Today, more than 600 health care and construction workers donned pink hard hats while forming a giant human ribbon on the roof of the still-under-construction UC San Diego Jacobs Medical Center in support of National Breast Cancer Awareness month.
Read more about the event here.
Phase III Clinical Trial to Evaluate Calcium Channel Blocker for Parkinson’s -
Researchers at the University of California, San Diego School of Medicine have launched a Phase III clinical trial to evaluate the drug isradipine, a calcium channel blocker often used to treat high blood pressure, as a potential new treatment for Parkinson disease (PD). The goal of the study is to determine whether the drug can slow the progression of the disease by keeping the brain’s dopamine-producing cells healthier for a longer period of time.
“Isradipine has been demonstrated to be safe and tolerable in patients with Parkinson’s disease,” said Irene Litvan, MD, site investigator and director of the Movement Disorder Center at UC San Diego Health System. “This new study will determine whether the drug can be effective in slowing the progression of the disease and could, thereby, complement existing symptomatic treatments to improve the quality of life of individuals with the disease.”
PD is a progressive neurological disorder that affects an individual’s speed and amplitude of movements and decreases the speech volume. Patients with PD experience stiffness or rigidity of the arms and legs and walking difficulties in addition to tremors in their hands, arms, legs or jaw. Patients with PD also experience vivid dreams, depression, and constipation.
Isradipine is a Food and Drug Administration-approved drug to treat high blood pressure. Prior population studies have shown that people taking isradipine for high blood pressure have a lower incidence of PD. Additionally, isradipine is in a category of drugs called calcium channel blockers, meaning they inhibit certain cellular functions. Overactive calcium channels may play a role in the death of the dopamine producing cells in the brain that is one of the hallmarks of PD.
A Phase II evaluation of isradipine, which was conducted to determine the safety and appropriate dosage for the drug, was completed in 2012. The study was funded by a $2.1 million grant from The Michael J. Fox Foundation for Parkinson’s Research (MJFF), which also supported preclinical research into the effects of isradipine on Parkinson’s progression by D. James Surmeier, PhD, of Northwestern University.
The study, called STEADY-PD, is sponsored by the Parkinson Study Group and is co-lead by the University of Rochester Medical Center (URMC) and Northwestern University. UC San Diego Health System is one of the national research participants.
Patients who are eligible for the clinical trial will have been diagnosed with PD for less than 3 years and are not currently on any dopaminergic therapy such as levodopa, dopamine agonist, or MAO-B inhibitors.
“If it proves to be effective, this drug will change the way we treat Parkinson’s disease, and the major advantage of it is that isradipine is already widely available, inexpensive and will allow for rapid translation of our research into clinical practice,” said Tanya Simuni, MD, principal investigator of the study and professor of neurology at Northwestern University Feinberg School of Medicine. “Although we now have very effective symptomatic treatments to manage Parkinson’s, the development of a disease-modifying intervention remains the Holy Grail.”
Patients with PD are advised not to take this medication if they are not part of this therapeutic clinical trial.
For additional information about this clinical trial, please contact the UC San Diego Health System site coordinator at 858-822-5751 or email@example.com
An Unforgettable Feeling
With Alzheimer’s disease (AD), the greatest fear is what will be lost, how accumulating neurofibrillary tangles and amyloid plaques in the brain (like those pictured above, courtesy of Thomas Deerinck at the National Center for Microscopy Imaging and Research) will eventually erase one’s recollected life.
But maybe it’s worse (or better?) than that. Researchers at the University of Iowa suggest that persons with AD may feel lingering emotions about past events even when they no longer remember what actually happened.
In a published study, scientists played clips of sad and happy movies to AD patients. The latter no longer remembered ever seeing the films, but still experienced sustained states of sadness and happiness.
“This confirms that the emotional life of an Alzheimer’s patient is alive and well,” said study author Edmarie Guzman-Velez.
The findings have implications for how AD patients should be treated.
“Our findings should empower caregivers by showing them that their actions toward patients really do matter,” Guzmán-Vélez said. “Frequent visits and social interactions, exercise, music, dance, jokes, and serving patients their favorite foods are all simple things that can have a lasting emotional impact on a patient’s quality of life and subjective well-being.”
A “Frenemy” in Parkinson’s Disease Takes to Crowdsourcing -
Protein regulates neuronal communication by self-association
The protein alpha-synuclein is a well-known player in Parkinson’s disease and other related neurological conditions, such as dementia with Lewy bodies. Its normal functions, however, have long remained unknown. An enticing mystery, say researchers, who contend that understanding the normal is critical in resolving the abnormal.
Alpha-synuclein typically resides at presynaptic terminals – the communication hubs of neurons where neurotransmitters are released to other neurons. In previous studies, Subhojit Roy, MD, PhD, and colleagues at the University of California, San Diego School of Medicine had reported that alpha-synuclein diminishes neurotransmitter release, suppressing communication among neurons. The findings suggested that alpha-synuclein might be a kind of singular brake, helping to prevent unrestricted firing by neurons. Precisely how, though, was a mystery.
Then Harvard University researchers reported in a recent study that alpha-synuclein self-assembles multiple copies of itself inside neurons, upending an earlier notion that the protein worked alone. And in a new paper, published this month in Current Biology, Roy, a cell biologist and neuropathologist in the departments of Pathology and Neurosciences, and co-authors put two and two together, explaining how these aggregates of alpha-synuclein, known as multimers, might actually function normally inside neurons.
First, they confirmed that alpha-synuclein multimers do in fact congregate at synapses, where they help cluster synaptic vesicles and restrict their mobility. Synaptic vesicles are essentially tiny packages created by neurons and filled with neurotransmitters to be released. By clustering these vesicles at the synapse, alpha-synuclein fundamentally restricts neurotransmission. The effect is not unlike a traffic light – slowing traffic down by bunching cars at street corners to regulate the overall flow.
“In normal doses, alpha-synuclein is not a mechanism to impair communication, but rather to manage it. However it’s quite possible that in disease, abnormal elevations of alpha-synuclein levels lead to a heightened suppression of neurotransmission and synaptic toxicity,” said Roy.
“Though this is obviously not the only event contributing to overall disease neuropathology, it might be one of the very first triggers, nudging the synapse to a point of no return. As such, it may be a neuronal event of critical therapeutic relevance.”
Indeed, Roy noted that alpha-synuclein has become a major target for potential drug therapies attempting to reduce or modify its levels and activity.
Suicide risk reduction in medical students
Medical school is grueling so is it any wonder that medical students have high rates of burnout, depression and, tragically, suicide?
Help is on the way.
Researchers at UC San Diego School of Medicine have successfully pilot-tested a two-pronged program, called HEAR, short for Healer Education Assessment and Referral, to educate medical professionals about mental illness and to screen and help medical students at risk of suicide.
The preliminary results,reported in the October issue of Academic Psychiatry, are promising.
The implementation of the HEAR program at one medical school reduced the self-reported percentage of medical students with suicidal tendencies from 8.8 percent to 6.2 percent from 2009 to 2013, almost a 30 percent decrease over the four-year period.
The UC San Diego team also observed an increase in the percentage of at-risk students in counseling, from 11.5 percent to 15 percent during the same period, a more than 30 percent increase. This is a good sign because it means people are seeking help.
The HEAR program involves both educational lectures to de-stigmatize mental illness within the broader medical community and voluntary anonymous participation in an interactive online screening survey, developed by American Foundation for Suicide Prevention. Those screened as having depression or at-risk of suicide are referred to counseling or other treatment options.
“Our goals are to educate, de-stigmatize, identify, refer and treat medical students with depression and at risk of suicide,” said Nancy Downs, MD, a professor in the Department of Psychiatry and lead author. “The next step is to follow medical students through time to document whether early intervention has lasting-long term benefits.”
More than a dozen medical schools across the nation are currently testing the HEAR program.
The statistics speak to the need: Medical students are 15 to 30 percent more likely to suffer depression than others in their age group and rates of suicide are 200 percent greater among female doctors and 40 percent greater among male doctors than other professionals.
Pictured: Image courtesy of Maryam Soltani, a first-year resident at UC San Diego in family psychiatry.
Disease Without Borders
Bioregional approach to healthy living involves health care, city planning and ecological restoration
In a paper published this week online in Global Society, researchers with University of California, San Diego School of Medicine and the Urban Studies and Planning Program, also at UC San Diego, present a bioregional guide that merges place-based (territorial) city planning and ecosystem management along the United States-Mexico border as way to improve human and environmental health.
Issues like climate change, economic crisis, natural disasters and disease outbreaks do not stop at national borders, compelling public health officials, academics and researchers to think differently about how to address wide-ranging human health challenges.
“City planners, health officials and researchers are combining knowledge and action in new ways to promote healthy placemaking,” said Keith Pezzoli, PhD, UC San Diego Department of Communication and director of the Urban Studies and Planning Program. “Our health is not entirely hardwired genetically. It is also affected by environmental exposures, stress, diet, urban design and behavior. In our region, we can’t think about health on just one side of the border because animals, sick people and pollutants move back and forth.”
In border towns, health risks are common on both sides of the border. In the paper, Pezzoli, with co-authors Wael K. Al-Delaimy, MD, PhD, professor and chief of the Division of Global Health in the UC San Diego Department of Family and Preventive Medicine, and Catherine Wood Larsen, staff research associate in the Department of Family and Preventive Medicine, recommend supporting ecological restoration in transborder metropolitan areas where urban sprawl is taking place, such as in the canyon communities of Tijuana, Baja California.
In a related paper, published in the International Journal of Environmental Research and Public Health on Sept. 15, Pezzoli, Al-Delaimy and Larsen looked at the impact of the environment on residents of Tijuana’s rapidly urbanizing settlement called Los Laureles Canyon. This was the first large scale investigation evaluating the health of this population.
In one decade, the area grew from zero residents to 70,000, forming multiple communities called “colonias.” These settlements do not typically comply with standard building codes and are without basic infrastructure, such as a sewer system, trash collection or paved roads. Many unregulated dumpsites dot the area, often containing a variety of hazardous waste from industry, construction and household garbage.
With Alter Terra (a binational non-governmental organization), the UC San Diego Superfund Research Center, the Center for U.S.-Mexican Studies and the Universidad Autonoma de Baja California, researchers interviewed residents of Los Laureles Canyon about their well-being and any symptoms of illness. The occupants of the 4.6-square-mile area, a sub-basin of the bi-national Tijuana River Basin, reported skin problems, stomach discomforts, eye irritation, confusion/difficulty concentrating and extreme fatigue, which are symptoms commonly associated with exposure to environmental toxins.
“We have people who are living in dismal situations surrounded by dump sites,” said Al-Delaimy, who was the principal investigator on the study. “Their houses are made of garage doors brought from the U.S. and other materials that are mismatched. This is an environmental injustice that is impacting their health and has consequences for the San Diego region as well.”
For example, the ecological health of the Tijuana River Estuary in San Diego County depends upon what happens in the Tijuana River Basin. Toxins in upstream soils can contaminate rain runoff from Los Laureles Canyon, which eventually drains north to the U.S. and into the Pacific Ocean.
“We are joined together to Mexico through the watershed,” said Pezzoli. “We are in it together because of land, buildings and streets, but also from a health perspective because disease doesn’t stop at the border. The failure of control measures in one country has the potential to put neighboring communities at risk.”
To achieve an interconnected healthy bioregion, the scientists said public health professionals need training in global health diplomacy and cooperation. In addition, universities, through programs like the UC San Diego Superfund Research Center, must integrate community engagement and basic research translation through a cross-border approach. Creating sustainable and resilient communities, even across national borders, is possible by fostering investment in natural resources, rooted livelihoods and institutions, they said.
Image courtesy of UC San Diego Superfund Research Center
UC San Diego Part of New Effort to Fight Autoimmune Disorders -
Major multi-year partnership will focus first on rheumatoid arthritis and lupus
The Division of Rheumatology, Allergy and Immunology at University of California, San Diego School of Medicine has been named a key site in a national, multi-institution, multi-year $41.6 million program to speed drug discovery, development, diagnostics and therapies for patients with autoimmune disorders, primarily rheumatoid arthritis (RA) and lupus erythematosus, which affect millions of Americans.
“We will be looking to pinpoint the genes, proteins, chemical pathways and networks involved in these diseases at the single cell level,” said Gary S. Firestein, MD, professor, dean and associate vice chancellor of translational medicine. “This approach allows us to make comparisons across many diseases, revealing new insights and aspects of the disease process. We hope to better understand why some RA patients, for example, respond to therapy and others do not – and develop new therapies that target their condition based upon their particular genetic and environmental variables.”
The effort is part of a five-year, $230 million program called Accelerating Medicines Partnership (AMP), a collaboration between the Food and Drug Administration, the National Institutes of Health (NIH), 10 biopharmaceutical companies and several non-profit organizations. It will initially focus upon autoimmune disorders, type 2 diabetes and Alzheimer’s disease, with other diseases and conditions added in the future. The program for RA and lupus is managed through the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
The unusual cross-sector partnership will emphasize finding tell-tale “biomarkers” for these disease areas, which are molecules that can be helpful for diagnosis or selecting treatment. The group also will identify promising drug targets and ways to reduce the time and cost of developing new therapeutics. A critical component of the effort, say officials, is that industry partners, such as Merck and Pfizer, will make AMP data and analyses publicly accessible to the broad biomedical community.
“To date, treatments for RA and lupus have been aimed at decreasing inflammation and pain,” said Stephen I. Katz, MD, PhD, director of NIAMS. “For the first time, we are bringing together multidisciplinary research teams to achieve a broad, systems-level understanding of these diseases, setting the stage for the development of more effective diagnostic and treatment approaches.”
In a consortium with the University of Colorado, the University of Nebraska and Cedars Sinai Medical Center, UC San Diego will be responsible for using the latest genomics and epigenomics research tools to collect and process tissue and blood samples from patients with RA.
RA is primarily an inflammatory disease of the joints, affecting an estimated 1.5 million Americans, or almost 1 percent of the U.S. adult population. While it most often diagnosed in middle age and occurs with increased frequency in older people, it also strikes children and young adults. Symptoms include pain, selling, stiffness and loss of function in joints. RA typically becomes chronic. There are many treatments, but no cure. Research at UC San Diego in RA has contributed to the discovery of several novel therapies that are currently being used. Despite these advances, many patients still have pain and diminished quality of life.
Both RA and lupus belong to a larger group of autoimmune disorders that includes multiple sclerosis, Crohn’s disease, ulcerative colitis, type 1 diabetes and psoriasis. These diseases, say researchers, share common flaws in immune function and regulation, leading to inflammation that destroys tissues and results in reduced quality of life, disability and increased risk of death.
If successful, the researchers said the combined efforts of academia, the NIH and biotechnology companies can change the way research is performed and create multi-disciplinary teams that can be more effective than individual groups.
UC San Diego Health System Continues to Provide Exceptional Care by “Top Docs” -
101 UC San Diego Physicians in 40 Specialties Named Best Doctors in Region
More than 100 physicians from UC San Diego Health System were named “Top Docs” in the annual San Diego Magazine “Physicians of Exceptional Excellence” annual survey. These physicians represent 40 diverse specialties, from internal medicine and oncology to obstetrics, cardiovascular and surgical care.
“As the only academic hospital in the region, UC San Diego Health System strives to serve the community with the best experts and state-of-the-art health care. We are honored to be recognized in a wide array of medical and surgical specialties,” said Paul Viviano, CEO, UC San Diego Health System. “This designation reflects the dedication of leaders in both clinical practice and research who provide a combination of high quality care, compassion and breakthrough discoveries. The ‘Top Docs’ list is also a valuable tool for patients who may be seeking prenatal care, a specialist for a chronic condition or who may need to select a primary care physician.”
The “Top Docs” annual survey, made possible through a partnership with the San Diego County Medical Society and San Diego Magazine, gives physician peers the opportunity to vote for board-certified physicians practicing in San Diego County to whom they would refer their own patients and family members. This year, there were 778 “Top Docs” named in the region.
Read more here
No longer oceans apart
What began as a casual dinner conversation – “Hey, what’s happening with marine biosciences in China?” – has evolved into a new collaborative initiative between UC San Diego and scientists in China, thanks to the efforts of Bill Gerwick, PhD, professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences and Scripps Institution of Oceanography.
Get the details here.
Another virus, another worry
Non-polio enteroviruses sound scary and they are quite common. They cause roughly 10 to 15 million infections in the United States each year, according to the Centers for Disease Control. Infants, children and teens are most likely to be affected, primarily because their immune systems haven’t previously been exposed to the pathogen.
Fortunately, enteroviruses typically don’t result in serious illness – think common cold – but there are exceptions. Some people can get very sick. Their hearts or brains may become infected. Despite the “non-polio” in the name, paralysis is a possibility, albeit remote.
One especially rare strain of enterovirus – enterovirus-D68 – is causing concern. In at least 16 states, more than 140 cases of enterovirus-D68 infection have been confirmed, mostly among children. Most patients recover without any treatment, but the virus (which tends to appear in the fall) may worsen breathing problems for some children.
“Children less than 5 years old and children with underlying asthma appear to be at greatest risk of having medical complications from EV-D68, Oklahoma epidemiologist Kristy Bradley, MD, told CNN. “If a child develops a cold or a cough, parents and caregivers should just watch the child a little more closely … if wheezing or asthma-like symptoms develop, medical care should be accessed immediately.”
There is no specific treatment for people with EV-D68, but there are standard precautions you can use to protect against infection. They are useful against similar viruses too.