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How muscles get stronger — and the nose knows

Scientists at Emory studying muscle repair have discovered an unexpected function for odorant receptors.

Odorant receptors’ best known functions take place inside the nose. By sending signals when they encounter substances wafting through the air, odorant receptors let us know what we’re smelling. Working with pharmacologist Grace Pavlath, graduate student Christine Griffin found that the gene for one particular odorant receptor is turned on in muscle cells during muscle repair.

The activation of the odorant receptor gene MOR23 is visible in muscle tissue in pink. Cell nuclei appear as blue.

The activation of the odorant receptor gene MOR23 is visible in muscle tissue in pink. Cell nuclei appear as blue.

Grace Pavlath, PhD

Grace Pavlath, PhD

Christine Griffin

Christine Griffin

“Normally MOR23 is not turned on when the tissue is at rest, so we wouldn’t have picked it up without looking specifically at muscle injury,” Pavlath says. “There is no way we would have guessed this.”

The finding could lead to new ways to treat muscular dystrophies and muscle wasting diseases, and also suggests that odorant receptors may have additional unexpected functions in other tissues.

While we’re on the topic of odorant receptors, a great article in November’s Howard Hughes Medical Institute Bulletin describes Emory psychiatrist Kerry Ressler’s work with Linda Buck when he was a graduate student.

From the article:

“I had never thought about smell a day in my life until I heard Linda give her talk,” Ressler says, still jazzed by the memory, “and I was absolutely blown away.” Buck had methodically identified about 1,000 odorant receptor (OR) genes and she outlined an orderly plan for decoding their function.

…Over the next three years, Ressler’s dissertation work contributed to the accomplishments that earned Buck the 2004 Nobel Prize in Physiology or Medicine, which she shared with HHMI investigator Richard Axel. Prominently displayed in Ressler’s Emory office is a framed picture of him with Buck at the Stockholm ceremony, both grinning broadly in formalwear.”

Ressler and his colleagues at Yerkes National Primate Research Center now study how fearsome memories become lodged in our brains. Since smell is often described as accessing the most primitive parts of the brain, the connection between Ressler’s past and present makes sense.

Kerry Ressler, MD, PhD, when he's not in Stockholm

Kerry Ressler, MD, PhD, when he's not in Stockholm — Parker Smith / PR Newswire, © HHMI

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Research match eases clinical trials participation

Research Match LogoIf you’d like to consider joining a clinical trial, a new secure website will make it easier. ResearchMatch.org will match any interested person living in the U.S. with researchers who are approved to recruit potential study volunteers.

Emory is one of 51 institutions participating in this first national, secure, volunteer recruitment registry. After registering at the website, potential volunteers can check out available trials. If a person indicates interest in a study, they are notified electronically about a possible match. Then they can decide whether to provide their contact information to a researcher.

The new website is sponsored by the National Center for Research Resources (NCRR) of the National Institutes of Health (NIH). ResearchMatch is the product of the NCRR’s Clinical and Translational Science Awards (CTSA) Consortium. The CTSA is a national network of 46 medical research institutions working together to improve the way biomedical research is conducted across the country.

Emory leads the Atlanta Clinical and Translational Science Institute (ACTSI), a CTSA partnership including Morehouse School of Medicine, the Georgia Institute of Technology and Children’s Healthcare of Atlanta.

ResearchMatch.org is a wonderful opportunity for those interested in participating in clinical research, says Arlene Chapman, MD, Emory professor of medicine and director of the ACTSI Clinical Interaction Network Program. It’s available to young and old, healthy or ill. And people with a rare disease can find out more about available research studies throughout the country.

The registry strictly protects anonymity. It also increases the chance to participate in local studies and saves much of the time typically spent finding out about eligibility for a particular study.

ResearchMatch is available at: www.researchmatch.org/route=emory

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World AIDS Day reminds of research priorities

AIDS quilt panels_shadowsEmory University is hosting an 800-panel display of The AIDS Memorial Quilt in recognition of World AIDS Day. “Quilt on the Quad,” on the Emory quadrangle, is the largest collegiate display and the second largest in the world today. An opening ceremony featured a talk by Sandra Thurman, president and CEO of the International AIDS Trust, based at Emory’s Rollins School of Public Health. Members of the Emory community read the names of each individual memorialized by a quilt panel on the quad.

An estimated 60 million people have acquired HIV, and 25 million people have died from AIDS. Emory scientists and physicians have been leaders in research to develop effective drugs and vaccines against HIV and AIDS. The Emory Center for AIDS Research is an official National Institutes of Health CFAR site. More than 120 faculty throughout Emory are working on some aspect of HIV/AIDS prevention or treatment.

More than 94 percent of HIV patients in the U.S. on life saving antiviral therapy take a drug developed at Emory. And many of the scientists within the Emory Vaccine Center are focused on finding an effective vaccine against HIV. A vaccine developed at the Vaccine Center and Yerkes National Primate Research Center is being tested nationally in a phase II clinical trial.

The Hope Clinic of the Emory Vaccine Center is conducting several clinical trials of HIV vaccine candidates through the HIV Vaccine Trials Network (HVTN) sponsored by the NIH. The HVTN 505 vaccine trial, which is currently enrolling at the Hope Clinic and 13 other cities around the country, is a test-of-concept efficacy trial for an NIH vaccine (DNA + Adnovirus – gag/pol/nef/EnvABC).

Mark Mulligan, MD, executive director of Emory’s Hope Clinic, emphasizes that on World AIDS Day there would be no better way to honor those who have already died or are already infected than to produce a vaccine that will protect their families and friends.

“The recent analysis of the RV144 Thai trial surprisingly taught us that an envelope glycoprotein vaccine regimen can protect (albeit modestly, thus far)! This is an amazing result that has re-ignited the field, and is capturing the attention of the community. We must do all we can to leverage this result for success,” Mulligan says. “Albert Sabin said that no scientist can rest while a vaccine that might help humanity sits on the shelf. To me, this underscores the importance of successfully executing the HVTN 505 trial.”

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Mapping mRNAs in the brain

If the brain acts like a computer, which of the brain’s physical features store the information? Flashes of electricity may keep memories and sensations alive for the moment, but what plays the role that hard drives and CDs do for computers?

A simple answer could be: genes turning on and off, and eventually, neurons growing and changing their shapes. But it gets more complicated pretty quickly. Genes can be regulated at several levels:

  • at the level of transcription — whether messenger RNA gets made from a stretch of DNA in the cell’s nucleus
  • at the level of translation — whether the messenger RNA is allowed to make a protein
  • at the level of RNA localization — where the mRNAs travel within the cell

Each neuron has only two copies of a given gene but will have many dendrites that can have more or less RNA in them. That means the last two modes of regulation offer neurons much more capacity for storing information.

Gary Bassell, a cell biologist at Emory, and his colleagues have been exploring how RNA regulation works in neurons. They have developed special tools for mapping RNA, and especially, microRNA — a form of RNA that regulates other RNAs.

In the dendrites of neurons, FMRP seems to control where RNAs end up

In the dendrites of neurons, FMRP seems to control where RNAs end up

Fragile X mental retardation protein (FMRP), linked to the most common inherited form of mental retardation, appears to orchestrate RNA traffic in neurons. Bassell and pharmacologist Yue Feng recently received a grant from the National Institute of Child Health and Development to study FMRP’s regulation of RNA in greater detail. The grant was one of several at Emory funded through the American Recovery and Reinvestment Act’s support for the NIH.

In the video interview above, Bassell explains his work on microRNAs in neurons. Below is a microscope image, provided by Bassell, showing the pattern of FMRP’s localization in neurons.

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Mammography can save lives by following ACS guidelines

The recent recommendation issued by the U.S. Preventive Services Task Force to revise screening mammography guidelines has generated considerable confusion and worry among women and their loved ones, says Carl D’Orsi, MD, FACR, director of the Emory Breast Imaging Center.

Carl D'Orsi, MD

Carl D'Orsi, MD

D’Orsi says he is counseling women who are concerned about mammograms and deciding what screening schedule to follow that they should use the long-established American Cancer Society guidelines: annual screening using mammography and clinical breast examination for all women beginning at age 40.

The recent recommendations by the task force advise against regular mammography screening for women between ages 40 and 49. It suggests that mammograms should be provided every other year (rather than yearly) for women between ages 50 and 74, and then breast cancer screening in women over 74 should be discontinued.

Mammography is not a perfect test, but it has unquestionably been shown to save lives, says D’Orsi, professor of radiology and of hematology and oncology in the Emory’s School of Medicine, and program director for oncologic imaging at Winship Cancer Institute of Emory. Since the onset of regular mammography screening in 1990, the mortality rate from breast cancer, which had been unchanged for the preceding 50 years, has decreased by 30 percent.

Winship Cancer Institute of Emory University

Winship Cancer Institute of Emory University

These new recommendations – which are based on a review that did not include experts in breast cancer detection and diagnosis – ignore valid scientific data and place a great many women at risk, continues D’Orsi.

Ignoring direct scientific evidence from large clinical trials, notes D’Orsi, the task force based its recommendations to reduce breast cancer screening on conflicting computer models and the unsupported and discredited idea that the parameters of mammography screening change abruptly at age 50.

The task force commissioned their own modeling study and made recommendations in reliance on this study before the study had ever been published, made public or held to critical peer review, and did not use both randomized, controlled trials and already-existing modeling studies, explains D’Orsi.

If Medicare and private insurers adopt these flawed recommendations as a rationale for refusing women coverage of these life-saving exams, it could have deadly effects for American women, says D’Orsi.

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Lupus expert hosts live chat on medications Nov. 23

Today, S. Sam Lim, MD, assistant professor of medicine, Emory School of Medicine, and chief of rheumatology at Grady Memorial Hospital, will host a live chat on the Lupus Foundation of America website to help educate people with lupus about the need to adhere to their medications as prescribed.

Sam Lim, MD

S. Sam Lim, MD

Lim heads two lupus clinics and is involved in several federal, state and privately funded projects, including the CDC-funded Georgia Lupus Registry. He also serves on the Medical Scientific Advisory Committee of the Lupus Foundation of America and its Georgia Chapter.

Lupus (systemic lupus erythematosus, or SLE) is a chronic inflammatory disease that can affect various parts of the body, especially the skin, joints, blood, and kidneys. The potentially life-threatening autoimmune disease affects an estimated 1.5 million Americans.

Medications cannot cure lupus, but they play an important role in managing the signs and symptoms of lupus and can often prevent or slow organ damage. Medication treatment for lupus often involves reaching a balance between preventing severe, possibly life-threatening organ damage, maintaining an acceptable quality of life and minimizing side effects.

Because most lupus symptoms are caused by inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) and antimalarial medications are usually enough to reduce symptoms, says Lim. Medications range in strength from mild to extremely strong, and often several drugs are used in combination to control the disease.

According to a new study published in the journal Arthritis Care and Research, depression is a leading reason why patients with systematic lupus erythematosus (SLE) may not take their medication.

Good communication between people with lupus and their doctors is essential to ensure effective management of the medicines that are prescribed, says Lim. An array of drug therapies is now available, and more than 30 clinical studies are underway of potential new treatments for lupus. Lim recently received a $1 million grant from the Georgia Department of Human Resources to continue his work gathering data for the five-year-old Georgia Lupus Registry, the largest, most comprehensive population-based lupus registry in the country.

Join Lim on his live chat today.

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Academic medicine at the table in health care debate

As the debate on health care reform legislation continues to move forward in Congress, Association of American Medical Colleges President and CEO Darrell G. Kirch, MD, urges leaders of the nation’s medical schools and teaching hospitals to be the standard bearers for innovation in health care delivery.

Darrell G. Kirch, MD

Darrell G. Kirch, MD

Kirch says that a year ago he was asked if he believed that academic medicine would have any voice in the health care reform debate. He answered that academic medical centers do have a strong voice in ensuring that the special contributions of our members are recognized in any proposed changes in the current legislation.

Kirch, who recently presented at Emory’s Woodruff Health Sciences Center Future Makers Lecture Series, says, “Just as we have a moral imperative to give people basic health insurance, we have an innovation imperative, as educators, researchers and clinicians, to finally make our health care system work well for everyone.”

In his presentation, Kirch pointed out that, by establishing new models of high-performance, high-value, integrated health systems, academic medical centers across the country are already undertaking clinical care innovations. Similar efforts are also occurring in research, where greater collaboration helps to address complex problems, and in medical education, where cutting-edge technologies are used to train physicians and promote lifelong learning, he noted.

AAMC-supported legislation, introduced by Rep. Allyson Schwartz (D-Pa.), to establish Healthcare Innovation Zones (HIZs), would promote the rapid expansion of successful pioneering efforts. These zones would empower centers to partner with local providers and hospitals to conduct large-scale experiments in health care delivery for specific patient populations.

Combining innovations in health care delivery, critically studying the effectiveness of these innovations and educating professionals to work in these new models play to the strengths of academic medicine, continues Kirch. The innovation imperative will allow academic medical centers to finally attain alignment of all three missions, while truly fulfilling their goal to improve the health of communities.

Listen to Kirch’s Emory presentation or read his recent address to the American Association of Medical Colleges.

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Sanjay Gupta shares stories on near-death experiences

Yesterday, Sanjay Gupta, MD, assistant professor of neurosurgery at Emory School of Medicine and associate chief of neurosurgery service at Grady Memorial Hospital, joined Emory and its community in a book-signing event to celebrate his newest book Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds.

Dr. Gupta signs his book

Dr. Gupta signs his book

It is hard to imagine having a busier schedule than the one Gupta has. On Wednesday he started his day as chief medical correspondent at CNN by discussing the new breast cancer recommendations issued by the U.S. Preventive Services Task Force. He, like other health reporters and doctors across the nation, had hundreds of questions pouring in about the controversial recommendations.

As the late afternoon approached, Gupta packed up for his visit to Emory where several hundred faculty, staff, students and neighbors awaited him for the book-signing event. After spending time presenting and answering questions, and then signing books for many people, Gupta again packed up and headed back to the CNN studio for a live show with Larry King.

Dr. Gupta presents

Dr. Gupta presents

During his presentation at Emory, Gupta talked about his experiences that led to his book. He notes one CNN story took him to Norway to meet the woman who had been skiing and slipped through a hole in the ice with her head caught under freezing water for an hour.

After an amazing rescue, Anna BÃ¥genholm was taken to the emergency room where the doctors did not give up. A doctor on the helicopter said there was a completely flat line. No signs of life whatsoever. But the team persevered and saved her life by warming her body very slowly. Even though BÃ¥genholm was alive, months of recovery lay ahead. Paralyzed for almost a year until her damaged nerves healed, she today is a radiologist at the hospital where she was saved. She has returned to skiing and other sports.

Read more about Gupta in Emory Magazine. Learn more about Gupta’s stories from on the road.

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$30M grant to Children’s Healthcare supports Emory partnership

Pediatric researchThe Joseph B. Whitehead Foundation has given $30 million to Children’s Healthcare of Atlanta to support pediatric research. The grant includes $25 million to help fund a new research building located on the Emory campus, and $5 million to support the Marcus Autism Center.

The grant will allow Children’s and Emory to expand their research partnership, attract top scientists, and advance research discoveries that will improve the health of children.

Some of the pediatric research conducted in a new building to be built on the Emory campus will focus on cardiology, cancer, vaccines, and new drug discovery. The grant has implications for the city of Atlanta as a growing research community, building on collaborations among Children’s Healthcare, Emory, Georgia Institute of Technology, Morehouse School of Medicine, and others.

Fred Sanfilippo, MD, PhD, executive vice president for health affairs at Emory, and Donna W. Hyland, president and CEO of Children’s Healthcare of Atlanta, explained that the new grant, which is the largest single gift ever to Children’s, will have an enormous impact on the two institutions, building on the strong partnership between Emory and Children’s and leading them to become a major pediatric research hub in the Southeast and the nation. Most importantly, it will help in finding cures for some of the most common and devastating childhood diseases.

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CNN reporter and Emory doctor tells his story

Sanjay Gupta, MD, assistant professor of neurosurgery at Emory School of Medicine and associate chief of neurosurgery service at Grady Memorial Hospital, navigates a busy schedule as a practicing doctor and the internationally known face of health reporting for CNN.

Sanjay Gupta, MD

Sanjay Gupta, MD

Next week, on Nov. 18, Gupta shares his story and discusses his new book at a book signing event at Emory. His book is titled “Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds.”

In a recent article, Emory Magazine profiles Gupta and remarkable journey:

  • Gupta can barely disguise the wonder he still feels when he ponders the complex circuitry of the human brain. And he can barely contain the wonder he feels when he is called upon to care for a patient, the way he saw doctors care for his grandfather.
  • “I love the intellectual challenge of it. I love the technical challenge of it. But at the end of the day—if someone comes in with a tumor or some kind of chronic pain issue that I can help in some way—that’s a remarkable feeling,” he says. “I operated all day Monday, and I walked home and told my wife all about my day, and it’s one of the most satisfying things I can do.”
  • Gupta reports from the field

    Gupta reports from the field

    Barely sixteen when he was accepted into an accelerated program to enter medical school, Gupta fast-tracked his career along parallel yet complementary paths. He wanted to be a great doctor and a great communicator. He wanted to heal patients, and he wanted to hear them.

  • Those interests synthesized when he joined CNN as its chief medical correspondent. With his straightforward yet reassuring manner, he has become the nation’s calm voice of medical reason—a doctor who possesses the rare ability to talk to the camera as if he were talking to a patient. He speaks, and somehow we believe he wouldn’t mind taking all the time in the world to help us separate facts from fears.

Read more about Gupta in Emory Magazine. Learn more about Gupta’s book signing event. For stories from Gupta on the road, visit here.

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