Investigating new treatment methods for people at risk of heart disease and stroke


Professor Shaun Jackson

28 May 2010

When most people think of blood clotting they think of the positive effects, stopping bleeding. However, NHMRC Australia Fellow Professor Shaun Jackson from Monash University in Victoria is working on the negatives, clots that cause heart disease and stroke.

In this podcast, Professor Jackson talks about his investigations into the mechanical factors that influence blood clotting in diseased arteries, and how this may lead to new treatments which can be used safely and effectively with existing, commonly used drugs, such as Aspirin or Warfarin.

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Transcript of podcast

Voice-over: Welcome to this National Health and Medical Research Council podcast.
Our podcasts aim to keep you in touch with major health and medical research issues and the people who shape them.

Introduction: Hello my name is Carolyn Norrie and I’m speaking today to Professor Shaun Jackson of Monash University in Victoria.

Interviewer: Hello Shaun, congratulations on your 2010 Australia Fellowship.

Prof Jackson: Thank you Carolyn it’s certainly a great honor.

Interviewer: When most people think of blood clotting they think of the positive effects, stopping bleeding, but you’re working on the negatives, clots that cause heart disease and stroke. Tell me a bit about your work in that area.

Prof Jackson: Well as you’ve indicated, blood clotting problems are very common problems and cause heart disease and stroke, and we’ve been interested for many years in trying to understand what leads to pathological blood clotting. We use a lot of different treatments to prevent pathological clotting, common drugs like Aspirin, Warfarin and Plavix, but these drugs have problems they cause bleeding and unfortunately they’re not very effective - they only prevent death from clotting in about one in six people who take the drug. So there really is a strong need for safer and more effective therapies and we think we’ve stumbled on a potentially new way of preventing these pathological blood clots and that’s through the discovery of a new pathway that triggers clotting in the body. We think by targeting this new pathway we can come up with therapies that will act in an additive or synergistic way with existing therapies, and hopefully it’ll improve the outcome for patients who are at risk of heart disease or stroke.

Interviewer: So what is this new avenue?

Prof Jackson: The drug that we use at the moment target the chemical activators of clotting and it’s been thought for almost forty years now that clotting’s primarily driven by molecules that are released from the blood vessel wall. What we’ve discovered is that there’s a key role for mechanical factors and the mechanical factors work in a cooperative way with chemical factors, but the drugs we use in the clinic don’t target those mechanical pathways. So we’ve been hitting one side of the clotting mechanism and ignoring this other important area of the clotting mechanism, which is regulated by mechanical factors. The Fellowship will allow us to start to target those mechanical pathways and we already have some ideas of potential ways of doing that and testing how effective those approaches are in reducing clot formations.

Interviewer: So you’re talking mechanical factors, but in layman’s terms what exactly are they?

Prof Jackson: What I’m referring to is the build up of a clot in a diseased artery where, as we all get older we develop arthroscerotic plaques in our arteries and these plaques affect the geometry of the blood vessel. What that means is when the blood flows over the plaques this leads to the development of sheer gradients. When those plaques rupture, which is a common event which precipitates either a heart attack or a stroke, the clotting mechanism is activated, the clot starts to build up and that exacerbates the disturbance in blood flow and exacerbates the sheer gradients. Now the drugs we use in the clinics such as Aspirin and Warfarin they don’t prevent the activation of clotting mechanism by these sheer gradients and that’s really the new and exciting part of this research proposal, is trying to come up with new approaches to dampen the effects of sheer gradients on the clotting mechanism.

Interviewer: And you see this whole clotting issue as a growing problem in Australian health?

Prof Jackson: Unfortunately it is. We are living longer, as I’m sure everyone knows, the incidence of obesity and diabetes other risk factors for heart disease continue to rise so whilst we’ve made considerable gains in improving health outcomes for people with cardiovascular disease, it is unfortunately still a growing problem in our community and will be for many years to come.

Interviewer: And what type of therapeutic benefits or outcomes do you see coming from your research work?

Prof Jackson: The longer term, what we see is entirely new treatment approaches for people at risk of heart disease and strokes and we’ve been interested in novel approaches to prevent excessive blood clotting. And really the holy grail is for us to identify new therapies which can be used safely and can be used effectively with existing drugs, such as Aspirin or Warfarin for example, commonly used drugs in the community.

Interviewer: Now you’re looking at International collaborations to add to this work?

Prof Jackson: Yes this is I think a really exciting part of the Fellowship. I have very good collaboration with colleagues at The Scripps Research Institute, which is a very famous institute in San Diego in the United States, and as part of the Fellowship we’re going to set up the Monash Scripps Fellowships and this is to appoint people who’ll have joint positions in both our university and in North America. This will allow really seamless transition of work to occur between our two institutions, as well as there are groups both locally here at Monash, at the Walter and Eliza Hall Institute, and RMIT that are going to work in a multi-disciplinary team to further this research.

Interviewer: A great opportunity for people working in multiple areas to improve their skills I imagine?

Prof Jackson: Yes, well the groups that we’re currently working with are engineers, biologists, pharmacologists as well as clinical investigators, and I mean I work in a hospital environment and the opportunity to bring really fundamental researchers working closely with people that are dealing with patients with these diseases… it’s a fantastic area to be involved in.

Interviewer: Professor Jackson it’s been a very interesting conversation. Thank you very much for speaking to us today.

Prof Jackson: Thank you Carolyn, I appreciate it.

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