Multiple myeloma patients display weakened antibody responses to mRNA COVID vaccines

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Precision medicine with multiple myeloma

“Precision medicine” is an anti-cancer treatment strategy in which doctors use genetic or other tests to identify vulnerabilities in an individual’s cancer subtype. Winship Cancer Institute researchers have been figuring out how to apply this strategy to multiple myeloma, with respect to one promising drug called venetoclax, in a way that can benefit the most patients. Known commercially as Venclexta, venetoclax is already FDA-approved for some forms of leukemia and lymphoma. Researchers had observed that multiple Read more

Promiscuous protein droplets regulate immune gene activity

Biochemists at Emory are achieving insights into how an important regulator of the immune system switches its function, based on its orientation and local environment. New research demonstrates that the glucocorticoid receptor (or GR) forms droplets or “condensates” that change form, depending on its available partners. The inside of a cell is like a crowded nightclub or party, with enzymes and other proteins searching out prospective partners. The GR is particularly well-connected and promiscuous, and Read more

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Finding success in retinoblastoma treatment

The idea of your child having an eye removed is shocking, an extremely difficult thing for a parent to cope with, says Baker Hubbard, MD, Thomas M. Aaberg Professor of Ophthalmology, and a pediatric ocular oncologist. Actually, says Hubbard, most children who lose an eye adapt very well and enjoy essentially normal lives.

Baker Hubbard, MD

Retinoblastoma is cancer that forms in the tissues of the retina (the light-sensitive layers of nerve tissue at the back of the eye). Retinoblastoma usually occurs in children younger than age five. It may be hereditary or nonhereditary (sporadic), and is caused by mutations in genes.

To six-year-old Emilia McKibbin, having a prosthetic eye is no big deal. She knows to protect it—wearing her glasses for school and playtime, donning a scuba mask at the beach—but it doesn’t limit her choices.

Following her interests, Emilia has earned a gold belt in karate. She’s learning gymnastics. She swims. She loves to romp with Daisy, her black cocker spaniel. And while most people don’t even notice that one of this little girl’s shining dark-brown eyes is different from the other, Emilia shares her story with a few. “I tell my teachers and my friends that I have a special eye,” she says.

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Stereotactic radiosurgery: fast, friendly, focused

Cynthia Anderson, MD

When Cynthia Anderson, MD, prepares her patients for stereotactic radiosurgery she emphasizes three things: the surgery is fast, friendly and focused. Initially used to treat the part of the brain associated with brain tumors, stereotactic radiosurgery has gained currency as a treatment for various types of cancer. This type of surgery uses x-ray beams instead of scalpels to eliminate tumors of the liver, lung and spine.

“It’s fast because the actual radiation treatment itself is very short,” says Anderson, a radiation oncologist at the Winship Cancer Institute of Emory University. “It’s friendly because it’s all done as an outpatient. And it’s focused because these targeted radiation beams get the maximum dose of radiation to a tumor and give the most minimal dose of radiation to the critical organs that surround the tumor.”

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Looking at quality of life in visually impaired children

Vision loss can affect one’s daily function and quality of life (QOL), but few research studies have actually looked at the impact of visual impairments on children’s quality of life.

An Emory project aims to develop an instrument that will measure the effect of vision loss on the quality of life of children age 8 to 18.

Pictured from left to right: J. Devn Cornish, MD, professor and vice chair, Department of Pediatrics, Emory University School of Medicine; Andy Lovas, grand recorder, Knights Templar Eye Foundation; Sheila Angeles-Han, MD, MSc, assistant professor, Pediatric Rheumatology and Immunology, Emory University School of Medicine; Larry Vogler, MD, division chief, Pediatric Rheumatology and Immunology, Emory University School of Medicine; and Tim Taylor, director of marketing, Knights Templar Eye Foundation

The project is being led by Emory pediatric rheumatologist Sheila Angeles-Han, MD, MSc. Han recently received a $40,000 grant from the Knights Templar Eye Foundation to augment her work in this area. She is collaborating with pediatric ophthalmologists at the Emory Eye Center.

Currently, there are no validated questionnaires or tools to determine how children in these age groups cope with their visual impairments and the impact of vision loss on their daily lives. This knowledge can enhance physicians’ understanding of diseases that affect vision.

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Biomarker may predict serious complications after lung transplantation

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.

Primary graft dysfunction after a lung transplant

The results are published in the American Journal of Transplantation. First author Andres Pelaez, a pulmonary medicine specialist at Emory’s McKelvey Lung Transplant Center, and postdoc Patrick Mitchell led the research team.

“Despite major advances in surgical techniques and clinical management, serious lung transplant complications are common and often untreatable,” Pelaez says. “PGD 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.”

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New education model for real-world health care

 

Emory’s Nell Hodgson Woodruff School of Nursing has started a new educational concept called the Dedicated Education Unit (DEU).

Launched by the School of Nursing and Emory Healthcare last fall, the DEU pairs a nursing student with a staff nurse for one-on-one clinical instruction in the medical-surgical unit at Emory University Hospital or Emory University Hospital Midtown.

Nursing senior Ivey Milton (left) checks on a patient’s medication, guided by Jackie Kandaya, her medical-surgical instructor at Emory University Hospital Midtown

A first at Emory and in Georgia, the DEU is based on the model implemented by the University of Portland School of Nursing and its clinical partners in the early 2000s.

Kelly Brewer, who holds a joint appointment with the School of Nursing and Emory Healthcare as DEU coordinator, says, “Our DEU initiative relies on these concepts and the skills of nurses and faculty to help students transition into the real world of nursing. It’s a win-win situation for both sets of professionals since faculty and clinical nurses are in short supply because of the nursing shortage.

“Both of our hospitals are committed to making students feel that they are part of the unit so they’ll want to work there after they graduate,” she adds. “They will already have a sense of what Emory’s health care system is about, and their transition into the real world of health care will be less stressful.”

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Improving measurement of pesticides in breast milk

Little is known about the exposure of infants to pesticides, despite their vulnerability and evidence of widespread dietary exposure among older children and adults. A study led by Emory Rollins School of Public Health researchers P. Barry Ryan, PhD, and Anne Riederer, ScD, seeks to improve methods for measuring pesticides in breast milk and infant formula.

“We really don’t know about how babies are exposed to pesticides in their everyday life,” says Riederer, assistant research professor, Department of Environmental and Occupational Health. “There are very few published studies on this topic, and we’d like to be one of the groups that actually publishes an analytical method that can be used by researchers in any country to be able to detect these different types of pesticides in breast milk.”

Although the breast milk method will be pilot tested on samples collected from a birth cohort in Thailand, it will have broad applications for the U.S. population.  Insight Pest Control Wilmington says that because these pesticides are widely distributed in the food supply, all U.S. infants are potentially exposed.

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Predicting individual risk for heart failure

Javed Butler, MD, MPH, and colleagues

Javed Butler, MD, MPH, director of heart failure research at Emory Healthcare and associate professor of medicine at Emory University School of Medicine, says heart failure is any condition in which the heart is unable to pump enough blood for the metabolic needs of the body, but that does not mean that the heart is not pumping or the heart has stopped working.

Heart disease is not a disease but a syndrome, so a whole family of different diseases can precede this condition. Diabetes, obesity, heart valve problems, lung disease, heart attack and irregular heartbeats are only some factors that can cause heart failure. “Pinning down the roots of heart failure can be confusing,” says Butler, who serves as deputy chief science advisor for the American Heart Association. “Unlike some heart problems, heart failure is not one disease. It has a few common causes, and a few less common, even rare, causes.”

Finding new ways to identify people at risk for developing heart failure—before damage is done—is his raison d’etre and primary research focus, according to Emory Medicine magazine.

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Eye diseases and immune system link studied

Drawing shows areas of the eye

Emory Eye Center researchers are looking at the role of the immune system in the inflammation of the eye and the progression of eye diseases.

Santa Ono, PhD, professor of ophthalmology, Emory School of Medicine and researcher at the Emory Eye Center, and Emory senior vice provost for undergraduate education and academic affairs, and his team at the R. Howard Dobbs Jr. Ocular Immunology Lab, focus on the immune component of age-related macular degeneration (AMD), ocular cancer (melanoma and retinoblastoma) and ocular inflammation.

Santa J. Ono, PhD

Macular degeneration is the leading cause of sight impairment and blindness in older people. The macula, in the center of the retina, is the portion of the eye that allows for the perception of fine detail. AMD gradually destroys a person’s central vision, ultimately preventing reading, driving, and seeing objects clearly

In a recent article of Emory Magazine, Ono, an ocular immunologist, says, “If a person with AMD looks at graph paper, some of the lines will be wavy instead of straight. Certain parts of the image are no longer being transferred to the brain.”

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Palliative care: Addressing suffering and quality of life

The palliative care program at Emory University is working to improve quality of life and wellness by addressing the physical, psychological, ethical, spiritual and social needs of patients with serious, life-threatening or progressive chronic illnesses, and provides support to their families and caregivers.

Tammie E. Quest, MD

Often mistakenly confused with hospice care, palliative care is appropriately provided to patients in any stage of serious illness – whereas hospice care is primarily used for those approaching the end stage of life, says Tammie Quest, MD, interim director of the Emory Center for Palliative Care.

A typical palliative care “team” consists of physicians, nurses, social workers, chaplains, mental health professionals, therapists and pharmacists, assisting patients through a wide array of illnesses, including stroke, heart and lung disease, cancer and HIV.

The palliative care teams work closely with primary physicians to control pain, relieve symptoms of illnesses – such as nausea, fatigue and depression. Teams help provide counseling in making difficult medical decisions and provide emotional and spiritual support, coordinate home care referrals and assist with identifying future care needs.

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Tailoring transplant drugs for children

For adult organ transplant recipients, juggling a lifetime regimen of immunosuppressant drugs is difficult enough, but for children it presents an even greater challenge.  These drugs, which also can have toxic side effects, must strike a delicate balance between preventing organ rejection and protecting from infections.

But children’s immune systems are still “learning” what distinguishes them from the world around them, and children are constantly developing and changing, both physically and emotionally. This puts them at greater risk for complications either through inappropriate medication or failure to take these drugs properly.

A grant from the National Institute of Allergy and Infectious Diseases (NIAID), through the American Recovery and Reinvestment Act (ARRA), will support new studies at Emory University and Children’s Healthcare of Atlanta to help clinicians tailor therapies specifically for children receiving transplants.  The project will include hiring of additional personnel to undertake these studies.

Allan D. Kirk, MD, PhD, is principal investigator of the project, which is supported by a two-year grant of nearly $1.65 million. Kirk is professor of surgery and pediatrics in Emory University School of Medicine and a Georgia Research Alliance Eminent Scholar. He also is vice chair of research in the Department of Surgery and scientific director of the Emory Transplant Center.

The ARRA-funded project will not only help determine which medications children should take, but also will give them the support to care for their transplanted organs.  The Emory scientists are studying new biological monitoring technologies that can identify unique ways to determine exactly how much medication a child really needs. These studies are being combined with a novel transition care clinic specializing in helping children cope with their illness and assuming responsibility for their care.

“This award indicates exceptional insight by the NIAID into the critical link between a child’s physical well-being and their emotional maturity,” says Kirk. “It will accelerate progress in this vital area of research for a very deserving subset of chronically ill children.”

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