The research portfolio at the University of Colorado Department of Surgery has expanded with the recent arrival of Jessica C. Cardenas, PhD, a researcher who is studying mechanisms of and therapeutics to prevent thrombotic and inflammatory complications — such as blood clots — in patients with traumatic injuries and acute critical illness.
Formerly an assistant professor at the University of Texas’ McGovern Medical School, Cardenas brings to Colorado research funded by the National Institutes of Health (NIH) and the U.S. Department of Defense (DOD), as well as industry contracts.
“My research specifically studies the antithrombin system and its role in endothelial regulation and how that contributes to prothrombotic conditions, as well as proinflammatory conditions,” says Cardenas, now an associate professor of GI, trauma, and endocrine surgery in the CU Department of Surgery. “In addition, the pathway we are studying plays a key role in how patients respond to standard of care preventative strategies for preventing thromboembolic complications.”
Improving response to anticoagulation therapy
Since September 2023, Cardenas has overseen an ongoing multicenter clinical trial — including the CU Department of Surgery — looking at the effectiveness of an antithrombin medication to improve response to prophylactic anticoagulation measures to prevent thrombotic disease.
It's an important area of study, Cardenas says, because thrombotic complications are very common in hospitalized patients who are recovering from traumatic injuries.
“The risk of having a venous thromboembolism — or a blood clot like you would experience on an airplane or if you are pregnant — goes up tenfold after a major traumatic injury,” she says. “It is one of the leading causes of morbidity in the recovering trauma patient population, and it's the second leading cause of death after patients are released from the hospital.”
The clinical trial, which is funded by industry, is of an existing drug that Cardenas and her research team hope will calm the procoagulant system by improving the effectiveness of standard anticoagulants to reduce the risk of having a thrombotic complication in the hospital or a secondary thrombotic event and subsequent mortality when patients are outside the hospital.
Cardenas’ research on the antithrombin system is also funded by the NIH.
“We think the complications are caused by a combination of activation of the coagulation system during hemorrhage with activation of the acute or the innate immune system, which is propagated by activation of the endothelial cells that form the inner lining of your blood vessels,” she says. “The antithrombin-heparan sulfate system is an endothelial pathway long known to regulate coagulation to prevent blood clots from forming in your vessels. Our team and others have discovered it plays an equally important role in how endothelial cells control inflammation. Because of these dual roles, we think loss of normal endothelial function and dysregulation of this pathway might drive microvascular thrombosis, inflammation, and injury to the vital organs after major trauma.”
A possible alternative to platelets
In a similar vein, Cardenas’ research funded by the DOD is aimed at developing new hemostatic drugs for treating traumatic hemorrhage.
“For this study, we are looking at particles released by platelets called platelet-derived extracellular vesicles,” she says. “They act similarly to platelets in that they support blood clotting to stop bleeding. We hope this could be an alternative medication that could be administered when platelets are not available — such as on the battlefield.”
An area ripe for research
Medicine is a family affair for Cardenas, whose father is a pediatrician. She originally thought of becoming a doctor as well, but when she got her first taste of lab research, she never looked back.
“I loved being in the lab. I loved the peace; the quiet, serene environment,” she says. “That's why I continued down that route. I'll always be indebted to my mentor when I was an undergrad for allowing me to have that experience in his lab.”
Cardenas received her PhD in molecular and cellular pathology, specializing in blood coagulation biology, a field she chose because of its clinical impact and translational potential.
“It's a field that's rapidly moving forward, and the clinicians are very open to trying new therapeutics,” she says. “It's a great space for researchers to make extensive progress in the clinical arena.”
At the CU Department of Surgery, Cardenas looks forward to furthering her research in a field she has found to be ripe for innovation and collaboration.
“There's so much interaction between the clinicians and the PhD scientists,” she says. “We're starting to advance from just treating hemorrhage to looking more into patients who are recovering from hemorrhage and some of the complications that affect those patients. It's an exciting time from that perspective, because deaths immediately due to hemorrhage are down, but subsequent complications are therefore up.
“It's an interesting area for people like me to get into and start saying, ‘OK, we can still study hemorrhage and hemostasis, but what are some of the other disease processes and the mechanisms involved that we can then apply to complications associated with survivorship?"
April 24, 2024