Haemolysis in Neurological Disease (HIND)
Research type
Research Study
Full title
Haemolysis in Neurological Disease
IRAS ID
318560
Contact name
Carmen Jacob
Contact email
Sponsor organisation
University Hospital Southampton NHS Foundation Trust
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
Neurological conditions are the leading cause of disability globally and the second most common cause of death worldwide (Feigin et al., 2020). Despite progress in understanding and treatment, pathophysiology of neurological conditions remains incompletely understood and disability and death attributable to neurological conditions have been rising in the past 30 years (Feigin et al., 2020).
Previous research has shown that systemic inflammation is associated with worsening of neurological symptoms, both temporarily and long-term (Correale et al., 2006, Perry, 2010). It has also been shown in animal models that systemic inflammation makes red blood cells more (RBC) fragile (in prep.). Breakdown of RBC in the vessels (haemolysis) releases haemoglobin into the blood. In places with disrupted blood-brain barrier (the lining between the vessels and brain tissue), haemoglobin might permeate into the tissue. Extracellular haemoglobin will eventually release free iron, and both are highly toxic (Garland et al., 2020, Andersen et al., 2014). Accumulation of iron in the brain is associated with many neurodegenerative disorders (Andersen et al., 2014, Adams, 1988). In the context of an archetypal long-term neurological condition, Multiple Sclerosis, both disruption of the blood-brain barrier (Varatharaj et al., 2019) and a number of changes to RBC function and structure (Groen et al., 2016) have been described.In this prospective observational study, we aim to collect clinical, radiological, haematological and biochemical markers of disease progression, inflammation and RBC characteristics to investigate the hypothesis of this chain of events: systemic inflammation -> haemolysis -> haemoglobin penetration into brain tissue in the presence of a leaky blood-brain barrier as evidenced by iron deposition in the brain -> disease progression. We expect this data to further our understanding of factors contributing to conditions progression in neurological conditions. We are hopeful this will open avenues for possible future treatment strategies.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
23/SC/0327
Date of REC Opinion
15 Dec 2023
REC opinion
Further Information Favourable Opinion