Longitudinal SIT Trial Plasma Proteomic Biomarker Discovery and Validation in SCI

SCI 中的纵向 SIT 试验血浆蛋白质组生物标志物的发现和验证

• 批准号: 7761227
• 负责人: James F Casella
• 金额: $ 39.4万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-01-15 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7761227
• 关键词: Age; Aging; Antibodies; Applications Grants; Area; Arts; Atherosclerosis; Biological Assay; Biological Markers; Brain; Brain Injuries; Brain Ischemia; Cardiovascular system; Cerebral Infarction; Cerebrum; Child; Chronic; Cognitive; Databases; Dementia; Development; Diabetes Mellitus; Diagnostic; Disease; Early treatment; Enrollment; Etiology; Evaluation; Fractionation; Genes; Goals; High Pressure Liquid Chromatography; Hypertension; Individual; Infarction; Infection; Institutes; Lesion; Life; Liquid Chromatography; Magnetic Resonance Imaging; Mass Spectrum Analysis; Migraine; Minority; Modeling; Morbidity - disease rate; Names; National Heart, Lung, and Blood Institute; Participant; Pathologic; Patients; Phase; Phenotype; Pilot Projects; Plasma; Plasma Proteins; Population; Principal Investigator; Proteins; Proteome; Proteomics; Public Health; Randomized; Research; Research Personnel; Resources; Risk; Sampling; Sampling Studies; Sickle Cell Anemia; Stream; Stroke; Structure; Symptoms; Systemic disease; Techniques; Technology; Therapeutic; Time; Transfusion; Treatment Efficacy; Validation; Western Blotting; abstracting; adverse outcome; arm; central nervous system injury; cognitive function; cohort; cost; design; insight; interest; patient population; prognostic; programs; protein expression; protein profiling; response; standard care; success; tv watching

DESCRIPTION (provided by applicant): Silent cerebral infarctions (SCI) occur in 22% of children with sickle cell disease (SCD) and are associated with decreased cognitive function. By definition, these children have MRI and pathologic evidence consistent with brain ischemia or infarction, without symptoms of overt stroke. As the etiology of SCI is unknown, we lack the means to identify children at risk for SCI, institute early therapy, or follow the success of therapy. The overall goal of this grant proposal is to identify diagnostic/prognostic plasma biomarkers of SCI in children ages 5-14 years with SCD. In our pilot studies, using a non-biased proteomic analysis of existing baseline plasma samples at enrollment in the Silent Infarct Transfusion (SIT) Trial from patients with or without SCI, we found differences in the protein profile and the presence of brain specific proteins in plasma of children with SCI. The SIT Trial represents a unique opportunity to: 1) extend these studies to serial plasma samples from study participants, which would be obtained as part of this proposal, but are not presently being obtained as part of the SIT Trial; 2) optimize sample procurement for deep proteomic analysis; and 3) assess biomarkers for prognostic value and therapeutic efficacy. We hypothesize that serial plasma samples optimized for proteomic studies from children with SCD and treated for SCI will contain diagnostic/prognostic biomarkers of SCI and treatment efficacy. The significance of the proposed studies is that identification of circulating markers of SCI could allow early intervention in these children, validate the efficacy of current therapy and provide insight into the design of new therapies. This proposal draws on the unique resources of the ongoing SIT Trial, the large and well phenotyped plasma samples in the SIT Trial Biologic Respository and the NHLBI Cardiovascular Proteomics Center at Johns Hopkins. In Specific Aim I, we will identify plasma biomarkers of SCI and evaluate differences in these biomarkers among 4 groups of patients: SCI patients randomly assigned to chronic transfusion (1) or standard care (2), patients without SCI (3), and patients with recent evidence of ischemic CNS injury (4), using state of the art, non-biased proteomic techniques (protein depletion, HPLC, ITRAQ and LC/MS/MS). In Specific Aim II, we will validate the efficacy of these biomarkers in predicting SCI and therapeutic response, using a combination of traditional western blotting and the development of high throughput multiplex antibody arrays. It is anticipated that these studies will provide new insights into the development of SCI and stroke in SCD and possibly ischemic CNS injury in other susceptible populations. This project has the potential to identify the protein biomarkers for the protection and evaluation of new and progressive silent cerebral infarcts. The identification of such circulating markers of SCI could allow early intervention in children who develop these lesions, help validate the efficacy of current therapy and provide insight into the design of new therapies. While we are studying a selected population of patients with a single gene disorder who develop silent cerebral infarction early in life, these results may generalize to the very large group of older individuals who develop silent cerebral infarctions as a presumed multi-factorial disorder (e.g., atherosclerosis, hypertension, diabetes, migraine, infection, other systemic diseases and aging), often associated with adverse outcomes such as dementia. Thus, the results of these studies could have a great deal of significance for public health in a variety of populations. (End of Abstract)

描述（由申请人提供）： 22% 的镰状细胞病 (SCD) 儿童会发生无症状性脑梗死 (SCI)，并且与认知功能下降有关。根据定义，这些儿童的 MRI 和病理证据符合脑缺血或梗塞，但没有明显的中风症状。由于 SCI 的病因尚不清楚，我们缺乏识别有 SCI 风险的儿童、进行早期治疗或跟踪治疗成功的方法。该拨款提案的总体目标是确定 5-14 岁 SCD 儿童的 SCI 诊断/预后血浆生物标志物。在我们的试点研究中，我们对参加无症状梗塞输血 (SIT) 试验的患有或未患有 SCI 患者的现有基线血浆样本进行无偏蛋白质组学分析，发现 SCI 儿童血浆中蛋白质谱和脑特异性蛋白质存在差异。 SIT 试验提供了一个独特的机会：1）将这些研究扩展到研究参与者的系列血浆样本，这些样本将作为本提案的一部分获得，但目前尚未作为 SIT 试验的一部分获得； 2) 优化深度蛋白质组分析的样品采购； 3) 评估生物标志物的预后价值和治疗效果。我们假设针对 SCD 儿童并接受 SCI 治疗的蛋白质组学研究进行优化的系列血浆样本将包含 SCI 的诊断/预后生物标志物和治疗效果。拟议研究的意义在于，识别 SCI 循环标志物可以对这些儿童进行早期干预，验证当前治疗的疗效，并为新疗法的设计提供见解。该提案利用了正在进行的 SIT 试验的独特资源、SIT 试验生物库和约翰·霍普金斯大学 NHLBI 心血管蛋白质组学中心中大量且表型良好的血浆样本。在具体目标 I 中，我们将使用最先进的无偏见蛋白质组学技术（蛋白质去除、HPLC、ITRAQ 和 LC/MS/MS）。在 Specific Aim II 中，我们将结合传统的蛋白质印迹和高通量多重抗体阵列的开发，验证这些生物标志物在预测 SCI 和治疗反应方面的功效。预计这些研究将为 SCD 中 SCI 和中风的发展以及其他易感人群中可能的缺血性中枢神经系统损伤提供新的见解。该项目有潜力识别蛋白质生物标志物，用于保护和评估新发和进行性无症状脑梗塞。 SCI 的此类循环标志物的识别可以对出现这些病变的儿童进行早期干预，有助于验证当前治疗的疗效并为新疗法的设计提供见解。虽然我们正在研究一群患有单基因疾病、在生命早期发生无症状脑梗塞的患者，但这些结果可能会推广到一大群老年个体，他们发生无症状脑梗塞，这是一种假定的多因素疾病（例如动脉粥样硬化、高血压、糖尿病、偏头痛、感染、其他全身性疾病和衰老），通常与痴呆等不良后果相关。因此，这些研究的结果可能对各种人群的公共卫生具有重要意义。 （摘要完）