NETs in stroke thrombi
Research type
Research Study
Full title
Role of Neutrophil Extracellular Traps (NETs) in thrombolytic resistance of ischaemic stroke thrombi
IRAS ID
317904
Contact name
Edward Littleton
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Acute ischaemic stroke is a major cause of death and disability in the UK. It occurs due to blockage of blood supply causing damage to part of the brain. The blockage is caused by thrombus or blood clot. Current standard treatment is to attempt to unblock the artery using a drug, called rt-PA. This drug breaks down fibrin, a major protein component of thrombus. Unfortunately, rt-PA fails to unblock the blood vessel in a significant proportion of patients treated. This failure is likely related to the other non-fibrin components of thrombus, which may make the thrombus resistant to breakdown.
Patients can sometimes be treated by mechanical thrombectomy, which is a surgical procedure in which a device is inserted into the patient's blood vessel and the blockage is sucked out. This procedure is only possible if the blockage is in a very large blood vessel. A better solution, which would benefit more stroke patients, would be to develop more effective drug treatments.
Recently published work has identified the presence of neutrophil extracellular traps (NETs) within stroke-causing thrombus. NETs consist of fibres of genetic material, DNA, which have been released by certain types of white blood cell (neutrophils) in the blood stream.
In this project, we seek to answer how the quantity of NETs in stroke-causing thrombus changes the effectiveness of rt-PA. We will also test thrombus breakdown when another drug (DNase), which breaks down DNA, is used in addition to rt-PA, and will see whether efficacy is related to the quantity or breakdown of NETs.
The project will run over 2 years. We aim to recruit any stroke patient admitted to the Queen Elizabeth Hospital Birmingham who meets the standard existing treatment criteria for mechanical thrombectomy. The results should confirm the importance of targeting NETs and may lead to future clinical trials.
REC name
London - Queen Square Research Ethics Committee
REC reference
23/LO/0249
Date of REC Opinion
12 Jun 2023
REC opinion
Further Information Favourable Opinion