Former National Institutes of Health director Elias Zerhouni created a vivid label for a persistent problem. He noted there was a widening gap between basic and clinical research. The “valley of death” describes the gap between basic research, where the majority of NIH funding is directed and many insights into fundamental biology are gained, and patients who need these discoveries translated to the bedside and into the community in order to benefit human health. Thus, a chasm has opened up between biomedical researchers and the patients who would benefit from their discoveries.
Translational research seeks to move ideas from the laboratory into clinical practice
Translational research seeks to move ideas from the laboratory into clinical practice in order to improve human health.
A new certificate program in translational research is designed to empower PhD graduate students to bridge that gap. Participants (PhD graduate students) from Emory, Georgia Tech and Morehouse School of Medicine can take courses in epidemiology, biostatistics, bioethics, designing clinical trials and grant writing, and will have rotations with clinicians and clinical interaction network sites where clinical research studies are carried out to get a better sense of the impact and potential benefit of the research they are conducting.
View of MR/PET scanner from front, with Ciprian Catana of MGH and Larry Byars of Siemens
The scanner is one of four world-wide and one of two in the United States, and permits simultaneous MR (magnetic resonance) and PET (positron emission tomography) imaging in human subjects. This provides the advantage of being able to combine the anatomical information from MR with the biochemical/metabolic information from PET. Potential applications include functional brain mapping and the study of neurodegenerative diseases, drug addiction and brain cancer.
Thursday’s event brought together leaders of the three other MR/PET programs in Boston, JÃ¼lich and TÃ¼bingen, the Siemens engineers who designed the device, and the Atlanta research community to explore the possibilities of the technology.
The drugs now available to treat Alzheimer’s address the symptoms of the disease — memory problems — rather than the underlying mechanism of neurodegeneration.
But what if something could do both? Here’s a tantalizing prospect, hinted at by a long-running thread of brain research: compounds that boost the function of certain acetylcholine circuits in the brain might also modify production of toxic beta-amyloid protein.
The possibility grows out of the properties of certain receptors for the neurotransmitter acetylcholine, called “muscarinic acetylcholine receptors.” Acetylcholine is a major transmitter of signals in the brain, and there are several varieties of receptors, or receiver dishes for the signals, on brain cells.
Researchers at Emory studying lung transplantation have identified a marker of inflammation that may help predict primary graft dysfunction (PGD), an often fatal complication following a lung transplant.
â€œDespite major advances in surgical techniques and clinical management, serious lung transplant complications are common and often untreatable,â€ Pelaez says. â€œPGD is a severe lung injury appearing just a few days after transplantation. Unfortunately, predicting which lung transplant recipients go on to develop PGD has been so far unsuccessful. Therefore, our research has been directed towards identifying predictive markers in the donor lungs prior to transplantation.â€
Briefly, they found that increased appetite and insulin resistance can be transferred from one mouse to another via intestinal bacteria. The results were published online by Science magazine.
Previous research indicated intestinal bacteria could modify absorption of calories, but Gewirtz and his colleagues showed that they influence appetite and metabolism (in mice)
“It has been assumed that the obesity epidemic in the developed world is driven by an increasingly sedentary lifestyle and the abundance of low-cost high-calorie foods,” Gewirtz says. “However, our results suggest that excess caloric consumption is not only a result of undisciplined eating but that intestinal bacteria contribute to changes in appetite and metabolism.”
A related report in Nature illustrates how “next generation” gene sequencing is driving large advances in our understanding of all the things the bacteria in our intestines do to us.
Gewirtz’s laboratory’s discovery grew out of their study of mice with an altered immune system. The mice were engineered to lack a gene, Toll-like receptor 5 (TLR5), which helps cells sense the presence of bacteria.
Two researchers at Emory, Anita Corbett and Grace Pavlath, recently have combined their expertise to probe how a puzzling form of muscular dystrophy develops.
Oculopharyngeal muscular dystrophy (OPMD) is an inherited type of muscular dystrophy that primarily affects muscles of the face and throat. In the video below, Anita Corbett explains how this affects patients as they get older.
The mutations that cause the disease make a protein called PABPN1 longer and stickier than normal, and the mutated protein appears to form clumps in muscle cells.
The puzzle lies in that PABPN1 (poly A binding protein nuclear 1)Â can be found everywhere in the body, but it’s not clear why the mutated protein specifically affects muscle cells — or why the muscles in the face and throat are especially vulnerable.
In December 2009, Corbett, Pavlath and postdoctoral fellow Luciano Apponi published a paper where they suggest that the clumps of mutated protein, which some researchers have proposed to be toxic, might not be the whole story. A lack of functioning PABPN1 might be just as strong a factor in the disease, they’ve discovered.
What a cancer patient wants to know after surgery can be expressed succinctly: “Did you get everything?” Having a confident answer to that question can be difficult, because when they originate or metastasize, tumors are microscopic.
Considerable advances have been made in “targeted therapy” for cancer, but the wealth of information available on the molecular characteristics of cancer cells hasn’t given doctors good tools for detecting cancer during surgery – yet.
Even the much-heralded advent of robotic surgery has not led to clear benefits for prostate cancer patients in the area of long-term cancer control, a recent New York Times article reports.
At Emory and Georgia Tech’s joint department for biomedical engineering, Shuming Nie and his colleagues are developing tools that could help surgeons define tumor margins in human patients.
Pathologist Keqiang Ye has made a series of discoveries recently, arising from his investigations of substances that can mimic the growth factor BDNF (brain-derived neurotrophic factor).
BDNF is a protein produced by the brain that pushes neurons to withstand stress and make new connections. Some neuroscientists have described BDNF as “Miracle Gro for brain cells.”
â€œBDNF has been studied extensively for its ability to protect neurons vulnerable to degeneration in several diseases, such as ALS, Parkinsonâ€™s and Alzheimerâ€™s disease,â€ Ye says. â€œThe trouble with BDNF is one of delivery. Itâ€™s a protein, so it canâ€™t cross the blood-brain barrier and degrades quickly.â€
Working with Ye, postdoctoral fellow Sung-Wuk Jang identified a compound called 7,8-dihydroxyflavone that can duplicate BDNFâ€™s effects on neurons and can protect them against damage in animal models of seizure, stroke and Parkinsonâ€™s disease. The compoundâ€™s selective effects suggest that it could be the founder of a new class of brain-protecting drugs. The results were published in Proceedings of the National Academy of Sciences.
Peripheral artery disease affects millions of people in the United States. It’s basically hardening of the arteries (atherosclerosis) leading to problems with getting enough blood to the limbs. Symptoms of severe PAD include leg pain that doesn’t go away once exertion stops and wounds that heal slowly or not at all.
Lifestyle changes, medication and surgery can address some cases of PAD, but often the disease is not recognized until it has advanced considerably. At Emory, cardiologist Arshed Quyyumi has been exploring whether a patient’s own bone marrow cells can repair the arteries in his or her limbs.
What may soon be old-fashioned: next-generation sequencing combines many reactions like the one depicted above into one pot
DNA polymerases, enzymes that replicate and repair DNA, assemble individual letters in the genetic code on a template. The PNAS paper describes efforts to modify Taq DNA polymerase to get it to accept “reversible terminators.” (Taq = Thermus aquaticus, a variety of bacteria that lives in hot springs and thus has heat-resistant enzymes, a useful property for DNA sequencing)
Ortlund was involved because he specializes in looking at how evolution shapes protein structure. Along with co-author Eric Gaucher, Ortlund is part of the Fundamental and Applied Molecular Evolution Center at Emory and the Georgia Institute of Technology.
To sequence DNA faster and more cheaply, scientists are trying to get DNA polymerases to accept new building blocks. This could facilitate next-generation sequencing technology that uses “reversible terminators” to sequence many DNA templates in parallel.