As
Dysautonomia Awareness Month starts to wind up for another year I thought it'd be great to have a short look at some of the research that is under way here in Australia.
The Baker IDI Heart and Diabetes Institute, here in Melbourne, Australia, is conducting research in a number of areas from drug trials to understanding the underlying mechanisms of various autonomic disorders. Thanks to the staff from the
Human Neurotransmitters Laboratory.
Researchers at the
BakerIDI Human
Neurotransmitters Laboratory are actively involved in
investigating disorders associated with abnormalities of the
sympathetic nervous system resulting in orthostatic intolerance.
Their research covers both disorders associated with Autonomic
Failure and the Dysautonomias. This group receives funding via
The Greg Page Fund for Orthostatic Intolerance.
Recent research from the group, headed
by Professor Murray Esler and Professor Gavin Lambert, has
contributed significantly to our understanding of these conditions.
POTS (Postural Orthostatic Tachycardia Syndrome) and Noradrenaline transport.
Dr Richard Bayles as
part of his PHD investigated patients with POTS. He found that POTS
patients have lower levels of the Noradrenaline transporter –the
protein that inactivates the noradrenaline signal. He then went on to
see if this was due to a genetic change – this wasn’t the case,
the genes were normal. What he found was a change in the proteins
that chromosomes are wrapped around that effectively turned off the
gene the codes for the noradrenaline transporter in patients with
POTS. So the gene is normal but it has been turned off. This insight
will guide further research into the biology of POTS and the
development of future therapies.
Bayles
R et al
(Arterioscler
Thromb Vasc Biol. 2012;32:1910-1916.)
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Work conducted by Dr Gautam Vaddadi demonstrated impaired tightening of blood vessels in response to upright posture in patients with vasovagal syncope, with different findings in patients with low BP at rest and those with a normal BP. This understanding has lead the group to undertake a trial of the Noradrenaline prodrug L-DOPS in patients with vasovagal syncope. I have linked to the study below throughout this month. Here are some more details for those here in Australia who may be interested in participating.
Clinical and Neural
Effects of L-DOPS on Low- and Normal- Supine Blood Pressure Variants
of Orthostatic Intolerance.
We are looking for
participants aged 18-50 who suffer from recurrent fainting or near
fainting spells due to Vasovagal Syncope to participate in a trial
investigating the benefit of a new medication - L-DOPS - in this
condition. Participants will have either low or normal lying blood
pressures. Participants will have had symptoms occurring at least
weekly for ≥ 6 months. Symptoms include lightheadedness, weakness,
blurred vision, fainting or near fainting.
Study details
The Human
Neurotransmitters laboratory at Baker IDI has commenced a new study
looking at the effect of a drug called L-DOPS in patients with
Vasovagal syncope in association with either low or normal lying
blood pressure. The study involves detailed examination of
sympathetic nervous system function on two occasions in addition to
clinical evaluations. The sympathetic nervous system, the stimulant
arm of the nervous system is responsible for our "flight and
fight" response to a threatening situation. The sympathetic
nervous system is also crucial in the control of blood pressure and
allows us to stand upright and supply blood to our vital organs,
including the brain, in the face of gravity that pulls blood towards
our legs. L-DOPS is a nerve transmitter precursor that is converted
by the body to noradrenaline, the main nerve messenger of the
sympathetic nervous system. We are studying whether increasing
noradenaline by the use of L-DOPs improves physiological responses
and symptoms in patients with these forms of orthostatic intolerance.
Eligibility
To be eligible for
this study, you must:
be aged 18-50
have a disorder
of Orthostatic Intolerance consistent with Vasovagal Syncope with
either low or normal lying blood pressure
have had other
conditions that could cause these symptoms excluded
be able to
withhold medications that affect blood pressure for the duration of
the study
be prepared to
use appropriate contraception for the duration of the study
not be pregnant
or breastfeeding
not be taking
antidepressant medications
have no history
of hypertension, heart disease, diabetes
Patients with the
Postural Orthostatic Tachycardia Syndrome (POTS) CANNOT be enrolled
in this study.
What happens in the
study?
During the study you
will have two detailed assessments of your sympathetic nervous
system, one at the beginning of the study and one at the end. These
assessments take 4 hours each and involve invasive procedures such as
the recording of nerve signals and the placement of a small tube in
an artery and a vein in your arm.
Following an open
label tolerability phase, the study will involve the blinded
administration of the trial drug or placebo for 28 days each with
clinical assessments at the end of each period. Further open label
administration of L-DOPS is undertaken prior to the final assessment.
The total study
duration is 4 months.
All study visits are
performed at The Alfred Hospital, Commercial Rd , Melbourne.
Participants will be
reimbursed for parking costs.
Interested?
If you would like to
participate, or would like to know how you can help, please email us
at fainting.study@bakeridi.edu.au
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For those unfamiliar, a short explanation of Dysautonomia can be found here.
One of the most famous people with a form of Dysautonomia is former Yellow Wiggle, Greg Page, who lent his name to a research fund at The Baker IDI, here in Melbourne, Australia. Donations can be made at The Greg Page fund For Orthostatic Intolerance.
And because many of us hope this research leads to us all feeling better, I give you Nina Simone's version of Feeling Good.
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