Multicenter, Multidisciplinary Effort to Study Hemorrhaging in Trauma Patients

McGowan Institute for Regenerative Medicine affiliated faculty member Stephen Wisniewski, PhD,Untitled senior associate dean and co-director of the Epidemiology Data Center at the University of Pittsburgh Graduate School of Public Health, will coordinate a new, multicenter, multidisciplinary effort – supported by a 5-year, $23.8 million National Institutes of Health (NIH) grant – to study a deadly bleeding syndrome called coagulopathy, which occurs without warning in some trauma patients.

Led by University of Vermont Professor Emeritus of Biochemistry Kenneth Mann, PhD, the Trans-Agency Consortium for Trauma-Induced Coagulopathy (TACTIC) study is a cooperative effort funded by the National Heart, Lung, and Blood Institute (NHLBI) that establishes a unique collaboration between the NIH and the Department of Defense (DOD).

“Multiple, parallel research projects will each explore a different side of coagulopathic syndromes in an effort to discover why they occur and, ultimately, to explore ways to treat and prevent them,” said Dr. Wisniewski, also professor of epidemiology. “Those projects will produce a massive amount of data, something we at Pitt Public Health are well-equipped to collect, analyze, and organize into useful information.”

Trauma is the major cause of death in people less than 34 years old and the third-leading cause of mortality in the United States, with uncontrollable hemorrhage representing the major cause of preventable deaths, according to the NIH. Each year, nearly 50 million traumatic injuries in the U.S. result in 170,000 deaths.

Little is known about the biological phenomena that lead to coagulopathy. When a person sustains a traumatic injury, some, regardless of proper treatment, can suddenly suffer from uncontrolled bleeding and die. It is believed that the shock from the trauma induces a “storm” of coagulation and inflammatory problems that prevent their blood from clotting.

“There are no analytical tools that allow emergency department staff to conclude that coagulopathy is occurring in trauma victims. We’re starting from ‘ground zero,’” Dr. Mann explains. “The physicians and staff are left without resources to guide an effective therapeutic approach.”

Study co-leader Charles Esmon, PhD, the Lloyd Noble Chair in Cardiovascular Biology at the Oklahoma Medical Research Foundation, will look at the role played by DNA and histones that escape from cells in initiating the inflammatory and coagulation abnormalities that occur in trauma.

“We’ve gathered the leading minds in the field to attack a problem that has a serious and immediate impact on patients,” said Dr. Esmon. “To understand and address the issue of severe trauma, we need a multidisciplinary approach. This project requires experts in clinical science, basic biology, laboratory science, and animal research.”

This trans-agency endeavor links the NHLBI-supported TACTIC program with DOD clinical trauma research centers in a unique initiative that integrates laboratory, clinical, and early translational, hypothesis-driven research by leading investigators across the country and enables the basic science investigative units to explore clinical specimens obtained from the DOD centers.

Additional institutions involved in the research funded by the TACTIC grant include Massachusetts Institute of Technology, Mayo Clinic, Scripps Research Institute, University of California-San Francisco, University of Illinois, and University of Pennsylvania. DOD-supported institutions participating in the clinical component of the TACTIC grant include University of Colorado, University of Pittsburgh, and Virginia Commonwealth University.

This research is funded by NIH grant UM1 HL120877-01.

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UPMC/University of Pittsburgh Schools of the Health Sciences Media Relations Press Release

Pittsburgh Post-Gazette