Association Between Haptoglobin Genotype and Brain Swelling
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - 85 |
| Updated: | 2/8/2015 |
| Start Date: | March 2014 |
| End Date: | June 2017 |
| Contact: | Spiros Blackburn, MD |
| Email: | spiros.blackburn@neurosurgery.ufl.edu |
| Phone: | 352-273-9000 |
Association Between Haptoglobin Genotype and the Development of Perihematomal Edema After Spontaneous Intracerebral Hemorrhage
Intracerebral hemorrhage is bleeding into the brain and is a major cause of stroke and other
complications. Brain injury from intracerebral hemorrhage occurs in two phases. The early
phase involves the mechanical compression of brain tissue by the expanding hematoma. In a
later phase, brain swelling develops causing further compression that may lead to brain
herniation and death. This study investigates the neuroprotective role of haptoglobin, in
minimizing the development of brain swelling following intracerebral hemorrhage.
complications. Brain injury from intracerebral hemorrhage occurs in two phases. The early
phase involves the mechanical compression of brain tissue by the expanding hematoma. In a
later phase, brain swelling develops causing further compression that may lead to brain
herniation and death. This study investigates the neuroprotective role of haptoglobin, in
minimizing the development of brain swelling following intracerebral hemorrhage.
Intracerebral hemorrhage is bleeding into the brain parenchyma. It is a major cause of
stroke, and is associated with significant morbidity and mortality. Brain injury from
intracerebral hemorrhage occurs in two phases. The early phase involves the mechanical
compression of brain tissue by the expanding hematoma. In a later phase, brain edema,
especially perihematomal edema, develops causing further compression that may lead to brain
herniation and death. Several factors are implicated in the development of brain edema,
including inflammation resulting from the oxidative stress caused by iron-rich hemoglobin
released from lysed erythrocytes in brain tissue. This study investigates the
neuroprotective role of an acute phase reactant, haptoglobin, in minimizing the development
of perihematomal edema following intracerebral hemorrhage. This protein protects brain
tissue from hemoglobin degradation products by forming haptoglobin-hemoglobin complexes that
are subsequently cleared by the spleen. Notably, different alleles of haptoglobin exist in
humans, with varying affinities for hemoglobin. Investigating the association between the
different alleles and the degree of perihematomal edema formation is the primary goal of
this study. The investigators will also look at a marker of inflammation, matrix
metalloproteinases, and analyze its level of expression in subjects with different alleles
of haptoglobin.
stroke, and is associated with significant morbidity and mortality. Brain injury from
intracerebral hemorrhage occurs in two phases. The early phase involves the mechanical
compression of brain tissue by the expanding hematoma. In a later phase, brain edema,
especially perihematomal edema, develops causing further compression that may lead to brain
herniation and death. Several factors are implicated in the development of brain edema,
including inflammation resulting from the oxidative stress caused by iron-rich hemoglobin
released from lysed erythrocytes in brain tissue. This study investigates the
neuroprotective role of an acute phase reactant, haptoglobin, in minimizing the development
of perihematomal edema following intracerebral hemorrhage. This protein protects brain
tissue from hemoglobin degradation products by forming haptoglobin-hemoglobin complexes that
are subsequently cleared by the spleen. Notably, different alleles of haptoglobin exist in
humans, with varying affinities for hemoglobin. Investigating the association between the
different alleles and the degree of perihematomal edema formation is the primary goal of
this study. The investigators will also look at a marker of inflammation, matrix
metalloproteinases, and analyze its level of expression in subjects with different alleles
of haptoglobin.
Inclusion Criteria:
- Spontaneous intracranial or intraparenchymal hemorrhage
- 18-85 years of age
- Hemorrhage occurred in a supratentorial location
Exclusion Criteria:
- Inability to obtain consent within 3 days of hemorrhage onset
- Known pregnancy
- Therapeutic anticoagulation with Lovenox, Coumadin or Heparin
- Prior history of therapeutic radiation to any area
- Brain tumor
- Hemorrhage related to trauma, aneurysm, arteriovenous malformation or other vascular
malformation
- Central nervous system infection
- Subdural hematoma
- Subarachnoid hemorrhage
- Chronic immunosuppression, including steroids or chemotherapy agents
- Infratentorial location
- Unable to obtain MRI due to mental status or other contraindication (metal,
pacemaker, etc.)
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