Role Of Tenascin-C And TLR-4 In Carotid Atherosclerosis Related Stroke
Funder
National Health and Medical Research Council
Funding Amount
$308,071.00
Summary
It is estimated that approximately 10,000 Australians per year suffer from strokes related to neck artery disease. Warning signs often go undiagnosed and unreported. Currently there are no blood tests available for early simple diagnosis and few specific drugs available to reduce the number of strokes. Based on preliminary studies we will investigate the role of a novel protein and its related pathway in stroke. We will also study the value of these proteins as a blood test for this problem.
Cerebrovascular Diseases And Brain Ageing – A Program Of Research Into Novel Mechanisms, Risk Prevention And Innovative Health Care Delivery
Funder
National Health and Medical Research Council
Funding Amount
$466,492.00
Summary
This research is aimed at understanding the ways in which age-related vascular disease affecting the brain leads to walking difficulty, cognitive impairment and falls in older people. It is also designed to discover potentially modifiable risk factors for such vascular disease. Ultimately the goal of this research is to design and conduct trials of interventions aimed at slowing the process of vascular brain ageing.
VITATOPS Study - A Randomised, Double-blind, Placebo-controlled Trial Of Vitamins To Prevent Stroke.
Funder
National Health and Medical Research Council
Funding Amount
$1,477,963.00
Summary
Stroke is one of the most important causes of death and long-term disability in developed countries. Hardening of the arteries (atherosclerosis) is the major cause of stroke and heart attacks. High blood pressure, high blood concentrations of cholesterol, cigarette smoking and diabetes accelerate the formation of atherosclerosis, but they do not account for all strokes and heart attacks caused by atherosclerosis. There is now increasing evidence that high blood concentrations of homocysteine, a ....Stroke is one of the most important causes of death and long-term disability in developed countries. Hardening of the arteries (atherosclerosis) is the major cause of stroke and heart attacks. High blood pressure, high blood concentrations of cholesterol, cigarette smoking and diabetes accelerate the formation of atherosclerosis, but they do not account for all strokes and heart attacks caused by atherosclerosis. There is now increasing evidence that high blood concentrations of homocysteine, a normal protein in the blood, are another major causal risk factor for atherosclerosis (and stroke and heart attacks). Furthermore, blood concentrations of homocysteine can be lowered by about one quarter with simple, safe and inexpensive multivitamin therapy (folic acid, vitamin B12, and vitamin B6). However, despite the potentially massive public health benefits of such a strategy, it remains to be demonstrated in properly designed clinical trials that lowering homocysteine levels in the blood actually prevents stroke and heart attack. The VITATOPS trial is the only ongoing randomised, double-blind, placebo-controlled trial in the world which aims to determine whether multivitamin therapy (folic acid 2 mg, vitamin B12 0.5 mg, and vitamin B6 25 mg) prevents recurrent stroke and heart attacks in patients who have suffered a recent stroke.Read moreRead less
VITATOPS Study - A Randomised, Double-blind, Placebo-controlled Trial Of Vitamins To Prevent Stroke.
Funder
National Health and Medical Research Council
Funding Amount
$470,887.00
Summary
The VITAmins To Prevent Stroke (VITATOPS) trial is the only ongoing randomised, double-blind, placebo-controlled trial in the world which aims to determine whether multivitamin therapy (folic acid 2 mg, vitamin B12 0.5 mg, and vitamin B6 25 mg) prevents recurrent stroke and heart attacks in patients who have suffered a recent stroke. To date more than 7,500 patients have been randomised. Ongoing support is requested to complete the follow-up of 8,000 patients by middle of 2009.
An International Comparison Of Systems Of Care, Risk Stratification And Outcomes In TIA And Minor Stroke
Funder
National Health and Medical Research Council
Funding Amount
$1,189,790.00
Summary
Transient ischaemic attacks (TIAs: self-limited brief episodes of stroke symptoms) are high-risk events with an approximately 15% risk of stroke within 90-days. Current practice calls for specialist treatment within 1-7 days. But this recommendation (based on 20 year old overseas evidence) may not apply in contemporary Australia. We will conduct a study of patients with TIA that will document their interactions with Australian health systems and inform contemporary Australian practice.
Substance P Antagonists As A Novel Therapeutic Intervention In Stroke
Funder
National Health and Medical Research Council
Funding Amount
$318,267.00
Summary
Stroke is the major cause of disability in adults over 45 years of age in Australia. The economic and social cost of stroke is enormous with billions of dollars spent each year on the management and rehabilitation of stroke patients. Despite the enormity of this public health problem, no effective treatment currently exists. A number of studies have now demonstrated that much of the morbidity following stroke is associated with the breakdown of the blood brain barrier, development of oedema, and ....Stroke is the major cause of disability in adults over 45 years of age in Australia. The economic and social cost of stroke is enormous with billions of dollars spent each year on the management and rehabilitation of stroke patients. Despite the enormity of this public health problem, no effective treatment currently exists. A number of studies have now demonstrated that much of the morbidity following stroke is associated with the breakdown of the blood brain barrier, development of oedema, and subsequent brain damage in areas surrounding the central region of the stroke. These events develop over hours to days following the stroke and are known as secondary injury. This delayed progression of injury suggests that appropriate pharmacologic intervention can prevent, or at least attenuate, this secondary injury process with a resultant improvement in outcome. Nonetheless, few interventions are available that can limit this development. Our own recent studies have demonstrated that regions in brains which demonstrate the presence of stroke also exhibit signs of neurogenic inflammation, which has been associated with oedema formation, oxidative damage and cell death in other tissues. Although a number of neuropeptides have been implicated in this process, it is thought that substance P release is closely associated with these pathophysiological processes. Thus, inhibiting substance P binding may offer a novel therapeutic approach to attenuating oedema formation and the development of neurologic deficits following stroke. This proposal will utilise a combined biochemical, pharmacologic and behavioural approach to characterize the role of neurogenic inflammation in the development of oedema and neurologic deficits following stroke. Moreover, we will develop a novel pharmacotherapy that can potentially be used in the treatment of clinical stroke.Read moreRead less
THE VASCULAR CONSEQUENCES OF SNORING AND OBSTRUCTIVE SLEEP APNOEA
Funder
National Health and Medical Research Council
Funding Amount
$476,052.00
Summary
Snoring refers to a condition where the throat narrows significantly during sleep, and allows the soft tissues which surround this part of the airway to vibrate and create the typical snoring noise. Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. More severe forms of snoring are associated with the obstructive sleep apnoea syndrome, which is a condition in which the throat completely blocks behind the tongue and palate during sleep leading ....Snoring refers to a condition where the throat narrows significantly during sleep, and allows the soft tissues which surround this part of the airway to vibrate and create the typical snoring noise. Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. More severe forms of snoring are associated with the obstructive sleep apnoea syndrome, which is a condition in which the throat completely blocks behind the tongue and palate during sleep leading to cessation of breathing for short periods of time. Sleep apnoea is among the commonest chronic disorders of adult males occurring in 5% of men over the age of 45 years. Increasingly, it is now recognised that snoring, without sleep apnoea, may be an independent risk factor for the development of both of these very common and significant medical disorders. However, there have been no studies exploring the mechanisms by which snoring might contribute to the development of stroke and hypertension. In this proposal, we will explore the hypothesis that chronic snoring transmits a pressure wave through the tissues of the neck to the carotid artery which is the main blood supply to the brain. We propose that the chronic vibration of this artery leads to disease such as atherosclerosis and hypertension. Our studies will help to prove that this is a common mechanism whereby both snoring and sleep apnoea may contribute to the development of important vascular diseases. Studies will also establish the prevalence of carotid atherosclerosis in snorers (with and without OSA), and the prevalence of habitual snoring and OSA in patients at risk of developoing completed stroke. The recognition of snoring as an independent risk factor for vascular disease will clearly have important and wide ranging implications for the future management of snoring in the prevention of stroke and hypertension.Read moreRead less
Targeting Necroptosis Signalling To Counter Stroke-induced Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$605,809.00
Summary
The origins of the brain injury that arises from stroke remain a matter of enormous interest. Our work suggests that a poorly understood form of cell death, termed necroptosis, contributes to injury to the brain following stroke. In addition to developing an advanced understanding of this process, we will use drugs developed at the Walter and Eliza Hall Institute to test whether blocking this process might be a plausible therapeutic strategy in stroke patients.
Discovery To Therapy Implementation In Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$585,269.00
Summary
Advances in acute stroke therapies are occurring rapidly but challenges remain in their safe and effective delivery to stroke sufferers. This research focuses on testing a potentially superior ‘clot busting’ drug therapy for acute stroke and on identifying reasons why one of the most widely used current therapies carries a risk of significant harm due to bleeding into the brain. The work also investigates how to better implement the newest form of acute therapy, mechanical blood clot extraction.
Tenecteplase Versus Alteplase For Stroke Thrombolysis Evaluation (TASTE) Trial
Funder
National Health and Medical Research Council
Funding Amount
$4,180,030.00
Summary
Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) is an Australian-led international randomised trial designed to generate practice-changing evidence by translating the advanced imaging treatment selection approach used in our previous pilot studies. TASTE aims to confirm the superiority of the new-generation clot-dissolving agent, tenecteplase, over the standard agent, alteplase, in the broad group of stroke patients eligible for acute clot-dissolving treatment.