A single blood sample could soon reveal whether a stroke patient’s clot will actually dissolve, or whether the standard “clot-busting” drug will fail them. Current stroke treatments fail to break down the clot in up to 25% of patients, and can cause dangerous bleeding. Doctors have no way to predict which patients will respond, because no reliable test exists to measure how a person’s blood clots or how easily those clots break apart. This project aims to fill that gap by developing a new measurement technique—advanced rheometry—that tracks both clot formation and breakdown in the same blood sample, in the same test. If successful, the work will produce functional biomarkers that pharmaceutical companies can use to design safer, more effective clot-dissolving drugs. For clinicians, better biomarkers mean they could one day match treatments to individual patients, reducing hospital stays and improving recovery. The research is pre-clinical, using blood from healthy volunteers and stroke patients in collaboration with NHS emergency medicine researchers, so practical clinical tools are still some years away. But the fundamental advance—a single test that captures the full life cycle of a clot—could underpin a new generation of personalised stroke care.
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Thrombosis (i.e blood clotting) is a leading cause of mortality globally and includes diseases such as stroke, heart attack and deep vein thrombosis. Stroke is the third leading cause of death and a major cause of adult disability in the UK. Current therapies ("clot busting" drugs) for blood clots in stroke can lead to bleeding complications and are often ineffective; in up to 25 % of patients the treatment is unable to break down the clot. Due to the lack of effective biomarkers of clotting and clot breakdown that accurately reflect clinical outcome, clinical practice is that interventional decisions are made on patients admitted to hospital with stroke with no knowledge of their clotting status. There is an urgent need for new and improved biomarkers. Such biomarkers will underpin the development of more effective therapeutic strategies and accelerate their clinical translation. The proposed work aims to develop new functional biomarkers of clot breakdown by exploiting recent advances in rheometry (superposition rheometry and Gaborheometry). We propose to develop a technique which provides clot formation and breakdown parameters, in the same test, on the same sample. In a pre-clinical study, we aim to establish that our rheological biomarkers reflect whole blood responses to both prophylactic and thrombolytic therapies utilising blood from (i) healthy volunteers and (ii) stroke patients, the latter under our collaboration with the NHS based Welsh Centre for Emergency Medicine Research. An advanced technological platform, which provides biomarkers reflecting clot functionality will greatly benefit the pharmaceutical industry, who will have access to improved and more accurate testing for the development of novel therapies. In turn, clinicians charged with patient care will enjoy more reliable, more efficient therapies thus improving clinical outcome. This will reduce the burden on healthcare (the NHS in the UK), as patients are likely to spend less time in hospitals. As future therapies emerge, timely and personalised treatment becomes more realistic, but these require accurate diagnostic tests.
Daniel Curtis (Co-Investigator)Francesco Del Giudice (Co-Investigator)Gareth McKinley (Co-Investigator)Karl Hawkins (Principal Investigator)Owen Guy (Co-Investigator)Suresh Pillai (Co-Investigator)
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