PROJECT #4. Neuroprotection of Erythropoietin Signaling in TBICerebral hypoperfusion plays a role in the injury that develops in contused brain. If the reduction in CBFis severe enough, cerebral ischemic injury develops. If the reduction in CBF is not severe enough to causeoxygen depletion, then the baseline low flow causes the brain tissue to be more vulnerable to secondaryischemic insults. Both circumstances have a well established adverse effect on neurological outcome.In the cortical impact injury model, cerebral hypoperfusion in contused brain is associated with a relativedeficiency of nitric oxide (NO) produced by the endothelial isoform of nitric oxide synthase (eNOS). Andadministration of L-arginine (the substrate for the eNOS) or administration of tetrahydrobiopterin (anessential cofactor of eNOS) results in an increase in the NO concentrations in the brain and restores CBF inthe contused brain back to pre-injury values. The improvement in perfusion of the contused brain with Larginineis associated with a reduction in contusion volume.Erythropoietin (Epo) is expressed in the brain after injury, and has several activities that might beneuroprotective. Numerous studies suggest that Epo administration upregulates NOS or increases NOproduction or dilates vessels in a manner that suggests NO production by endothelium. In physiologicalcircumstances where endogenous Epo production is increased, such as in athletes training at high altitudes,production of NO is also increased. Finally in some pathological conditions, Epo administration has beenfound to dilate cerebral vessels. In a subarachnoid hemorrhage model, Epo reversed the vasoconstrictionthat occurred in intracranial vessels. A single dose of Epo has been shown to preserve autoregulation ofcerebral blood flow following subarachnoid hemorrhage.The purpose of this study is to investigate these potentially neuroprotective mechanisms of Epo on thevascular dysfunction that occurs after trauma.
The specific aims i nclude the following: To study the expression of Epo and Epo receptor (EpoR) by the injured brain. To study the acute effects of augmented Epo signaling on cerebral hemodynamics. To study the chronic effects of augmented Epo signaling on the brain's response to injury.To study the synergistic effects of Epo and EpoR peptide administration on the brain's response to injury.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Program Projects (P01)
Project #
2P01NS038660-06A2
Application #
7018085
Study Section
National Institute of Neurological Disorders and Stroke Initial Review Group (NSD)
Project Start
2005-12-01
Project End
2010-11-30
Budget Start
2005-12-01
Budget End
2007-01-31
Support Year
6
Fiscal Year
2006
Total Cost
$174,117
Indirect Cost
Name
Baylor College of Medicine
Department
Type
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
Rubin, Maria Laura; Chan, Wenyaw; Yamal, Jose-Miguel et al. (2017) A joint logistic regression and covariate-adjusted continuous-time Markov chain model. Stat Med 36:4570-4582
Aisiku, Imoigele P; Yamal, Jose-Miguel; Doshi, Pratik et al. (2016) The incidence of ARDS and associated mortality in severe TBI using the Berlin definition. J Trauma Acute Care Surg 80:308-12
Aisiku, Imo P; Yamal, Jose-Miguel; Doshi, Pratik et al. (2016) Plasma cytokines IL-6, IL-8, and IL-10 are associated with the development of acute respiratory distress syndrome in patients with severe traumatic brain injury. Crit Care 20:288
Vedantam, Aditya; Yamal, Jose-Miguel; Rubin, Maria Laura et al. (2016) Progressive hemorrhagic injury after severe traumatic brain injury: effect of hemoglobin transfusion thresholds. J Neurosurg 125:1229-1234
Lazaridis, Christos; Yang, Ming; DeSantis, Stacia M et al. (2015) Predictors of intensive care unit length of stay and intracranial pressure in severe traumatic brain injury. J Crit Care 30:1258-62
Yamal, José-Miguel; Benoit, Julia S; Doshi, Pratik et al. (2015) Association of transfusion red blood cell storage age and blood oxygenation, long-term neurologic outcome, and mortality in traumatic brain injury. J Trauma Acute Care Surg 79:843-9
Yamal, Jose-Miguel; Rubin, M Laura; Benoit, Julia S et al. (2015) Effect of Hemoglobin Transfusion Threshold on Cerebral Hemodynamics and Oxygenation. J Neurotrauma 32:1239-45
Yamal, Jose-Miguel; Robertson, Claudia S; Rubin, M Laura et al. (2014) Enrollment of racially/ethnically diverse participants in traumatic brain injury trials: effect of availability of exception from informed consent. Clin Trials 11:187-94
Robertson, Claudia S; Yamal, Jose-Miguel; Tilley, Barbara C (2014) Erythropoietin for traumatic brain injury--reply. JAMA 312:1929
Robertson, Claudia S; Hannay, H Julia; Yamal, José-Miguel et al. (2014) Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. JAMA 312:36-47

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