dedicated to conducting
groundbreaking research with life changing results. TGen is focused
on helping patients with cancer, neurological disorders and
diabetes, through cutting edge translational research (the process
of rapidly moving research towards patient benefit). TGen
physicians and scientists work to unravel the genetic components of
both common and rare complex diseases in adults and children.
Working with collaborators in the scientific and medical
communities literally worldwide, TGen makes a substantial
contribution to help our patients through efficiency and
effectiveness of the translational process. For more information,
visit: www.tgen.org.
Press Contact:
Steve Yozwiak
TGen Senior Science Writer
602-343-8704
syozwiak@tgen.org
*
About the National Institutes of Health (NIH):
NIH, the nation's medical research agency, includes 27 Institutes
and Centers and is a component of the U.S. Department of Health and
Human Services. NIH is the primary federal agency conducting and
supporting basic, clinical, and translational medical research, and
is investigating the causes, treatments, and cures for both common
and rare diseases. For more information about NIH and its programs,
visit www.nih.gov. Research
reported in this publication was supported by the National Center
For Advancing Translational Sciences of the National Institutes of
Health under Award Number UH2TR000891. The content is solely the
responsibility of the authors and does not necessarily represent
the official views of the National Institutes of Health.