Dr. Christopher Kellner is Assistant Professor of Neurosurgery and Director, Intracerebral Hemorrhage Program at the Icahn School of Medicine at Mt. Sinai in New York. He is also a principal investigator of The Bee Foundation’s 2016 research grant. At the October 2018 Honey Bash in Philadelphia, PA. he gave attendees some exciting news about the grant’s findings to date.
You titled your presentation at the Honey Bash “Imagine if we had a blood test for brain aneurysms.” Was that the major focus of the 2016 research grant, and why is that so important?
With 40% of brain aneurysm ruptures resulting in death, identifying an aneurysm before it ruptures is key. But typically, the first sign of a brain aneurysm is the rupture. Blood tests exist for other diseases with high fatality rates – BRCA ½ for breast cancer, PSA for prostate, and BNF for heart failure. But there is no test, no screening, currently for brain aneurysms. We want to change that.
In layman’s terms, can you tell us about the original research grant?
In order to get to that final “Holy Grail” of a biomarker, it’s vital to identify the genes and molecular pathways involved in formation and development of brain aneurysms. Our study was designed to increase understanding of the role of both key immune cells and molecular mechanisms in both the formation and rupture of IAs and through this, to identify blood-based biomarkers, as well as genes and genetic networks, that may indicate a predisposition for brain aneurysms.
What’s been your progress so far?
Currently, our work has focused on proteomic analysis – basically, proteomics simply refers to the study of the complete set of proteins found in an organism, including cells and tissues. It includes the study of changes in those proteins when things like disease, or environmental influences, are involved. We’ve processed blood from thirty patients with unruptured brain aneurysms, looking for a protein “profile” to predict aneurysm size. In addition to pointing to cigarette smoking as a factor in aneurysm size, the analysis identified blood levels of two specific proteins as powerful drivers of aneurysm size. This is especially interesting as cigarette smoking, while typically identified as one of the risks associated with brain aneurysm rupture, certainly is not present in many patients who experience ruptures.
That sounds pretty significant.
It is. The findings could mean that these proteins contribute to aneurysmal growth in some way, or that they are a response to the presence of an aneurysm. And that brings us one step closer to identifying and ultimately being able to test for a biomarker.
Next steps?
We’ve already submitted this finding to the International Stroke Conference, Now we’re focused on completing the study, which will involve a full RNA analysis of these same blood samples so that we can better determine what, exactly, to look for in a blood sample to detect the presence of an intracranial aneurysm. As always, our progress depends on having a great team working with us – and I’d like to especially thank here Dom Nistal, a fourth year medical student at Mount Sinai who has been doing awesome work on this project and really moving it along. His work has been critical to putting all of the moving pieces together – and there are a lot of moving pieces here! – including teams to collect, process, and sequence the samples as well as analyze the data.
