The unifying theme of this PPG renewal is understanding the pathophysiology, and establishing the optimal management, of two of the most serious and frequently encountered conditions among critically ill, premature infants: anemia and thrombocytopenia. Current treatment for these conditions relies largely on transfusion of red blood cells and platelets?therapies that remain controversial and incompletely investigated. Prior research by our PPG group and others has established that many aspects of the pathophysiology of the anemia and thrombocytopenia of prematurity are unique. However, our understanding is incomplete. Hence, the goals of our renewal are to further define the mechanisms that give rise to these pressing and related clinical conditions, to optimize their treatment per such mechanistic knowledge, and consequently, to reduce both short- and long-term disabilities associated with these conditions. Our 4 interrelated projects, whose objectives are directly relevant to our unifying theme, include: Project 1 "Optimized erythropoietin treatment of neonatal anemia," PL JA Widness (and P Veng-Pedersen);Project 2 "Pathogenesis and treatment of neonatal thrombocytopenia," PL M Sola-Visner;Project 3 "Preterm transfusions: brain structure/function outcomes," PL PC Nopoulos;and Project 4 "The role of neonatal anemia In learning and memory," PL MK Georgieff. Core A ("Administrative, statistical, and research personnel") and Core B ("Laboratory and database," PL DM Mock) will provide support for all projects. To enhance effectiveness, our program has expanded to involve four (vs. two) performance sites, so that data can be shared among Projects 1, 2 and 3 (i.e. data from the same infants will be used In studies at multiple sites). Our history of success conducting multisite research will be invaluable in coordinating studies across the various performance sites. Because our Program rests on a highly-qualified, multidisciplinary group of new and experienced investigators, our renewal program consists of unique and collaborative research teams capable of accelerating the acquisition of knowledge vital to the fields of neonatal anemia and thrombocytopenia. Over the past 17 years, our productive PPG group (200 publications) has made a substantial impact on clinical practice and research in neonatal transfusion medicine and hematology. Our program embraces and exemplifies the synergistic P01 approach, which has and will enable us to make more rapid progress than any of us could individually. With this renewal, we are poised to continue to challenge paradigms and advance knowledge, as we build on prior results and maximize collaboration.

Public Health Relevance

The research proposed will enhance understanding of the pathophysiology of the 2 most important, common and costly hematological conditions encountered in the NICU: anemia and thrombocytopenia. It will do so by providing definitive answers to important, challenging, and timely clinical questions and by expanding potential treatment options to reduce costly short- and long-term consequences of these 2 challenging conditions. Results of our studies support the NIH's mission of reducing the burdens of illness and disability.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Program Projects (P01)
Project #
5P01HL046925-17
Application #
8491917
Study Section
Heart, Lung, and Blood Initial Review Group (HLBP)
Program Officer
Mondoro, Traci
Project Start
2000-04-01
Project End
2017-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
17
Fiscal Year
2013
Total Cost
$1,878,101
Indirect Cost
$324,219
Name
University of Iowa
Department
Pediatrics
Type
Schools of Medicine
DUNS #
062761671
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Liu, Zhi-Jian; Hoffmeister, Karin M; Hu, Zhongbo et al. (2014) Expansion of the neonatal platelet mass is achieved via an extension of platelet lifespan. Blood 123:3381-9
van 't Erve, Thomas J; Wagner, Brett A; Martin, Sean M et al. (2014) The heritability of metabolite concentrations in stored human red blood cells. Transfusion 54:2055-63
Mock, Donald M; Widness, John A; Veng-Pedersen, Peter et al. (2014) Measurement of posttransfusion red cell survival with the biotin label. Transfus Med Rev 28:114-25
Rosebraugh, Matthew R; Widness, John A; Nalbant, Demet et al. (2014) Pharmacodynamically optimized erythropoietin treatment combined with phlebotomy reduction predicted to eliminate blood transfusions in selected preterm infants. Pediatr Res 75:336-42
van 't Erve, Thomas J; Doskey, Claire M; Wagner, Brett A et al. (2014) Heritability of glutathione and related metabolites in stored red blood cells. Free Radic Biol Med 76:107-13
Josephson, Cassandra D; Mondoro, Traci Heath; Ambruso, Daniel R et al. (2014) One size will never fit all: the future of research in pediatric transfusion medicine. Pediatr Res 76:425-31
McCoy, Thomasin E; Conrad, Amy L; Richman, Lynn C et al. (2014) The relationship between brain structure and cognition in transfused preterm children at school age. Dev Neuropsychol 39:226-32
Kuruvilla, Denison J; Nalbant, Demet; Widness, John A et al. (2014) Mean remaining life span: a new clinically relevant parameter to assess the quality of transfused red blood cells. Transfusion 54:2724-9
Khan, Irfan; Zimmerman, Bridget; Brophy, Patrick et al. (2014) Masking of syndrome of inappropriate antidiuretic hormone secretion: the isonatremic syndrome. J Pediatr 165:722-6
Nalbant, Demet; Bhandary, Prasad; Matthews, Nell I et al. (2013) Comparison of multiple red cell volume methods performed concurrently in premature infants following allogeneic transfusion. Pediatr Res 74:592-600

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