You can make a difference by participating in research

Written by Linda Rice, RN, CCRC, director of clinical operations at the UK Center for Clinical and Translational Science, which is dedicated to accelerating discoveries that improve health.

Health research changes lives. It’s how we learn more about health conditions and make discoveries to improve treatments, care and diagnostics. Every medicine or device we use – from aspirin to pacemakers – was developed through a process of research. But research needs people in order to move forward. All too often, studies are forced to end early or don’t enroll enough participants, which means that many important questions go unanswered.

At UK, doctors, nurses and researchers are working diligently to advance discoveries that improve health, and we invite you to join us. You can make a difference by participating in research – you could even be part of a study whose results will help people in the future. Participating is a way to help others by “giving forward,” and it’s also an opportunity to learn more about your own health.

Whether you are healthy or have a medical condition, there are opportunities for you to participate. Health research is more than clinical trials for rare diseases. Sometimes it’s as simple as a questionnaire, a screening or helping to test a type of exercise. Many studies compensate participants.

Health research also includes extensive protection for participants. The ethical and legal codes that govern medical care also apply to research, which is further regulated with safeguards for participants. UK, like every research institution, also has a review board that evaluates all research to ensure protection of participants’ rights and welfare. Every study follows a carefully controlled plan of what researchers will do and what is asked of participants, and this plan is explained in detail before you decide to join. Participants are free to leave a study at any time.

Learn more

There are two ways to learn more and get involved in the process of discovery: You can view current research opportunities at UK, and you can also join ResearchMatch, which connects you with researchers nationwide.

Current Studies at UK: To explore opportunities to participate in ground-breaking research at UK, visit UKClinicalResearch.com and click on “Current Studies.” You can browse opportunities by topic, like Alzheimer’s disease, diabetes, cancer, healthy volunteers, women’s health, drug and alcohol use, and many others.

ResearchMatch: To join this national database of research opportunities, visit ResearchMatch.org/uky. ResearchMatch is an easy, secure, registry that unites people who are interested in research with active studies. Joining is free and fast. Simply register and wait to be contacted, or “matched,” to studies that might interest you. You can also browse studies, share ideas with researchers, and find patient organizations and health information. You always have the choice to participate or not, and you can leave ResearchMatch at any time. Individuals under the age of 19 must be enrolled by a parent or guardian.

If you’d like to learn more about health research, including frequently asked questions, please visit UKClinicalResearch.com. If you have questions about participating in research or current studies at UK, please contact us at UKClinicalResearch@uky.edu or by phone at 859-257-7856 or 859-323-8150.

Next steps:

Registration open for third-annual neurogastronomy symposium

Registration is now open for the third annual International Society of Neurogastronomy Symposium, which will be held at UK on March 2-3, 2018.

Both day’s events offer continuing education credit.

This year’s symposium will explore the connection between brain and behavior in the context of food.

Luminaries from the worlds of science, nutrition and culinary arts will share their knowledge on a variety of topics, including the psychological influences on eating and behavior, the chemosensory properties of food and how we experience them, the role of food as medicine and the history and evolution of flavor and flavor perception.

The term neurogastronomy was coined by Dr. Gordon Shepherd, professor of neurobiology at Yale University – first in 2006 in an article in Nature and six years later in an eponymous book. While Dr. Shepherd has been interested in the concept from a research perspective, a group of neuroscientists, chefs and food scientists are enthusiastic about making it a clinical translational science, with applications in cancer, stroke, and brain injury (which can destroy the sense of taste) as well as diseases like obesity, diabetes and heart disease.

The day’s format differs from the typical symposium, featuring brief presentations modeled after the popular TED talks and punctuated with breaks for tastings and a contest where food prepared by nationally acclaimed chefs Taria Camerino and Jehangir Mehta will be judged by UK HealthCare patients with diabetes.

Here is a link to video highlights from last year’s symposium.

This year, there is an experiential event on Friday, March 2: a five-course dinner with wine pairings by world-class sommelier Francois Chartier and bourbon flavor wheel instruction by Chris Morris, Master Distiller at the Woodford Reserve, plus interdisciplinary clinical neuroscience lectures.

For more information about the symposium, including a full list of speakers and how to register, visit isneurogastronomy.org.


Next steps:

 

Owensboro Health joins Markey Affiliate Network

Owensboro Health has joined the UK Markey Cancer Center Affiliate Network, enhancing cancer care available to patients in Western Kentucky and Southern Indiana and allowing them to stay closer to home and their support systems for most treatments.

Markey is the only National Cancer Institute-designated cancer center in Kentucky.

“Owensboro Health exists to heal the sick and to improve the health of the communities we serve,” said Owensboro Health President and CEO Greg Strahan. “When it comes to offering national-quality, outstanding cancer care, we are proud to team up with the UK Markey Cancer Center, which is recognized as one of the foremost cancer care and research centers in the nation.”

Owensboro Health’s Mitchell Memorial Cancer Center (MMCC) serves the health system’s coverage area, a population of nearly 400,000 people across 14 counties in Western Kentucky and Southern Indiana. More than 1,000 patients are treated at the center annually. Last year, Owensboro Health also joined Markey’s Research Network, which allows MMCC to run many of Markey’s clinical trials on-site.

“As a native of Owensboro, it is a great honor to welcome Owensboro Health as our newest UK Markey Cancer Center Affiliate,” said Dr. Mark Newman, UK executive vice president for health affairs. “These relationships are very important to both of our institutions and most significantly to the care of patients throughout the region and the Commonwealth. We look forward to continuing to work with the outstanding team at Owensboro to provide the highest level of cancer treatment and prevention measures.”

The UK Markey Cancer Center Affiliate Network was created to provide high-quality cancer care closer to home for patients across the region and to minimize the effects of cancer through prevention and education programs, exceptional clinical care, and access to research. The affiliate network is especially important for Kentucky, where cancer rates are the highest in the nation.

“Kentucky is home to some of the worst cancer rates in the country,” said Dr. Tim Mullett, medical director of the UK Markey Cancer Center Affiliate Network. “Collaborating with our affiliate hospitals across the state will enable us to make a positive impact on the dire cancer rates here in the Commonwealth.”

Markey is one of only 69 medical centers in the country to earn an NCI cancer center designation. Because of the designation, Markey patients have access to new drugs, treatment options and clinical trials offered only at NCI centers.

Moving forward, the UK Markey Cancer Center is working toward the next tier of designation – an NCI-designated Comprehensive Cancer Center. Currently, 45 of the 69 NCI-designated cancer centers in the country hold a comprehensive cancer center status. The UK Markey Cancer Center Affiliate Network will play a large role in bringing that next level of cancer funding to Kentucky.

The affiliate network was created in 2006 and is made up of 20 hospitals across the Commonwealth of Kentucky.


Next steps:

  • Markey is Kentucky’s only National Cancer Institute-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.
  • Markey’s new state-of-the-art cancer care floor will allow our care teams to treat more patients with complex cancer diagnoses in an environment specifically designed for healing.

UK tobacco-free group helps teens advocate for healthier communities

UK’s Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE) team recently partnered with Youth Empowered Solutions (YES!) to host tobacco and youth advocacy training for leadership students from Hazard High School, as well as a training session for adult community advocates from around the state on the importance of youth empowerment and mentorship.

The training was part of the Tobacco-free Ambassador Partnership (TAP) project, funded through a $100,000 gift from CVS Health. The day-long workshops focused on tobacco, health and social justice, sustainable change in communities, and a breakdown of tobacco policies in Hazard, Perry County and across Kentucky. The students also honed their advocacy skills, such as how to conduct surveys, start petitions and make presentations to decision-making bodies such as their local school board. The training was funded through the TAP project and support from Kentucky Youth Advocates.

“It was encouraging to see all of the ideas and energy from young people in Hazard,” said Melinda Ickes, associate professor in the department of kinesiology and health promotion in the UK College of Education and director of Tobacco-free Take Action! and Go Tobacco-Free, two initiatives at UK that promote tobacco-free college campuses.

“After completing a community assessment, the youth came to the training with an understanding of the challenges their community faces with regard to tobacco. However, they have also come to realize that change is possible when they work together and let their voices be heard.”

In the adult leader training session, community members from across Kentucky learned about community advocacy and how to mentor and partner with student groups advocating for change in their communities. Their objectives included:

  • Shared understanding of racial equity and its importance to youth empowerment.
  • Understand recruitment and retention of young people to support policy, system and environmental changes.
  • Assess and build capacity within organizations/communities to partner and foster the inclusion of youth.

“I believe we are well prepared to engage youth and their adult mentors across Kentucky to reduce the enormous toll that tobacco takes on Kentuckians and on our economy,” said Ellen Hahn, professor in the UK College of Nursing and director of UK’s BREATHE.

“It was uplifting to see so many interested adults from one end of the state to the other with a desire to engage youth in making health policy change.”

YES! is a nonprofit organization that empowers teens and their adult allies to create community change by giving them the tools necessary to take a stand in their communities and create change that will positively impact adolescent health.

For more information about tobacco prevention and cessation initiatives, visit BREATHE at www.breathe.uky.edu/.


Next steps:

New year, new goals for UK grad student and cancer survivor

Meg Gravil has a few major goals for 2018. She wants to continue to build her level of fitness, and she plans to finish her dissertation by the end of the year.

But most importantly, Gravil wants to remain cancer-free.

As a UK College of Education graduate student studying interdisciplinary early childhood education, Gravil finished her qualifying exams in spring 2015 and began working on her dissertation. But just a few months later, her life ground to a halt.

After a regular annual exam, she was called back for a diagnostic mammogram and then a biopsy. Shortly after, she got a phone call from the UK Markey Cancer Center.

Diagnosis and recurrence

“I was sitting home on a Friday afternoon, and I had just five minutes to walk to go get my daughter from school,” Gravil said. “The phone rang. It was a nurse at Markey, and she said, ‘The results are positive. You have cancer.’”

The news came as a shock to Gravil, who was only 43 years old at the time and had no family history of breast cancer. She chose to have a bilateral mastectomy with reconstruction, performed in separate surgeries by UK’s Dr. Patrick McGrath and Dr. Brian Rinker.

“For peace of mind, I thought, take it all,” Gravil said.

Although the entire breast is removed during a mastectomy, the surgery isn’t a guarantee that the patient will remain cancer-free. Breast cancer can still return to the chest wall or nearby lymph nodes, known as locoregional recurrence, and an estimated 5 to 10 percent of women who undergo a mastectomy will experience a recurrence.

For Gravil, all was well at first. But just a few months later, she noticed a nodule that continued to get larger and redder. After having several doctors examine it, she received the bad news: The breast cancer had returned.

“I was absolutely stunned,” she said. “It was worrisome, because the recurrence was so soon after my initial diagnosis. The biggest part of that was thinking about my daughter – what if something happens to me? What effect will that have on my daughter’s life?”

Just one year after her initial surgery, Gravil was back in the operating room for surgery to remove the new tumor and install a port for chemotherapy. Chemo came next, and then radiation. The second time around, Gravil said, she was determined to do whatever it took to beat the disease. When her hair began falling out, she hosted a head-shaving party in her backyard with family and friends.

“The first time I was diagnosed, I was worried about losing my hair,” she said. “The second time, that was an afterthought – it was just, ‘I’ll do whatever I need to do to kick this thing.’”

Aiding recovery with exercise

While undergoing treatment at Markey, Gravil chose to participate in several programs at the UK Integrative Medicine & Health Clinic, including jin shin jyutsu and narrative medicine. Through Integrative Medicine & Health, she learned about LIVESTRONG at the YMCA, a free 12-week exercise program offered to cancer survivors. While attending Markey’s Expressions of Courage survivorship event last June, Gravil spoke with Corey Donohoo, director of community health at the Y, and decided to start the program in July.

Some of the most common side effects of cancer treatment include fatigue and weakness. Through the LIVESTRONG at the YMCA program, the certified trainers help survivors build up their strength and endurance based on their individual assessment and goals.

“At the beginning and end of the program, we do functional assessments, and we’re likely to see improvement,” Donohoo said. “But what’s really rewarding is to hear the stories of what these participants are able to do because of the program, like playing with their kids or grandkids, getting up and down, running errands, and more.”

Although Gravil is relatively active – she enjoys being outdoors and hiking – she hadn’t participated in any regular exercise routine in decades. Through the program, she got the opportunity to try a number of new fitness modalities, from learning to use the equipment on the floor of the gym, to TRX, yoga and Pilates Reformer.

And last September, she discovered that she was stronger than she realized, when she scaled a rock wall during a mother-daughter retreat at Life Adventure Center in Versailles. However, her newfound strength isn’t the only thing she’s gained.

“The big component wasn’t just feeling physically stronger and getting stamina back,” Gravil said. “The mental health and psychological benefits were really great for me.”

Regular exercise (and by extension, weight management) plays a significant role in maintaining the well-being of cancer survivors, according to Gravil’s oncologist at Markey, Dr. Aju Mathew. During treatment, it can help patients better tolerate their therapy. After completion of their treatment, it will improve functional capacity and promote healing.

Additionally, Mathew says, exercise may offer some protective benefits for survivors.

“There is increasing evidence that regular exercise can reduce the risk for cancer recurrence, as well,” Mathew said. “Overall, exercise and fitness training is a win-win for persons with a history of cancer.”

Looking forward

Throughout her journey, she says she’s been happy and confident in the care she received from her Markey physicians, nurses and staff.

“I was really impressed with the time that they took with me during my appointments,” she said. “I never felt like I was being rushed off – they answered all my questions to my satisfaction.”

With life more settled, Gravil already has momentum for her first two 2018 goals. She continues to go to the YMCA (Pilates Reformer is now her favorite class), and has begun the research and writing for her dissertation. If she finishes in December, she can walk to receive her PhD in special education next May.

And with her treatments at Markey complete – she finished her last dose of Herceptin in December – Gravil is looking forward to maintaining that most important goal of all.


Next steps:

  • Markey is Kentucky’s only National Cancer Institute-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.
  • Watch our Making the Rounds post featuring breast cancer specialist Dr. Aju Mathew, where he tells us about his newest hobby and which historical figure he most admires.

New technology helps diagnose hidden heart disease, says UK cardiologist

Dr. Gretchen Wells

Written by Dr. Gretchen Wells, director of the Women’s Heart Health Program at the UK Gill Heart & Vascular Institute.

Today’s technology has made tremendous strides in the diagnosis and treatment of heart disease, but until recently it was tricky to diagnose a heart condition called Microvascular Coronary Dysfunction (MCD).

The most common type of heart disease is caused by plaques that begin to clog one or more of the large arteries that carry blood to the heart. When the heart gets too little blood to meet its needs, people have chest pain (called angina). If blood flow is restricted even further – usually due to a clot that lodges in the narrowed artery – a heart attack and death may occur.

Plaque is often involved in MCD, too. But instead of accumulating in the larger coronary arteries, MCD occurs when the tiny blood vessels that branch off from the larger coronary arteries are blocked or damaged.

For unknown reasons, MCD occurs more frequently in women. In fact, it’s estimated that almost 50 percent of women who have persistent chest pain and low blood flow to the heart but no blockage of major arteries have undiagnosed MCD.

Unfortunately, standard tests for heart disease, such as stress tests and cardiac catheterizations, aren’t designed to detect MCD. These tests look for blockages in the large coronary arteries, but MCD affects the tiny coronary arteries. That means that you can have a cardiac catheterization that finds no blockages yet still be at high risk for a heart attack.

Sadly, people who have been reassured that “everything was OK” because their cardiac catheterization was clear might not feel the need to make lifestyle changes that would reduce their coronary risk and/or ignore warning signs that a heart attack is imminent.

If you have persistent chest pain, see a doctor right away. Your doctor may give you a stress test, which compares coronary circulation while you are at rest with your circulation during exercise. He or she may also recommend a cardiac catheterization, which involves threading a long thin tube from a small incision in your groin, neck or arm up into the heart to look for blockages in your arteries.

If your catheterization shows no sign of blockages and you are still experiencing chest pain, ask for a coronary reactivity test which can identify blockages in the smaller coronary arteries – the hallmarks of MCD.  Available at specialized centers around the U.S., coronary reactivity testing is the gold standard for diagnosing coronary microvascular disease.

And always, if you experience severe chest pain, if that pain radiates down your arm or to your back or jaw, and/or you are short of breath, call 911 right away.


Next steps:

UK HealthCare's 2017 Year in Review

A few of our favorite stories from 2017 that you might have missed

2017 was a year to remember for all of us here at UK HealthCare.

Before we look ahead to 2018, here are a few of our favorite stories from the past year that you might have missed.


Second-grade teacher returns to the classroom after leukemia treatment at Markey

Markey Cancer Center success story, Erika Carter on Tuesday May 9, 2017. Photo by Mark Cornelison | UKphotoA regular checkup revealed that Erika Carter’s white blood cell count was low. Within a few months, she was diagnosed with acute promyelocytic leukemia. With help from the UK Markey Cancer Center and Dr. Gerhard Hildebrandt, the Versailles second-grade teacher conquered her leukemia diagnosis and got back in the classroom. Read Erika’s story.


‘I feel so much better’: Gill helps 70-year-old woman conquer lifelong heart problems

After a fever damaged her heart as a young child, Priscilla Riley, now 70, had battled heart problems her entire life. For decades, she managed her symptoms, but earlier this year, things took a turn for the worse. That’s when Riley came to the UK Gill Heart & Vascular Institute and met Dr. Andrew Leventhal, who had an idea to help her feel better. Read Priscilla’s story.


After hip surgery at UK, triathlete gets back in the race

When Patty Lane was diagnosed with arthritis in her hip, she was told her time as a competitive triathlete was over. Not willing to give up on her dreams, Patty turned to UK Orthopaedic Surgery & Sports Medicine for a second opinion. Read Patty’s story and find out how UK helped her keep pursuing.


‘I can’t imagine a better place to be,’ says UK heart patient

By the time he was 13, Jason Conn had undergone three open-heart surgeries to repair a congenital heart defect. Although he was able to enjoy a normal life with few health problems, his childhood condition became a concern once again in adulthood. That’s when he turned to the experts at the UK Gill Heart & Vascular Institute. Read Jason’s story on our blog.


Pediatric surgeon tells little Connor’s story of hope

After being born prematurely and dealing with a series of complications, Connor Stacy had less than a 50 percent chance of survival. That’s when Kentucky Children’s Hospital pediatric surgeon Dr. Ana Ruzic and her team sprang into action to save Connor’s life. Read Dr. Ruzic’s account of Connor’s journey.


UK HealthCare named the No. 1 hospital in Kentucky – again!

No. 1 hospital in KentuckyIn August, we were thrilled to announce that UK Chandler Hospital was once again named the No. 1 hospital in Kentucky by U.S. News & World Report! Four specialties – Neurology & Neurosurgery, Cancer, Geriatrics and Diabetes & Endocrinology – ranked in the top 50 nationwide. Learn more about this exciting recognition.


Next steps:

Family honors veteran’s memory with toy drive for KCH

Jonathan Edward Ard always wanted to serve his country. As an Eagle Scout, he lived his life by the Boy Scout creed, vowing to always help others. After the events of 9/11, he joined the army where he trained to become a member of the U.S. Special Forces and served two tours of duty in Iraq.

But to his family and friends, “Jon” was so much more than a soldier; he was a big kid at heart who delighted in shopping for toys to donate at Christmas.

“Purchasing and donating toys was a cherished Christmas tradition for him,” said Jon’s older brother Michael. His family honored Jon’s memory by continuing that tradition on the first anniversary of his death.

During his tours in Iraq, Jon was exposed to toxic burn pits and depleted uranium. Little was known at the time of the long-term effects of the exposure.

After returning from Iraq, Jon graduated from Eastern Kentucky University, got married and started a family. He was working as an engineer at 3M when he began to experience flu-like symptoms in the summer of 2015.

On Oct. 28, 2015, Jon was diagnosed with leukemia and was admitted to the UK Markey Cancer Center for several rounds of chemotherapy, during which his second daughter, Elizabeth, was born. In February 2016, Jon underwent a bone marrow transplant with stem cells from an anonymous donor.

“While going through chemo and the stem cell transplant, he often expressed concern for children who might be going through cancer treatment,” said Jon’s mother LaBera.

Though the transplant went well, Jon developed pneumonia and passed away on Dec. 14, 2016. At Jon’s visitation and memorial service, the family requested toys in lieu of flowers or other offerings. Jon’s pickup truck was parked in front of the church, and visitors were asked to put their donations in the truck, which would be driven to Kentucky Children’s Hospital after the service.

Visitors filled the truck five times over.

“Jonathan was a generous person and a big kid at heart and loved selecting and purchasing toys to donate to local toy drives at Christmas,” his mother said. “To continue a celebration of Jonathan’s life and some of the things that made him so dear to us, we decided to collect toys again this year for donation to KCH and deliver them on the anniversary of his death.”

Friends, Jon’s coworkers from 3M and members of the community generously donated over a thousand toys. His family delivered them on the anniversary of Jon’s passing. The donations collected by the Ards were made available to the parents of patients at KCH’s Winter Wonderland Toy Workshop, an annual event where parents select Christmas gifts for their children without having to leave the hospital.

“One of the things my brother Jon really enjoyed doing was Christmas shopping and bringing the toys he had and donating them to the children in need at the hospital,” Michael said. “So we thought that was a fitting way to honor his memory.”


Next steps:

  • Interested in donating to the Kentucky Children’s Hospital? Visit Give to KCH to learn more about ways you can support our mission.
  • Markey’s new state-of-the-art 11th floor will allow our care teams to treat more patients with complex cancer diagnoses, including blood cancers such as leukemia.
stroke research

UK team first to offer innovative stroke care through clinical trials

The combination of a new clinical trial and a tissue bank is innovating stroke care and research at the UK. Led by a multidisciplinary team of clinicians and scientists, the two studies aim to develop new treatments using existing therapies that protect brain tissue after a stroke, and to learn more about the physiology of the event.

The MAVARIC (Magnesium and Verapamil After Recanalization in Ischemia of the Cerebrum) clinical trial leverages existing standards of care and approved drugs to improve how the brain heals following a stroke. The related BACTRAC (Blood and Clot Thrombectomy Registry and Collaboration) study is developing a tissue bank of thrombi (stroke-causing clots) and distal and peripheral blood to examine the immediate molecular changes that occur at the stroke site. Both the MAVARIC trial and the BACTRAC study are the first of their kind.

The burden of stroke is especially severe in Kentucky, where it’s the third-leading cause of death (compared to fifth nationally) and occurs at earlier ages than in the rest of the country. Globally, stroke is the leading cause of morbidity and physical incapacity.

Despite the prevalence of stroke, current standards of care include only two potential treatments. One is a drug called tPA, which, if administered quickly enough, can break up the clot that caused the stroke. This treatment, however, has a limited window of opportunity – three to four and a half hours – and can exacerbate injury if delivered too late. The second treatment option is a thrombectomy, where the clot that caused a stroke is physically removed through a catheter inserted into the blood vessel. The therapeutic window for thrombectomy is much longer, sometimes up to 24 hours.

Even with the advances of tPA and thrombectomy, which can be highly effective in removing the cause of the stroke, neither therapy treats the injury inflicted by a stroke.

“Thrombectomy has become common and widely effective, but only 60 to 70 percent of patients will be independent in three months – so there is more to be done,” said Dr. Justin Fraser, director of cerebrovascular surgery at UK and one of the principal investigators of the MAVARIC trial.

Leveraging existing drugs and modalities

In the hope of improving stroke outcomes by treating the injured area of the brain, Fraser partnered with Dr. Gregory Bix, director of the UK Center for Advanced Translational Stroke Science, to look at repurposing existing drugs that, in combination with thrombectomy, could limit brain tissue damage and promote healing in stroke survivors.

“After the clot is removed through the catheter, there’s immediate access to the site in the brain where the injury is occurring. We’re taking therapeutics that already exist and putting them into the catheter immediately after we remove the clot, so that the drug is delivered directly to the stroke-affected area of the brain,” Bix said.

Fraser and Bix began by repurposing an existing calcium channel blocker called Verapamil, which is mainly used to treat heart arrhythmias but is also FDA-approved for use to relax brain blood vessels that contract after a thrombectomy. Fraser noticed anecdotally that patients who received Verapamil during a thrombectomy had better outcomes than their imaging and symptoms would have predicted.

In a previous preclinical study and Phase I trial – the first in the world to pair thrombectomy with immediate, intra-arterial administration of a neuroprotective drug – Fraser and Bix found that intra-arteria delivery of Verapamil was safe. Furthermore, in cell culture and animal models of stroke, it was effective in preventing significant ischemia-induced injury. But they also understood that Verapamil alone wasn’t addressing the complex process of damage caused by stroke.

“There’s not going to be a single magic bullet in terms of drugs. When someone has a stroke, multiple pathways get activated and damaged. If you give a drug that addresses only one pathway, it doesn’t treat everything. So we need to try combining drugs,” Fraser said.

MAVARIC clinical trial

In the MAVARIC trial, which opened in October, Fraser and Bix are investigating whether combining magnesium with Verapamil can bestow even greater neuroprotective benefits. Magnesium has previously been studied for its potential to protect the brain after a stroke, but this trial is the first to intra-arterially deliver a neuroprotective “cocktail” to the stroke site. A total of 30 stroke patients will be enrolled; stroke size, safety, and functional and cognitive outcomes will be evaluated through randomized, blinded outcome assessment.

“By using the catheter that was inserted to remove a clot, we’re then able to deliver neuroprotective drugs directly into the brain tissue that was just reopened,” Frasier said.

The combination of Verapamil and magnesium was first validated in preclinical models before moving to a clinical trial.

“When I used these two drugs in experimental stroke models, it demonstrated very cleanly that there was a significant reduction in mean infarct volume – in other words, smaller strokes – as well as better functional outcomes. We were the first to model this completely in lab animals,” Bix said.

Because the trial uses existing FDA-approved therapeutics and modalities, the research team can conduct animal model and clinical research simultaneously, allowing them to refine the animal model as they learn more through the clinical research.

The trial also includes collaboration with Kentucky Appalachian Stroke Registry, which will enable analysis of thrombectomy and severe stroke patients who might have been candidates for the new procedure, as well as analysis of a rare but increasing stroke condition called moyamoya.

Support for the MAVARIC trial comes from the UK Multidisciplinary Value Program, which funds investigator-initiated clinical trials at UK through support from the College of Medicine, the Office of the Vice President for Research, and the Center for Clinical and Translational Science.

BACTRAC study

Leveraging thrombectomy technology even further, Fraser, Bix, and Keith Pennypacker, PhD, professor of neurology and associated director of the UK Center for Advanced Translational Stroke Science, are developing a stroke tissue bank that will greatly enhance stroke research through increased molecular understanding of the injury. The BACTRAC study is the first to collect and analyze both the stroke clots and surrounding blood. The samples are obtained as a matter of standard thrombectomy procedure and require nothing additional. The process does, however, rely on a highly collaborative process of tissue collection and informed consent that will enable inclusion of nearly every thrombectomy case at UK.

“We have a pager – we call it the Thrombectomy Pager – and when it goes off, everyone involved swarms together. One of the people who carries a pager is a researcher who will come in and process the samples on the spot. There’s centrifuge right outside the angio suite,” Frasier said.

Clot and blood samples are analyzed to examine protein, genetic and blood gas changes that occur at the stroke site. From early analysis of their first samples, the team is already noticing surprising changes in the blood and tissue where strokes occur. The observations could eventually allow for more targeted treatment of strokes.

“We’re getting the first glimpse of molecular events that are occurring due to the stroke, and some of these events are involved in signaling the immune system,” Pennypacker said. “The inflammation response is essential for the healing of the injury, but sometimes it can overreact and cause additional damage. So if we can get a handle on these molecular events, we can possibly eliminate the molecules that cause excess damage without blocking the beneficial immune molecules.”

In analyzing the first samples they collected, the team has observed calcium depletion in the blood and blood vessel distal to the clot, as well as changes in protein and RNA related to gene expression.

“We’re discovering things about stroke that no one knew six months ago – incredible changes even in single samples that could really help us understand stroke on the very acute, early side of things, which has been very difficult to study until now,” Fraser said.

Eventually, they hope, the BACTRAC study will include enough stroke cases that researchers will be able see how stroke affects people differently based on age, sex and other health conditions, such as obesity or diabetes. One limitation of current stroke research is that animal research models use predominantly young, homogeneous male mice, whereas the human population that experiences stroke is older, less healthy and much more diverse.

Such a diverse patient population is one of the main problems in finding a cure for stroke.

“In basic science animal models, we mostly use a homogeneous population, and we’ve found that they’re receptive to experimental therapies in ways that we don’t always see in humans,” Pennypacker said. “But, if we have a huge database with thousands of patients that allows us to pull out various groups and see the differences in their response to stroke, it could give insight into different treatments that work better for people based on age, sex and other health conditions.”

Initial support for the BACTRAC tissue bank comes from the UK Department of Neurology Pilot Grant Program, which funds investigator-initiated pilot studies. Further grant applications are currently underway.

Translating discoveries through team science

The multidisciplinary innovations of the MAVARIC and BACTRAC studies, which unite patient care and lab research, depend on the combined expertise of scientists, clinicians and research staff.

“There aren’t a lot of places in the U.S. that have this translational integration for stroke between basic research and clinical research,” Bix said. “What makes an academic medical center special is that we are at the cutting edge of developing new therapies. Where’s the next cure going to come from? A place like UK – an academic medical center running clinical trials it has developed itself, where people are pushing the envelope.”

To learn more these studies, visit the MAVARIC and BACTRAC clinical trial webpages.

As a designated Comprehensive Stroke Center by The Joint Commission, UK HealthCare is distinguished from other stroke centers for meeting the highest standards of care to receive and treat the most complex stroke cases.

The Multidisciplinary Value Program supports innovative, multidisciplinary clinical trials at UK. Learn more here.


Next steps:

  • Researchers are working hard to identify new treatments and strategies to improve health, but they need healthy participants and those with medical conditions to participate in clinical studies. Find out how you can participate in clinical research at UK HealthCare.
  • At the UK Comprehensive Stroke Center, we offer treatment, prevention and rehabilitation services for stroke patients. Learn more about our program.

UK doctoral student combining passions to advance Alzheimer’s prevention and treatment

When Alex Helman began her search for a doctoral program that would allow her to further her knowledge of neuroscience and conduct research on Alzheimer’s disease, she was surprised to add the University of Kentucky to her list.

Initially, she was shocked by the number of people doing research on Alzheimer’s disease, but when she looked more, she found that the UK Sanders-Brown Center on Aging’s designation as an Alzheimer’s Disease Center by the National Institutes of Health provided numerous opportunities to work on research to advance the prevention and treatment of Alzheimer’s disease.

Research opportunities at UK

After her visit to campus, she learned that many of the faculty conducting research were eager to include students as research assistants and there were abundant opportunities to do the work she loved.

“I left my visit thinking ‘Oh my gosh, I want to go to UK.’”

She is now a doctoral candidate in the UK College of Medicine Department of Molecular and Cellular Biochemistry. She completed a year of lab rotation and then joined the research staff of Paul Murphy, associate professor of molecular and cellular biochemistry.

Helman currently works on a project in the lab of Elizabeth Head, professor of pharmacology and nutritional sciences, as part of a team conducting a longitudinal study to examine the development of Alzheimer’s disease among people with Down syndrome.

“I’ve always been interested in a range of policy issues but my primary passion has always been science, and for a long time I kept those two things separate,” Helman said.

But, as she paid more attention to politics, she realized the fields of science and politics were more connected than she thought, and she found a role to play in both.

Applying research to policy

For the past 2 1/2 years, Helman has served the Alzheimer’s Association as a liaison between the organization and U.S. Rep. Andy Barr’s office in Lexington. She began her advocacy work as a congressional team member, tasked with working with an assigned legislator to advocate for the policy goals of the organization. For the past year and a half, she has been leading these efforts as an ambassador.

This spring, she will take her passions for policy and science to the next level as a Christine Mirzayan Science & Technology Policy Graduate Fellow. This fellowship program, offered by the National Academies of Sciences, Engineering and Medicine, will provide her with the opportunity to work in Washington, D.C., for 12 weeks. She chose to apply to serve on the Committee on Women in Science, Engineering and Medicine to learn more about policies that improve the retention of women in science, technology, engineering and medicine fields.

Helman will defend her doctoral dissertation this summer and earn her PhD. She hopes to work for the federal government in science policy work, possibly in workforce policy or scientific advising through the American Association for the Advancement of Science policy fellowship.

“If we stay in our labs and don’t advocate for ourselves it’s easy to be forgotten. Your data doesn’t speak for itself; you speak for your data.” She said. “You can do your work, and it’s important to continue to be as unbiased as possible, but our data means nothing if no one values and understands it.”


Next steps: