C4TS SUMMER 2014 NEWSLETTER
Issue 3
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C4TS
SUMMER 2014 newsletter
WELCOME
Welcome to the Summer 2014 edition of the Barts Centre for Trauma Sciences (C4TS) newsletter. In this edition, we outline some recent achievements and the current priorities for the Brain and Spinal Cord Injury research theme. A practical and effective means of measuring recovery and quality of life after neurotrauma (or indeed any traumatic injury) is essential for achieving our Centre’s aim of ‘Total translation of trauma research into practice’. Here we highlight the “Evaluation of Rehabilitation Outcome after Severe Trauma (EROS)” study, undertaken by the Outcomes support core that aims to develop a globally-applicable Prof. Adina Michael-Titus: Lead, assessment tool to address this currently unmet need in trauma. Brain & Spinal Cord Injury Theme
Lead, Brain and
Neurotrauma The need to study Brain and Spinal Cord Injury Traumatic brain injury (TBI) and spinal cord injury (SCI) lead to devastating consequences for patients and are associated with significant health care costs. TBI accounts for over half of all trauma fatalities and is a major cause of prolonged disability and significant long-term burden, for both survivors and their carers. It is estimated that 10 million people globally will be affected by TBI every year. There are an estimated 40,000 spinal cord injured people in the UK – with one more person injured every eight hours. The annual cost of caring for people paralysed by SCI is conservatively estimated at more than £500 million in the UK alone. SCI affects predominantly young people (16 to 35 year olds); the most common causes are falls and road traffic collisions, but also include sporting accidents (e.g. horse riding, rugby, diving). Recent trends show that more over 50s are becoming affected by this type of injury. There remains an ever increasing unmet need for the provision of treatments that protect the brain and spinal cord immediately after injury.
By
Adina Michael-Titus (Professor of Neurosurgery)
Research background Despite many advances in imaging and brain monitoring, there are few therapeutic options for neurotrauma and outcomes remain universally poor. New treatment approaches and products have been characterized in the laboratory but we need to identify the key reasons for their repeated translational failure in the clinic. The consequences associated with TBI and SCI are due to the fast propagation of tissue destructive processes, in the minutes and hours following trauma. Most trials of neuroprotective agents have had a period of 8 hours or longer between injury and administration of the drug. Our research focuses on the development and hyperacute delivery (i.e. on scene within minutes of injury) of new interventions and drugs that promote both neuroregeneration and neuroplasticity (connectivity), which ultimately lead to some restoration of function. Research achievements to date We have at present a large preclinical programme of research focused on a polyunsaturated omega-3 fatty acid, Docosahexaenoic acid (DHA).
A
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Figure 1 - DHA exhibits high neuroprotective potential in experimental models of neurotrauma. DHA administered in the “golden hour” after injury (Figure A) significantly reduces the lesion size in the spinal cord compared to a control model group (Figure B), and yields better neurological outcome. Research priorities Our pre-clinical work with DHA has validated this compound in a number of SCI and TBI models. We are also working on novel preparations which could be used in the chronic phase of neurotrauma, to support the restoration of circuits damaged by injury. The most significant challenge remains the development of clinical trials where DHA could be administered to patients by the prehospital emergency team and the demonstration that it significantly modifies the neurological outcome after injury. Click here to find out more about C4TS research and clinical trials activities.