Blood clots are associated with life-threatening conditions such as sepsis, sickle cell disease, heart attack and stroke. However, new research from Emory University may revolutionize how clinicians understand and treat these harmful blood clots, or thrombi, a byproduct of a condition called thromboinflammation. In a groundbreaking study published in Nature, researchers have discovered the potential to provide life-saving medications to patients with blood clots at the right time, with the right dose, in novel combinations based on a new model.

To gain these insights, researchers developed a thromboinflammation-on-a-chip model that can sustain the clots for several months in a more accurate, human-like manner, leveraging 3D microvessels on a chip. This novel model allows the thrombi to exist in human blood and veins for months and resolve as they would naturally in a real patient. Researchers are then able to track the blood clot and measure the effectiveness of various treatment options. This model differs from existing models, which can only sustain blood clots for short periods. Additionally, this new model includes the real cells necessary for clot resolution, whereas other lab models do not.

Wilbur Lam, corresponding author of the study, professor at Emory University and Georgia Tech, and a clinician at Children’s Healthcare of Atlanta, explains that little is known about how blood clots are resolved in real life after one survives a stroke or heart attack, but replicating the process on a chip can reveal critical information in the application or development of new treatments.

In addition to stroke or cardiac arrest, it’s noteworthy that hypertension, diabetes, severe trauma, burns and other infections are also factors in developing thromboinflammation, leaving much of the nation at risk.

Since this model opens the door to understanding how blood clots naturally resolve, researchers can now further study the timing, dosage, and impact of existing medical interventions, as well as possible new combinations. One such discovery from this study is the vital role of neutrophils, which both resolve thrombi and create inflammation — a double-edged sword, according to Lam.

Additionally, this study reveals that the treatment used after a stroke, tPA, or Tissue Plasminogen Activator, also directly repairs any vasculature, which was previously unknown.

The study also suggests that combining existing mediations may protect the endothelial function, or the opening and closing of arteries, in patients with sickle cell disease. Finally, this study notes that those experiencing bone marrow transplantation may benefit from certain drug combinations to protect against veno-occlusive disease, a condition resulting from high doses of chemotherapy that can cause liver damage by blocking small veins in the liver.