Women in Science group teaches Chicago high schoolers about heart health
By Erinn Connor
Loyola University Chicago is leading the way when it comes to getting more women in STEM (science, technology, engineering and math) fields, ranking seventh in female STEM graduates according to data from the Department of Education.
Some female biomedical graduates in the Health Sciences Division are making sure they pay it forward by inspiring and educating high school girls to consider a STEM career as well. The biomedical students participated in a “Go Red Go STEM” event at Northwestern University this fall.
The group was made of members of Loyola’s Women in Science group, founded by immunology graduate students Abby Cannon and Anya Nikolai. Part of the mission of the Women in Science group is to empower young girls to be interested and passionate about science and increase female representation within the field.
“It’s important for me to create environments of strong female leadership, especially in STEM,” says Cannon.
Earlier in the year, Cannon and Nikolai organized the first Science Sisters Day, which brought 30 middle school girls from the Maywood and Broadview communities to the Health Sciences Campus for a day of educational science experiments and learning about women science pioneers.
The Women in Science members know how important it is to get girls interested in science while they’re young.
“Often, science education in schools lack fun experiments because there isn’t enough funding or resources for every student to run the experiment,” says Nikolai. “I think this leads to students thinking science is boring and they fail to learn how incredible imagination and innovation are for science. Our outreach always includes engaging, hands-on experiments so the students are having enough fun so they don’t even notice they are learning.”
For the “Go Red Go STEM” event, they performed small experiments for about 100 Chicago-area junior and senior high school girls during a session they called “One Bite at a Time: Healthy Habits for a Healthy Heart.” Provost Margaret Callahan, CRNA, PhD, FNAP, FAAN, joined the graduate students for the event.
“I’m so proud of these women leaders in our biomedical graduate programs and their passion for science,” says Callahan. “They’re helping to shape the future of women in science.”
Demonstrating that healthy everyday habits lead to long-term heart health, the graduate students had the high schoolers create bacterial plates with swabs from their mouth and swabs from yogurt to show what makes up a healthy gut microbiome.
Christina Cunha, a graduate student in the Department of Microbiology and Immunology who volunteered for the event, knows firsthand how important it is to have role models in science growing up.
“I never knew a scientist when I was growing up, nor did I have any female leaders in science reach out to me until college,” says Cunha. “Your high school years can be so formative for your future career path, so I wanted young girls to see that female scientists are cool and fun, and hopefully inspire them to see what a joy it is to work in science every day.”
Loyola Study Suggests a Way to Stop HIV in its Tracks
By Jim Ritter
MAYWOOD, IL – When HIV-1 infects an immune cell, the virus travels to the nucleus so quickly there's not enough time to set off the cell's alarm system.
Now, a Loyola University Chicago study has discovered the protein that helps the virus travel so fast. Researchers found that without this protein, the virus became stranded in the cytoplasm, where it was detected by the viral defense system. (The cytoplasm is the portion of the cell outside the nucleus.)
"By preventing its normal movement, we essentially turned HIV-1 into a sitting duck for cellular sensors,” said Edward M. Campbell, PhD, corresponding author of the study, published in the Proceedings of the National Academy of Sciences. Campbell is an associate professor in the Department of Microbiology and Immunology of Loyola University Chicago Stritch School of Medicine.
HIV-1 infects and kills immune system cells, including T cells and macrophages that were used in the study. This cripples the immune system, making the patient vulnerable to common bacteria, viruses and other pathogens that are usually harmless in people with healthy immune systems.
After HIV-1 enters a cell, it has to work its way through the cytoplasm to the nucleus. Once inside the nucleus, HIV-1 takes control of the cell and makes additional HIV-1 copies. But getting through the cytoplasm is not easy. Cytoplasm consists of fluid that is thick with proteins and structures such as mitochondria. “Something the size of a virus cannot just diffuse through the cytoplasm," Campbell said. "It would be like trying to float to the bathroom in a very crowded bar. You need to have a plan.”
HIV-1 is able to get to the nucleus quickly via tubular tracks called microtubules. The virus attaches itself to a molecular motor called dynein, which moves down the microtubule like a train car on tracks.
Campbell and colleagues discovered the "ticket" HIV-1 needs to get on the train -- a protein called bicaudal D2. HIV-1 binds to bicaudal D2, which then recruits the dynein molecular motor to transport the HIV-1 towards the nucleus.
The finding raises the possibility of developing a drug that would prevent HIV-1 from binding to bicaudal D2, thus stranding the virus in the cytoplasm. This would not only prevent infection, but also give the cell time to turn on antiviral genes that would protect it and neighboring cells from infection.
The study is titled "Bicaudal D2 facilitates the cytoplasmic trafficking and nuclear import of HIV-1 genomes during infection."
In addition to Campbell, other co-authors are Adarsh Dharan, PhD, (first author), Omar Abdel-Rahim, Sevnur Komurlu Keceli, PhD, and Sabrina Imam of Loyola and Silvana Opp, PhD, and Felipe Diaz-Griffero, PhD, of Albert Einstein College of Medicine.
Francis Alonzo, PhD, awarded the Junior Scientist of the Year award
By Erinn Connor
It is a bacterium that is commonly found on our skin and in our nose. Most people can live with Staphylococcus aureus and be perfectly healthy. But for others, it can turn into a potentially deadly infection.
So how can Staphylococcus aureus transform itself from harmless bacterium into one that can completely avoid our immune system and resist usual antibiotic treatment?
That is what Francis Alonzo, PhD, assistant professor in the Department of Microbiology and Immunology, is trying to figure out in his lab. For his ongoing work, he was awarded the Junior Scientist of the Year award at this year’s St. Albert’s Day research celebration.
Dr. Alonzo is examining what gives Staphylococcus aureus the ability to maneuver past the body’s natural defenses. Figuring out these mechanisms could help lead to non-antibiotic based and more effective treatments for staph and methicillin-resistant Staphylococcus aureus (MRSA) infections. MRSA infections have become more common and more difficult to treat over the past few decades.
“My lab is looking to challenge a lot of old ideas about staph,” said Dr. Alonzo. “We are trying to identify the factors that make staph so powerful and understand how it is able to make the immune system unable to figure out it’s there.”
Dr. Alonzo came to Loyola in 2014 after completing his PhD at University of Illinois at Chicago (UIC) and postdoctoral work at New York University (NYU) School of Medicine. While at UIC he studied the pathogenesis of listeria, and NYU was where he started investigating Staphylococcus aureus under the mentorship of Victor Torres, PhD.
“While I was at NYU it allowed me to see how a young scientist works and sets up his lab,” said Dr. Alonzo. “It helped me figure out what I was interested in and what I wanted my career as a researcher to look like.”
Since he started his research, Dr. Alonzo has found that toxins released by Staphylococcus aureus are able to disarm the immune system in different ways. Some even poke holes directly into the cells that ward off bacteria, causing them to explode and become unable to fight off infection.
His research has also identified the cellular receptors on host cell surfaces that some of these toxins use to find their targets in the immune system.
Staphylococcus aureus can also mutate easily, another reason why it’s so resistant to antibiotic treatment.
“There are so many things about this bacterium to explore, it is so pervasive,” said Dr. Alonzo. “It colonizes us all the time, and all it takes is it being at the wrong place at the wrong time to become a really serious illness for someone.”
Dr. Alonzo is hoping his research will eventually lead to new therapeutic treatments for staph and MRSA infections that work differently than antibiotics and are more effective. He is looking at ways to use the power of the immune system to fight Staphylococcus aureus, much like how immunotherapy treatments are using a person’s immune system to fight certain cancers.
Dr. Alonzo’s work is funded by the National Institutes of Health. He has published more than 30 peer-reviewed publications about bacterial pathogenesis. In 2016, he was named Faculty Member of the Year by the graduate student body in the Stritch School of Medicine.
“The science is what I love doing. It is humbling to be recognized for that and it is exciting to feel that I am contributing to all the great science happening here at Loyola,” said Dr. Alonzo.
Mashkoor Choudhry, MPhil, PhD, receives Senior Scientist of the Year award
By Erinn Connor
Alcohol is well-known for being the culprit behind many chronic illnesses: liver disease, cancer, pancreatitis, gastrointestinal issues, and more. Alcohol is also commonly the cause of traumatic injury—from car crashes to physical violence. When you’re the victim of trauma or burns, having alcohol in your system can have a more serious effect than you think.
Mashkoor Choudhry, MPhil, PhD, professor in the Department of Surgery and director of the Alcohol Research Program in Loyola University Chicago’s Stritch School of Medicine, has been studying the role of alcohol in burn complications for more than 20 years. For his work, he was given the Senior Scientist of the Year award, presented at the annual St. Albert’s Day research celebration.
In his lab, Dr. Choudhry and his team are studying the hypothesis that being exposed to alcohol increases the suppression of the immune system of the intestines and breaks down their natural barriers, eventually causing sepsis (blood infection) and multi-organ failure. His research could be key in coming up with new treatments for people with these specific injuries.
“We seem to see an increase in bad bacteria in the gut microbiome as a result of a burn or alcohol-related trauma,” said Dr. Choudhry. “And during a trauma, it’s much easier for the gut bacteria to escape the lining of the intestines and get into the bloodstream, which leads to sepsis.”
Dr. Choudhry’s interest in this research began when he noticed that patients who were under the influence of alcohol at the time of injury were more susceptible to infection and had poorer outcomes compared to those who were sober at the time of a trauma.
Using laboratory models, he has found that the combination of alcohol and a burn trauma specifically, increases the suppression of an immune function in the gut, which keeps the lining in our intestines intact.
When that barrier breaks, bacteria that live in the gut can leak out and get into the blood stream. This can result in severe infections, sometimes sepsis. Sepsis is when the body releases a flood of chemicals to fight an infection and cause widespread inflammation, leading to blood clots, poor circulation, and leaky blood vessels. Sepsis can quickly turn into organ failure and can be deadly.
Residents and postdoctoral fellows working in the Alcohol Research Program are also part of a National Institute on Alcohol Abuse and Alcoholism T32 training grant, led by Dr. Choudhry. This grant involves training in the neuroimmunoendocrine effects of alcohol, or how it effects the communication between the nervous system, the immune system, and the endocrine (hormone regulating) system.
“Alcohol is a major problem, and there are a lot of diseases that come from abusing it,” said Dr. Choudhry. “This grant allows trainees to study mechanisms behind how alcohol is influencing those diseases.”
Dr. Choudhry has published more than 180 articles including review articles and book chapters. Dr. Choudhry has presented his research at various national and international meetings and is a member of NIH research review panels as well as on the editorial board of a number of scientific journals.
“To have come to Loyola as a young trainee and then be honored like this by my colleagues, I’m very humbled and honored,” said Dr. Choudhry.
New Loyola study on IKs channels in the heart published in PNAS
The slow potassium channel in the heart, IKs, responds to sympathetic nervous system (the body’s ‘fight or flight’ response) to adjust the time the ventricles have to fill with blood in response to changes in heart rate. These channels open to allow potassium ions to pass out of cells, relaxing the heart muscle to its resting state at the end of each beat.
In a new study in Proceedings of the National Academy of Sciences (PNAS), Steve Goldstein, MD, PhD, dean of the Stritch School of Medicine, and professor in the departments of pediatrics and cell and molecular physiology led a team comprised of Drs. Dazhi Xiong and Hui Dai, also in the department of cell and molecular physiology, and former colleagues at Brandeis University, showing that the energy it takes to open IKs channels depends on the number of times they are modified by small ubiquitin-like modifier (SUMO) proteins.
The exquisite and adjustable sensitivity of IKs channels is what makes them so important to the length and rhythm of cardiac action potentials. During a cardiac action potential there is a brief positive change in the voltage across a heart cell’s membrane, which leads the heart to contract and pump blood and also opens IKs channel after a delay to end the heartbeat. The work shows that SUMO is central to how IKs channels operate.
IKs channels can be modified by SUMO up to four times and each SUMO shifts the increase in voltage required to open the channels. Whereas ubiquitin modification controls protein half-life, SUMO controls protein function.
The funding for this research was provided by the National Heart, Lung and Blood Institute. The full paper can found on the PNAS website.
New study shows more breast cancers were diagnosed at early stage after Affordable Care Act took effect
A Loyola University Chicago study published this month has found an increase in the percentage of breast cancer patients who were diagnosed in early Stage 1, after the Affordable Care Act took effect.
The increases in Stage 1 diagnoses were higher among African American and Latina breast cancer patients, compared to white patients.
The study by Abigail Silva, PhD, MPH, and colleagues is published in the journal Cancer Epidemiology. Silva is an assistant professor in the Department of Public Health Sciences of Loyola University Chicago Stritch School of Medicine.
The Affordable Care Act eliminated copayments and other out-of-pocket costs for 45 preventive care services, including mammograms. This made mammograms more affordable, potentially leading to earlier diagnoses.
The earlier cancer is detected, the more effectively it can be treated. Diagnosing breast cancer when it is still in Stage 1 could improve the prognosis for thousands of women and reduce the need for invasive treatments such as chemotherapy for a substantial number of women, Silva and colleagues wrote.
Breast cancer is the most common cancer among women in the United States. The American Cancer Society estimates nearly 253,000 women will be diagnosed this year.
Compared to white women, Latinas are less likely to receive mammograms overall and African Americans are less likely to receive mammograms at recommended intervals. Out-of-pocket payments have been identified as a potential barrier to getting screening mammograms.
The retrospective study included 470,465 breast cancer patients between the ages of 50 and 74 who were covered by private insurance or Medicare and were newly diagnosed with Stage 1-4 cancer. Researchers examined two time periods: 2007-2009 (before the Affordable Care Act took effect) and 2011-2013 (after the act took effect). Researchers obtained data from the National Cancer Database, which includes approximately 70 percent of all newly diagnosed cancers in the United States from about 1,500 hospitals.
Overall, the percentage of breast cancers that were diagnosed at Stage 1 increased 3.6 percentage points, from 54.4 percent to 58.0 percent. There was a corresponding decrease in Stage 2 and Stage 3 diagnoses, while the proportion of Stage 4 cancers did not change. The shift toward Stage 1 breast cancer diagnoses increased by 3.2 percentage points among whites, 4.0 percentage points among African Americans and 4.1 percentage points among Latinas.
Compared to African Americans and Latinas, a higher percentage of white breast cancer patients are diagnosed at Stage 1. This disparity decreased following the Affordable Care Act, as minorities saw modestly higher improvements in Stage 1 diagnoses.
Researchers concluded that further studies to evaluate the impact of the Affordable Care Act on cancer outcomes and disparities "should be supported as they will help inform future policy recommendations."
The study was supported by grants from the National Institutes of Health and the Avon Foundation.
The study is titled "Potential impact of the Affordable Care Act's preventive services provision on breast cancer stage: A preliminary assessment."
In addition to Silva, other co-authors are Talar Markossian, PhD, MPH, of Loyola's Department of Public Health Sciences; Yamile Molina, PhD, of the University of Illinois School of Public Health, and Nazia Saiyed, MPH, of the Sinai Urban Health Institute.
Kathy Albain, MD, receives Huizenga Family Endowed Chair in Oncology Research
Grateful for the life-saving care they received at Loyola Medicine, Peter and Heidi Huizenga have made a generous gift to further oncology research and to honor Kathy Albain, MD, FACP, FASCO.
The gift will fund the Huizenga Family Endowed Chair in Oncology Research at Loyola University Chicago Stritch School of Medicine. Dr. Albain is the first professor to hold the chair.
“The appointment to a named and endowed chair is among the highest academic recognitions for a University faculty member. Dr. Albain is an accomplished clinician scientist who is dedicated to improving human health, and we are thrilled to be presenting her with this most deserving honor,” said Margaret Faut Callahan, CRNA, PhD, FNAP, FAAN, provost, Loyola University Chicago Health Sciences Division.
An investiture ceremony for Dr. Albain was held May 31 at Loyola University Chicago’s Center for Translational Research and Education in Maywood.
The gift will enable Dr. Albain to devote more time to cancer research, said Larry M. Goldberg, president & CEO of Loyola University Health System. “This gift also is in recognition of the outstanding contributions Dr. Albain has made as a physician, researcher, teacher and mentor.”
Mrs. Huizenga credits Dr. Albain for successfully treating her for cancer and twice saving her life. First, in 2003, Dr. Albain diagnosed and treated Mrs. Huizenga for breast cancer. In a follow-up exam two years later, Dr. Albain discovered tumors in Mrs. Huizenga’s neck, which proved to be an indolent form of non-Hodgkin’s lymphoma. In 2008, an inoperable tumor was found on the optic nerve of Mrs. Huizenga’s eye. The tumor could not be biopsied, but Dr. Albain’s earlier diagnosis helped identify the growth as non-Hodgkin’s lymphoma. The cancer was treated successfully by Patrick Stiff, MD, director of Loyola’s Cardinal Bernardin Cancer Center.
Dr. Albain has become Mrs. Huizenga’s close friend as well as her physician.
“Kathy treats the body and nurtures the human spirit,” said Mrs. Huizenga, pictured at left with her husband, Peter, and Dr. Albain. “She takes time with each patient, listens to their concerns and makes the correct diagnosis. Dr. Albain carries this dedication, thoroughness and work ethic into her research. Her strong Christian commitment also is very evident in her professional life.”
Peter Huizenga added, “Heidi and I are very pleased to support Dr. Albain’s contributions in research and medical services. The endowed chair provides her with the recognition and resources she so richly deserves. She has been a great help to me as well.”
Dr. Albain said the therapies used to treat Mrs. Huizenga were made possible by the type of research the Huizenga endowed chair will fund.
“I’m extremely honored to be appointed to the first Huizenga endowed chair,” Dr. Albain said. “I greatly appreciate the Huizenga family’s support, both for my research and for that of faculty members who will hold this chair in the future.”
Dr. Albain is a professor in the division of hematology/oncology in the department of medicine of Loyola University Chicago Stritch School of Medicine. She is director of Loyola’s breast clinical research program, co-director of the multidisciplinary breast oncology center and director of the thoracic oncology program.
Dr. Albain is a leader in national clinical trials of new treatments for breast and lung cancer. She also studies cancer survivorship. She chaired the Committee on Special Populations for SWOG, a National Cancer Institute cooperative research group, since the committee’s inception. Dr. Albain is a member of SWOG’s working groups for breast and lung cancer, devoting her career to research in both diseases, and also sits on SWOG’s Cancer Prevention and Control Executive Committee. She is a member of the international Early Breast Cancer Trialists’ Collaborative Group and its Steering Committee. She served on the National Cancer Institute Concept Evaluation Panel for lung cancer. She was a charter member of the NIH Committee on Research on Women’s Health and completed a four-year term on the Oncologic Drugs Advisory Committee of the FDA, followed by service as a consultant to the FDA Center for Drug Evaluation and Research.
Dr. Albain is an author of nearly 200 publications in peer-reviewed journals and textbooks. She is a Fellow of the American College of Physicians (FACP) and a Fellow of the American Society of Clinical Oncology (FASCO).
Dr. Albain was co-valedictorian of her high school and graduated summa cum laude from Wheaton College. She earned her medical degree from University of Michigan Medical School. Dr. Albain completed a residency in internal medicine at the University of Illinois at Chicago Medical Center and a fellowship in hematology/oncology at University of Chicago. She was granted tenure at Loyola in 2005 and appointed Dean’s Scholar in 2011.
Dr. Albain is a member of Grace Evangelical Lutheran Church in River Forest, Illinois and enjoys travel, reading and fitness training.
Mrs. Huizenga is a graduate of DePauw University. She has served on the board of Loyola’s president’s advisory council and has volunteered with many Christian, civic and educational organizations, including Prison Fellowship, which was founded by Chuck Colson. The Huizengas live in Oak Brook, Illinois and have four children and 10 grandchildren.
Mr. Huizenga graduated from University of Illinois College of Law in 1963 and practiced law for eight years. During that time he became one of the founders of Waste Management, where he spent a career as vice president, secretary and member of the board of directors. In 1990, Mr. Huizenga retired from Waste Management and established Huizenga Capital Management, an Oak Brook-based financial services business. He also has chaired and served on many civic, educational and Christian organizations.
Loyola researchers develop enhanced test for urinary tract infections
By Jim Ritter
One of the primary ways physicians diagnose urinary tract infections is with a test that detects bacteria in urine.
A new enhanced test, developed at Loyola University Chicago, detects significantly more bacteria than the standard test, according to a study presented at a meeting of the American Society for Microbiology in New Orleans.
The study, by a multidisciplinary team of basic scientists, clinical microbiologists and obstetrician gynecologists at Loyola University Chicago and Loyola Medicine, was presented by Travis Price, a PhD student in the lab of Alan Wolfe, PhD. Wolfe is a professor in the department of microbiology and immunology at Loyola University Chicago Stritch School of Medicine.
Urinary tract infections (UTIs) are among the most common reasons for visits to doctors’ offices and emergency departments. A UTI is an infection in the urinary system, usually involving the bladder and urethra. Women are at higher risk. Symptoms include a strong urge to urinate, a burning sensation when urinating, pelvic pain and urine that appears cloudy or discolored. Antibiotics often are the first-line treatment.
The current test for urinary tract infections is called a standard culture. In a lab, a sample of urine is added to a substance (growth medium) that promotes the growth of bacteria that may be in the urine. Two growth media are used and samples are incubated for 24 hours in room air.
The new test, called enhanced quantitative urine culture (EQUC), uses a higher volume of urine. In addition to room air, samples are incubated in air containing a high concentration of carbon dioxide and in an anaerobic (absence of oxygen) environment. Samples are incubated for 48 hours in three growth media.
The study enrolled 150 urogynecologic patients, half of whom reported symptoms of UTIs. Urine samples from the patients were subjected to both the standard culture and the EQUC tests. In 69 of the 75 women reporting UTI symptoms, the EQUC test detected one or more bacteria species, for a total of 110 species. Using the standard culture, only 50 percent of these bacteria species were identified. The standard culture identified most of the E. coli bacteria, but only 24 percent of the non-E. coli bacteria.
Loyola researchers will soon launch a clinical trial to investigate whether using the EQUC method could improve the clinical care of women with UTIs. The trial will enroll 225 women who have UTI symptoms. Seventy five women will receive the standard culture plus EQUC and 150 women will receive the standard culture alone.
The clinical trial will be headed by Elizabeth Mueller, MD, Loyola Medicine division director of female pelvic medicine and reconstructive surgery and a co-author of the EQUC study.
“EQUC is a tool,” Dr. Mueller said. “Now we have to figure out the best way to use it.”
The EQUC study is titled, “Detecting Clinically Relevant Microorganisms: We can do better.” Other co-authors are Tanaka Dune, MD, Evann Hilt, MS, Cynthia Brincat, MD, PhD, Linda Brubaker, MD, and the late Paul Schreckenberger, PhD.
Science Sisters Day strives to cultivate young girls’ interest in science
Balloons took the place of lungs, a tub of water and ping pong balls represented blood, and magnets acted as antibodies. These were just a few of the experiments that took place at the first Science Sisters Day, hosted by biomedical graduate students from Loyola University Chicago.
The full-day event brought 30 middle-school girls from local schools—Stevenson Middle School in Maywood and Irving Middle School in Melrose Park—to the Center for Translational Research and Education on Loyola’s Health Sciences Campus for a day of educational science experiments and learning about women science pioneers.
“Interest in science drops off at this age, so we wanted to target these girls and hopefully help keep up their interest in science as they get closer to high school and college,” said Abby Cannon, one of the Science Sisters Day organizers.
Cannon and Anya Nikolai, both immunology graduate students, who also founded the Women in Science group at Loyola, wanted this event to address the underrepresentation of girls pursuing education and careers in the sciences.
Research from the U.S. Department of Education shows that girls lose interest in math and science sometime around middle school. A report from the National Research Center for College and University Admissions found that only 20 percent of women intend to major in a STEM (science, technology, engineering, math) field.
Science Sisters Day was a way for these girls to get some hands-on experience with science and continue to nurture their interest in the field.
“This event gave young girls hands on experience with the types of biomedical research we do at the Health Sciences Division and taught them about successful female scientists, with the hope that these students will realize that they, too can aspire to careers in science and medicine,” said Leanne Cribbs, PhD, Associate Dean for Graduate Education at the Stritch School of Medicine and an associate professor in the department of Cell and Molecular Physiology.
Susan Baker, PhD, professor in the department of microbiology and immunology, lead an activity that taught the girls how viruses and bacteria are different than the body’s normal cells. They then made their own bacteria and viruses out of model clay inside of a petri dish.
“While we were working on the models, I asked the girls about what kind of science experiments they liked to do and what type of career they might want to pursue,” said Dr. Baker. “Everyone had different answers and it was fun to hear about the different careers, including CSI investigators, that they might want to do.”
One experiment had the students learn how antibodies work by mixing iron filings in with salt, and then using a magnet to attract the iron. The iron represented viruses and the magnet was the body’s antibodies, showing how the memory cells of an antibody can tell the difference between the body’s healthy cells (salt) and viruses.
Another had students extract DNA from strawberries, showing how cells can be broken open and DNA can be separated out and studied. The importance of sunscreen was shown in using different SPF strengths on UV beads that changed colors when exposed to the sun.
The event was funded by Plan 2020, Loyola’s five-year strategic plan that aims to use its influence to help better society and its surroundings, along with support from BioLegend, a lab supply company.
“I’m so proud of our biomedical graduate students who are sharing their enthusiasm for science with these middle school girls from our surrounding community,” said Margaret Callahan, CRNA, PhD, FNAP, FAAN, provost of Loyola University Chicago’s Health Sciences Division. “Their commitment and passion is what makes these biomedical programs a shining example of outreach on our Health Sciences campus.”
Cannon and Nikolai are also planning more events with their growing Women in Science organization, including seminars and lectures hosted by prominent female scientists in many different fields.
“We really want to see what we can do to keep our female scientists interested and invested in their career and moving up the ladder into leadership positions,” said Nikolai.
Loyola study reveals a crucial feature common to Alzheimer's, Parkinson's, and Huntington's Diseases
Finding suggests that treatment for one disease could work for the other two
By Jim Ritter
A Loyola University Chicago study has found that abnormal proteins found in Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease all share a similar ability to cause damage when they invade brain cells.
The finding potentially could explain the mechanism by which Alzheimer’s, Parkinson’s, Huntington’s, and other neurodegenerative diseases spread within the brain and disrupt normal brain functions.
The finding also suggests that an effective treatment for one neurodegenerative disease might work for other neurodegenerative diseases as well.
The study by senior author Edward Campbell, PhD, first author William Flavin, PhD, and colleagues is published in the journal Acta Neuropathologica.
“A possible therapy would involve boosting a brain cell’s ability to degrade a clump of proteins and damaged vesicles,” Campbell said. “If we could do this in one disease, it’s a good bet the therapy would be effective in the other two diseases.”
Neurodegenerative diseases are caused by the death of neurons and other cells in the brain, with different diseases affecting different regions of the brain. Alzheimer’s destroys memory, while Parkinson’s and Huntington’s affect movement. All three diseases are progressive, debilitating and incurable.
Previous research has suggested that in all three diseases, proteins that are folded abnormally form clumps inside brain cells. These clumps spread from cell to cell, eventually leading to cell deaths. Different proteins are implicated in each disease: tau in Alzheimer’s, alpha-synuclein in Parkinson’s and huntingtin in Huntington’s disease.
The Loyola study focused on how these misfolded protein clumps invade a healthy brain cell. The authors observed that once proteins get inside the cell, they enter vesicles (small compartments that are encased in membranes). The proteins damage or rupture the vesicle membranes, allowing the proteins to then invade the cytoplasm and cause additional dysfunction. (The cytoplasm is the part of the cell that’s outside the nucleus).
The Loyola study also showed how a cell responds when protein clumps invade vesicles: The cell gathers the ruptured vesicles and protein clumps together so the vesicles and proteins can be destroyed. However, the proteins are resistant to degradation. “The cell’s attempt to degrade the proteins is somewhat like a stomach trying to digest a clump of nails,” Campbell said.
Flavin said the finding that protein clumps associated with the three diseases cause the same type of vesicle damage was unexpected. Loyola researchers initially focused on alpha-synuclein proteins associated with Parkinson’s disease. So they asked collaborator Ronald Melki, PhD, to send them samples of different types of alpha-synuclein. (To do the experiment in a blinded, unbiased manner, the Loyola researchers did not know which types of alpha-synuclein were which.) Melki, a protein researcher at the Paris-Saclay Institute of Neuroscience, is known for his ability to generate distinct types of alpha-synuclein. Without telling the Loyola researchers, Melki sent other types of proteins as well. This led to the surprise finding that tau and huntingtin proteins also can damage vesicles.
Campbell stressed the study’s findings need to be followed up and confirmed in future studies.
The Loyola study is titled, "Endocytic vesicle rupture is a conserved mechanism of cellular invasion by amyloid proteins.” It was supported by grants from the Michael J. Fox Foundation, Parkinson’s Disease Foundation, Illinois chapter of the ARCS Foundation, Arthur J. Schmitt Foundation and other sources.
Campbell is an associate professor in the Department of Microbiology and Immunology at Loyola University Chicago Stritch School of Medicine. Flavin is a Loyola University Chicago MD/PhD student. Other co-authors are Zachary Green, Stratos Skarpathiotis, and Michael Chaney of Loyola University Chicago; Luc Bousset and Ronald Melki of the Paris-Saclay Institute of Neuroscience; and Yaping Chu and Jeffrey Kordower of Rush University Medical Center.
American Heart Association presents Loyola with a symbolic check for $668,000
During an April 4 ceremony, the American Heart Association presented Loyola University Chicago with a symbolic check for $668,000, the amount the AHA is funding for active cardiovascular research.
Since 1984, the AHA has provided more than $11 million to support more than 100 studies at Loyola. The current funding includes two-four year grants and a two-year grant.
“This support is critically important, not only for researchers, but for the patients whose lives will be saved,” said Margaret Faut Callahan, CRNA, PhD, FNAP, FAAN, provost, Health Sciences Division.
The symbolic check was presented by Brian Shields, executive director, Chicago, American Heart Association/American Stroke Association.
These are the LUC researchers and projects that are currently being funded by the AHA:
- Jonathan Kirk, PhD, cardiac dyssynchrony, four-year grant for $308,000
- Virginie Mansuy Aubert, PhD, receptor trafficking regulation in hypothalamic neurons, four-year grant for $308,000
- Daniel Shepherd, M3, effect of anti-Nogo-A immunotherapy on neurogenesis after stroke, two-year grant for $52,000
We are tremendously thankful to the American Heart Association for its longstanding support, which has done so much to elevate our cardiovascular research.
Loyola study provides new evidence that exercise is not key to weight control
By Jim Ritter
An international study led by Loyola University Chicago is providing compelling new evidence that exercise may not be the key to controlling weight.
Researchers who studied young adults from the United States and four other countries found that neither physical activity nor sedentary time were associated with weight gain.
“Our study results indicate that physical activity may not protect you from gaining weight,” said lead author Lara R. Dugas, PhD, MPH. Dugas is an assistant professor in the Department of Public Health Sciences of Loyola University Chicago Stritch School of Medicine.
The study is published in the journal PeerJ.
Physical activity has many proven health benefits, ranging from reducing the risk of heart disease, diabetes, and cancer to improving mental health and mood. People who are physically active tend to be healthier and live longer. But while physical activity burns calories, it also increases appetite, and people may compensate by eating more or by being less active the rest of the day.
Some experts have suggested that a decline in physical activity, especially in the workplace, has been a key contributor to the obesity epidemic. But research such as the new Loyola study, in which physical activity is objectively measured and participants are followed over time, has not found a meaningful relationship between weight gain and physical activity.
The Loyola study is one of the primary outcomes of the Modeling the Epidemiologic Transition Study (METS). In METS, researchers followed adults aged 25 to 40 living in five countries: the United States, Ghana, South Africa, Jamaica and Seychelles (an island country east of Africa). The U.S. adults live in Maywood, Illinois, a suburb of Chicago. Participants are predominantly of African descent and represent a broad range of social and economic development. Principal investigator of METS and senior author of the Loyola study is Amy Luke, PhD, professor and vice chair of Loyola’s Department of Public Health Sciences.
Previous research has found that when people are asked about their physical activity, they tend to overstate the amount they do. To provide a more objective measure, participants wore tracking devices called accelerometers on their waists for a week. The devices measured the wearers’ energy expenditure and step count. Researchers also measured participants’ weight, height and body fat. After an initial exam, participants were asked to return one year and two years later.
At the initial visit, Ghana participants had the lowest average weights (139 pounds for both men and women), and Americans the highest weights (202 pounds for women, 206 pounds for men). Ghanaians also were fitter than Americans. Seventy-six of Ghanaian men and 44 percent of Ghanaian women met the U.S. Surgeon General physical activity guidelines, while only 44 percent of American men and 20 percent of American women met the guidelines. The guidelines recommend doing at least two and a half hours of moderate-intensity aerobic exercise (such as brisk walking) per week.
Surprisingly, total weight gain in every country was greater among participants who met the physical activity guidelines. For example, American men who met the guidelines gained a half pound per year, while American men who did not meet the guideline lost 0.6 pounds.
Researchers did not find any significant relationships between sedentary time at the initial visit and subsequent weight gain or weight loss. The only factors that were significantly associated with weight gain were weight at the initial visit, age and gender.
The study was funded by the National Institutes of Health. It’s titled “Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations.”
In addition to Dugas, other co-authors of the study include Liping Tong, PhD, Ramon A. Durazo-Arvizu, PhD, David A. Shoham, PhD, Guichan Cao, MS, Richard S. Cooper, MD, and Amy Luke, PhD, all from Loyola and researchers from the University of Wisconsin-Madison, Kwame Nkrumah University, Lausanne University Hospital, Seychelles Ministry of Health, University of West Indies, University of Cape Town, University of Cambridge and Norwegian School of Sport Sciences.
CTRE awarded LEED® Gold certification
By Jim Ritter
Loyola University Chicago’s Center for Translational Research and Education (CTRE) has received the prestigious LEED® gold certification from the U.S. Green Building Council.
LEED (Leadership in Energy and Environmental Design) is the foremost program for the design, construction and operation of green buildings. LEED-certified buildings use less water and energy and reduce greenhouse gas emissions.
Loyola’s innovative medical research and education center opened in April, 2016 on the university’s Health Sciences Division campus in Maywood, Ill. The five-story, $137 million building houses 500 students, faculty and staff. The CTRE is a collaborative initiative of Loyola University Chicago, Loyola University Health System, and Trinity Health.
“While the CTRE is the biggest and most complex building the university has ever built, it also has a relatively small environmental footprint,” said Peter Schlecht, Loyola University Chicago’s senior project manager. “The CTRE uses 30 to 40 percent less energy than a standard research building that meets energy codes, and is more energy efficient than at least 90 percent of comparable research facilities.”
The CTRE's high-performance exterior walls provide maximum insulation. Occupants are able to open the windows, thus allowing for natural cooling in the spring and fall. The inside of the building is awash in daylight, reducing the need for artificial lighting. Exterior shading devices provide shade in the summer, while allowing the sun to shine through in the winter.
“Loyola’s LEED certification demonstrates tremendous green building leadership,” said Mahesh Ramanujam, president and CEO of the Green Building Council. “Buildings that achieve LEED certification are lowering carbon emissions, creating a healthier environment and reducing operating costs while prioritizing sustainable practices.”
Annual St. Albert’s Day celebrates student and faculty research
By Megan McKinley
On November 3rd, the Health Sciences Division hosted the 37th annual St. Albert's Day, which celebrates the research from Loyola University Chicago faculty, staff, and students. Throughout the day, students and faculty attended symposiums on topics ranging from the possible benefits of peony extract on inner eye injuries to the effect of alcohol on a protein that controls metabolism and our immune system. The day ended with the poster review of students’ prospective research projects lining the hallways of the Cuneo Center and Stritch School of Medicine.
This year's Junior Scientist Award recipient was Lara Dugas, PhD, MPH, Department of Public Health Sciences. Before joining Loyola in 2007, Dugas worked primarily in South Africa examining factors affecting obesity, body energy expenditure, and metabolism. Recently work done by Dugas included tracking an athlete's physiological changes throughout 140 days of marathons from the west to the east coast. Dugas is a founder of the Loyola University Chicago Sports Medicine Epidemiology research group focusing on the risks for adolescent athlete injury.
William Small, Jr., MD, was awarded the Senior Scientist Award for his excellence in research and continued efforts in the field of oncology, specifically in gynecological cancer and innovative radiotherapy techniques.
After presenting his research discoveries and journey, Small Jr., choked up while crediting his parents as the inspiration to become a doctor and work hard at his research.
"My hobby is doing this [research]," said Small Jr. "I'm getting an award for doing what I really, really like."
Loyola to host major international symposium to mark 100th anniversary of discovery of heparin
By Stasia Thompson
This year marks the 100th anniversary of the discovery of one of medicine’s most essential drugs – the blood thinner heparin.
To mark the occasion, Loyola University Chicago is hosting the Heparin Centennial Symposium on Friday, October 28. Many of the world’s leading heparin experts will report the latest advances in the research and clinical applications involving heparin and related drugs.
The symposium will be held at the new Center for Translational Research and Education on Loyola’s Health Sciences Division campus in Maywood, Illinois.
Heparin is an anticoagulant and one of the world’s most commonly used drugs. It’s used to prevent or treat blood clots in veins, arteries and lungs and before surgery to reduce the risk of clots. Heparin is injected or administered intravenously. Heparin also is used in devices that come in contact with blood, such as kidney dialysis machines and test tubes. The World Health Organization has named heparin to its List of Essential Medications.
Heparin was discovered in 1916 by Jay Mclean, a medical student at Johns Hopkins University. Much of what is known today about bleeding and clotting disorders is based on observations and scientific research on heparin and related drugs.
“The surgical, interventional, and medical uses of heparin have revolutionized medicine,” said Jawed Fareed, PhD, a professor in the Department of Molecular Pharmacology and Therapeutics and Department of Pathology and director of the Hemostasis and Thrombosis Research Program at Loyola University Chicago Stritch School of Medicine.
Dr. Fareed said the symposium will cover developments in heparin drug substances, the development of heparin-related drugs, and the chemistry and biology of these drugs. The symposium is open to basic scientists, clinicians, allied health professionals and regulatory groups.
On Saturday, October 29, Loyola will also host an international workshop on research into the potential of obtaining heparin from cattle and sheep. As demand for heparin continues to grow, experts worry of possible shortages. Heparin now is primarily derived from pigs, and to reduce the risk of shortages, cattle and sheep have been proposed as alternative sources for heparin and related drugs.
The symposium and workshop are hosted by Loyola’s departments of Pathology and Molecular Pharmacology and Therapeutics, under the auspices of the International Union of Angiology and the North American Thrombosis Forum.
For more information on the symposium and workshop please contact Erin Erickson at email@example.com.
At home in the lab
By Erinn Connor
The first time Alan Wolfe, PhD, set foot in a research lab, he knew it was exactly where he was meant to spend his career. He felt at home among the Bunsen burners, test tubes, and microscopes after not getting into medical school, his original goal.
After his medical school rejection, Wolfe spent some time as a formulation supervisor in a manufacturing lab that made mouthwash, shampoo, and other toiletries. He knew he did not want a career there, and that he needed to get back to school.
He ended up crossing the country to the University of Arizona and getting a PhD in genetics and a master’s degree in systems engineering, an unusual combination that would pave the way to his unique approach to research and teaching.
Wolfe, a professor in the Department of Microbiology and Immunology within the Graduate School, was named Loyola University Chicago’s Faculty Member of the Year in September. His students cite his willingness to give them the freedom they need to grow their research and become leaders in their field as one of the many reasons he’s such a popular faculty member in the Health Sciences Division.
“He gave me the space to do what I thought I needed to do,” said Krystal Thomas-White, a PhD student studying in Wolfe’s lab. “He encouraged me to start new collaborations, to reach out to people, and to build connections as a graduate student. He allowed me to take risks because he knew how great the payoff those risks could have.”
Getting inside the cell
Wolfe headed to Cal Tech for his postdoctoral career, where his work was understanding how bacterial cells sense and respond to their environment. His random-seeming master’s degree in systems engineering (creating processes to ensure quality and efficient systems in many industries) was helpful in dissecting the “circuit system” of the cell.
“When I tell people what I do, I say I’m figuring out the circuit board of the cell,” Wolfe said. “I go in and clip wires and see what happens. We’re doing this genetically, so we’re using molecular biology to clip these wires and see their behavior afterwards.”
Wolfe followed his mentor, Howard Berg, from Cal Tech to Harvard and continued studying the intricacies of the cell. But Wolfe received an invitation to interview from Katherine Knight, PhD, who had just been appointed chair of the Department of Microbiology and Immunology at Loyola.
“I could have easily made a big mistake by not coming to Loyola,” Wolfe said. “With Katherine, it’s about science, but also about the people who do the science. For her it’s important that people in the department are interacting and that everyone is being mentored.”
Since coming to Maywood from Cambridge in 1989, Wolfe has nurtured his basic science research into thriving translational work, Knight said, and he’s earned a reputation as a fantastic teacher.
“He really loves his students and wants to help them learn as much as they can,” Knight said. “He’s very sincere about getting the best out of students.”
Unraveling the puzzle
Wolfe learned many researcher fundamentals from his peers. He received help in writing his first funded grant during his first few years on campus. Eventually, he would meet faculty members from all across the Health Sciences campus who would help shape his future research.
His best known work is with the Loyola Urinary Education & Research Collaborative (LUEREC), a group he founded with Stritch School of Medicine Dean and Chief Diversity Officer Linda Brubaker, MD, a urogynecologist.
The research of LUEREC challenges the common belief that urine is sterile. As a microbiologist, Wolfe just didn’t believe it to be true. So with the help of samples from Dr. Brubaker’s patients, his lab began to test the dogma.
Wolfe’s lab collected urine by transurethral catheter and by suprapubic aspirate. These urine samples were negative for bacteria by the standard urine culture protocol used by the clinical microbiology laboratory. Wolfe and his team then used Next Generation Sequencing technology to test the urine samples for bacterial DNA and found evidence in both the catheter and aspirate samples.
The group published a paper about this research four years ago proving urine was not sterile.
“We determined that the bacteria in the samples were alive but they don’t grow under the normal urine testing protocols,” Wolfe said. He began enlisting the help of bioinformaticians, geneticists, and immunologists to keep unraveling the puzzle. “We turned the world of the bladder upside down.”
This means in a urinary tract infection test, the current test would not have a positive result for the bacteria Wolfe and his team found in bladder samples. Now LUEREC is focusing on figuring out if these bacteria cause infectious.
“His insights, training, and persistence have resulted in significant NIH funding to advance knowledge about clinically-relevant conditions that are related to the bacterial community in the bladder,” Dr. Brubaker said.
A unique mentor
Wolfe allows his students to be as hands-on as they can with the research in his lab. He closely mentors new students and gradually gives them more and more space to be independent researchers as they get more comfortable with the lab and with their own research interests.
“My interests for my PhD have shifted into more of a basic science viewpoint with the urinary microbiome, and Alan has fully supported my transition into that type of work,” said Evann Hilt, a PhD student in Wolfe’s lab. “He always encourages me and other students to go out and make connections for the lab and then to take charge and lead those collaborations. This is a unique quality for a mentor to have and truly shows how much trust and faith he has in us.”
Wolfe said he’s grateful his original goal of going to medical school and becoming a clinical doctor didn’t work out. Over the years he realized being in the lab and training 20- and 30-somethings were his true callings.
“I realized I love taking things apart and figuring out how they work. I just didn’t know that when I was younger,” Wolfe said. “It’s the same with teaching and watching students bloom. I know what my role is as their mentor, that’s the part where I’m indispensable. Other than that, I just get the hell out of their way.”
Much more than a researcher
By Erinn Connor
Before 2003, Tom Gallagher, PhD, was researching a family of viruses that was relatively unknown to the general public. Then, human coronaviruses were known only for causing relatively harmless respiratory illnesses like the common cold. Now, they’re infamous for being the cause of more troubling diseases like Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS).
The scope of Gallagher’s field expanded rapidly, though he’d been researching coronaviruses since his PhD work, and has kept his studies going since he arrived at Loyola University Chicago’s Health Sciences Campus in 1992. His work on dissecting the machinations of coronaviruses has continued in his lab in the Department of Microbiology and Immunology within the Graduate School, and from there, so has the joy he gets from teaching and mentoring post-doctoral, graduate, and medical students.
For his tireless work, Gallagher received the Graduate Faculty Member of the Year award on September 19 at the Health Sciences Division Faculty Convocation—for a job he never imagined he’d have.
“When I was an undergraduate, and even as a graduate student, I never thought I would be a professor. It just wasn’t on my radar,” Gallagher said. “But as I learned more about what it meant to be a scientist, it seemed like staying on the academic side was the right thing to do, and I’m glad I made that choice.”
An early passion for science
Like so many scientists, Gallagher’s interest in the field came from wanting to know the “whys” and “hows” of nature. Of how things worked, why they behaved in certain ways, to hopefully explain the unknown.
“Like a lot of people with an affinity for science, I was just curious about everything from the start,” Gallagher said. “So a science career seemed like a good fit right from when I was young.”
Gallagher stayed in his home state of California to receive his undergraduate degree at University of California-Santa Barbara, but he then came to the Midwest and the University of Wisconsin-Madison for his post-graduate studies. At the time, UW-Madison was one of the few universities that had a separate institute for the research Gallagher was interested in—virology, or the study of viruses.
He narrowed down his interest in viruses while at the Institute for Molecular Virology in Madison.
“It was there that I learned the technical work of doing research in a lab, while also learning about how a virus replicates,” Gallagher said. “Back then there were many features about viral replication that were not well understood—there still are many knowledge gaps—and so we focused on answering some questions. What I really got out of those times is an enduring enthusiasm for the lab, and how good experiments can reveal some answers. Bench research has a way of capturing your attention.”
Focusing on SARS
With the help of his mentor Roland Rueckert, the former chair of the institute, Gallagher earned his PhD in cell and molecular biology with a focus in virology “Roland was a superb mentor,” Gallagher said. “He truly cared about showing me what science is all about, and he had incredible infectious energy.”
Gallagher then returned to the West Coast to the sprawling Scripps Research Institute in San Diego for his postdoctoral fellowship. It was there that he started his work on coronaviruses in the laboratory of his next mentor, Michael Buchmeier, back when no one knew the SARS acronym and before videos of people wearing masks while traveling abroad were all over the news.
There are many coronaviruses that only infect animals, which is what Gallagher studied in San Diego. He studied the virus in mice, but not because scientists could foresee a human epidemic of coronaviruses coming.
“The diseases caused by the mouse coronavirus were varied and would reflect certain human diseases,” he said. “One infection could lead to the development of neurological symptoms that were a lot like multiple sclerosis, and there was enthusiasm for those models to potentially reveal the mechanisms behind certain human diseases.”
At some point in the year 2002, the SARS virus figured out a way to infect humans. There were just over 8,000 cases of SARS and more than 700 deaths from the virus from 2002-2003 alone. The MERS epidemic in 2012 generated even more interest in the field.
By the time coronaviruses became a household name, Gallagher was already at Loyola, building his own lab that focused on the viruses. His lab has published papers on the mechanism behind the virus infecting a vulnerable cell, and is continuing to focus on how exactly the virus will latch onto a cell and cause infection.
Moving beyond research
Katherine Knight, PhD, chair of the Department of Molecular Biology and Immunology, was one of the major reasons Gallagher came back to the Midwest.
“From the first day I was here, I got the feeling she was someone far more special than the average department chair, and it turns out I had the right first impression,” he said. “Dr. Knight is just about the most understanding and helpful mentor in the world.”
Knight said over the years she’s continually been impressed by Gallagher’s level of integrity and his ability to explain complex scientific concepts for his students.
“Tom really enhances the intellectual environment of the department and of his classes,” Knight said. “He’s a superb teacher who asks really good questions of his students and knows how to engage them so they’re learning in the best possible way.”
Loyola is also where Gallagher started and honed his teaching career, even though he always expected his research to remain at the forefront.
“A beautiful aspect of being a professor is that you can explore and utilize your assets in different ways,” he said. “At most universities the expectation is that you’re a researcher first and foremost because that’s what brings in funds, but of course there are also plenty of opportunities to contribute to the University through teaching and service.”
Now Gallagher’s teaching responsibilities range from covering the basic molecular cell biology with first-year medical and graduate students to being a mentor to PhD students and postdoctoral associates working in his lab.
Edward Thorp, PhD, FAHA, now an assistant professor in the Department of Pathology at the Feinberg Cardiovascular Research Institute at Northwestern University, had Gallagher as his mentor while getting his PhD.
“Tom’s teaching style was balanced by both his knowledge of the field as well as practical insight on the bench,” Thorp said. “His experimental insight was critical to my productivity as a postdoc.”
Helping students succeed
Gallagher works with the three other virologists in the department---Susan Baker, PhD; Edward Campbell, PhD; and Susan Uprichard, PhD—and they all end up helping one another’s students throughout their careers. Gallagher said the new Center for Translational Research and Education, with its open lab space, makes working with his colleagues and their adjoining labs much easier.
“Science is not something you do alone,” he said. “This setup naturally allows for many more opportunities for collaboration. It’s wonderful to see Loyola’s commitments to research in this building.”
For Gallagher, he finds satisfaction in the daily routine research, teaching, and watching his students grow after they leave his lab. He enjoys seeing what they accomplish when they are out on their own, with their own projects.
“Some of the best times are in the office, discussing results with fellow lab members, talking with students about ways to push forward with new experiments,” Gallagher said. “It’s also great to see the things they’ve done and found out at Loyola and after they’ve left. I don’t for a second think they’re just reflections of our teaching, but I do believe that somehow all the professors they encounter at Loyola contribute a little bit.”
Oncology Research Institute hosts Loyola undergrads for research internships
By Erinn Connor
The world of cancer research is constantly looking for fresh ideas in the ongoing fight against the disease, which is the second leading cause of death in the United States. For the first time, undergraduate students from Loyola University Chicago’s Lake Shore Campus had the opportunity to contribute to cancer research through the Oncology Research Institute’s summer internship program.
Students presented their summer research projects at a Research Symposium to their mentors as well as other Oncology Research Institute faculty. Their internships involved intense lab work alongside graduate and PhD students—valuable hands-on experience for science undergraduates still considering their post-graduation options.
“This was an opportunity to build strong bridges between campuses,” said Michael Nishimura, PhD, co-director of the Oncology Research Institute and professor of surgery at the Stritch School of Medicine. “We always think students from the Lake Shore Campus will never come here, but these are students who are motivated and they’ll do what they need to do to get valuable experience.”
For their projects, students took on a small piece of ongoing research in their mentor’s lab. This ranged from learning more about the mechanisms behind a type of leukemia, figuring out how to harness T-cells, what makes breast cancer cells more sensitive to chemotherapy, and more.
During their presentations, students summarized the goal of their lab’s research and what their daily work in the lab consisted of. Much of it involved the use of complicated lab equipment and tedious processes, taught to them by seasoned graduate students.
Undergraduate Thomas Bank worked in the lab of Wei Qui, PhD, an assistant professor of surgery in the division of surgical research. Qui’s lab focuses on hepatocellular carcinoma, a type of liver cancer that will cause more than 27,000 estimated deaths in 2016.
Bank’s project involved studying the role of ATP6V1C1, a gene that helps to regular the PH of a cell. It is also thought to play a role in cell transformation, tumor formation and cancer cell metastasis.
Through his research, Bank found that by knocking down ATP6V1C1, or reducing the gene’s ability to express its function, it decreased liver cancer cell growth and invasion. This knowledge could eventually lead to the development of a new drug to treat liver cancer.
“Using this information from my research, the next step for the lab is to also test how sensitive ATP6V1C1 is to current cancer drugs,” said Bank.
Many projects in Nishimura’s lab concentrated on T-cells. T-cells are a type of white blood cell that target invading viruses and bacteria and destroy them. But, as Loyola undergraduate Claire Auger explained, “T-cells don’t recognize your own cells, and that’s how cancer originates, from your own cells. So that’s why they can’t stop cancer.”
Auger’s summer research looked at the expression of T-cell receptors, which activate the T-cell in response to a foreign antigen. She compared T-cells that were activated by outside the body means to T-cells that were activated by an antigen. She found that the receptors were very sensitive, and that just because they were expressed in a T-cell did not necessarily mean the T-cell was activated to do its job.
This information could be helpful in developing new immunotherapy methods. Immunotherapy is a fast-growing type of cancer treatment that harnesses your own immune system to fight cancer. There are different types of immunotherapy, one that isolates T-cells from a tumor and modifies them to make them better at destroying cancer cells. Another is a using a drug that can “mark” cancer cells so to the T-cells can better find and fight cancer cells.
The work started by the undergraduate students will be continued in their mentors’ labs. The internship organizers hope this can become an annual program offered to Loyola undergrads every summer.
“We really wanted to get together with the basic sciences students and improve their opportunities for research,” said Patrick Stiff, MD, co-director of the Oncology Research Institute, division director of hematology and oncology and Coleman Professor of Oncology. “We wanted them to be able to use the knowledge they gained in the classroom to do real-world, first-class cancer research.”
Loyola study reveals how HIV enters cell nucleus
By Jim Ritter
Loyola University Chicago scientists have solved a mystery that has long baffled HIV researchers: How does HIV manage to enter the nucleus of immune system cells?
The discovery, reported in the journal PLOS Pathogens, could lead to effective new drugs to treat HIV/AIDS, said Edward M. Campbell, PhD, corresponding author of the study. Campbell is an associate professor in the Department of Microbiology and Immunology of Loyola University Chicago Stritch School of Medicine.
HIV infects and kills immune system cells, including T cells and macrophages. This cripples the immune system, making the patient vulnerable to common bacteria, viruses and other pathogens that usually don’t cause problems in people with healthy immune systems.
Once HIV enters a cell, it has to find a way to get inside the nucleus, the compartment that contains the cell’s DNA. Many related viruses do this by waiting until the cell divides, when the protective membrane surrounding the nucleus breaks down. But HIV has the insidious ability to enter the nucleus in a non-dividing cell with an intact nuclear membrane. (This membrane also is known as the nuclear envelope.)
How HIV gets through the nuclear envelope has been a mystery. In part, this is because the HIV core (the protein shell that protects the HIV genome) is 50 percent larger than the pores in the envelope. These pores normally enable cellular proteins and other materials to go back and forth between the nucleus and the rest of the cell.
Campbell and colleagues discovered that a motor protein, called KIF5B, interacts with both the HIV-1 core and the nuclear pore in a way that allows HIV into the nucleus. Normally KIF5B transports various cargoes within the cell, away from the nucleus. But HIV hijacks KIF5B to serve a different purpose: It induces KIF5B to tear off pieces of the nuclear envelope and transport them away from the nucleus, thus making the pore wide enough for HIV to pass through. (The pieces that are torn off are proteins called Nup358.)
The discovery opens a potential new strategy for fighting HIV. Developing a drug that prevents KIF5B from disrupting nuclear pores would prevent HIV from sneaking into the nucleus without detection. This would give the immune system enough time to sound the alarm to attack and destroy HIV.
Cells have surveillance mechanisms to detect viruses, and their DNA, in the cytoplasm (the part of the cell outside the nucleus). But HIV typically can enter the nucleus before it is detected by these mechanisms. Trapping HIV in the cytoplasm would not only prevent an infection, it might also lead to HIV being detected and thus prompt an immune response.
“It’s like making a bank vault harder to break into,” Campbell said. “In addition to making the money more secure, it would increase the chance of sounding the alarm and catching the burglars.”
The study was supported by a grant from the National Institute of Allergy and Infectious Diseases. It’s titled “KIF5B and Nup358 cooperatively mediate the nuclear import of HIV-1 during infection.”
In addition to Campbell, co-authors are Adarsh Dharan, PhD, (first author); Sarah Talley, MS; Abhishek Tripathi, PhD; and Matthias Majetshak, PhD; all of Loyola’s Stritch School of Medicine; and Thomas J. Hope, PhD and João Mamede, PhD of Northwestern University Feinberg School of Medicine.
Consistent treatment guidelines could help chronic kidney disease patients
By Zoë Fisher
Most patients at dialysis centers in Maywood can’t afford food, said Holly Mattix-Kramer, MD, MPH, Nephrology and Associate Professor of Public Health Sciences. Chronic Kidney Disease (CKD) occurs when damaged kidneys cannot filter blood and is one of the most expensive chronic conditions, according to the Centers for Disease Control and Prevention.
One fourth of people over 65 have CKD, yet there’s no single national guideline physicians must adhere to for patient treatment. This leads to inconsistent patient care. Kramer and Talar Markossian, MPH, PhD, Assistant Professor of Public Health Sciences, Health Policy at Loyola University Chicago, partnered with eight other specialists to research prevention of CKD based on patient care and physician behavior.
The data for the study is collected from the National Veteran Affairs Database and the Edward Hines, Jr., Veterans Administration Hospital. However, this population isn’t reflective of the entire US; the patients used for the study are usually poor, male and have high-risk factors like smoking, poor diet, and physical activity, Kramer said. Because these characteristics affect doctor’s treatment plans, Kramer said that the study hopes to address both physician knowledge and attitude towards CKD treatment.
The research project uses a mixed-method approach that retroactively analyzes 200,000 past patients’ treatment plans while still interviewing current physicians. A common response from physicians they interviewed is that there’s an information overload. Medical specialties such as nephrology, endocrinology, and cardiology all have their own guideline on how to address CKD.
Because there isn’t a universal guideline, Markossian found that physicians were just picking one specialty guideline and sticking to it. However, the interdisciplinary team believes the Kidney Disease Improving Global Outcomes (KDIGO) guideline is best because it is specific to kidney disease patients.
The research the interdisciplinary team found shows that CKD patients have a greater chance of developing and dying from cardiovascular disease. “The KDIGO 2013 clinical practice guideline for lipid management in CKD recommends that adults 50 years or older with non–dialysis-dependent CKD be treated with a statin or statin plus ezetimibe regardless of blood lipids levels,” Markossian said. KDIGO is an organization dedicate to improving care for patients with CKD. The guideline classifies CKD, and discusses physician identification, management and treatment.
With one article published earlier this year and one to be completed by the end of the summer, the researchers note their strategy has been effective. The collaboration between non-physicians and clinicians is an inclusive way to approach a clinical problem, Kramer said. Most of the disciplinary team primarily works at Loyola with adjunct employment at Edward Hines, Jr., Veterans Administration Hospital.
They say that, for now, provider care is the most important issue in addressing CKD. But getting patients to take their medicine is also a barrier. Statin, a drug used for reducing cholesterol in the heart, should be taken by all patients over 50 with CKD, Markossian said. However, many patients associate statins, such as Lipitor or pravastatin, with side effects like muscle pain or memory loss.
So far, the team has synthesized over 13 guidelines and evaluated statin use among patients. “Our next step is to develop interventions to improve the prevention of cardiovascular disease in adults with kidney disease,” Kramer said.
Discovery of cancer gene may predict survival and guide treatment in patients with mouth cancers
By Jim Ritter
Loyola researchers have identified a tumor gene that may help to predict survival outcomes in patients with cancer of the mouth and tongue.
If the gene is expressed (turned on), patients are 4.6 times more likely to die at any given time, according to a study by researchers at Loyola Medicine and Loyola University Chicago Stritch School of Medicine.
The finding, published in the journal Otolaryngology – Head and Neck Surgery, could help guide treatment, researchers say. If the cancer gene is expressed, a patient may require more aggressive treatment, such as radiation and possibly chemotherapy in addition to surgery. Conversely, if the gene is unexpressed (turned off), the patient might be able to safely forgo aggressive treatment and undergo surgery alone.
The Gene Expression Barcode, a research tool co-invented by Michael J. Zilliox, PhD, was used to examine genetic data from 54 patients with mouth cancer. Zilliox is corresponding author of the study, director of the Loyola Genomics Facility and an assistant professor in Loyola Stritch School of Medicine and Graduate School’s department of public health sciences.
The study involved a type of mouth cancer called squamous cell carcinoma. Physicians estimate survival based on the stage of the disease. Staging is based on factors including the size of the tumor and whether it has spread to nearby lymph nodes or other organs.
But staging provides an imprecise estimate of prognosis. In some cases, patients with early-stage disease can have worse outcomes than patients with later-stage disease. Previous studies have found that patients with oropharynx cancers associated with the human papillomavirus (HPV) tend to have better outcomes. But there is no reliable biomarker to predict outcomes among patients who are HPV negative, said Carol Bier-Laning, MD, a Loyola head-and-neck cancer surgeon and co-author of the study. Dr. Bier-Laning is an associate professor in Stritch School of Medicine’s department of otolaryngology.
Using the Gene Expression Barcode, researchers examined publically available genetic data from 54 tumor samples. The samples were taken from patients who had HPV-negative squamous cell carcinoma in the mouth.
The study found that subjects whose tumors expressed a gene called spectrin were 4.6 times more likely to die at any given time when compared with patients without spectrin. (Spectrin is a gene involved in the formation of cell membranes.)
Even when researchers controlled for cancer stage and other factors, patients with the expressed spectrin gene still were significantly more likely to die than those in which the gene was turned off. This finding suggests that the spectrin gene may provide more information about survival than cancer stage alone.
The researchers caution the results are preliminary and need to be validated in an independent patient group. Such research is ongoing.
Research institutions have made public genetic data from nearly 100,000 patients, most of whom had cancer. In raw form, however, these data are too unwieldy to be of much practical use for most researchers. The Gene Expression Barcode applies advanced statistical techniques to make the mass of data much more user-friendly to researchers.
The barcode algorithm is designed to estimate which genes are expressed and which are unexpressed. Like a supermarket barcode, the Gene Expression Barcode is binary, meaning it consists of ones and zeroes – the expressed genes are ones and the unexpressed genes are zeros.
The Gene Expression Barcode has received funding from the National Institutes of Health and Loyola institutional funds, and is available to academic researchers at no charge.
The new study is titled “Candidate biomarkers for HPV-negative head and neck cancer identified via Gene Expression Barcode analysis.” Other co-authors are Shiayin Yang, MD (first author) and William Adams.
Loyola celebrates grand opening of translational research center
Cancer, public health, cardiovascular, and infectious disease researchers alike showed off their new state-of-the-art labs on April 21, to mark the grand opening of Loyola University Chicago’s Center for Translational Research and Education (CTRE).
The 225,000-square-foot building is the biggest and most complex building in University history, and more than 200 people were on hand to celebrate the start of many translational research discoveries.
“Tonight’s celebration marks an important milestone for our Health Sciences Campus,” said John Pelissero, PhD, interim president of Loyola University Chicago. “The opening of this facility builds upon our reputation as a leader in health care research and education. It also provides our students with the opportunity to work and learn in an inter-professional environment where life-changing discoveries will be made.”
Pelissero was joined by Margaret Faut Callahan, CRNA, PhD, FNAP, FAAN, provost of the Health Sciences Division, and several other University, Loyola University Health System, and Trinity Health leaders for a ceremonial ribbon cutting on the stage of the auditorium. Father Michael J. Garanzini, S.J., chancellor of Loyola University Chicago, led those present in a prayer and blessing.
“We are called to make a difference as ‘persons for others,’” Callahan said. “The scientists working in this beautiful new building are just that. Each and every day they are working to help others. They are making discoveries that are poised to have a profound effect on people’s lives.”
Richard Pazdur (MD ’79), director of the Office of Oncology Drug Products for the Food and Drug Administration, gave remarks on how far translational research, particularly in the world of oncology treatment, has come since he started his medical career.
“Loyola has a special place in my heart and I have watched the progress of the medical center here in Maywood over the last four decades with a great deal of pride and admiration for the work of the faculty in terms of excellence in patient care, research, and education,” Dr. Pazdur said.
Guests were given tours of the various labs in the CTRE, by researchers who study everything from heart failure to obesity in underserved populations to innovative new cancer drugs. Each floor has study space for students along with a mix of wet labs (where typical test tube and microscope research is done) and dry labs (where more statistical and computational-based research is conducted). The second and fourth floors have open atriums that invite collaboration between labs and scientists.
The CTRE houses more than 500 faculty, staff, and students from the Stritch School of Medicine, The Graduate School, Marcella Niehoff School of Nursing, and Loyola University Health Systems.
The heart of the matter
A professor’s journey from India to America led him to a surprising discovery about how a genetic disease affects people from his home country
By Erinn Connor
The state-of-the-art lab on the top floor of the new Center for Translational Research and Education is nearly 9,000 miles away from Pattiveeranpatti, Tamilnadu, India. Both are home to Dr. Sakthivel Sadayappan, and they show how far he’s come in his short time at Loyola University Chicago.
Sadayappan, an associate professor of cell and molecular physiology, and his colleagues study one specific muscle protein called myosin binding protein-C, found in skeletal and cardiac tissues. But his interest in the protein is even more specific: mutations in the cardiac myosin binding protein-C (cMyBP-C) gene are associated with hypertrophic cardiomyopathy. This genetic disease, which causes abnormal thickening of the heart muscle, is the leading cause of sudden death in people under the age of 30, particularly young athletes.
“It’s something where people have no symptoms, have no idea they’re carrying this mutation that could potentially kill them,” says Sadayappan. “From the beginning we’ve been looking into not only what causes this sudden cardiac death but what population is most at risk, and eventually, what we could do to treat it.”
When he was a young boy in India, Sadayappan did not think that looking for the cause of a complicated heart disease would be his destiny. In his hometown, the most likely occupation for men was coconut farmer. But his parents urged him to pursue bigger dreams outside of his small town of 7,700.
Sadayappan was still intrigued by the plant life of his farm home, so he got an undergraduate degree in botany. He went on to explore his interest in cardiovascular research and earned his graduate and postdoctoral degrees in biochemistry. He made the move to the United States (with a four-year stopover in Germany), where he could further nurture his research interests.
In 2009 he established his lab at Loyola and has since been dedicated to studying heart failure and the cMyBP-C. Sadayappan was named 2012 Junior Scientist of the Year at the Stritch School of Medicine for his novel findings.
His research so far on the protein has shown that it breaks apart during a heart attack. This means that a non-mutated cMyBP-C is vital to normal heart function and normal heart muscle. “It’s a muscle protein that controls how many folds of muscle the heart can generate, which helps the heart to contract properly,” Sadayappan says.
A groundbreaking piece of his research took Sadayappan back to his home country. Through collecting blood samples from all over the world, he and his colleagues found that one in 25 people from India and South Asian countries carry a mutation of the gene that codes for cMyBP-C, making them susceptible to hypertrophic cardiomyopathy and heart failure. In the mutated gene, 25 DNA base pairs are missing. As a result, the tail end of the protein is altered.
“South Asians have a 50 percent greater mortality rate in the United States from cardiovascular disease,” says Sadayappan. “Like anyone with heart disease, it’s a combination of lifestyle influence, risk factors, and genetics. But with South Asians the genetic aspect plays a much bigger role.”
Now the goal is to figure out the exact pathology from the mutation to hypertrophic cardiomyopathy and to develop potential drug therapies to treat it. For this Sadayappan has received funding from the National Heart, Lung, and Blood Institute, the American Heart Association, and the pharmaceutical industry.
As part of this research he’s recruiting South Asians from the Chicagoland area and other parts of the United States to be tested for the cMyBP-C mutation. Sadayappan’s lab is gathering samples from the United States instead of going abroad—about 4 million people of South Asian ancestry live in America. Sadayappan and his lab members go into local community centers and educate people on the gene and what the mutation could potentially cause.
For those who test positive, they’re offered an echocardiogram at Loyola University Medical Center to see if there is any heart muscle damage. They are also given the opportunity to discuss risk factors that may increase their likelihood for suffering a heart attack.
Recently, Sadayappan traveled back to his alma mater, American College in Madurai, India. There he gave a seminar to current students who were in the same shoes he was in 25 years ago—studying botany. He told the students of the wide variety of career opportunities open to them after graduation. Returning to visit his alma mater, he says, was “certainly one of the happiest days of my life.”
Sadayappan’s own life story and research journey should prove to be plenty of inspiration for students back in India and for those under his tutelage in his lab at Loyola.
“It’s taken 17 years to get here and to gradually piece together what we know so far about this protein and how it gets mutated,” he says. “We’re hoping that we can not only understand the mechanism behind hypertrophic cardiomyopathy but also have ways to treat it and reduce the number of sudden deaths.”
Inspiring future medical scientists
By Susan A. Clarke
Even after 25 years in Loyola’s Stritch School of Medicine, Dr. Katherine Knight exudes excitement, optimism, and commitment in her role as an educator in its Microbiology and Immunology graduate program. Passionate about teaching graduate students both in the classroom and the lab, she finds it “exciting to be doing not just research with these students but also developing their scientific minds.”
Questions are central to Knight’s teaching philosophy and practice. In the classroom, she rarely lectures but rather uses the Socratic method of questioning the class about course material in order to continuously engage her students. She believes that a crucial part of the didactic process is to help students to discover what they are passionate about, and to give them the tools to pursue their goals.
Says Knight: “Telling students what to do is not my idea of teaching....My strategy is to help students find their way by teaching them how to identify important questions and to devise ways to and the answers.” Right now there are five graduate students in Knight’s lab, with four pursuing PhDs in Immunology and one in the new MS program in Infectious Diseases and Immunology.
The program offers an array of educational opportunities outside of the classroom and lab, many established by Knight as enrichments to an already rigorous program. These include the (now required) first-year weekly journal club, in which a student summarizes a published research paper and leads the group discussion. In the “sampler” seminar series, a student invites three scholars from different fields to provide a short summary of their research. Only the organizer knows the identity of the speakers in advance, who may be from any subfield of microbiology, immunology, or infectious disease, piquing attendees’ interest and adding a sense of spontaneity. The series is well-attended by both faculty and students alike.
Every program activity is designed to be an active learning experience and to stimulate students’ independent thinking. The content of Knight’s Advanced Immunology class is driven by the latest research findings in the field; for each class a recent research paper is chosen to be presented by a student and scrutinized by the group.
For the pre-doctoral preliminary exam, students write a formal research proposal as might be submitted to a federal agency, and then present a departmental seminar summarizing the state of the problem leading to the proposal’s testable hypotheses and defending the proposal. However, the proposed research must be outside of their own specialty area, in order to further broaden and diversify their expertise.
Says Knight, “Our philosophy of training graduate students is to ensure that they have a broad background in microbiology and immunology and are versed in subfields other than their specialty training area.” This diverse and extensive presentation and analytical experience ensures that nearly all of program PhD graduates go into some of the most competitive national and international post-doctoral training programs.
Knight is keenly interested in “best practices” in mentoring, focusing on what motivates and excites a particular student. She is impassioned about her own research and wants her students to feel the same way about theirs. She summarizes her educational philosophy, which is strongly related to Ignatian pedagogy, simply: “I want to help them to be the best scientists that they can be.”
Biostatistics in the realm of the patient: Advancing medicine and global health
In her two years at Loyola’s Stritch School of Medicine, Professor Stephanie Kliethermes has accomplished quite a bit. While completing her PhD in biostatistics at the University of Iowa, Kliethermes anticipated landing a teaching career at a liberal arts college. She applied for the biostatistician position she holds at Stritch on a whim, but now says that her heart has found a home here. She was hired as the first biostatistician in the Stritch Clinical Research Office, in order to help medical investigators to design their research protocols and analyze their data. However, her position has grown and changed, and she is now Director of the newly formed Biostatistics Center that also employs two Master’s level statisticians.
Kliethermes takes both a holistic and social justice approach to her work in biostatistics and in helping medical researchers. The physicians are experts in their fields, but they may need help with the technical aspects of research design, data analysis, and interpretation of their results. Kliethermes and the Biostatistics Center staff work with medical researchers across the Stritch campus, helping them to determine data collection protocols, perform sample size analyses, and analyze their data. Her expertise in helping investigators write these sections of their grant proposals and publications has garnered her co-investigator status on seven federally-funded research studies led by Stritch faculty. She also has an appointment in the Department of Public Health Sciences, where she teaches a graduate course in statistics for medical students who may not be future investigators, but who as clinicians need to be able to critically evaluate published medical research.
Two of Kliethermes’ passions are Bayesian (inferential) statistics and global public health, and how the former can be used to promote the latter. Given that the use of inferential statistics provides perhaps one of the ultimate examples of reason, how can medical research data be informed by the perspectives of faith and justice to help people? Can we use the conclusions that we draw from data to help people and improve health both locally and globally? Ultimately, Kliethermes is interested in how biostatistical data can be applied to the realm of patient care and used to improve health and save lives.
An example of the real-world application of these concepts is Kliethermes’ work with “Statistics without Borders,” a pro bono service organization conceptually similar to the well-known “Doctors without Borders.” Statisticians in this organization help scientists in developing countries to design research projects and analyze and interpret health data in cases where local scientists may not have statistical expertise themselves nor access to experts. These clinical researchers are often working on health problems critically affecting their countries.
This year Kliethermes is volunteering with health professionals from the Community Health Initiative Haiti (chihaiti.org), an NGO providing health services for rural Haitians. With a mission based on the intersection of reason and justice, CHI Haiti’s premise is that it is unjust to let people live in terrible physical conditions, poverty, and/or disease when there are resources in the world that could help them. CHI Haiti volunteers have established several medical clinics in rural Haiti. Kliethermes will help the clinics transition to an electronic medical records system, enabling them to serve more patients more efficaciously. CHI Haiti’s philosophy is based on the medical ethical principal of autonomy, i.e., that the population served can best determine their communities’ critical health challenges and the best solutions; thus they train and employ local citizens.
In 2012, 104 volunteers served over 5,400 Haitian patients. Having recently returned, Kliethermes described her experience in Haiti: “a country filled with so much beauty….it was inspiring, difficult, honest, and real.”
Kliethermes believes that biostatistics provide a powerful tool to advance medicine and thereby help people by improving health and potentially saving lives. She notes that “All kinds of data relevant to health issues are present everywhere you look in society. The question then becomes, how can medical biostatistical data be used from a perspective of faith and reason in the service of justice, in this case for helping people by improving their health?” This question continually inspires her work.
How hospitals can improve outcomes of weekend surgeries
More nurses, electronic medical records among resources that help overcome “weekend effect”
Studies have shown that patients who undergo surgeries on weekends tend to experience longer hospital stays and higher mortality rates and readmissions.
For the first time, a study has identified five resources that can help hospitals overcome this “weekend effect”: increased nurse-to bed ratio; full adoption of electronic medical records; inpatient physical rehabilitation; a home-health program; and a pain management program.
The study by researchers at Loyola University Medical Center and Loyola University Chicago is published in the October, 2015 issue of the journal Annals of Surgery.
The findings suggest that improved staffing, inpatient and aftercare resources “can play an important role in ensuring patients are not disadvantaged by being admitted to the hospital on the weekend,” senior author Paul Kuo, MD, MS, MBA, first author Anai Kothari, MD, and colleagues reported.
Several reasons have been proposed to explain the weekend effect, including reduced staffing and resources and fewer experienced doctors and nurses working on weekends.
Loyola researchers hypothesized that boosting hospital resources before, during and after surgery could overcome the weekend effect. They tested their hypothesis in patients undergoing three types of urgent surgeries that could not be delayed until weekdays: appendectomies, hernia repairs and gall bladder removals.
The researchers examined records of 126,666 patients at 166 Florida hospitals participating in a data base program sponsored by the U.S. Agency for Healthcare Research and Quality. Florida was picked because of its large, diverse population. To determine characteristics of individual hospitals, the patient data were linked to the American Hospital Association Annual Survey database.
Researchers examined a five-year period (2007-2011). The weekend effect was defined as having longer length of stays on the weekend than during the week. During these five years, 21 hospitals developed a weekend effect and 41 hospitals experienced a weekend effect for all five years. Twenty-one hospitals developed a weekend effect and 87 hospitals oscillated between having a weekend effect one year and no weekend effect the next.
Researchers were most interested in the 17 hospitals that were able to overcome the weekend effect. They examined 21 hospital resources, and after controlling for patient characteristics, identified five resources that helped to overcome the weekend effect:
- Hospitals with increased nurse-to-bed ratios were 1.44 times more likely to overcome the weekend effect. Hospitals that overcame the weekend effect had a median nurse-to-bed ratio of 1.3, compared with a nurse-to-bed ratio of 1.1 among hospitals with a persistent weekend effect.
- Hospitals with home health programs were 2.37 times more likely to overcome the weekend effect. In such programs, skilled caregivers check on patients after they are discharged, providing wound care, administering medications, etc.
- Hospitals that fully adopted electronic medical records were 4.74 times more likely to overcome the weekend effect. Only 12.2 percent of hospitals that had persistent weekend effect had fully adapted electronic medical records, compared with 40 percent of hospitals that overcame the weekend effect.
- Hospitals with inpatient physical rehabilitation programs were 1.03 times more likely to overcome the weekend effect. Such programs identify patients who require additional physical conditioning prior to discharge or need extra resources at home.
- Hospitals with pain management programs were 1.48 times more likely to overcome the weekend effect. Seventy percent of hospitals that overcame the weekend effect had pain management programs, compared with 49.3 percent of hospitals that had persistent weekend effects.
Researchers plan to conduct a follow-up study of hospitals in California, which also has a large, diverse population.
The study was conducted by Loyola’s predictive analytics program, which mines large data sets to predict health outcomes. In addition to the weekend effect study, researchers are studying, for example, how many rectal cancer operations a hospital needs to perform for the best results, and whether having a trauma department confers a beneficial “halo effect” on patient outcomes across the board.
Large new databases, electronic medical records and more powerful computers are enabling researchers to conduct such studies. “We’re now able to ask and answer a broad range of questions that could significantly help improve patient care and reduce costs,” Dr. Kuo said. Dr. Kuo heads Loyola’s analytics group, One to Map Analytics. (One-to-map is a common computer command in analytics research.)
Dr. Kuo is the John P. Igini professor and chair of the Department of Surgery at Loyola University Chicago Stritch School of Medicine.
The study is titled, “Components Of Hospital Perioperative Infrastructure Can Overcome The Weekend Effect In Urgent General Surgery Procedures.” In addition to Drs. Kuo and Kothari, other co-authors are Matthew Zapf; Robert Blackwell, MD; Talar Markossian, PhD; Victor Chang; Zhiyong Mi, PhD; and Gopal Gupta, MD.
Preliminary findings of the study were reported during the American Surgical Association's 135th Annual Meeting in April 2015.
Knee replacement is effective treatment for degeneration caused by Blount disease
MAYWOOD, Ill. – A first-of-its kind study has found that total knee replacements can effectively treat degeneration caused by a bone deformity called Blount disease.
Middle age Blount disease patients who underwent joint replacements on one or both knees were found to have stable knees, excellent range of motion, and no need for pain medications, according to the study, conducted by researchers at Loyola University Chicago Stritch School of Medicine.
“With proper attention paid to technical details, patients with Blount or Blount-like deformity can undergo successful total knee arthroplasty [replacement],” corresponding author Harold Rees, MD, and colleagues report. The study is published in the Journal of Arthroplasty.
Blount disease is a disorder of the tibia (shin bone) that occurs in young children and adolescents. The inner part of the tibia, just below the knee, does not develop normally. Consequently, the lower leg turns inward, like a bowleg. Blount disease can be treated with braces or surgery to place the shin bone in the proper position.
Blount disease is more common in African Americans and is associated with obesity and learning to walk early.
Depending on the severity of the disease, and when it first occurs, patients can experience recurrent deformity and arthritis.
In the Loyola study, researchers reviewed the records of five Blount disease patients. Three patients had replacements on both knees and two patients had replacements on one knee. Four patients were African Americans and four were male. All were obese. The average age at the time of the knee replacements was 49.9. Patients were followed-up an average of 75.2 months (6.3 years) after their knee replacements.
Researchers used a scoring system, devised by the Knee Society, that combines clinical, functional and satisfaction scores. The mean Knee Society score was 212.5, out of a maximum possible score of 255. Patients also were rated on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which rates patients on a scale of 0 to 96, with higher scores representing more pain, stiffness and disability. The patients’ mean score was just 13.5.
The study is limited by its small size, retrospective design and lack of long-term follow-up, Dr. Rees and colleagues write.
However, the authors added, “the main purpose was to highlight surgical considerations in performing total knee arthroplasty in patients with Blount disease or Blount-like deformity. Despite a challenging patient population in which to perform total knee arthroplasty, we show that it can be done with a low risk of complication and reasonable medium-term results.”
Dr. Rees is an assistant professor in the Department of Orthopaedic Surgery and Rehabilitation of Loyola University Chicago Stritch School of Medicine. Co-authors are Roman Natoli, MD, PhD (first author), a former Loyola resident; Chrissy Nypaver, a Stritch medical student; Adam Schiff, MD; and William Hopkinson, MD. Dr. Schiff is an assistant professor and Dr. Hopkinson is a professor in Loyola’s Department of Orthopaedic Surgery and Rehabilitation.
The study is titled “Total Knee Arthroplasty in Patients with Blount Disease or Blount-Like Deformity.”
New limb-lengthening technique is less cumbersome for patients, study finds
Technique Can Prevent Amputation in Trauma Patients
MAYWOOD, Ill. – A highly specialized procedure that lengthens bones can avoid the need for amputations in selected patients who have suffered severe fractures.
A new study has found that an alternative limb-lengthening technique makes the long recovery process less cumbersome, while providing good-to-excellent outcomes. First author is Mitchell Bernstein, MD, an assistant professor in the Department of Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine. Senior author is Robert Rozbruch, MD, of the Hospital for Special Surgery in New York.
The standard limb-lengthening technique requires patients to be fitted with a device called a circular external fixator. The device consists of a rigid frame made of stainless steel and high-grade aluminum. Three rings surround the lower leg and are secured to the bone in order to manipulate bone fragments with stainless-steel pins.
The study examined an alternative technique used on trauma patients who underwent lengthening of the tibia (shinbone) to prevent amputation. The technique significantly reduced the amount of time patients had to spend in the external fixator (from 11 months to seven months).
Preventing amputation is known as limb salvage. A prerequisite for salvaging an arm or a leg is the ability to regenerate the missing bone.
Limb lengthening is used to replace missing bone or to lengthen or straighten deformed bones. Patients include children born with birth defects and patients who have suffered severe fractures or bone cancer. In trauma patients, broken bones can become infected, requiring surgeons to remove the infected segment. In bone cancer patients, the surgeon takes out a segment of bone in order to remove the tumor. The limb-lengthening technique enables the patient to grow back the section of bone lost to infection or tumor.
Limb lengthening works on a principle known as distraction osteogenesis. Four times a day, the external fixator pulls apart two bone segments, and new bone tissue fills in the gap. As a result, the bone lengthens at a rate of about 1 mm. per day. Bones can be lengthened by between 15 percent and 25 percent of their original length at a time.
Once the new bone tissue is formed, it takes several more months until it fully regenerates. In the standard limb-lengthening technique, the patient wears the external fixator until the bone completely matures, in order to support the weight of the limb. In the alternative technique, the surgeon implants a titanium rod inside the bone, in order to reduce the amount of time the patient must spend in the external fixator.
The study was conducted at the Hospital for Special Surgery, where Dr. Bernstein completed a fellowship in limb lengthening and complex reconstruction. The study included 58 trauma patients who underwent limb lengthening. Thirty patients were treated with the standard technique. Twenty-eight patients were treated with the alternative technique, which combined the external fixator with the titanium rod implantation. In both groups, the average limb lengthening was 2.1 in.
There was no statistically significant difference in the severity or number of complications between both groups, and good-to-excellent results were found in all patients.
Wearing an external fixator can irritate the skin and cause infections at the pin sites. Also, it’s difficult to wear clothes over the device, and sleeping can be uncomfortable.
“As soon as we get patients out of the external frame they feel better,” Dr. Bernstein said. “Limb deformity surgeons are trying their best to make it a bit easier for patients, without compromising the safety of the procedure.”
In addition to limb lengthening and limb salvage, Dr. Bernstein’s clinical expertise includes broken bones, malunion, nonunion, bone infection, bowlegs, joint distraction, limb-alignment problems, problem fractures, and knock-knees.
Targeting bacteria in the gut might help burn and trauma patients
Loyola Study Finds that Severe Burns Dramatically Alter Bacteria Populations
MAYWOOD, Ill. – A study published in PLOS ONE has found that burn patients experience dramatic changes in the 100 trillion bacteria inside the gastrointestinal tract.
Loyola University Chicago Health Sciences Division scientists found that in patients who had suffered severe burns, there was a huge increase in Enterobacteriaceae, a family of potentially harmful bacteria. There was a corresponding decrease in beneficial bacteria that normally keep harmful bacteria in check.
The findings suggest that burn patients might benefit from treatment with probiotics (live beneficial bacteria). The findings also might apply to other trauma patients, including patients who have suffered traumatic brain injuries, said senior author Mashkoor Choudhry, PhD.
In healthy individuals, the gastrointestinal tract contains more than 100 trillion bacteria, called the microbiome, that live symbiotically and provide numerous benefits. If this healthy balance is disrupted, a state called dysbiosis occurs. Dysbiosis has been linked to many conditions, including inflammatory bowel disease, obesity, rheumatoid arthritis, and diabetes.
Dr. Choudhry and colleagues examined fecal samples from four severely burned patients who were treated in the Burn Center of Loyola University Medical Center. The samples were taken 5 to 17 days after the burn injuries occurred. The microbiomes of these patients were compared with the microbiomes of a control group of eight patients who had suffered only minor burns.
In the severely burned patients, Enterobacteriaceae accounted for an average of 31.9 percent of bacteria in the gut microbiome. By comparison, Enterobacteriaceae accounted for only 0.5 percent of the microbiome in patients who had suffered minor burns. Enterobacteriaceae is a family of bacteria that includes pathological bacteria such as E. coli and Salmonella.
Dr. Choudhry said such imbalances of bacteria may contribute to sepsis or other infectious complications that cause 75 percent of all deaths in patients with severe burns. The imbalance could compromise the walls of the gastrointestinal tract, enabling harmful bacteria to leak out of the gut and into the bloodstream. Dr. Choudhry is planning further studies to confirm this hypothesis.
A burn or other traumatic injury appears to start a vicious cycle: In response to the injury, the body’s immune system mounts an inflammatory response. This causes an imbalance in the microbiome, further boosting the inflammatory response and triggering an even greater imbalance in the microbiome, said Richard Kennedy, PhD, a co-author of the study.
Dr. Choudhry said further research would be needed to determine whether administration of probiotics could restore a healthy microbiome and reduce the risk of sepsis and other infectious complications.
Dr. Choudhry is a professor in the Burn & Shock Trauma Research Institute, Department of Surgery and Department of Microbiology and Immunology of Loyola University Chicago Health Sciences Division. Dr. Kennedy is vice provost for Research and Graduate Programs for the Health Sciences Division. Other co-authors are Zachary Earley (first author), Suhail Akhtar, Stefan Green, Ankur Naqib, Omair Khan, Abigail Cannon, Adam Hammer, Niya Morris, Xiaoling Li, Joshua Eberhardt and Richard Gamelli. Dr. Green is director of the DNA Services Facility at the University of Illinois at Chicago.