The cerebrovascular-neurotrauma lab is directed by Dr Lewis and focuses on two of his three areas of expertise including neurotrauma and cerebrovascular neurosurgery.
Neurotrauma
The lab has developed a clinical platform to investigate proteomics and their potential utility in the field of acute brain injury in collaboration with Professor Ron Hayes PhD, and Kevin Wang PhD. Dr Lewis is the principal investigator of an IRB approved pilot study at the University of Florida. The pilot results were presented in August 2004 at the International Neurotrauma meeting, submitted for publication to the Journal of Neurotrauma and form the basis for an NIH RO1 proposal submitted in October 2004. The overall hypothesis of this proposal is that specific proteins or peptide fragments detectable in the cerebrospinal fluid (CSF) are biochemical markers associated with the magnitude of brain injury, occurrence of secondary insults and outcome. Appropriate markers, alone and/or in combination, can provide information critical for diagnosis, triage and management, as well as data on possible injury mechanism(s) and cellular and subcellular localization of injury. Dr Lewis has founded a human proteomics laboratory in the McKnight Brain institute dedicated to the development of clinical biomarkers.
Other current activities in the field of neurotrauma include:
1. A 2 center NIH funded study originating from the Medical College of Virginia (Dr. Ross Bullock) examining the pharmacokinetics of a single intravenous infusion of cyclosporine A in patients with severe traumatic brain injury.
2. A 2 center NIH funded study originating from the Medical College of Virginia (Dr. Ross Bullock) examining the neurochemical monitoring of the intracerebral microenvironment using microdialysis in severely head injured patients
Cerebrovascular neurosurgery
The lab has broadened work in proteomics and biomarkers to include acute brain injury from aneurysmal subarachnoid hemorrhage (SAH). Dr. Lewis is the principal investigator of an IRB approved pilot study at the University of Florida. The aim of this study was to determine if specific candidate biomarkers are elevated in CSF in response to aneurysmal SAH and to determine if elevations of these biomarkers could be used to define specific neurochemical and metabolic events occurring in the injured brain. The preliminary results were recently presented at the University of Florida Department of Neurosurgery research day and are in preparation for submission for publication in Nature medicine and oral presentation at the 2005 Congress of Neurosurgeons meeting. These results will form the basis of an RO1 grant to be submitted in June 2005. The overall hypothesis of this proposal is that specific proteins or peptide fragments detectable in the cerebrospinal fluid (CSF) are biochemical markers that can be used to define specific neurochemical and metabolic events occurring in the injured brain after aneurysmal SAH. These biomarkers may allow us to stratify patients, better monitor injury progression or resolution, detect secondary injury from vasospasm, to monitor the effects of therapy/intervention and to predict outcome more accurately after aneurysmal SAH.
There are no other centers, to our knowledge, utilizing this multiparameter cross platform investigative approach to the problem of vasospasm and aneurysmal subarachnoid hemorrhage.
Other current activities in the field of cerebrovascular neurosurgery include:
1. A multi-center, NIH-funded study originating from the University of Cincinnati ( Investigator: Dr. Joseph Broderick, PO21-040-K663-1105) The specific aim of this study is to identify susceptibility genes that are related to the formation of intracranial aneurysms. Our site is the 5th highest of 23 recruiting centers.
2. A NIH funded study originating from the University of California Davis Medical Center (Principal Investigator Dr. Paul Muizelaar). The research study is a multi-center, randomized clinical trial comparing prophylactic transluminal balloon angioplasty (TBA) treatment to standardized conventional management in patients with aneurysmal SAH. The hypothesis of this study is that prophylactic TBA will reduce the incidence of vasospasm after aneurysmal SAH.
