Showing 27 ideas for tag "vascular"

Goal 1: Promote Human Health

Mechanisms of Vascular Stiffness

Increased vascular stiffness has been identified as an important cardiovascular event that accompanies aging and cardiovascular disease. Although multiple vascular changes have been identified and suggested to cause increased vascular stiffness, our understanding of the underlying mechanisms needs to be refined in order to develop useful therapeutic strategies to prevent or reverse these changes. An example of critical... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Ultimately, addressing this CQ would impact treatment of CV disease, reduce incidence of significant and life threatening CV events and improve quality of life. This area of investigation is relevant to therapeutics and potentially lifestyle changes that will improve CV health and slow CV age related changes linked to disease.

Feasibility and challenges of addressing this CQ or CC

Current advances in our technologies make it very feasible to address new questions to improve our knowledge of the mechanisms underlying vascular stiffness. Challenges will include developing multi-scale and cross disciplinary strategies that will, by design, facilitate an integrated understanding of the process leading to altered vascular stiffness.

Name of idea submitter and other team members who worked on this idea Gerald A. Meininger

Voting

55 net votes
88 up votes
33 down votes
Active

Goal 2: Reduce Human Disease

Lipid apheresis as adjunct therapy in peripheral vascular disease

What is the roll of inflammation and how does lipid apheresis alter inflammation in peripheral vascular disease when added to standard therapy and/or when used alone? Does lipid apheresis result in long-term improvement with reduced morbidity, mortality, and expense compared to standard therapy?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

The prevalence of peripheral vascular disease (PVD) in the United States is estimated to be 5.9%, affecting up to 20% of adults over the age of 65. Therapy for PVD is vascular surgical intervention for limb ischemia; combined with medical therapy and anti-platelet agents but morbidity and mortality remains high. Low density lipoprotein cholesterol (LDL-c) is associated with increased risk for development and progression of PVD. Preliminary studies of the use of lipid apheresis have demonstrated improvement in symptoms and a variety of laboratory measures with decreased morbidity when added to standard therapy. The mechanism of this treatment may go beyond reducing LDL-c as the columns also affect levels of inflammatory cytokines, alter blood rheology, and affect other lipids.

Feasibility and challenges of addressing this CQ or CC

Currently two lipid apheresis devices have been cleared by the Food and Drug Administration and are in use in the United States. The presence of cleared devices, the large number of affected patients, and availability of testing for lipoproteins, fibrinogen, CRP, PAI-1, IL-6, IL-17, IL-1, IL-10, INF-γ, VEGF, PGI2, IGF-I and rheology factors make the enrollment and evaluation of patients into a clinical trial examining the use of this treatment of PVD feasible. Challenges for the performance of a clinical trial would include the limited number of centers offering lipid apheresis, the chronic nature and length of time needed to perform lipid apheresis, and the expense of the lipid apheresis devices and disposables.

Name of idea submitter and other team members who worked on this idea Bruce Sachais on behalf of ASFA

Voting

96 net votes
116 up votes
20 down votes
Active

Goal 2: Reduce Human Disease

Vascular Origins of Cognitive Decline

A comprehensive research plan is needed to identify the vascular causes of cognitive decline, to develop early treatment options, and most ideally, develop effective measures to maintain cognitive function.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Reduction in the number of elderly with cognitive impairment would not only increase quality of life but would reduce health care costs. Research is indicating that the pathologic decline in cognitive function is complex and may involve multiple pathways of cardiovascular and metabolic origin.

Feasibility and challenges of addressing this CQ or CC

Addressing this issue requires research on vascular biology, tools for brain imaging and measurements of cognitive decline, all of which are advancing in development and implementation. The 2013 BRAIN Initiative includes $100 million in commitments from 5 federal agencies, including $46 million from NIH in grant awards focusing on new tools and techniques.
The frequently observed cognitive decline with aging can occur in a mild state or can progress to forms of dementia that are devastating to individuals and families and require a functioning and affordable support system for the affected individual. The vascular origin of this decline is only beginning to be understood. With increasing numbers of the US population surviving to their 80s and 90s, healthy cognition is critical for these elderly to be able to live independent functioning lives. .

As always commitment of funds is required as well as identifying appropriate research populations and efficient study designs.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

30 net votes
51 up votes
21 down votes
Active

Goal 4: Develop Workforce and Resources

Establishment of an independent study section on Pulmonary Vascular Biology and Translational Research

The research on pulmonary vascular biology including smooth muscle cell biology and endothelial cell biology and related pulmonary vascular diseases such as pulmonary hypertension and related right heart failure, and endothelial dysfunction in lung vascular inflammation and acute lung injury, as well as pulmonary embolism and lung transplantation has been rapidly expanding. The field is attracting an ever increasing... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Establishment of a study section on Pulmonary Vascular Biology and Translational Research will provide adequate funding to stimulate innovative research on this rapidly expanding field and promote translational research and thereby promote human health by providing potential novel therapeutic strategies for the devastating diseases such as pulmonary hypertension and acute lung injury.

Name of idea submitter and other team members who worked on this idea Youyang Zhao, Kurt Denmark, Asrar B. Malik, Mark Gladwin, Jahar Bhattacharya, Michael Matthay, Sharon Rounds, Jason Yuan

Voting

23 net votes
50 up votes
27 down votes
Active

Goal 1: Promote Human Health

New Approaches to study interactions of blood cells with components of the vascular wall

To eventually modulate pathologic communication processes employing new therapeutics, there is a need to better understand the transcellular communication between blood cells and components of the vascular layer in vivo.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

A better understanding of this largely unrecognized and underappreciated form of transcellular communication would allow us to use the information to not only detect disease at its very earliest stages, but perhaps also modulate pathologic communication processes employing new therapeutics.

Feasibility and challenges of addressing this CQ or CC

It is now feasible to address this CQ because of the availability of techniques such as atomic force microscopy, multi-photon intravital microscopy, computational and experimental approaches.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

15 net votes
25 up votes
10 down votes
Active

Goal 1: Promote Human Health

Intersecting Developmental Biology with Vascular Physiology and Biology

Although many think of the vasculature as a lump sum of vessels that all react in a similar fashion to a certain stimulus, e.g., alpha-adrenergic activation, this is not the situation. For example, coronary resistance vessels show little to no direct response to alpha-adrenergic activation while resistance vessels in most organs show marked constriction. Another example is the response of different vessels to angioplasty... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

A challenge facing many specialists in vascular medicine, vascular surgery, and cardiology is understanding the ramifications, and the basis, of the vascular pathology in the context of the organ system. Another way of re-stating this as a question is: Are the unique attributes of the vascular biology, pathology and physiology of a particular organ system connected to specific aspects of development. This question would help both the basic on clinical scientists understand the basis of why a blood vessel in the kidney may be different than one in the heart, or in the brain with the goal of devising more selective therapies to approach vascular disease in specific organs. Scientists in the area of vascular development have long appreciated that vascular cells in different organs arise from different embryological origins; yet how this information translates into the intricacies of vascular control, or responses to pathology is not resolved. Understanding the basic biological mechanisms of how the embryological source of the vasculature affects pathology and physiology could engender treatment of vascular disorders.

Feasibility and challenges of addressing this CQ or CC

This idea could be implemented by encouraging multi-PI efforts from vascular developmental biologists, and investigators engaged in studies of microvascular control mechanisms and/or vascular biologists interested in vascular pathologies such as restenosis and vascular lesions. Advances in fate mapping techniques have enabled developmental biologists to track embryological origins of cells into specific organ systems into adulthood. With such a multi-faceted approach a better understanding of vascular physiology and pathophysiology will be obtained that hopefully will be translated into more effective treatments.

Name of idea submitter and other team members who worked on this idea William M. Chilian

Voting

15 net votes
26 up votes
11 down votes
Active

Goal 2: Reduce Human Disease

what endogenous anti-inflammatory mechanisms can improve vascular diseases

the role of pro-inflammatory mechanisms of vascular disease are well characterized, but we know little about potentially protective endogenous anti-inflammatory mechanisms.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

this will identify new therapy or targets of therapy to improve our understanding of most vascular disease and lead to improved human health.

Feasibility and challenges of addressing this CQ or CC

this is quite feasible; if we know so many pro-inflammatory mechanisms which for years we have tried to reduce or prevent, we can just as easily identify endogenous anti-inflammatory mechanisms that we can identify and enhance.

Name of idea submitter and other team members who worked on this idea Mike Autieri

Voting

10 net votes
18 up votes
8 down votes
Active

Goal 2: Reduce Human Disease

Understanding the Role of the Vasculature in Dementia

Dementia is traditionally grouped into vascular dementia, Alzheimer's dementia, Parkinson's dementia and other causes of dementia. Vascular dementia is generally thought to be a consequence of strokes but there are some recent studies indicating that even Alzheimer's dementia may have a vascular underpinning. Vascular permeability is increased in the early stages of Alzheimer's disease and it is possible that similar... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

The NHLBI could fund programs which enable vascular biologists to collaborate with neuroscientists and neurologists in order to understand whether the vasculature has a causal role in the progression of dementia.

 

 

Can interventions that improve vascular function prevent the progression of dementia? Instead of using broad interventions such as statins which affect numerous signaling pathways, vascular biologists could target selected aspects of vascular health such as improving vascular barrier function and vascular regeneration.

If these interventions that have been shown to be efficacious in other vascular beds outside of the brain are also effective in the brain, then important new therapies could be developed for dementia which is likely to become one of the leading cause of death in the next decades.

Feasibility and challenges of addressing this CQ or CC

A key challenge for targeting the brain vasculature will be the blood-brain barrier. Understanding the role of the blood-brain barrier in dementia will be a prerequisite to developing novel vasculature-directed therapies.

Name of idea submitter and other team members who worked on this idea Jalees Rehman

Voting

9 net votes
13 up votes
4 down votes
Active

Goal 2: Reduce Human Disease

Vascular biology and the pathophysiology of sepsis

Unravel the cellular & molecular mechanisms related to the vascular biology of sepsis and related cardiovascular collapse. The goal is to develop a new scientific framework for the prevention of sepsis related morbidity and mortality by applying novel approaches to discover new targets for biomarkers and therapy by promoting multidisciplinary research required for scientific cross-talk between complementary research disciplines... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea Society of Critical Care Medicine Executive Committee/Council

Voting

4 net votes
8 up votes
4 down votes
Active

Goal 4: Develop Workforce and Resources

Develop Vascular Anomalies Medical Training and Research Programs

Patients with vascular anomalies frequently see many physicians and undergo extraneous tests with incorrect diagnoses. A major reason for this is due to the fact that medical training does not include Vascular Anomalies in the syllabus. Thus, many specialties erroneously use the term "hemangioma" for any vascular diagnosis. Over the past 2 decades, there have been major breakthroughs in basic and genetic research, as... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Developing a training program for vascular anomalies will facilitate improved, more efficient and meaningful patient care. It will also engender collaborative research and data collection for these patients.

Feasibility and challenges of addressing this CQ or CC

This is very feasible. There are key individuals, advocacy groups, and programs in each of the disease entities - Hemangiomas of infancy, Syndromic Vascular Anomalies (CLOVES, Sturge Weber, Proteus, Maffucci, Klippel Trenaunay, Cutis Marmorata, PTEN Associated Hamartoma Syndrome, Lymphedema Syndromes, etc) which would benefit from a coordinated strategic plan to pool resources, develop a data bank and tissue bank and foster collaborations to move this field forward. This could also serve to develop a network of tiered Vascular Anomalies Programs with certification.

Name of idea submitter and other team members who worked on this idea Francine Blei, MD

Voting

-1 net votes
7 up votes
8 down votes
Active

Goal 2: Reduce Human Disease

How gene mutations contribute to defects in vascular development

How do gene mutations in endoglin and alk 1 create arteriovenous malformations leading to disease. Alk 1 and endoglin are receptors in TGFB/BMP family signaling. TGFB/BMP have roles in vascular development, remodeling and maintenance in vascular integrity. Understanding the downstream effect will lead to advancements in reducing genetic diseases such as HHT as well as vascular malformations in general

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea Marianne Clancy MPA, Chris Hughes PhD

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

National network to study the pathobiology of sepsis

Sepsis is the leading cause of death in hospitalized patients, the 3rd leading cause of death in all people in the US, the most common condition leading to widespread vascular collapse, among the most common causes of respiratory failure, and a frequent cause of acute cardiac dysfunction.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Developing a national network to address important aspects of sepsis (causes and consequences of cardiac dysfunction, molecular determinants of respiratory failure) and serve as a trials group for testing novel interventions for new discoveries.

Name of idea submitter and other team members who worked on this idea Society of Critical Care Medicine Executive Committee/Council

Voting

2 net votes
4 up votes
2 down votes
Active

Goal 2: Reduce Human Disease

Cause of disparity in prevalence and progression of various vascular disorders

What are the causative factors underlying the disparity in prevalence and progression of various vascular disorders (PAD, CVD, aneurysm) across populations?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

­Genetic, epigenetic, biochemical, nutritional, environmental, and psychosocial factors should be characterized.

Name of idea submitter and other team members who worked on this idea Society for Vascular Surgery

Voting

2 net votes
2 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Animal models of vascular diseases

How can we better model human vascular disease in all its complexity?

­This is key to more effective translation of both diagnostics and therapeutics. Develop improved animal models of vascular diseases including PAD, aneurysm, venous diseases, to facilitate fundamental research and preclinical development.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea Society for Vascular Surgery

Voting

2 net votes
3 up votes
1 down votes
Active