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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html xmlns="http://www.w3.org/1999/xhtml"> <head> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <title>Organ Dysfunction & Protection - Centre For Trauma Sciences</title> <base href="https://www.c4ts.qmul.ac.uk/" /> <link href="https://www.c4ts.qmul.ac.uk/templates/default/css/designstyle.css?v=1450952891" rel="stylesheet" type="text/css" /> <link href="https://www.c4ts.qmul.ac.uk/templates/default/css/layout.css?v=1632214427" rel="stylesheet" type="text/css" /> <meta name="viewport" content="width=device-width, initial-scale=1"> <link href='https://fonts.googleapis.com/css?family=Source+Sans+Pro:400,600,300italic,700' rel='stylesheet' type='text/css'> <link href="https://www.c4ts.qmul.ac.uk/templates/default/css/responsive.css?v=1555508567" rel="stylesheet" type="text/css" /> <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.4.4/jquery.min.js"></script> <script type="text/javascript" src="templates/default/js/responsive.js?v=1423218394"></script> <link rel="shortcut icon" type="image/x-icon" href="https://www.c4ts.qmul.ac.uk/favicon.ico"> <meta name="language" content="english" /> <meta name="generator" content="Unicity CMS 5.13" />  <link rel="canonical" href="https://www.c4ts.qmul.ac.uk/organ-dysfunction-protection-research-programme/organ-failure-protection" /> <meta property="og:title" content="Organ Dysfunction & Protection"><meta property="og:type" content="website"><script type="text/javascript" src="https://platform-api.sharethis.com/js/sharethis.js#property=645285d1609ddb00198daf91" async="async"></script> </head> <body> <script type="text/javascript"> var _gaq = _gaq || []; _gaq.push(['_setAccount', 'UA-2757605-32']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); </script> <div id="wrapper"> <div id="main-container"> <div id="header"> <div id="upperHeader"> <div id="upperHeaderInner"> <div id="upperHeaderLeft"> <div id="upperMainLogo"> <a href="https://www.c4ts.qmul.ac.uk/"> <img src="https://www.c4ts.qmul.ac.uk/templates/default/images/logo.png"/> </a> </div> </div> <div id="upperHeaderRight"> <div id="upperMenu"><a href="main/home" >Home </a><span id="upperMenuSeperator">/</span><a href="main/latest-news" >News</a></div> <div id="searchBox"><form name="" action="main/search-results" method="get"><input type="text" id="searchInput" name="searchtext"/><input type="image" src="https://www.c4ts.qmul.ac.uk/templates/default/images/searchButton.png" id="searchSubmit"/></form></div> <div id="upperSmallLogo"><img src="https://www.c4ts.qmul.ac.uk/templates/default/images/upperSmallLogo.png"/></div> </div> </div> </div> <div id="toggleMenuButton"> <a id="responsive-nav-toggle" class="button-blue">Menu <span class="icon">≡</span></a> </div> <div id="main-nav"> <ul><li class="menu-first"><a href="research-1-research-1/trauma-research">Research</a></li><li><a href="education-outreach/msc-trauma-sciences">Education</a></li><li><a href="get-involved/get-involved">Patient Involvement</a></li><li><a href="london-trauma-system/trauma-care">London Trauma System</a></li><li><a href="intrn/intrn">INTRN</a></li><li><a href="future-natric-studies/future-natric-studies">NaTRIC Studies</a></li></ul> </div> </div> <div id="topImage" style="background-image:url('images/heart_cropped46609.jpg'); background-repeat:no-repeat; background-position:75% top;"/><img id="topImageMask" src="templates/default/images/topMask.png"/></div> <div id="content"> <div class="breadcrumb"> <span class="here">You are here: </span><div id="sw-breadcrumbs"><a href="index.php">Home</a> > Organ Dysfunction & Protection Research Programme</div> </div> <div id="contentRight"> <h1>ORGAN <span style="color: #ac182c;">DYSFUNCTION</span> AND <span class="redTextBold">PROTECTION</span></h1> <p><span class="introText">Our current research programme projects are listed below.</span></p> <h2>Trauma <span class="redTextBold">Organ Protection</span> using <span class="redTextBold">Artesunate</span> (TOP-ART)</h2> <p>C4TS are conducting a Phase 2a clinical trial of Artesunate for the protection of organs in severely injured trauma patients with traumatic haemorrhage. We have discovered the drug enhances the protection of organs by reducing the body’s excessive response (i.e. inflammation) to injury and blood loss, and by activating well-known cell-survival pathways. </p> <p>A therapeutic agent that reduces the incidence and severity of multiple organ failure could have a major global impact on trauma patient outcomes and their demands for healthcare utilisation. The trial started at the Royal London Hospital in 2017.</p> <p><a class="redArrowText" href="organ-dysfunction-protection-research-programme/top-art">More information about TOP-ART</a></p> <p><a class="redArrowText" href="http://www.isrctn.com/ISRCTN15731357">TOP-ART on the ISRCTN trial registration site</a></p> <h2>MODET:  Multiple Organ Dysfunction in <span class="redTextBold">Elderly Trauma</span></h2> <p>MODET (Multiple Organ Dysfunction in Elderly Trauma) was a Pan London Trauma System prospective observational study, funded by the <a href="http://dunhillmedical.org.uk/">Dunhill Medical Trust</a>. A key objective was to identify the prevalence, severity and patterns of MODS in older patients, including predictors and risk factors.  Patients were enrolled from the four Major Trauma Centres (MTCs: Royal London Hospital, St Marys Hospital, Kings College Hospital and St Georges Hospital) over a two year period.</p> <p>Findings show that MODS is a significant burden for the majority of major trauma patients admitted to critical care units. In older patients, frailty rather than chronological age was a significant predictor of MODS. Frail older patients had worse outcomes than non-frail patients, and older patients with traumatic brain injury suffered prolonged MODS, where recovery took place weeks after admission. In older patients who did not develop MODS, outcomes were better and half of this group were able to go back to their usual place of residence from the MTC.</p> <p><a class="redArrowText" href="organ-dysfunction-protection-research-programme/modet">More information about MODET</a></p> <h2>ORDIT: <span class="redTextBold">Organ Dysfunction</span> in <span class="redTextBold">Trauma</span>: A National Point Prevalence study</h2> <p>Multiple organ dysfunction syndrome (MODS) is a dysfunctional systemic inflammatory response following major tissue trauma. Despite reductions in the reported incidence of MODS over recent years it remains a resource-intensive, morbid and potentially lethal sequelae following serious injury.  </p> <p>ORDIT was a one month, prospective point prevalence cohort study of trauma patients (≥16 years) admitted to UK Major Trauma Centre (MTC) adult critical care units during Spring 2016. The primary outcome was to describe the patterns of single and multiple organ failure following trauma (identified using Sequential Organ Failure Assessment [SOFA] scoring). </p> <p>MODS was a significant burden for major trauma patients nationally with poor mortality outcomes. Three patterns of MODS emerged from clustering analysis: 1. MODS with an early resolving, uncomplicated recovery; 2. MODS with a prolonged recovery associated with TBI; 3. MODS with a significantly prolonged recovery associated with admission shock/haemorrhage.</p> <p><a class="redArrowText" href="national-studies-ordit/what-is-ordit">More information about ORDIT</a></p> <h2><strong><span class="redTextBold">Trauma</span> Immunology</strong></h2> <p>The human body's response to injury is complex and vital to survival.  Many of the complications after severe trauma injury are due to organ ischaemia and an excessive, inappropriate or dysfunctional immune-inflammatory response, and one of our research priorities is to better understand this complex process. We are investigating the nature of the systemic immune-inflammatory response to trauma using gene expression profiling of blood samples taken from trauma patients on first admission to hospital and throughout their treatment.</p> <p>Our research focuses on patients during the first life-saving hours of care, before widespread inflammation has been established. Other immune response studies to date have generally focused on patients’ pathophysiology at a much longer time period after the initial assault. As we collect samples immediately upon admission and through acute care (ie 3-6 hours) as well as data for up to 28 days after the initial trauma event, we believe we are addressing a key gap in research.</p> <p><a class="redArrowText" href="organ-dysfunction-protection-research-programme/trauma-immunology">More information on our trauma immunology studies</a></p> <h2>Inhibitors of <span class="redTextBold">NF-kB</span></h2> <p>C4TS has developed an experimental model to test the effects of drugs during resuscitation on the development of organ injury and dysfunction.</p> <p>Using this model, we have discovered that the activation of the transcription factor nuclear factor kappa B (NF-kB) occurs in all organs that later develop organ failure. We are now testing specific interventions which inhibit the activation of NF-kB when given at the time of resuscitation in order to evaluate whether such remedies also reduce the incidence or the severity of multiple organ failure.</p> <div id="bottomRedBox"> <div id="lowRedBoxTitle">Staff and Publications</div> <div id="lowRedBoxText"><p><strong>Research Theme Leads:</strong></p> <p><a class="whiteArrowText" href="staff/professor-chris-thiemermann">Professor Chris Thiemermann</a> (Discovery)</p> <p><a class="whiteArrowText" href="staff/karim-brohi">Professor Karim Brohi </a> (Clinical)</p> <p><strong>QM Co-investigators:</strong></p> <ul> <li><a class="whiteArrowText" href="http://www.qmul.ac.uk/blizard/staff/centre-for-genomics-and-child-health/staff/joanne-martin.html" target="_blank" rel="noopener noreferrer">Professor Joanne Martin</a></li> <li>Professor Norbert Avril </li> <li>Professor Magdi Yaqoob</li> <li>Dr. Rupert Pearse</li> <li>Dr Daniel Pennington</li> <li>Dr. Michael O’Dwyer </li> </ul> <p><strong>Research team:</strong></p> <ul> <li><a class="whiteArrowText" href="staff/dr-jordi-lopez-tremoleda">Dr Jordi Lopez Tremoleda</a></li> <li>Dr Michael Barnes</li> <li><a class="whiteArrowText" href="staff/dr-elaine-cole">Dr Elaine Cole</a></li> <li><a class="whiteArrowText" href="staff/joanna-shepherd">Joanna Shepherd</a></li> <li><a class="whiteArrowText" href="staff/dr-henry-de-ath">Dr Henry De'Ath</a></li> <li><a class="whiteArrowText" href="staff/joanna-manson">Joanna Manson</a></li> </ul> <p><strong style="font-size: 14.3999996185303px;">Collaborators:</strong></p> <ul> <li>Dr. Mark Turner (Nottingham Trent)</li> <li><a class="whiteArrowText" href="http://www.bidmc.org/Research/Departments/Surgery-Research/Acute-Care-Surgery-and-Critical-Care/Carl-Hauser.aspx" target="_blank" rel="noopener noreferrer">Dr. Carl Hauser</a> (Harvard)</li> <li><a class="whiteArrowText" href="http://www.hhdp.uni-jena.de/index.php/people/16-michael-bauer" target="_blank" rel="noopener noreferrer">Professor Michael Bauer </a>(Germany) </li> <li>Dr. Anthony Cerami and Dr. Michael Brines (Netherlands)</li> <li>Professor Peter Radermacher (Ulm)</li> <li>Dr. Dan Traber (Texas)</li> <li><a class="whiteArrowText" href="http://sunnybrook.ca/research/team/member.asp?t=11&m=416&page=172" target="_blank" rel="noopener noreferrer">Professor Marc Jeschke </a>(Toronto)</li> <li>Professor Helder Mota-Filipe (Lisbon)</li> <li>Professor Shabbir Moochhala (Singapore)</li> </ul></div> </div> <div id="bottomDottedBorder"> </div> </div> <div id="leftColumn"> <div class="menu-left" id="sub-nav"> <div id="menuLeftList"> <div id='leftMenuSectionTitle'><div id='menuSectionLink'><a href='organ-dysfunction-protection-research-programme/organ-failure-protection'>Organ Dysfunction & Protection Research Programme</a></div></div> <ul class="unicity-sectionmenu"><li class=""><a class="menu-first" href="national-studies-ordit/what-is-ordit">ORDIT</a></li><li class=""><a href="organ-dysfunction-protection-research-programme/modet">MODET</a></li><li class=""><a href="organ-dysfunction-protection-research-programme/top-art">TOP-ART</a></li><li class=""><a href="organ-dysfunction-protection-research-programme/organ-dysfunction-protection-cardiac-injury">Cardiac Injury Studies</a></li><li class=""><a href="organ-dysfunction-protection-research-programme/trauma-immunology">Trauma Immunology</a></li></ul> </div> </div> <div class="sidebarBlock"><div class="sidebarImg" style="background-image:url(images/jo-wall-tisci-images-1_cropped.jpg); background-repeat:no-repeat; background-position:center top;"> <img src="templates/default/images/sidebarBlockBg1.png"/> </div> <div class="sidebarblockContent"> <div class="sideBarTitle"><p>Findings</p></div> <div class="sidebarText"><p>Using experimental models, we have discovered that the intravenous injection of small doses of artesunate (1 to 4.8 mg/kg) upon resuscitation after severe haemorrhage reduces multiple organ failure</p></div><div class="clear"></div> </div></div> <div class="sidebarBlock"><div class="sidebarImg" style="background-image:url(images/blood-cells-2_cropped.jpg); background-repeat:no-repeat; background-position:center top;"> <img src="templates/default/images/sidebarBlockBg1.png"/> </div> <div class="sidebarblockContent"> <div class="sideBarTitle"><p>Findings</p></div> <div class="sidebarText"><p>By analysing immune cell genes in blood from critically injured trauma patients, we have discovered that changes in the first few hours of injury can identify patients who go on to develop multiple organ dysfunction syndrome</p></div><div class="clear"></div> </div></div> <p> </p> </div> <div id="addThisFooter"> <div id="shareThis"> <p>Share this page</p> <span id="addThisModule">  <div class="sharethis-inline-share-buttons"></div>  </span> </div> </div> </div> <div id="footer"> <div id="footerInner"> <div id="footerLeft"> <div id="footerLogo"><img src="https://www.c4ts.qmul.ac.uk/templates/default/images/footerLogo.png"/></div> <div id="copyright">© Queen Mary University of London</div> </div> <div id="footerRight"> <div id="address"> <h4><strong>TRAUMA</strong> SCIENCES</h4> Blizard Institute<br/>Queen Mary University of London<br/>4 Newark Street, London, E1 2AT<br/> <div id="footerTel"><strong>Tel:</strong> <a href="tel:+442078826175">+44 (0)20 7882 6175</a></div> </div> <div id="footerRightRight"> <div id="footerSocial"> <a href="https://twitter.com/CommsC4TS"><h4><strong>FOLLOW</strong> US</h4> <img id="twitterImg" src="https://www.c4ts.qmul.ac.uk/templates/default/images/footerTwitter.png"/></a> </div> <div class="footerNav"> <a href="https://www.c4ts.qmul.ac.uk/staff/staff">Staff</a> <a href="https://www.c4ts.qmul.ac.uk/contact/contact">Contact</a> </div> </div> </div> </div> <div id="footerBottom"> <div id="footerBottomInner"> <div id="privacy"><a href="https://www.qmul.ac.uk/site/privacy/" target="_blank">Privacy Policy</a></div> <div id="design"><a href="https://www.adeptdesign.co.uk" target="_blank">Website by Adept</a></div> </div> </div> </div> <div class="responsive-nav blackBG" id="responsivenavmenu"><div class="container"><p> </p><ul><li><a id="subMenuHome" href="main/home">Home</a></li></ul><ul><li class=""><a class="menu-first" href="research-1-research-1/trauma-research">Research</a></li><li class=""><a href="education-outreach/msc-trauma-sciences">Education</a></li><li class=""><a href="get-involved/get-involved">Patient Involvement</a></li><li class=""><a href="london-trauma-system/trauma-care">London Trauma System</a></li><li class=""><a href="future-natric-studies/future-natric-studies">NaTRIC Studies</a></li><li class=""><a href="intrn/intrn">INTRN</a></li></ul><ul><li><a href="main/latest-news">News</a></li></ul></div></div> </div> </div> <script src="https://ajax.googleapis.com/ajax/libs/jquery/1.11.1/jquery.min.js"></script> <script type="text/javascript" src="templates/default/js/jquery.easing.1.3.js"></script> <script type="text/javascript" src="templates/default/js/jquery.cycle2.min.js"></script> <script> $( document ).ready(function() { $('#staffDetailsTextBox').show(); 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