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Support from Family and Close Friends Helps Recovery

Representative Gabrielle Giffords

Representative Gabrielle Giffords. Photo courtesy Giffords’ House office.

As we watch the daily progress of Representative Gabrielle Giffords, many close observers have commented that her recovery has been moving along more quickly than expected, and took a big leap after the visit from President Obama.  Related?  Perhaps.

Emory Psychologist, Dr. Nadine Kaslow, says there is no question that love and support from family, friends, and others individuals a patient is close to, can make an enormous difference in the recovery process.

She explains that after people come out of a coma, they often seem to have a special connection to those who were there for them during the coma, even if they don’t actually remember anything in a conscious way. Efforts to communicate with the patient, she says, whether those be verbal or physical, can reinforce linking and communication. She adds patients who have physical contact from a loved one seem to visibly relax and engage more.

At Emory, as we move more and more to patient and family centered health care, we actively encourage loved ones to talk with the patient, read to the patient, touch and stroke the patient. Additionally, beds and shower facilities are provided so that family members can be with their loved ones around the clock.

Owen Samuels, MD, director of Emory University Hospital’s neuroscience critical care unit, reiterates that patient families are now recognized as central to the healing process and their presence can even reduce a patient’s length of stay. He says that in a neurology ICU, where the average length of stay is 13 days, but is often many, many more, this can be especially beneficial.

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H1N1 2009 virus may point way to universal flu vaccine

Emory MedicalHorizon

Scientists at Emory and the University of Chicago have discovered that the 2009 H1N1 flu virus provides excellent antibody protection. This may be a milestone discovery in the search for a universal flu vaccine.

Researchers took blood samples from patients infected with the 2009 H1N1 strain and developed antibodies in cell culture. Some of the antibodies were broadly protective and could provide protection from the H1N1 viruses that circulated over the past 10 years in addition to the 1918 pandemic flu virus and even avian influenza or bird flu (H5N1).

The antibodies protected mice from a lethal viral dose, even 60 hours post-infection.

The research is published online in the Journal of Experimental Medicine.

Some of the antibodies stuck to the “stalk” region, or hemagglutinin (H in H1N1) protein part of the virus. Because this part of the virus doesn’t change as much as other regions, scientists have proposed to make it the basis for a vaccine that could provide broader protection. The antibodies could guide researchers in designing a vaccine that gives people long-lasting protection against a wide spectrum of flu viruses.

The paper’s first author, Emory School of Medicine’s Jens Wrammert, PhD, says “Our data shows that infection with the 2009 pandemic influenza strain could induce broadly protective antibodies that are very rarely seen after seasonal flu infections or flu shots. These findings show that these types of antibodies can be induced in humans, if the immune system has the right stimulation, and suggest that a pan-influenza vaccine might be feasible.”

Rafi Ahmed, PhD, director of the Emory Vaccine Center, and a Georgia Research Alliance Eminent Scholar, is co-senior author of the publication, along with Patrick Wilson at University of Chicago.

Multimedia

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  • See YouTube for video commentary by Dr. Ahmed
  • For access to raw video for media purposes, contact Kathi Baker, kobaker@emory.edu, 404-727-9371 Office, 404-686-5500 Pager (ID 14455), 404-227-1871 Mobile.

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Posted on by admin in Immunology 2 Comments

Reassuring news on viral immunity + HIV vaccine

A recent paper in Journal of Immunology suggests that a platform for an HIV vaccine developed by Yerkes National Primate Research Center scientists won’t run into the same problems as another HIV vaccine. Postdoc Sunil Kannanganat is the first author of the JI paper, with Emory Vaccine Center researcher Rama Amara as senior author.

Harriet Robinson, MD and Rama Rao Amara, PhD

Many HIV vaccines have been built by putting genes from HIV into the backbone of another virus. Some have used a modified cold virus (adenovirus 5). The vaccine developed at Yerkes uses modified vaccinia Ankara (MVA), a relative of smallpox and chicken pox.

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Posted on by Quinn Eastman in Immunology Leave a comment

Challenges in islet transplantation

Two recent research papers from the Emory Transplant Center describe research on pancreatic islet transplantation, an experimental procedure that could help people with type I diabetes live without daily insulin injections.

Islet transplantation may offer people with type I diabetes the ability to produce their own insulin again

As with other types of transplantation, the challenge with islet transplantation is to avoid rejection of the donated organ and to balance that goal against side effects from the drugs needed to control the immune system. These papers illustrate how that balancing act is especially complex.

In the last decade, transplant specialists developed a method for islet transplantation named the “Edmonton protocol” after pioneers at the University of Alberta. While the emergence of this method was a major step forward, there are limitations:

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Posted on by Quinn Eastman in Uncategorized 3 Comments

Global climate change and health risks

Public health experts, including researchers, practitioners and policy makers from Emory, CARE, the Centers for Disease Control and Prevention (CDC), and other public and private organizations met at Emory recently for a symposium focusing on the health risks associated with global climate change.

Climate change is affecting the growth of crops, access to water, floods, malnutrition, and the prevalence of disease.

The goal was to form an agenda to develop the tools, policies, and approaches needed to address climate health risks and incorporate climate change adaptation into global health and development work.

And for good reason: right now climate change is contributing to the destruction of livelihoods and the aggravation of social inequalities, said speaker Jean-Michel Vigreux. Vigreux, CARE’s senior vice president of program quality and impact, said climate change is affecting the growth of crops, access to water, floods, malnutrition, and the prevalence of disease–especially climate sensitive disease. All this, he says, disproportionately affects the poor and other vulnerable populations.

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Secrets of the elite: Effective immune control of HIV

A small minority of individuals infected with HIV — about one in 300 – are naturally able to suppress viral replication with their immune systems, and can keep HIV levels extremely low for years. Doctors have named these individuals “elite controllers.”

“These individuals have naturally achieved the outcome sought by HIV vaccine researchers worldwide.  Studying them will ultimately inform the design of a more effective HIV vaccine,” says Vincent Marconi, a physician-scientist at Grady Health System’s Infectious Disease Clinic on Ponce de Leon and an associate professor in the Emory School of Medicine.

Vincent Marconi, MD

Marconi is a co-author (along with investigators at over 200 institutions) on a genomics study of elite controllers published Thursday in Science Express. Led by Bruce Walker at Massachusetts General Hospital and Paul de Bakker at the Broad Institute and Brigham and Women’s Hospital in Boston, the team of researchers scanned through the genomes of close to 1,000 elite controllers and 2,600 people with progressive HIV infection. They identified several sites linked with immune control of HIV, all in a region encoding HLA proteins.

HLA proteins play key roles in activating T cell immunity, and are also necessary for the development of T cells. They grab onto segments of proteins, called peptides, inside the cell and carry them to the cell membrane. In the right context, certain viral peptides can mark infected cells for destruction by “killer” T cells.

Previously, MGH/MIT researchers theorized that people with certain forms of their HLA genes develop T cells with a restricted repertoire, yet broader activity. Their T cells would be more likely to still recognize HIV when the virus mutates. A drawback is that these individuals may have a higher risk for developing autoimmune diseases. The theory is described in more detail in this Nature News article.

Marconi is continuing his part of this research into what makes elite controllers’ immune systems special, which he began at the Department of Defense Infectious Disease Clinical Research Program, in collaboration with Eric Hunter, co-director of Emory’s Center for AIDS Research, and research associate Ling Yue at Emory Vaccine Center. The research is supported by the Center for AIDS Research and the National Institute of Allergy and Infectious Diseases.

Posted on by Quinn Eastman in Immunology Leave a comment

Number of diabetic Americans could triple by 2050

As many as 1 in 3 U.S. adults could have diabetes by 2050, federal officials recently announced.

The Centers for Disease Control and Prevention (CDC) estimate that 1 in 10 have diabetes now – approximately 24 million Americans – but that number could grow to 1 in 5 or even 1 in 3 by mid-century if current trends continue.

The report was published in the Oct. 22 issue of Population Health Metrics. Edward Gregg, Emory adjunct professor of global health, and David Williamson, Emory visiting professor of global health, were co-authors.

The CDC’s projections have been a work in progress. The last revision put the number at 39 million in 2050. The new estimate takes it to the range of 76 million to 100 million.

The growth in U.S. diabetes cases has been closely tied to escalating obesity rates. A corresponding rise in diabetes has even prompted researchers to coin a new hybrid term: diabesity.

“There is an epidemic going on that, if left unchecked, will have a huge effect on the U.S. population and on health care costs,” says K. M. Venkat Narayan, MD, MSc, MBA, professor of global health and epidemiology at the Rollins School of Public Health, who came to Emory from the CDC’s Division of Diabetes Translation. “The numbers are very worrying.”

K. M. Venkat Narayan, MD, MSc, MBA

Narayan also heads the Emory Global Diabetes Research Center, which aims to find solutions to the growing global diabetes epidemic. The Center serves as the research leader and hub for population-based research and large intervention trials throughout South Asia and globally.

“Whatever we do, the fruits of our research have to be available to people everywhere,” says Narayan.

Read more about Dr. Narayan’s global efforts and diabetes research underway at Emory.

Hear Dr. Narayan talk about the Global Diabetes Research Center.

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Anticipating approval from a renowned scholar

Charles Raison, MD, with the Dalai Lama

When Charles Raison hosted a fundraising dinner for Jestun Pema, the sister of His Holiness the Dalai Lama some years ago as a faculty member at the University of California at Los Angeles, little did he know his future would become intertwined with His Holiness.

Raison, who is a psychiatrist and an associate professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine, began his career at Emory in 1999. Since that time, he has emerged as one of the leaders in Emory’s remarkable relationship with the Dalai Lama through the Emory Tibet Science Initiative (ETSI) and his research on the potential health benefits of compassion meditation.

The Dalai Lama recently visited Emory in his role as Emory Presidential Distinguished Professor and presided over a series of conferences related to ETSI.  Raison made a presentation to His Holiness during the Compassion Meditation Conference.

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A path to treatment of lymphedema

Lymphedema, or swelling because of the impaired flow of lymph fluid, can occur as a consequence of cancer or cancer treatment. Chemotherapy can damage lymph ducts, and often surgeons remove lymph nodes that may be affected by cancer metastasis. Lymphedema can result in painful swelling, impaired mobility and changes in appearance.

Young-sup Yoon, MD, PhD

Emory scientists, led by cardiologist and stem cell biologist Young-sup Yoon, have shown that they can isolate progenitor cells for the lining of lymph ducts. This finding could lead to doctors being able to regenerate and repair lymph ducts using a patient’s own cells. The results are described in a paper published recently in the journal Circulation.

The authors used the cell surface marker podoplanin as a handle for isolating the progenitor cells from bone marrow. Previous research has demonstrated that podoplanin is essential for the development of the lymphatic system.
In the paper, the authors use several animal models to show that the progenitor cells could contribute to the formation of new lymph ducts, both by becoming part of the lymph ducts and by stimulating the growth of nearby cells.

“This lymphatic vessel–forming capability can be used for the treatment of lymphedema or chronic unhealed wounds,” Yoon says.

Isolated lymphatic endothelial cells (red) incorporate into lymph ducts (green) in a model of wound healing in mice.

The authors also show that mice with tumors show an increase in the number of this type of circulating progenitor cells. This suggests that tumors send out signals that encourage lymph duct growth – a parallel to the well-known ability of tumors to drive growth of blood vessels nearby. Yoon says the presence of these cells could be a marker for tumor growth and metastasis. Because tumors often metastasize along lymph ducts and into lymph nodes, studying this type of cells could lead to new targets for blocking tumor metastasis.

A recent review in the journal Genes & Development summarizes additional functions of the lymphatic system in fat metabolism, obesity, inflammation, and the regulation of salt storage in hypertension.

Posted on by Quinn Eastman in Cancer Leave a comment
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