Two million people die every year because of bleeding during trauma. Managing major blood loss becomes a race against time, where fast and effective treatment is needed. Current strategies for managing blood can be ineffective in certain cases of trauma and difficult to administer in remote locations. So, is there a better way to manage severe bleeding during trauma?
Dr. Christian Kastrup and his team have come up with a promising solution that is attracting much attention. They have formulated a topical drug delivery system using their own invention of self-propelling particles to help manage severe bleeding.
Topical deliveries sound like a simple fix, but they are actually quite complex – mainly because they are ineffective in blood as the outward flow of liquid prevents the treatment from effectively entering the site. Meaning, the blood pushes out the drug before it can even get to the source.
Giving medicine a boost
The Kastrup lab’s self-propelling particle system seemed to be the perfect vehicle for tranexamic acid (TXA), a known medicine that can be used to manage bleeding. TXA is given intravenously and is most effective when taken immediately after the injury. Having a topical treatment of TXA makes the drug more accessible and effective in patients. The researchers tested the use of self-propelled TXA and found that this method of delivery was effective in animal models. The results were published in the Journal of Thrombosis and Haemostasis.
We caught up with Dr. Christian Kastrup, corresponding author and Associate Professor at the Michael Smith Laboratories, to learn more about this research.
Q: This research shows that the use of topical treatments of self-propelled TXA was more effective than non-propelled TXA in animal models. In which applications do you see this research having the most impact?
Dr. Christian Kastrup: One of the biggest needs is in combat casualty care. It can be challenging to treat hemorrhage stemming from injuries to the junctions of limbs. This is particularly challenging if soldiers cannot be rapidly transported to more advanced care. A better TXA therapy will help in these situations and we think self-propelled TXA might be particularly beneficial.
Q: In just a few words and in lay language, can you explain how the self-propelling particles work?
CK: The self-propelling particles are actually just calcium carbonate mixed with an organic acid. This is the same chemistry used in antacids and other effervescing products. In our case, the calcium carbonate are porous microparticles and the organic acid is a form of TXA. When this powder is submerged in an aqueous solution, such as blood, the calcium carbonate particles release CO2, which pushes and pulls on particles, sending them moving in all directions.
Q: There seems to be a lot of potential for self-propelling particles. What other types of molecules can be potentially delivered using this system?
CK: A wide range of molecules can be attached to the particles. So far, we have propelled several enzymes and polymers, in addition to small molecules such as TXA. In other animal studies, we found that self-propelled particles enhanced the efficacy of thrombin, a hemostatic enzyme.
Q: You recently started a company called CoMotion Drug Delivery Systems with Dr. James Baylis who is also the first author on this paper. Can you tell me more about your company?
CK: We incorporated CoMotion to help translate self-propelling particles and save lives from surgical bleeding and combat injuries. James Baylis, one of the first members to join my lab in 2011, is now leading this effort as CoMotion’s CEO. We were able to secure intellectual property for this technology though UBC, and our first patent was just issued. We have been fortunate to be funded by Canada’s Department of National Defence, and James is working hard to secure private funding to complete the remaining preclinical development steps.
Q: What are the next steps in advancing this new technology?
CK: The major remaining hurdle is getting approval by Health Canada or the FDA to test in humans. We have developed initial manufacturing methods for the gauze product, and are working with several experts to determine what the first clinical trial will be and what the key experiments are to make sure the gauze and self-propelling are safe and reproducible for humans.
This research was funded by Canadian Institutes of Health Research, the Canadian Foundation for Innovation and BC Knowledge Development Fund, the Michael Smith Foundation for Health Research, and with in-kind support by the Centre for Drug Research and Development.
We would like to thank Dr. Christian Kastrup for accepting our interview and providing the answers to our questions. To learn more about the research in the Kastrup lab, please visit kastruplab.msl.ubc.ca/.