Cerebral Revascularization Reduces Stroke in Sickle Cell Disease with Moyamoya Syndrome: Retrospective Study

Faculty Mentor’s Name: Dr. Philipp Aldana
Phone Number: (904) 633-0789 
Project Category: Clinical
International Component or Travel: No

Research Project Description:
Sickle cell disease (SCD) is the most common co-existing risk factor for stroke in African-Americans. For at-risk children with SCD, chronic transfusion therapy (CTT) decreases stroke 10-fold. Despite CTT, up to 40% with SCD and Moyamoya syndrome (MMS) still experience stroke or TIA. We are examining the effect of cerebral revascularization surgery (CRS) on stroke occurrence in this population. We are recruiting children with SCD and MMS receiving CTT, with and without CR, in this multicenter retrospective cohort study. Stroke histories and medical treatment for SCD were examined in detail. Cerebrovascular events (CVE – stroke or TIA) and complications of treatment are the main endpoints. We are presenting in AANS conferences on a regular basis and will also be presenting at Peds section AANS in December 2020. Medical students will help in Data Collection, Management and Analysis as well as the Quality improvement.

Chronic Stress and Anemia Recovery Following Major Trauma

Faculty Mentor’s Name: Dr. Alicia Mohr
Phone Number: (352) 273-5670
Project Category: Surgery
International Component or Travel: No

Research Project Description:
Injury-associated persistent anemia is a persistent anemia seen in the absence of acute blood loss and is one manifestation of bone marrow end organ dysfunction that occurs following severe trauma and prolonged critical illness. We have recent data showing that norepinephrine is a key regulator of erythroid progenitor cell growth and mobilization following trauma, although the exact mechanisms involved have yet to be elucidated. Based on our published observations, the overarching hypothesis is that chronic stress and prolonged adrenergic stimulation following injury and hemorrhagic shock are directly responsible for the persistence of injury-associated anemia with impaired differentiation and maturation of erythroid cells, and reduction of chronic stress can improve anemia and alter recovery. This research is supported by the NIH-NIGMS.

The medical student will determine the role of selenium and selenoproteins in injury-associated anemia. These studies will be conducted in Sprague Dawley rats that have undergone our model of lung contusion, hemorrhagic shock followed by either 7 (LCHS/CS-7) or thirteen days of restraint stress (LCHS/CS-14). In addition to survival, we will examine plasma, bone marrow and bone marrow stroma and compare these findings to our previous work on day 7 after LCHS/CS. The medical student will begin an understanding of reviewing scientific literature and learn basic science laboratory techniques, including cell culture, qRT-PCR, ELISA and western blot. He/she will develop insight on how basic science research can be applied in the clinical arena. The medical student will also perform statistics and report the results from the experiments.

Loftus TJ, Mira JC, Kannan KB, Plazas JM, Delitto D, Stortz JA, Hagen JE, Parvataneni HK, Sadasivan KK, Brakenridge SC, Moore FA, Moldawer LL, Efron PA, Mohr AM. (2018). The post-injury inflammatory state and the bone marrow response to anemia. Am J Respir Crit Care Med 198, 629-638. PMID: 29768025

Apple CG, Miller ES, Kannan KB, Stortz JA, Cox M, Loftus TJ, Parvataneni HK, Patrick M, Hagen JE, Brakenridge S, Efron PA, Mohr AM. (2020). Vitamin D status is associated with hepcidin and hemoglobin concentratoins in patients with severe traumatic injury. J Trauma Acute Care Surg epub Jul 28. PMID:32769953