Recently Erin Kreszl, TBF Executive Director, spoke with MirHojjat Khorasanizadeh, our 2021 research grantee and a post doctoral research fellow with Beth Israel Deaconess Medical Center.
Erin: Mir, we’re so glad to be able to support this exciting research, and we’re looking forward to hearing a little more about it. First though, can you tell us a little about yourself? I understand you are living in Boston – how do you like it?
Mir: Other than I think it may be one of the most expensive cities in the world – it’s a wonderful town!
Erin: So, you’re not originally from there!
Mir – No. I graduated from the Teheran University of Medical Sciences in Iran, three years ago. My parents still live there although my sister is in Canada. I got involved in brain aneurysm research in the middle of medical school, and it was really due to something that happened when I was working on my thesis with one of my professors. He was a neurosurgeon, serving underdeveloped areas in Iran. One of his patients had an aneurysm that, in Iran at that time, was untreatable. I need to explain that the scientific community in Iran was more isolated than the rest of the world and there were large gaps in training. We reached out to many, many people in the global medical community for help and finally someone from Canada volunteered to come, but unfortunately by that time the patient could not be treated successfully. I was devastated. So that was what triggered me, initially to get into the field, and the more I read, the larger the challenge seemed.
Erin: Let’s talk a little about your project. Technically, it is called Correlation of Circulating Endothelial Progenitor Cell Levels with Outcomes of Intercranial Aneurysm Flow Diversion Treatment. Can you put that into layman’s terms for us?
Mir: Of course. So first, as you know, there is a relatively new field in the treatment of unruptured aneurysms called flow diversion. The technique is a promising approach to treating aneurysms that were not treatable by other conventional methods. However, despite its potential, a high percentage of patients – from 15-40% – do not benefit from the treatment, and the reasons are not well understood. Our research is designed to provide additional insight into that, specifically by studying the effect of circulating endothelial progenitor cell (EPC) levels on flow diversion outcomes.
Let me give you a little background! Endothelial cells release substances that control vascular relaxation and contraction as well as enzymes that control things like blood clotting. In flow diversion, endothelialization – the process of endothelial tissue formation – is critical. Endothelial progenitor cells (EPCs) are stem cells circulating in the blood that have been shown to contribute to endothelialization, and it is hypothesized that the number of circulating EPCs can help explain variations in response to flow diversion treatment in brain aneurysms. If we can determine a relationship, it would be tremendously important as, to date, a lot of effort by many people has failed to produce any clear cut findings. While factors like age, smoking, having the device out of position or use of certain medications, might play a part, nothing definitive has been learned and we simply cannot predict treatment response accurately.
Erin: What would be the immediate outcomes of this research?
Mir: This would be revolutionary as we would be testing the hypothesis on humans, using a non-invasive blood sampling technique. The blood samples allow us to measure the presence of the needed cells. The first use of the results would be to select patients who are most likely to benefit in a “precision medicine” approach. The other application is to devise a way to actually improve endotheliazation – to increase the EPCs, perhaps by medication, perhaps by device design. We can certain antibodies on the device itself so that the cells can integrate more easily into the devise. That has never been studied. It has the potential to truly revolutionize aneurysm treatment.
Erin: It’s definitely blazing new research trails, and it’s a perfect fit with our goal of funding research that promises innovative approaches to preventing aneurysm rupture. On behalf of everyone at TBF, we are thrilled to be supporting this research!
Mir: And we are thrilled to receive it! Dr. Ogilvy, who is the primary researcher on this project, has been involved directly in more than 600 flow diversion procedure and authored many, many articles about the treatment in peer-reviewed journals, and we are anxious to advance our findings in the area, so we are deeply gratified to receive your support! And thank you again for the work you are doing in the field – your efforts in both education and funding are truly impressive.