Supported Research

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supported research

+2012-2013

Biomarker Discovery for Transverse Myelitis Using Human Proteome Microarray Technology
Awarded to Cheng-Ho Jimmy Lin, MD, PhD, MHS
Rare Genomics Institute

Clinical Support Funding for Clinical Program Manager at Johns Hopkins Transverse Myelitis Center
Awarded to Maureen Mealy, RN, BSN, MSCN
Mentor – Dr. Carlos Pardo

Johns Hopkins University, Baltimore, MD

James T. Lubin Clinician Scientist Fellowship
Awarded to Allen DeSena, MD
Mentor – Dr. Benjamin Greenberg
University of Texas Southwestern, Dallas, TX

FIRST-STIM: CNS Growth Factor Release and Changes in the Inflammatory Environment in Response to Electrical Stimulation in Subjects with Inflammatory Myelopathies
Awarded to Daniel Becker, MD
Hugo W. Moser Research Institute at Kennedy Krieger Institute, Baltimore, MD

Noninfectious inflammatory myelopathies were previously often categorized as idiopathic transverse myelitis, but advances in neuroimaging and neuroimmunology have allowed more specific diagnoses, such as multiple sclerosis (MS) and neuromyelitis optica (NMO). With the exception of relapsing remitting multiple sclerosis (RRMS) there are no existing therapies that alter the course of these diseases. People with these disorders inexorably accumulate disability. Functional electrical stimulation (FES) cycling is a method of applying low level electrical currents to the leg and buttock muscles to cause the weakened or paralyzed muscles to contract and produce a cycling motion of the legs. It has been used most in rehabilitation of patients with traumatic spinal cord injuries (SCI). Over the recent years FES cycling has become an increasingly important modality in rehabilitation of patients with paralysis. It has been shown to have multiple primary medical benefits including: increased muscle mass, improvements in bone density, enhanced cardiovascular function, improved bowel function, decreased spasticity and reductions in bladder infection rate. Most importantly FES may enhance the spontaneous neural repair program and reduce the inflammatory environment within the CNS. One of the most important questions unanswered in regards to this technology is: How much FES is required to result in the most optimal recovery? Currently, an experience based approach is followed (3 to 5 FES cycling sessions per week, 1 hour each). From extensive clinical experience at the International Center for Spinal Cord Injury, it is suspected that the more FES is applied the better recovery is. In order to find the optimal dose of FES a biomarker has been identified that can be measured in the spinal fluid of individuals receiving FES. Brain derived neurotrophic factor (BDNF) levels correlate closely with functional recovery. Currently, there are no controlled clinical trial data available on the effect of FES ergometry on neurotrophin release and functional recovery following neurological injury. The goal of this trial is to measure CSF BDNF concentrations in response to FES ergometry in patients with inflammatory myelopathies. In addition clinical improvement and markers of inflammation in response to FES will be measured. These data will be crucial for the design of a phase 2/3 clinical trial evaluating the efficacy of FES in patients with inflammatory myelopathies.

+2011

Evaluating the Therapeutic Potential of Carbenoxolone (CBX) for the Treatment of Transverse Myelitis

Awarded to Adam Kaplin, MD, PhD
Johns Hopkins University, Baltimore, MD

Cognitive impairment occurs in roughly 50% of patients with Multiple Sclerosis and pilot data suggests that such changes are also comparably prevalent in TM patients. Currently there are no treatments, even experimental ones, that have been shown to improve autoimmune cognitive impairment. The goal of this study is to evaluate the therapeutic potential of carbenoxolone (CBX) for the treatment of transverse myelitis (TM), especially the associated cognitive impairment, using three unique animal models of TM. Carbenoxolone (CBX) is a compound that regulates endogenous cortisol levels. CBX inhibits the activity of the enzyme 11b-hydroxysteroid dehydrogenase 1 (11b-HSD1), decreasing the rate of formation and concentration of cortisol. Increased cortisol levels cause degeneration of the hippocampus, a brain region that mediates the generation and recall of memories, and impaired spatial memory. Hippocampal degeneration has been demonstrated in a variety of disorders that often result in cognitive deficits, including MS

 

Below are research articles and presentations supported in part by grants from The Transverse Myelitis Association for research faculty and staff support.

+2013

Differentiating Vascular Myelopathy from Transverse Myelitis
Maureen A. Mealy, RN, BSN, Jorge A. Jimenez, MD, Philippe Gailloud, MD, Daniel Becker, MD Scott D. Newsome, DO, MD, Michael Levy, MD, PhD, Carlos A. Pardo-Villamizar, MD
Johns Hopkins University, Baltimore, MD
Poster presentation at the 2013 American Academy of Neurology meeting, San Diego, CA

Clinical and Neuroimaging Features of Sarcoid Associated Myelopathy
Jorge A. Jimenez, Maria I. Reyes-Mantilla, Diana L. Tapias, Carlos A. Pardo
Johns Hopkins University, Baltimore, MD
Universidad de Antioquia, Medellín, Colombia
Poster presentation at the 2013 American Academy of Neurology meeting, San Diego, CA

+2009

Distinct subtypes of myelitis in systemic lupus erythematosus.
Birnbaum J, Petri M, Thompson R, Izbudak I, Kerr D
Division of Rheumatology/Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Arthritis Rheum. 2009 Nov;60(11):3378-87.

Nineteen episodes of recurrent myelitis in a woman with neuromyelitis optica and systemic lupus erythematosus.
Nasir S, Kerr DA, Birnbaum J
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Arch Neurol. 2009 Sep;66(9):1160-3.

Priapism in infantile transverse myelitis.
Hammond ER, Kerr DA
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Arch Neurol. 2009 Jul;66(7):894-7.

Quality care in transverse myelitis: a responsive protocol.
Trecker CC, Kozubal DE, Quigg M, Hammond E, Krishnan C, Sim PA, Kaplin AI
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Child Neurol. 2009 May;24(5):577-83. Epub 2009 Feb 11.

+2008

Optic neuritis and recurrent myelitis in a woman with systemic lupus erythematosus.
Birnbaum J, Kerr D
Division of Rheumatology, Johns Hopkins University of Medicine, Baltimore, MD, USA.
Nat Clin Pract Rheumatol. 2008 Jul;4(7):381-6. Epub 2008 May 20.

Interleukin-17 in transverse myelitis and multiple sclerosis.
Graber JJ, Allie SR, Mullen KM, Jones MV, Wang T, Krishnan C, Kaplin AI, Nath A, Kerr DA, Calabresi PA
The Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA.
J Neuroimmunol. 2008 May 30;196(1-2):124-32. Epub 2008 Apr 16.

+2007

Idiopathic transverse myelitis: corticosteroids, plasma exchange, or cyclophosphamide.
Greenberg BM, Thomas KP, Krishnan C, Kaplin AI, Calabresi PA, Kerr DA
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neurology. 2007 May 8;68(19):1614-7.

Acute transverse myelitis in childhood: center-based analysis of 47 cases.
Pidcock FS, Krishnan C, Crawford TO, Salorio CF, Trovato M, Kerr DA
Department of Physical Medicine and Rehabilitation, Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
Neurology. 2007 May 1;68(18):1474-80.

Devic’s syndrome in a woman with systemic lupus erythematosus: diagnostic and therapeutic implications of testing for the neuromyelitis optica IgG autoantibody.
Birnbaum J, Kerr D
The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Arthritis Rheum. 2007 Mar 15;57(2):347-51.

+2006

Demyelinating disorders: update on transverse myelitis.
Krishnan C, Kaplin AI, Pardo CA, Kerr DA, Keswani SC
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Curr Neurol Neurosci Rep. 2006 May;6(3):236-43.

+2005

IL-6 induces regionally selective spinal cord injury in patients with the neuroinflammatory disorder transverse myelitis
Adam I. Kaplin, Deepa M. Deshpande, Erick Scott, Chitra Krishnan, Jessica S. Carmen, Irina Shats, Tara Martinez, Jennifer Drummond, Sonny Dike, Mikhail Pletnikov, Sanjay C. Keswani, Timothy H. Moran, Carlos A. Pardo, Peter A. Calabresi, Douglas A. Kerr
Published in Volume 115, Issue 10
J Clin Invest.2005; 115(10):2731–2741 doi:10.1172/JCI25141 

Recurrent transverse myelitis following neurobrucellosis: immunologic features and beneficial response to immunosuppression.
Krishnan C, Kaplin AI, Graber JS, Darman JS, Kerr DA
Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland, USA.
J Neurovirol. 2005 Apr;11(2):225-31.

Transverse myelitis after lumbar steroid injection in a patient with Behcet’s disease.
Deshpande DM, Krishnan C, Kerr DA
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Spinal Cord. 2005 Dec;43(12):735-7.

Idiopathic transverse myelitis.
Krishnan C, Kerr DA
Department of Neurology, Johns Hopkins Transverse Myelitis Center, Johns Hopkins University, Baltimore, MD, USA.
Arch Neurol. 2005 Jun;62(6):1011-3.

Diagnosis and management of acute myelopathies.
Kaplin AI, Krishnan C, Deshpande DM, Pardo CA, Kerr DA
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neurologist. 2005 Jan;11(1):2-18.

+2004

Venous hypertensive myelopathy as a potential mimic of transverse myelitis.
Krishnan C, Malik JM, Kerr DA
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Spinal Cord. 2004 Apr;42(4):261-4.

Transverse Myelitis: pathogenesis, diagnosis and treatment.
Krishnan C, Kaplin AI, Deshpande DM, Pardo CA, Kerr DA
Department of Neurology, Johns Hopkins Transverse Myelitis Center, Baltimore MD, USA.
Front Biosci. 2004 May 1;9:1483-99.

Recurrent transverse myelitis associates with anti-Ro (SSA) autoantibodies.
Hummers LK, Krishnan C, Casciola-Rosen L, Rosen A, Morris S, Mahoney JA, Kerr DA, Wigley FM
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Neurology. 2004 Jan 13;62(1):147-9.

+2002

Proposed diagnostic criteria and nosology of acute transverse myelitis. 
Transverse Myelitis Consortium Working Group.
Neurology. 2002 Aug 27;59(4):499-505.