# Novel Regenerative Therapeutic in Chronic Complex TBI

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2024 · —

## Abstract

Novel Regenerative Therapeutic in Chronic Complex TBI
Allopregnanolone (ALLO) is a neurosteroid endogenously produced in brain that exhibits pleiotropic actions
highly relevant to the neurobiology and treatment of chronic complex TBI. ALLO exhibits pronounced
regenerative actions, in addition to marked neuroprotective, analgesic, and anti-inflammatory effects in rodent
models. Furthermore, our recent human data suggest that ALLO is decreased in TBI, suggesting that
ameliorating deficits of this neurosteroid may be clinically therapeutic. We have also recently determined that
ALLO levels are positively correlated with cortical gray matter thickness on MRI. In addition, multiple groups
have now reported reductions in ALLO among patients with conditions that frequently co-occur with TBI,
including depression and pain disorders. Replenishing ALLO could thus have tremendous therapeutic
promise for multiple symptom constellations that greatly impact functional outcome and quality of life.
The goal of this project is thus to conduct a proof-of-concept Phase 2 randomized controlled trial (RCT) in
Veterans with chronic complex TBI to investigate the efficacy and tolerability of this regenerative therapeutic,
providing critical foundational data in this population that could lead to a novel treatment addressing the
multidimensional pathophysiological underpinnings of TBI and frequently co-occurring conditions such as
depression and pain. This study will therefore provide initial data for the potential therapeutic efficacy of ALLO
for co-occurring depression symptoms and pain symptoms (primary endpoints), as well as possible
enhancement of functional outcome (secondary endpoint). In addition, we will examine TBI-only groups
without depression or pain symptoms (also randomized to ALLO or placebo). This will now thus be a 4-arm
study with 22 participants per group (88 total participants): Complex TBI groups (randomized to ALLO or
placebo) and TBI-only groups (randomized to ALLO or placebo). As ALLO has anti-inflammatory actions, we
will also investigate possible reductions in inflammatory biomarkers post-treatment (exploratory endpoint) and
heart rate variability (exploratory endpoint). In addition, we will obtain important pharmacokinetic data for this
intervention (ALLO levels to be quantified by mass spectrometry).
Veterans with chronic complex TBI and a minimum HAM-D score of 14 (consistent with moderate depression)
will be randomized to either intravenous placebo (6% cyclodextrin) or ALLO (0.5mg/ml of GMP-grade ALLO in
6% cyclodextrin); n=22 per group/n=44 with complex TBI. We will also randomize Veterans with TBI-only (no
depression or pain symptoms) to ALLO or placebo; n=22 per group/n=44 with TBI-only. Total study number
of OEF/OIF/OND Veteran participants with mild TBI will now be 88 (4 arms; 22 participants per group).
Following a loading dose, Veterans will receive a 4-hour placebo or ALLO infusion targeted to achieve a serum
ALLO level of 50 nanom...

## Key facts

- **NIH application ID:** 11174309
- **Project number:** 5I01RX002798-06
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Christine E. Marx
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11174309

## Citation

> US National Institutes of Health, RePORTER application 11174309, Novel Regenerative Therapeutic in Chronic Complex TBI (5I01RX002798-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11174309. Licensed CC0.

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