Microvesicle production after trauma & its Clinical Impact on Venothromboembolism

创伤后微泡的产生

• 批准号: 8241998
• 负责人: MYUNG SOO PARK
• 金额: $ 12.27万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-15 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8241998
• 关键词: Acceleration; Accounting; Acute; Age; Anticoagulant therapy; Apoptosis; Award; Biochemistry; Biological Markers; Blood; Blood Cells; Blood Circulation; Blood Clot; Blood Platelets; Blood coagulation; Cardiovascular system; Cell Death; Cell membrane; Cells; Characteristics; Chemoprophylaxis; Clinic; Clinical; Clinical Research; Coagulation Process; Cohort Studies; Complication; County; Critical Care; Data; Deep Vein Thrombosis; Development; Development Plans; Diagnosis; Endothelial Cells; Epidemiology; Functional disorder; Future; General Population; Generations; Goals; Guidelines; Hematology; Hemorrhage; Hospitals; Hypoxia; Incidence; Individual; Infection; Injury; K-Series Research Career Programs; Lead; Leg; Leukocytes; Lung; Measurement; Mechanics; Medical Records; Medicine; Mentors; Minnesota; Modeling; Molecular Biology; Nested Case-Control Study; Observational Study; Operative Surgical Procedures; Outcome; Pathogenesis; Patients; Physicians; Physiology; Populations at Risk; Positioning Attribute; Production; Prophylactic treatment; Pulmonary Embolism; Research; Research Design; Risk; Risk Assessment; Risk Factors; Role; Science; Scientist; Screening procedure; Severities; Stratification; Stress; Surface; Surgeon; Testing; Thrombin; Thromboembolism; Thrombophilia; Thrombosis; Time; Tissues; Trauma; United States; Vascular Endothelial Cell; Venous; aggressive therapy; base; career development; clotting enzyme; cohort; cytokine; high risk; improved; injured; multidisciplinary; novel; particle; patient population; population based; prevent; prospective; public health relevance; response; risk benefit ratio; sex; skills; statistics; tool

DESCRIPTION (provided by applicant): Background: After patients suffer from traumatic injuries, the clotting mechanism in the blood is accelerated, but the mechanism involved in this acceleration is not clearly understood. The goal of this proposal titled," Microvesicle production after acute trauma and its clinical impact on venothromboembolism," is to investigate the role of sub-cellular particles that are released by injured tissue. It is believed that these particles, called microvesicles, are released from tissue such as white blood cells and platelets during infection, injury and cell death. On their surface, the microvesicles carry a cargo of clotting enzymes and cell membrane components thought to be important in clot generation. By gaining a better understanding of their role in clotting after injury, we can begin to look for ways to identify patients who may have high amount of microvesicles in their blood and to see if they are more prone to clotting such as deep leg clots (also known as deep vein thrombosis) or clots lodged in the lung (also known as pulmonary embolism), collectively known as venous thromboembolism. In the United States alone, there are over 900,000 cases per year of deep vein thrombosis and pulmonary embolism in hospitalized patients. Trauma patients are especially at high risk of developing these complications. The immediate goal of the proposed research is to be able to identify those trauma patients, based on their physical characteristics (such as age, sex, injury severity) and their blood clotting physiology (such as type and number of microvesicles found in the blood after trauma). Proposed Research: It has two components. The first component will be an extensive review of the medical records of trauma patients who suffered from deep vein thrombosis and pulmonary embolism in Olmsted County, Minnesota (1996-2005). We will study their physical characteristics and assess which are important risk factors for clotting. The second research component is an observational study involving the measurement of microvesicle clotting potential in trauma patients who develop venous thromboembolism. This study will create several opportunities for the applicant. A risk/assessment model will be generated from the proposed research. Ultimately, this information will allow us to better target aggressive therapy early to those assessed to be at high-risk of the morbid hospital complication of venous thromboembolism. Applicant: The applicant is a Trauma/Critical Care Surgeon at the Mayo Clinic in Rochester MN, who is applying for a Mentored Career Development Award. This award entails a research and a career development plan; the receipt of this award will give the applicant protected time to focus on her research objectives and in obtaining a Masters in Biomedical Science Degree. The long-term research goal of the applicant is for her to be an independent physician-scientist with the tools and skills needed to continue her clinical studies that will have a positive impact on the outcome of trauma patients. PUBLIC HEALTH RELEVANCE: In the United States, there are over 900,000 cases per year of an abnormal clotting that occurs in the legs and lung. Almost a third of the patients with this clotting abnormality die as a result of this. More research needs to be done to better diagnose and prevent this complication.

描述（由申请人提供）：背景：患者遭受创伤性损伤后，血液中的凝结机制加速了，但是涉及这种加速的机制尚未清楚地了解。该提案的目的为“急性创伤后的微囊泡产生及其对Venothromboombolism的临床影响”，是为了研究受损伤组织释放的亚细胞颗粒的作用。据信，这些称为微泡的颗粒在感染，损伤和细胞死亡期间从组织（如白细胞和血小板）中释放出来。在其表面上，微泡中携带凝血酶和细胞膜成分的货物，认为对凝块的产生很重要。 By gaining a better understanding of their role in clotting after injury, we can begin to look for ways to identify patients who may have high amount of microvesicles in their blood and to see if they are more prone to clotting such as deep leg clots (also known as deep vein thrombosis) or clots lodged in the lung (also known as pulmonary embolism), collectively known as venous thromboembolism.仅在美国，住院的患者每年就有超过900,000例深静脉血栓形成和肺栓塞。创伤患者尤其有发展这些并发症的高风险。拟议的研究的直接目标是能够根据其身体特征（例如年龄，性别，损伤严重程度）及其血液凝结生理学（例如，创伤后的血液中发现的微伏的类型和数量）来识别那些创伤患者。拟议的研究：它有两个组成部分。第一个组成部分将是对在明尼苏达州奥尔姆斯特郡（1996-2005）患有深静脉血栓形成和肺栓塞的创伤患者的医疗记录的广泛综述。我们将研究他们的身体特征，并评估哪些是凝结的重要风险因素。第二个研究成分是一项观察性研究，涉及在产生静脉血栓栓塞的创伤患者中测量微丝凝结潜力。这项研究将为申请人创造几个机会。拟议的研究将产生风险/评估模型。最终，这些信息将使我们能够尽早靶向侵略性疗法，以应对那些被评估为病态医院静脉血栓栓塞并发症的人。申请人：申请人是明尼苏达州罗切斯特梅奥诊所的创伤/重症监护外科医生，他正在申请指导的职业发展奖。该奖项需要研究和职业发展计划；该奖项的收到将使申请人受到保护的时间，以专注于她的研究目标并获得生物医学科学硕士学位。申请人的长期研究目标是让她成为一名独立的医师科学家，并具有继续她的临床研究所需的工具和技能，这将对创伤患者的结果产生积极影响。 公共卫生相关性：在美国，每年有超过900,000例异常凝结发生在腿和肺中。由于这种情况，几乎三分之一的患有这种凝血异常的患者死亡。需要进行更多的研究以更好地诊断并防止这种并发症。