It’s reassuring to know that for whatever ails us, someone out there is doing research on it. Below, we’ve compiled a group of current studies we find interesting. Some are closer to clinical practice than others, but all hold promise for a better tomorrow..
Millions of Americans suffer from chronic kidney disease, which, even before symptoms appear, can cause the blood vessels to harden and calcify. That’s really bad news for the heart. Early research at Washington University School of Medicine has shown that restricting phosphate can reverse calcification and kidney damage.
Phosphates are found in colas and other carbonated beverages, cheese and other dairy products, beans and high-protein foods. They are also used as a preservative in many processed foods. In appropriate levels, these are essential to keep our bones and teeth healthy and prevent rickets. Dr. Eduardo Slatopolsky, professor of renal disease and senior author of the research, based conclusions on rat studies. But if the findings are confirmed in people, limiting dietary phosphate early in kidney disease could help people live longer and healthier. “Phosphorus is usually not a problem because the excess is eliminated by the kidneys,” Slatopolsky says.
Chemotherapy-induced peripheral neuropathy (CIPN) is a painful, debilitating side effect of many anticancer drugs. It can cause tingling and numbness in the hands and feet, shooting pains in the limbs or extreme sensations of hot and cold. Symptoms may resolve after therapy or never go away.
Saint Louis University pain researcher and professor Daniela Salvemini, Ph.D., has identified two molecules important in pain and inflammation and has uncovered a link with CIPN. Her lab discovered that the molecules play a role in the CIPN pathway. If they can block the production, action or metabolism of those molecules, they could prevent or control the pain. “We already have a drug used to treat multiple sclerosis, Gilenya, which seems to block the CIPN pathway; clinical trials will start within the next year to see how it affects the pain,” she says. “If we can give the drug for pain and it’s relieved, then we could give it with more effective doses of chemotherapy in a therapeutic cycle.”
A recent study by a University of Missouri researcher demonstrates that resverat rol, found in grape skins and red wine, can make tumor cells more susceptible to radiation treatment—at least in a petri dish. Dr. Michael Nicholl, surgical oncologist, studied the effect on melanoma cells, having obtained earlier, similar results with prostate cancer. He found the cells more susceptible to radiation if they were treated first with resveratrol.
Says Nicholl, “Our study investigated how resveratrol and radiation inhibit the survival of melanoma cells. However, without a delivery system, it can’t be used on people yet.” They are working with nanotechnology to develop a system.
To get your own healthy dose of resveratrol, he suggests a glass of Concord grape juice or red wine. He says that’s better for absorption than isolating the resveratrol in a supplement.
Health benefits and disease prevention potential require only a low level in food; however, using resveratrol as a therapy would require a much higher concentration than that found in food.
Researchers are working with game technology to collect valuable data on risk factors for falls and how they occur. Between 700,000 and 1 million people each year fall in American hospitals. Marilyn Rantz, Ph.D., R.N., is a leader on the University of Missouri research team. She says, “Since 2008, we’ve investigated ways to detect and prevent falls in older adults living in our independent senior apartments. We thought what we’ve learned regarding older people would apply to protecting hospital patients, as well.”
Some of their earlier technology, like Doppler radar and sound sensors, could detect a fall but not what caused it. Video cameras could record events leading up to the fall but only with enough light. When video game motion-capture technology was released a few years ago, they gained a new tool, one that works with infrared for all lighting levels and portrays people as anonymous 3-D silhouettes to protect their privacy. The Microsoft Kinect system taps into the normal communication system for hospital staff and offers a video clip.
They installed it in six rooms at University Hospital in Columbia. During the eight months of the study, there weren’t any patient falls in those rooms, but stunt actors simulated 50 falls to provide data for the algorithm. Says Rantz, “The technology is promising because it accurately identified falls and may eventually help prevent them.”
It’s simple. Doctors implant a small device about one-third the size of a AAA battery under the skin near your chest, and you go about your business. Called the Reveal Linq, the tiny implant was first used by cardiologists at Saint Louis University to do some difficult diagnoses.
Dr. Michael Lim, co-director of the Center for Comprehensive Cardiovascular Care, explains how it works: “We might have a patient who has fainted, experienced dizziness or even had a stroke, and we want to know if it was due to abnormal heart rhythms. Older methods required them to wear a monitor that was cumbersome and only gave us 30 days of data. If the patient didn’t have an episode, it didn’t help.”
The Reveal Linq is implanted and records a patient’s heart data on a daily basis, sending the information to the physician via a cell tower. It will keep recording for up to three years. “This device,” Lim says, “allows us to confirm or rule out an abnormal heart rhythm more accurately than other tests.” The need to identify an abnormal heart rhythm, especially atrial fibrillation, is important because of its relationship to stroke. The device is covered by most insurance as a diagnostic tool.
New ‘Cancer goggles,’ developed at Washington University School of Medicine, help surgeons visualize cancer cells, which glow blue during an operation. Dr. Ryan Fields, a Siteman Cancer Center surgeon, says, “This is great because with these goggles, we can see stray cells and capture them, usually avoiding a second surgery.”
So far they have used the goggles with 10 patients: five with breast cancer and five with melanoma. Breast surgeon Dr. Julie Margenthaler performed the first operation and says about 20 to 25 percent of breast cancer patients who have lumps removed have required a second surgery because current technology hasn’t accurately shown the extent of the disease. Tumors as small as 1 millimeter have been detected with the glasses.
They were developed by a W.U. team lead by Samuel Achilefu, Ph.D., and incorporate a specialized video technology, a head-mounted display, and a molecular agent that attaches to cancer cells, making them glow when viewed.
[volume and autism]
Autism is known for problems with memory formation, higherlevel thinking and social interaction. These may be due in part to the activity of certain brain cell receptors. The receptor in question is mGlu5, which becomes activated when it binds to the neurotransmitter gluta mat e, associated with learning and memory. Current drugs decrease signaling by the mGlu5 receptor, essentially turning down the volume at which brain cells talk to each other, something that becomes exaggerated in autism. Karen O’Malley, Ph.D., is professor of neurobiology and senior investigator on a new study that sheds more light on the role of the receptors inside the cells. “When we compared how much of the receptor was on the surface of the cell and how much was inside, there was so much more inside the cell, in some cases 90 percent of the total, and we wondered if those had separate functions.” Working with brain cells in a dish, O’Malley and her colleagues demonstrated that the receptors on the cell surface sent completely different messages than the same receptors inside the cell. Previous autism studies used compounds that blocked the receptors on the surface but couldn’t get into the cells. When O’Malley used compounds that activated only the mGlu5 receptors inside the cells, she found they played a bigger role in turning down the volume of brain cell communication than the surface receptors. She says, “It’s probably important that we design a drug to block both types if we are going to have an effective treatment.”
The most common cancer-related death in this country is from lung cancer. When it strikes, it is more likely to spread silently into advanced stages before being detected. There is no proven screening test for it. The next best thing would be early detection at the molecular level. “The National Cancer Institute conducted a huge trial to detect nodules in the lungs of people at high risk for cancer, and 96 percent did not turn out to be lung cancer, but patients had to endure the stress and cost of a biopsy,” says Dr. Michael Wang, assistant professor of pathology and anatomical sciences at MU School of Medicine. In a new study on early detection, researchers used blood plasma samples from lung cancer patients to look for a specific microRN A molecule that is often elevated. They put an extract of blood plasma through a nanopore, a tiny hole in a thin membrane just large enough for a single molecule to pass through. By applying a current to the nanopore, they could measure changes that occur when that specific microRNA molecule was present. The microRNA testing could increase or rule out the likelihood of cancer before a biopsy.
Ovarian cancer, found in 22,000 women annually, has nonspecific symptoms, which means it’s often detected late. That leads to a five-year survival rate of only 43 percent. According to a recently published study by Washington University School of Medicine, at least one in five women with ovarian cancer has inherited genetic mutations that increase her risk, but she may not know it because there is no family history of the disease. While earlier studies focused on ovarian cancer patients with known family histories, the most recent study looked at tumors from 429 women without a family history of ovarian cancer.
Using advanced genomic analysis, they found 20 percent of those cancers showed inherited mutations in a gene pathway associated with inherited breast and ovarian cancer. Siteman Cancer Center researcher, Li Ding, Ph.D., was surprised. The researchers identified 222 inherited genetic variants that increase the risk of ovarian cancer, some in genes never before linked to the disease. “We need to find better ways to screen women for ovarian cancer, even without known family histories,” Ding notes.
Tumors develop their own blood supply, and tumor blood vessels have different characteristics than normal ones. A great deal of effort has gone into targeting these abnormal blood vessels to cut off their blood supply. Unfortunately, tumors adapt, so a different approach is under study: hijacking the blood vessels.
Working in mice, Drs. Jeffrey Arbeit and David Curiel have designed a viral vector that is attracted to abnormal blood vessels in tumors. There is some evidence that those blood vessels provide protection for certain cancer stem cells that are resistant to treatment. By using the vector to alter the epithelial cells in the inner walls of the vessels, they hope the stem cells won’t survive.
“We want to turn these vessels into factories for producing molecules that alter the tumor microenvironment so it no longer nurtures the tumor,” Arbeit explains. The system they designed includes a deactivated virus carrying a section of DNA called RO BO4, known to be switched on in cells lining vessels within the tumor. When injected into the blood stream, it is attracted to the tumor vasculature, avoiding the major organs and other healthy tissue. In theory, this approach also could help other diseases with abnormal blood vessels, like Alzheimer’s, MS and heart failure.
By Mary Jo Blackwood, R.N., MPH