A new five-year, $23.8 million National Institutes of Health (NIH) grant will support a multi-center, multidisciplinary study on a deadly bleeding syndrome – called coagulopathy – that occurs without warning in some trauma patients. Led by University of Vermont (UVM) Professor Emeritus of Biochemistry Kenneth Mann, Ph.D., the TACTIC (Trans-Agency Consortium for Trauma-Induced Coagulopathy) study is a cooperative effort funded by the National Heart, Lung and Blood Institute that establishes a unique collaboration between the NIH and the Department of Defense. Faculty representing five departments at UVM will lead projects for the grant.

Trauma is the major cause of death in people less than 34 years old and the third leading cause of mortality in the U.S., with uncontrollable hemorrhage representing the major cause of preventable deaths, according to the NIH. Each year there are nearly 50 million injuries in the U.S. that result in 170,000 deaths.

Little is known about the biological phenomena that lead to coagulopathy. When a person sustains a traumatic injury, whether on the battlefield or in a car accident, he/she typically suffers serious physical damage. Doctors treat the injuries and, if all goes well, the patient gradually heals. However, some patients, regardless of proper treatment, can suddenly suffer from uncontrolled bleeding and die. It is believed that the shock from the trauma induces a “storm” of coagulation and inflammatory problems that prevent their blood from clotting.

“There are no analytical tools that allow emergency department staff to conclude that coagulopathy is occurring in trauma victims – we’re starting from ‘ground zero,’” Mann explains. “The physicians and staff are left without resources to guide an effective therapeutic approach,” he adds.

This trans-agency endeavor links the NHLBI-supported TACTIC program with Department of Defense (DoD) clinical trauma research centers in a unique initiative that integrates laboratory, clinical and early translational, hypothesis-driven research by leading investigators across the country and enable the basic science investigative units to explore clinical specimens obtained from the DoD centers.

In addition to Mann, principal investigators include Stephen Wisniewski, Ph.D., senior associate dean and co-director of the Epidemiology Data Center at the University of Pittsburgh Graduate School of Public Health, and Charles Esmon, Ph.D., Lloyd Noble Chair in Cardiovascular Biology at the Oklahoma Medical Research Foundation. The University of Pittsburgh serves as the Coordinating Center. Additional institutions involved in the research funded by the TACTIC grant include Massachusetts Institute of Technology, Mayo Clinic, Scripps Research Institute, University of California-San Francisco, University of Colorado, University of Illinois, and University of Pennsylvania. DoD-supported institutions participating in the clinical component of the TACTIC grant include University of Colorado, University of Pittsburgh, and Virginia Commonwealth University.

University of Vermont key personnel on the grant include Beth Bouchard, Ph.D., assistant professor of biochemistry; Kathleen Brummel-Ziedins, Ph.D., associate professor of biochemistry; Saulius Butenas, Ph.D., associate professor of biochemistry; Yves Dubief, Ph.D., associate professor of engineering; Kalev Freeman, M.D., Ph.D., assistant professor of surgery and pharmacology; Mark Nelson, Ph.D., professor and chair of pharmacology; Thomas Orfeo, Ph.D., research associate in biochemistry. UVM consultants on the grant include Mark Fung, M.D., Ph.D., associate professor of pathology, and Turner Osler, M.D., professor of surgery.

This research is funded by NIH grant #UM1 HL120877-01.