University of Virginia researchers have made a discovery that could help prevent stroke in younger people.
Dr. Andrew Southerland, a neurologist and a professor of vascular neurology, led the team that discovered differences in the expression of 11 genes in patients who had cervical artery dissections, a leading cause of stroke in younger adults. They published their findings in the journal of Neurology Genetics.
Dr. Andrew Southerland serves as the executive vice-chair in the UVA Health Department of Neurology. (Contributed photo)
Southerland spoke with UVA Today about the team’s findings and what the public should know about strokes.
Q. What happens during a cervical artery dissection?
A. During a cervical artery dissection, there is a tear or an injury to the lining of the artery. The arteries are your blood vessels that allow blood and oxygen to get out of different organs and tissues of the body.
When that injury occurs, it can affect the way blood is flowing, block blood flow or create other smaller blood clots that can travel further downstream to cause additional blockages. The arteries in the neck, also called cervical arteries, are the main arteries getting blood flow from the heart and pumping it up into the brain. If a dissection or injury occurs to one of those arteries, it can affect blood flow to the brain and be a potential cause of stroke injury.
Q. Aren’t strokes mostly a concern for older adults?
A. We think of stroke as a disease that predominantly affects folks in their older years and those with certain vascular risk factors like high blood pressure or high cholesterol. But stroke is a condition that can affect people of many ages, including the young. Cervical artery dissections may cause 1 out of 5 strokes in people under the age of 55.
Q. How could this research help doctors better predict or prevent strokes?
A. We found that patients with cervical artery dissection had differences in the activity of 11 genes shortly after their injury, most of which were related to hemoglobin metabolism, which transports oxygen in our blood. Based on these results, we hypothesize that impaired oxygen transport or delivery may play a role in the event of a cervical artery dissection.
This is one of the first studies to identify a specific gene signature in patients suffering cervical artery dissection. While these results are preliminary, we hope that better understanding the pathogenesis of the condition will one day help us identify those most vulnerable and prevent recurrences.
The research was sponsored by a grant from the American Heart Association/American Stroke Association and through the UVA Medical Student Summer Research Program. It involved a multidisciplinary research team across Grounds, including collaborators in the departments of Genome Sciences and Public Health Sciences, as well as several partner institutions.
Q. What method did you use to conduct this research?
A. We are part of a global study called CADISP, which stands for “Cervical Artery Dissection and Ischemic Stroke Patients.” We’ve participated in large-scale, genome-wide association studies, which look at small blips in the DNA or the human genome that are different in people who have these cervical artery dissections, compared to those who don’t.
In this most recent study, we used a method called gene expression analysis, where we look at the RNA that DNA produces to make proteins. We were looking at which genes are being turned on and off in people who have these cervical artery dissections around the time that they occur, and how those gene signatures differ from those of other people of the same age and sex who don’t have these dissections.
