A laboratory study evaluating the endothelium in trauma coagulopathy
Research type
Research Study
Full title
A laboratory study evaluating the role of the endothelium in traumatic coagulopathy.
IRAS ID
281116
Contact name
Nicola Curry
Contact email
Sponsor organisation
Oxford University Hospitals NHS Foundation Trust
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Worldwide, trauma is the most common cause of death for people aged less than 44. Uncontrolled bleeding and associated clotting abnormalities lead directly to the deaths of two-thirds of injured patients who might otherwise have survived.
The main purpose of the clotting system is to reduce blood loss at sites of injury. In order that a clot remains only at the site of injury, anticoagulant and clot breakdown proteins act at the edges of the clot. One of the most important of these proteins is activated protein C. Activated protein C forms after it binds to the thrombin-thrombomodulin complex. In health, thrombomodulin is found on the surface of the cells that line blood vessels (the endothelium) and it acts mainly to restrict clot formation to the site of injury.
So far, research into trauma coagulopathy has looked at the changes that happen to blood clotting factor levels in simple experiments. This work has several problems. Firstly, it does not look at the complex interactions of all the proteins with each other. Secondly, it does not test how the injured vessel wall interacts with the forming clot. And finally, these tests do not consider that a clot forms in a vessel i.e. whilst blood flows past the clot. Understanding the links between injury, the blood vessel wall and the coagulopathy will allow more effective treatments to be developed.
This study will use tests to evaluate an overall measure of how well a clot can be formed or broken down. A cellular model will be developed which includes two further elements: endothelial cells and blood flow. I will test samples of blood taken from trauma patients and look at how their clots form. This will provide greater understanding of the clotting problems in trauma and will inform new therapies.
REC name
Wales REC 5
REC reference
20/WA/0313
Date of REC Opinion
25 Nov 2020
REC opinion
Favourable Opinion