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New Grant Supports Research on How Cigarette Smoking Could Cause Brain Aneurysms

For many years experts have linked cigarette smoking to a higher risk of cerebral aneurysms. Now researchers at the University of Miami Miller School of Medicine are getting closer to figuring out how this happens.

Boosted by a $600,000 National Health Foundation Grant, Robert M Starke, M.D., and colleagues are taking a deeper look into cellular changes driving these sometimes life-threatening events in people who smoke.

Dr. Robert M. Starke

“The ultimate goal in our research would be to develop a test to predict who will get a cerebral aneurysm and determine why some aneurysms rupture and others do not,” said Dr. Starke, associate professor of clinical neurosurgery and neuroradiology at the Miller School. “You want to identify people who need intervention earlier rather than later.”

The work will build on previous research showing how cigarette smoke can damage cells in blood vessel walls. Dr. Starke plans to evaluate changes to the endothelial cells lining the blood vessels in the brain, and how that can lead aneurysms to form, progress, and rupture.

“This specific grant focuses on the role of cigarette smoke – understanding those molecular mechanisms – and hopefully that will contribute to medical therapies, molecular imaging and minimally invasive treatment options,” he said.

Under normal conditions, the endothelial cells form a barrier against toxins circulating in the blood. They also can help control blood pressure and the rate of blood flow. However, when damaged, they change, Dr. Starke said. “That is what we are trying to figure out in aneurysms.”

Smoking is the only major, modifiable risk factor for cerebral aneurysms, he added. The other major risk factor is family history. “We still don’t understand those genetics, and it’s something we’re working on in other projects.”

The facility infrastructure at UM allows Dr. Starke and colleagues to conduct this type of research. His lab features, for example, biplane angiography, MRI, ultrasound, and CT machines. Furthermore, the building housing his lab also has floors with experts on genetics and cellular and molecular pathways.

It’s all about interdisciplinary collaboration, Dr. Starke said. “It’s not just neurosurgery. There are also experts in cardiology, pulmonology, hematology, ophthalmology, peripheral vascular surgery, biochemistry, and molecular biology. So there are other people who will help make this grant successful.”

Without medical therapies available, people with a cerebral aneurysm generally have three options: an endovascular procedure, open surgery, or a wait-and-see approach. Studying the mechanisms underlying these aneurysms could someday lead to effective medications even in non-smokers.

 

 

 

 

 

 

 

Tags: cerebral aneurysms, Dr. Robert M. Starke, National Health Foundation