PICARD – Personalised medicine for complex aortic disease

Dr. Kakkhee Yeung, Vaatchirurg in VUmc heeft een subsidie aanvraag gedaan bij de Europese commissie voor het onderzoek PICARD, personalised medicine for complex aortic disease. Dit onderzoek heeft tot doel: optimalisatie van behandeling van aortaziektes, waaronder aneurysmata en dissecties. Hierbij worden nieuwe methodes gebruikt om de pathofysiologie van aorta aneurysmata en dissecties te onderzoeken. Hiermee hopen zij een betere voorspelling te kunnen doen op het verloop van het ziektebeeld, welke patiënten wel moeten worden geopereerd en welke beter een follow-up kunnen krijgen. Mogelijk leidt dit zelfs tot nieuwe medicijnen en ontdekking van nieuwe genen die betrokken zijn bij aortadissecties aneurysmata.

PERSONALISED MEDICINE FOR COMPLEX AORTIC DISEASES

PICARD consortium applied for H2020 for European support of the project.

Aortic diseases contribute to the wide spectrum of vascular diseases: aortic aneurysms, aortic dissection and congenital abnormalities as bicuspid aortic valves. An aortic aneurysm is an abnormal dilatation of the aorta and an aortic dissection a tear in the wall of the aorta. The cause of the aortic diseases is unknown. The prevalence of aortic diseases is high, which can be 5-8% of the male population above 65 years. Despite improvement in surgical treatment in the last years, it continues to be a main threat to health system because of severe outcome when the disease progress or in case of rupture leading to death in 80%. No medication exists and aortic disease progression is unpredictable, because the cause of aortic diseases remains unclear and is multifactorial.

To treat aortic diseases better, we are in need to improve the pathophysiological knowledge with better models and address the multifactorial cause. PICARD is the first project that will use new methods and models (live aortic models, new imaging models, cell specific studies, genetic studies) to study the biology involved in aortic remodelling and addressing the multifactorial cause.

The main aim of PICARD is prediction of aortic impairment and choice of treatment (earlier aortic repair (and type), new medical therapy or combination therapies) to achieve personalised aortic treatment. Besides the prediction, we will gain more knowledge about the pathophysiology and connection of the aortic diseases.

Our consortium consists of interdisciplinary team members’ specialties (vascular, cardiology, oncology, radiology, immunology, biology, genetics and lab, software engineers, bio-engineers), led by Dr. K.K. Yeung from Amsterdam UMC, location VU medical center, Amsterdam, the Netherlands and Dr. V.S. Costache from University L. Blaga, Sibiu, Romania. Dr. K.K. Yeung is a true translational researcher, she is a vascular surgeon and PI of Vascular Surgery. She is part of the team that setup the national biobank PARELSNOER AAA with location Amsterdam Medical Center and Leiden University medical center. She developed new methods to study aortic remodelling: generating smooth muscle cells (SMC) from skin biopsies similar to aortic smooth muscle cells (Yeung KK, et al Human Mutation 2017), novel techniques to analyse live aortic tissue and development of live aortic models (Meekel JP,… Yeung KK, Scientific Reports Nature publishing group 2018). She works closely with the lab in Porto with Dr. A. Leite-Moreira and endograft manufacturer W.L. Gore&Associates. Dr. V.S. Costache is a well-known cardiovascular surgeon and has developed a large image and databank in Romania called NEXTCARDIO. He has experience in leading a large team and works closely with endograft industry (Cardiatis), using computerized fluid dynamics analysis to optimize the treatment. Dr. T. Kratimenos and Dr. P. Liuba are well-known cardiovascular researchers, specialized in conducting clinical trials, focused on hemodynamics in aortic diseases. Dr. Ciprian Candea is specialized in software development, predictive algorithms and will bring his experience from other research projects within PICARD. Dr. R. Woitsch and Dr. E. Miron will perform data modelling.

Together, PICARD consortium will deliver improved therapy for aortic diseases.

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