Sherry Chou, MD, Awarded R21 Grant to Study Biomarker for Subarachnoid Hemorrhage

Associate Professor Sherry Chou, MD, was awarded an R21 grant to determine if an early biomarker test can identify subarachnoid hemorrhage (SAH) patients who will develop further brain injury and long-term disability. The study, entitled “MicroRNA Endotypes of Systemic Inflammation in Sub-Arachnoid hemorrhage” (MESSAGE) is funded by the National Institute of Neurological Disorders and Stroke.

A unique, and unfortunate, feature of SAH is that, in addition to brain injury, patients can develop an acute and severe systemic illness with multiple extra-cerebral organ dysfunctions and a systemic inflammatory response syndrome. SAH is disproportionately lethal and morbid for young patients causing extensive long-term disability and resulting in a significant health-economic burden to society.

“Sherry’s newly funded work is exploring the ability of powerful microRNAs to regulate key inflammatory mediators that directly and indirectly impact secondary brain damage and outcome,” said Dr. Chou’s mentor Patrick Kochanek, MD, who is Director of the Safar Center for Resuscitation Research at the University of Pittsburgh. “This approach has the potential to offer new therapeutic possibilities with interventions early after the insult.”

He added that, “The evolution of secondary brain damage in patients with subarachnoid hemorrhage has evolved from an almost singular focus on delayed vasospasm to a contemporary concept of early brain injury, with a cascade of mediators being set into motion early after the hemorrhage.”

A major barrier to a therapeutic breakthrough in SAH is the lack of appropriate biomarkers to identify patients most at risk for subsequent injury, complications, and bad outcome in this heterogenous population. Dr. Chou’s MESSAGE study will investigate miR-26a as a potential biomarker in an existing SAH patient cohort and biobank while simultaneously recruiting a separate, independent replication SAH cohort for prospective validation of this biomarker.

Further, since miRs may function in networks, the research team will explore the global blood miR transcriptome in a subset of patients to identify possible miR networks associated with SAH outcome and with delayed cerebral ischemia. To examine biological plausibility of miR-26a in defining a novel inflammation endotype in SAH, Dr. Chou will explore the relationship between blood miR-26a expression and subsequent manifestations of clinical systemic inflammatory response syndrome and changes in blood inflammatory cytokine levels.