In this SPOTRIAS application, we propose 3 new studies, one of which (project #1) is a collaborative multicenter phase 2 trial across several SPOTRIAS centers, one entirely new project (project # 2), and one (project #3) which is the next phase of a project started during the first 5 years of our SPOTRIAS program. All three of these projects are translational in the true sense of the word. Project 1 is a trial of a combination of neuroprotective treatments (caffeinol and hypothermia), one of which (caffeinol) was discovered in our lab and has undergone extensive preclinical testing in our animal stroke models. The combination was also first tested in our lab. The phase 1 and early phase 2 evaluations of these treatments were part of the first SPOTRIAS from UT and UC San Diego, and showed feasibility and safety. In the spirit of translation, the study that we jointly propose in Project 1 is designed to replicate as much as possible the laboratory experiments which demonstrated the most robust benefit of this combination. The purpose of this study is to do a factorial design phase 2 study of both treatments alone and in combination compared with standard treatment in order to determine as quickly as possible which treatment arms should move forward to a phase 3 study. Project 2 is a study of a PPARgamma agonist in patients with ICH. Our lab was the first to demonstrate changes in PPARgamma expression in an animal model of ICH, and the PI of Project 2 was part of the lab team that first discovered that PPAR gamma agonists promoted the phagocytosis of the red blood cells comprising the hematoma. Project 2 is a direct clinical translation of that work. Finally, project 3 carries on our previous work with ultrasound enhanced clot lysis. The safety and benefit of ultrasound has been tested in our animal stroke models and in other labs, and then in a phase 2 study as part of our previous SPOTRIAS. In an effort to make this treatment more widely applicable, we have developed a hands-free ultrasound unit that we first tested in animals as part of a supplementary award to our first SPOTRIAS, and now propose to test for the first time in humans. We also propose 3 Cores (Clinical, Data, and Tissue) to support these translational studies, and a Career Development Program to train new investigators to carry out future translational studies. All of these projects and Cores were approved by the previous review of our grant, but there were concerns about the Data Core and Project #1 that we have thoroughly addressed in this re-submission.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center (P50)
Project #
5P50NS044227-10
Application #
8266888
Study Section
Special Emphasis Panel (ZNS1-SRB-G (29))
Program Officer
Janis, Scott
Project Start
2002-09-15
Project End
2014-04-30
Budget Start
2012-05-01
Budget End
2014-04-30
Support Year
10
Fiscal Year
2012
Total Cost
$2,039,631
Indirect Cost
$637,897
Name
University of Texas Health Science Center Houston
Department
Neurology
Type
Schools of Medicine
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225
Wu, Tzu-Ching; Sitton, Clark; Potter, Andrew et al. (2014) CTP infarct core may predict poor outcome in stroke patients treated with IV t-PA. J Neurol Sci 340:165-9
Alderazi, Yazan J; Barot, Niravkumar V; Peng, Hui et al. (2014) Clotting factors to treat thrombolysis-related symptomatic intracranial hemorrhage in acute ischemic stroke. J Stroke Cerebrovasc Dis 23:e207-14
McDonald, Mark M; Archeval-Lao, Joancy M; Cai, Chunyan et al. (2014) Iodinated contrast does not alter clotting dynamics in acute ischemic stroke as measured by thromboelastography. Stroke 45:462-6
Barlinn, Kristian; Tsivgoulis, Georgios; Barreto, Andrew D et al. (2014) Outcomes following sonothrombolysis in severe acute ischemic stroke: subgroup analysis of the CLOTBUST trial. Int J Stroke 9:1006-10
Kawano-Castillo, Jorge; Ward, Eric; Elliott, Andrea et al. (2014) Thrombelastography detects possible coagulation disturbance in patients with intracerebral hemorrhage with hematoma enlargement. Stroke 45:683-8
Bowry, Ritvij; Fraser, Stuart; Archeval-Lao, Joancy M et al. (2014) Thrombelastography detects the anticoagulant effect of rivaroxaban in patients with stroke. Stroke 45:880-3
Gonzales, Nicole R (2013) Ongoing clinical trials in intracerebral hemorrhage. Stroke 44:S70-3
Rahbar, Mohammad H; Gonzales, Nicole R; Ardjomand-Hessabi, Manouchehr et al. (2013) The University of Texas Houston Stroke Registry (UTHSR): implementation of enhanced data quality assurance procedures improves data quality. BMC Neurol 13:61
Guerrero, Waldo R; Grotta, James C (2013) Defining intravenous recombinant tissue plasminogen activator failure. Stroke 44:819-21
Ifejika-Jones, Nneka L; Peng, Hui; Noser, Elizabeth A et al. (2013) Hospital-acquired symptomatic urinary tract infection in patients admitted to an academic stroke center affects discharge disposition. PM R 5:9-15

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