Governor Rod Blagojevich's recent announcement of $10 million in stem cell research grants will undoubtedly impact the emerging field.
In the last decade, money spent on medical research in the United States doubled, reaching nearly $95 billion a year. A report published last fall in the Journal of the American Medical Association, in an issue devoted entirely to the state of U.S. medical research, found that while the dollars invested in research continue to grow, controversy, heightened scrutiny and a profit-driven fervor present challenges in the medical research arena.
"If we're soon going to be spending $100 billion a year, we'd better have treatments that work over a long period of time against diseases that are important today and will be more important tomorrow," said Dr. Hamilton Moses III, co-author of the JAMA report, which encourages the medical industry, government and foundations to concentrate more dollars in research on diseases with fewer effective treatments and translate fundamental research into new cures and treatments.
Moses and his colleagues cited a growing imbalance between late-stage and early-stage research, due in part to clinical trials necessary for new drug approval and marketing. The report identified that the United States spends approximately six cents of every health care dollar on medical research, but only one-tenth of a cent of every dollar on longer-term evaluation of which drugs and treatments work best at the lowest cost.
At the heart of U.S. medical research, Illinois plays a significant role. Governor Rod Blagojevich's recent announcement of $10 million in stem cell research grants will undoubtedly impact the emerging field. Illinois is only the fourth state in the nation to commit public funds for stem cell research.
In Chicago, medical research, including stem cell research, is flourishing. Several groundbreaking studies are occurring throughout the city. Here are highlights of some of the most exciting recent and current studies.
With more than 600,000 cases of ischemic strokes -- those caused by a blood clot -- occurring each year, this third largest killer of the American people is truly at epidemic proportions. Faced with the harsh realities of numbers that continue to increase, local hospitals are looking into both advancing precautionary measures and lessening the after-effects of a stroke.
At Northwestern Memorial Hospital, doctors are working with patients who are at high risk for a stroke by implementing Abbots system of carotid stenting. In this kind of procedure, "elastic-like metal scaffolding" is inserted in the neckthrough the femoral artery to aid in maintaining normal blood flow. Not only does the stent help keep the artery open, it also assists in removing and trapping any material lodged in the artery. The less invasive nature of this procedure presents serious advantages over the more commonly used procedure, carotid endarterectomy.
Local researchers are also looking for ways to limit the effects of a stroke. At Loyola University Hospital, Dr. Jos? Biller and staff are studying the effects of using saliva from vampire bats to break down blood clots in stroke patients. The specific anti-coagulant agent in the bats' saliva is being processed into a drug, desmoteplase, which after some preliminary trials is being shown to be effective for up to nine hours. Alteplase, the current anti-coagulant drug administered to stroke victims, lasts only for three hours. The study being conducted will look at patients 18 years and older for a 90-day period.
For patients already debilitated by a stroke, the Rehabilitation Institute of Chicago is using its adaptive training robotics technology to help patients regain the use of their motor functions. In a preliminary study using robots that either facilitate or magnify movement errors, researchers found that 10 out of 18 stroke victims saw improvements in their hand movements and coordination. Further studies are planned for the future.
As the baby boomer generation ages, more people continue to be afflicted with diseases that affcct the organs. With almost 100,000 people on U.S. organ waiting lists, chances can often seem bleak. Fortunately, doctors at the University of Illinois at Chicago, under the supervision of Dr. Enrico Benedetti, are looking into addressing this looming, major issue. Recently, Dr. Benedetti and his team performed Illinois' first living kidney swap, where two women were able to give their kidneys to each other's husbands, due to their incompatibility with their own spouses. More than 65,000 people are currently awaiting a kidney transplant. While only 82 surgeries of this kind have been performed since 2000, it is hoped that this method can help meet the needs of many of those on the waiting list for kidney transplants.
Across town, the University of Chicago Hospitals has just approved the creation of a lung transplant program. This program has recently received approval from the United Network for Organ Sharing, so the University of Chicago is now able to start placing patients on the waiting list for lung transplants. Considered one of the most experienced teams in this relatively new field, the University of Chicago doctors have already completed 480 transplants in trials with an 85 percent one-year survival rate, which far exceeds the average. The team already has patients waiting and plans on beginning to perform this surgery at the University of Chicago Hospitals soon.
Because stem cell research is typically associated with Alzheimer's and other degenerative diseases, very few recognize the unlimited potential benefits of this extraordinary process. At Rush University Medical Center, Dr. Gary Schaer and his team are using stem cells harvested from bone marrow, as opposed to those from human embryos, to treat the effects of a heart attack. Doctors have found that these stem cells can actually repair any damage to the heart caused by an initial heart attack. Perhaps even more astonishing, in animal tests, these stem cells were able to not only identify the areas of injury, but also, if not needed, return back to the bone marrow of the animal. Unlike blood transfusions, mesenchymal (bone marrow) stem cells are universally accepted by all patients, thus requiring no donor matching. Although this process is promising in all aspects, Rush is currently only in their preliminary human trials. Patients age 21 to 85 who have suffered a recent heart attack are eligible for admittance into a two- to three-day blind study. The totalobservational period for this upcoming trial will be two years.
As cancer continues to be the second largest killer in America, doctors strive to find new methods to halt this deadly disease. One of the most recent trends in cancer research is combinational therapy, and Northwestern Memorial Hospital is a front-runner in this emerging treatment. Under the direction of Dr. Mark Talamonti, doctors are using chemotherapy in conjunction with drug treatments to diminish pancreatic tumors. In an upcoming study, Dr. Talamonti will be using the drug bevacizumab, more commonly known as Avastin, in conjunction with chemotherapy to treat up to 40 patients with stage-1, -2 or -3 cancer. Bevacizumab is being used for its known ability to inhibit the growth of blood vessels, and doctors are hoping that when used in conjunction with chemotherapy, this treatment can reduce pancreatic tumors that have not metastasized or spread throughout the body.
Northwestern Memorial is also looking into the effects of combinational treatments on cervical cancer. Afflicting nearly 10,370 American women, cervical cancer is one of the largest killers of women worldwide. Using a combination of heat therapy in conjunction with chemotherapy, Dr. William Small Jr. is hoping that response and survival rates can be improved. He's currently testing the effects of using an investigational device that provokes hyperthermia in an effort to make the tumor more susceptible to chemotherapy and radiation. With sites all around the world participating in this study, test patients with invasive cervical cancer will be put through a two-arm, phase III prospective randomized trial combining radiation, chemotherapy and heat therapy. Similar tests were conducted in April of 2000, reporting overall positive results.
The University of Illinois is taking a bit of a different approach. Instead of trying to fight the effects of cancer, Andrew Mesecar is collaborating with other doctors to find preventative properties of certain foods. According to Dr. Mesecar, "Sulforaphane in broccoli and resveratrol in wine have been shown to prevent cancer?..They do that by signaling our bodies to ramp up the production of proteins capable of preventing damage to our DNA." Once foods are ingested that contain certain chemicals, like the ones above, Keap1, a sensory protein, identifies the chemical and binds to Nrf2, in effect turning on the protective proteins that prevent DNA damage. Amazingly, this method of prevention uses one's own bodily functions to ward off one of nature's most dangerous killers. Dr. Mesecar suggests that Keap1 will someday be integrated into new drugs.
Besides using heat therapy to treat cancer patients, doctors at the University of Chicago Hospitals, under the supervision Dr. Imre Noth, are using this technique to try to reduce the symptoms of asthma patients. Because asthma attacks are caused by a contraction in the smooth muscle around the breathing passage, Dr. Noth and team are testing a revolutionary process that actually kills the smooth muscle, thus keeping it from contracting. Being one of only 30 hospitals testing this experimental technique, known as bronchial thermoplasty, Dr. Noth considers this process "quite exciting" and "unlike anything else." Although no trials have been performed in the United States, doctors are hoping to produce results similar to those elsewhere in the world. In Canada, 75 percent of participants in the trials reported feeling "less limited" in their daily lives years after having the treatment. Bronchial thermoplasty is a procedure where a catheter is inserted down the nose or mouth, and then a tiny heat source is used to render the smooth muscle incapacitated. Testing of this new technique will begin shortly at University of Chicago Hospitals.
Researchers at the University of Illinois at Chicago are studying the effects that certain drugs have on chemical addiction. Under the supervision of Dr. Z. Jim Wang, anti-psychotics -- trifluoperazine in particular -- are injected into mice that are addicted to morphine, in an effort to break the addiction. According to Wang, "trifluoperazine inhibits calmodulin," required in the activation of the enzyme CaMK-2, which "plays an important role in the generation and maintenance of opioid tolerance." Wang and his team are hoping that by using trifluoperazine, patients will only need a "low dose of the painkiller to achieve fairly good pain control and no drug dependence."
UIC researchers are also looking into the relationship between alcoholism and anxiety. They recently found a strong link between anxiety and alcohol consumption in rats. Adapting this study, Dr. Subhash Pandey and team are researching the causal effects of the molecule referred to as the cyclic AMP responsive element binding protein or CREB. According to Dr. Pandey, the CREB molecule is believed to be responsible for many typical brain functions; one of these is the CREB molecules' ability to regulate the protein referred to as neuropeptide Y.
From what scientists have gathered in research, rats with lower levels of CREB are more susceptible to anxiety than those with higher levels of the CREB molecule. The researchers then ran tests to determine the effects of alcohol on the rats with lower CREB levels. Surprisingly, those rats that had lower CREB levels and suffered from anxiety could increase their CREB levels, thus lowering their anxiety, by consuming alcohol. While these tests are still in preliminary stages, Dr. Pandey and associates say they see these recent results as very promising. o
Published: June 01, 2006
Issue: Summer 2006