Following the people and events that make up the research community at Duke

Author: Karl Bates Page 2 of 17

Director of Research Communications, Duke University

Panic in the Poster Session!

For their recent retreat, Regeneration Next tried something a little different for the time-honored poster session.

Rather than simply un-tubing that poster they took to the American Association of Whatever a few months ago, presenters were asked to DRAW their poster fresh and hot on a plain sheet of white paper in 15 minutes, using nothing more than an idea and a couple of markers.

Concerns were shared, shall we say, with the leadership of the regenerative medicine initiative when the rules were announced.

“People are always nervous about something they haven’t tried before,” said Regeneration Next Executive Director Sharlini Sankaran. “There was a lot of anxiety about the new format and how they would explain their research without charts and graphs.”

There was palpable poster panic as the retreat moved to the wide open fifth floor of the Trent Semans Center in the late afternoon. Administrative coordinator Tiffany Casey had spread out a rainbow of brand-new sharpies and the moveable bulletin boards stood in neat, numbered ranks with plain white sheets of giant post-it paper.

After some nervous laughter and a few attempts at color-swapping, the trainees and junior faculty got down to drawing their science on the wobbly tackboards.

And then, it worked! It totally worked. “I think I saw a lot more interactivity and conversation,” Sankaran said.

Valentina Cigliola

A fist-full of colorful sharpies gave Valentina Cigliola a colorful launching point for some good conversations about spinal cord repair, rather than just standing there mutely while visitors read and read and read.

 

Louis-Jan Pilaz

Louis-Jan Pilaz used the entire height of the giant post-it notes to draw a beautifully detailed neuron, with labeled parts explaining how the RNA-binding protein FMRP does some neat tricks during development of the cortex.

 

Delisa Clay

Delisa Clay’s schematics of fruitfly cells having too many chromosomes made it easier to explain. Well, that and maybe a glass of wine.

 

Jamie Garcia

Jamie Garcia used her cell-by-cell familiarity with the zebrafish to make a bold, clear illustration of notochord development and the fish’s amazing powers of self-repair.

 

Lihua Wang

Don’t you think Lihua Wang’s schematic of experimental results is so much more clear than a bunch of panels of tiny text and bar charts?

In the post-retreat survey, Sankaran said people either absolutely loved the draw-your-poster or hated it, but the Love group was much larger.

“Those who hated it felt they couldn’t represent data accurately with hand-drawn charts and graphs,” Sankaran said. “Or that their artistic skills were ‘being judged’.”

A few folks also pointed out that the drawing approach might work against people with a disability of some sort – a concern Sankaran said they will try to address next time.

There WILL be a next time, she added. “I had a few trainees come up to me to say they weren’t sure how it was going to go, but then they said they had fun!”

Post and pix by Karl Leif Bates, whose hand-drawn poster on working with the news office contained no data and was largely ignored.

Duke’s Researchers Are 1 Percent of the Top 1 Percent

This year’s listing of the world’s most-cited researchers is out from Clarivate Analytics, and Duke has 34 names on the list of 3,400 researchers from 21 fields of science and social science.

Having your publication cited in a paper written by other scientists is a sign that your work is significant and advances the field. The highly-cited list includes the top 1 percent of scientists cited by others in the years 2005 to 2015.

“Citations by other scientists are an acknowledgement that the work our faculty has published is significant to their fields,” said Vice Provost for Research Lawrence Carin. “In research, we often talk about ‘standing on the shoulders of giants,’ as a way to explain how one person’s work builds on another’s. For Duke to have so many of our people in the top 1 percent indicates that they are leading their fields and their work is indeed something upon which others can build.”

In addition to the Durham researchers, Duke-NUS, our medical school in Singapore,  claims another 13 highly cited scientists.

The highly-cited scientists on the Durham campus are:

Barton Haynes

CLINICAL MEDICINE
Robert Califf
Christopher Granger
Kristin Newby
Christopher O’Connor
Erik Magnus Ohman
Manesh Patel
Michael Pencina
Eric Peterson

ECONOMICS AND BUSINESS
Dan Ariely
John Graham
Campbell Harvey

Drew Shindell

ENVIRONMENT/ECOLOGY
John Terborgh
Mark Wiesner

GEOSCIENCES
Drew Shindell

IMMUNOLOGY
Barton Haynes

MATHEMATICS
James Berger

Georgia Tomaras

Georgia Tomaras

MICROBIOLOGY
Bryan Cullen
Barton Haynes
David Montefiori
Georgia Tomaras

PHARMACOLOGY & TOXICOLOGY
Robert Lefkowitz

PHYSICS
David R. Smith

PLANT AND ANIMAL SCIENCE
Philip Benfey

Terrie Moffitt

Terrie Moffitt

PSYCHIATRY & PSYCHOLOGY
Angold, Adrian
Caspi, Avshalom
Copeland, William E
Costello, E J
Dawson, Geraldine
Keefe, Richard SE
McEvoy, Joseph P
Moffitt, Terrie E

SOCIAL SCIENCES (GENERAL)
Deverick Anderson
Kelly Brownell
Michael Pencina

If the Cancer Doesn't Kill You, the Drug Prices Might

The medical community is growing alarmed about a creeping malady that can diminish the quality of life for patients in treatment and even shorten their lives.

It’s found everywhere in the United States, but not to the same degree in other developed countries. They’re calling it “Financial Toxicity.”

Yousuf Zafar is an oncologist and health policy researcher.

A cancer diagnosis more than doubles an American’s chance of declaring bankruptcy, Duke medical oncologist  Yousuf Zafar, MD, MHS,  told an audience of nursing faculty and students at a May 10 luncheon lecture sponsored by the Duke Center for Community and Population Health Improvement. And that bankruptcy, in turn, has been shown to decrease survival rates.

In addition to treating cancer patients, Zafar studies access to care and the cost of care at the Duke Cancer Institute, the Sanford School of Public Policy, and the Margolis Center for Health Policy.

Zafar told personal stories of two patients who waved off treatments because of the financial hardship they feared.

Gleevec (Imatinib) is an oral chemotherapy made by Novartis.

One of them had a job with health insurance, but no prescription drug coverage, which put him on the hook for $4,000 in medications to treat his rectal cancer for just a few weeks. Had either the patient or Dr. Zafar brought the topic up, the costs might have been avoided, but they never talked about money, he said.

The other patient passed up another round of treatment for his pancreatic cancer, for fear of the bills his family would be saddled with when he died.

Chemotherapy for cancer would typically cost $100/month in the 1970s, Zafar said. But today that figure can be “ten, or tens, of thousands per month.” (Inflation would make that 1970 dollar about $6, not $600.)

“Pricing in the European Union and the rest of the world is a completely different picture,” he said.  In the US, pricing “simply reflects what the market will bear.”

Another source of the steep climb is the advent of biologic drugs, which are expensive to develop, use and store, but offer more targeted therapy for individual patients. One of the most successful of these is Gleevec (Imatinib) an oral chemotherapy that became 158 percent more expensive from 2007 to 2014, Zafar said.

If you do a Google search for Gleevec, the first thing you find is a Novartis page with the headline “Understand Your Out-Of-Pocket Costs For Gleevec” that includes a link to financial assistance resources.

In the face of outrageous costs and questionable benefits, a treatment team in many cases can help patients find other means of support or alternative treatments to achieve the same end with less financial damage. But they have to have the conversation, Zafar said. He’d like to see Duke’s Cancer Center become the first in the country to be totally transparent about costs, but he acknowledged that it may be a difficult quest.

To help enable those conversations, Zafar developed a mobile app called Pathlight to help patients make more informed decisions and plan better for the financial burden of treatment. For some of the technology used in the project, Zafar has partnered with a software company called Vivor, which has found innovative ways to help patients navigate to financial assistance programs. That part of the project is supported by the NIH’s National Cancer Institute.

Even for people not in treatment, drugs have become more costly. Healthcare premiums rose 182 percent from 1999 to 2013, with workers paying an increasing share of the cost of their own employee health plans.

Is this any way to run a health system?

“I don’t have all the answers – I don’t think anybody does,” Zafar said. “But I think we need to move toward a single-payer system.”

Post by Karl Leif Bates

 

Venturing Out of the Lab to Defend Science

It’s 6 p.m. on a Wednesday and the grad students aren’t at their lab benches. IM softball doesn’t start till next week, what gives?

We’ve snuck out of our labs a bit early to take in a dose of U.S. policy for the evening.

Politics fall far outside our normal areas of expertise. I’m a biology Ph.D. student studying plants — even with my liberal arts education, politics isn’t my bread and butter.

Buz Waitzkin of Science & Society (blue shirt) gave grad students a highly accelerated intro to matters of science policy.

But the current political climate in the U.S. has many scientists taking a more careful look into politics. Being scholars who have a sense of the world around us has become more important than ever.

“Agency regulation, funding, it’s all decided by our branches of government,” says Ceri Weber, a 3rd year Ph.D. candidate in Cell Biology.

Weber, a budding “sci-pol” enthusiast and the general programming chair for the student group INSPIRE, feels passionately about getting scientists informed about policy.

So she organized this event for graduate scientists to talk with the deputy director of Duke Science & Society, Buz Waitzkin, who previously served as special counsel to President Bill Clinton, and now teaches science policy classes cross-listed between Duke’s Biomedical Science programs and the Law School.

Seated with food and drinks—the way to any grad student’s heart—we found ourselves settling in for an open discussion about the current administration and the impact its policies could have on science.

We covered a lot of ground in our 2-hour discussion, though there was plenty more we would love to continue learning.

We discussed: lobbying, executive orders, the balances of power, historical context, tradition, and civil actions, to name a few.

There were a lot of questions, and a lot of things we didn’t know.

Even things as simple as “what exactly is a regulation?” needed to be cleared up. We’ve got our own definition in a biological context, but regulation takes on a whole new meaning in a political one. It was neat having the chance to approach this topic from the place of a beginner.

We were floored by some of the things we learned, and puzzled by others. Importantly, we found some interesting places of kinship between science and policy.

When we discussed the Congressional Review Act, which impacts regulations—the main way science policy is implemented—we learned there is ambiguity in law just like there is in science.

One area on all of our minds was how we fit into the picture. Where can our efforts and knowledge as scientists and students can make a difference?

I was shocked to learn of the lack of scientists in government: only five ever in Congress, and three in the Cabinet.

But luckily, there is space for us as science advisors in different affiliations with the government. There are even Duke graduate students working on a grant to develop science policy fellowships in the NC state legislature.

At the end of the night, we were all eager to learn more and encouraged to participate in politics in the ways that we can. We want to be well-versed in policy and take on an active role to bring about change in our communities and beyond.

Hopefully, as the years go on, we’ll have more opportunities to deepen our knowledge outside of science in the world around us. Hopefully, we’ll have more scientists who dare to step out of the lab.

Guest Post by Graduate Student Ariana Eily

Cells Need Their Personal Space

One of the body’s first lines of defense against harmful pathogens is the skin. The constant maintenance of this epithelial cell layer which serves as a barrier to infection  is essential to fighting off disease.

Jody Rosenblatt, an Associate Professor in the Department of Oncological Sciences at the University of Utah School of Medicine, has made it her lab’s mission to study the function of epithelia as a barrier, how this barrier is maintained, and what happens when it goes awry.

Jody Rosenblatt, PhD is an investigator for the Huntsman Cancer Institute at the University of Utah School of Medicine and a Howard Hughes Medical Institute Faculty Scholar

Rosenblatt recently spoke at Duke’s Developmental & Stem Cell Biology Colloquium where she presented some extraordinary findings about how epithelia can squeeze out  both healthy and dying cells  to preserve the protective barrier.

Some c cells commit suicide via programed cell death and are forced out of the cell layer because they are no longer functional. But in the case of forcing out living cells, “cell extrusion is more like a homicide” said Rosenblatt. The fact that perfectly functional living cells are pushed out of a cell layer perplexed her group until they discovered it was happening as a response to cell overcrowding.

Rosenblatt explained that like people, cells tend to like their personal space, so when this is compromised, live cells are actively pushed out of the cell layer, restoring balanced cell numbers.

Rosenblatt’s lab took this discovery a step farther and pinpointed the pathway that likely induces the extrusion of live cells.

Piezo1, a stretch-activated calcium ion channel present in epithelial cells, senses crowding and activates sphingosine-1-phosphate (S1P), the driver of epithelial cell extrusion. When Piezo1 channels are inhibited and don’t sense stretching, cells cannot extrude.

Using zebrafish, Rosenblatt showed that when extrusion was blocked by compromising the S1P2 pathway, epidermal cells form masses that are resistant to chemotherapy drugs and signals for programmed cell death.

Rosenblatt explains the importance of regulating cell extrusion in the epithelium to maintain the tissue’s function as a protective barrier for our organs. Misregulation of this function can result in diseases such as metastatic cancers.

This finding lead them to examine samples of human pancreatic, lung, colon, and breast tumors. They found that in all of these cancers, S1P2 is significantly reduced. But if they restored S1P2 activity in cell lines of these cancers, the extrusion pathway was rescued and tumor size and metastases were greatly decreased!

Rosenblatt and her colleagues have shown that the importance of cell extrusion cannot be overstated. If extrusion is compromised, cells can begin to pile up and move beneath the cell layer, which can lead to invasion of the tissues beneath the epithelium and metastasis to other sites in the body.

Now that we are uncovering more of the pathways involved in tumor formation and metastasis, we can develop new drugs that may be the key to fighting these devastating diseases.

Guest Post by Amanda Cox, PhD candidate in biology

 

Young Scientists, Making the Rounds

“Can you make a photosynthetic human?!” an 8th grader enthusiastically asks me while staring at a tiny fern in a jar.

He’s not the only one who asked me that either — another student asked if Superman was a plant, since he gets his power from the sun.

These aren’t the normal questions I get about my research as a Biology PhD candidate studying how plants get nutrients, but they were perfect for the day’s activity –A science round robin with Durham eighth-graders.

Biology grad student Leslie Slota showing Durham 8th graders some fun science.

After seeing a post under #scicomm on Twitter describing a public engagement activity for scientists, I put together a group of Duke graduate scientists to visit local middle schools and share our science with kids. We had students from biomedical engineering, physics, developmental biology, statistics, and many others — a pretty diverse range of sciences.

With help from David Stein at the Duke-Durham Neighborhood Partnership, we made connections with science teachers at the Durham School of the Arts and Lakewood Montessori school, and the event was in motion!

The outreach activity we developed works like speed dating, where people pair up, talk for 3-5 mins, and then rotate. We started out calling it “Science Speed Dating,” but for a middle school audience, we thought “Science Round-Robin” was more appropriate. Typically, a round-robin is a tournament where every team plays each of the other teams. So, every middle schooler got to meet each of us graduate students and talk to us about what we do.

The topics ranged from growing back limbs and mapping the brain, to using math to choose medicines and manipulating the different states of matter.

The kids were really excited for our visit, and kept asking their teachers for the inside scoop on what we did.

After much anticipation, and a little training and practice with Jory Weintraub from the Science & Society Initiative, two groups of 7-12 graduate students armed themselves with photos, animals, plants, and activities related to our work and went to visit these science classes full of eager students.

First-year MGM grad student Tulika Singh (top right) brought cardboard props to show students how antibodies match up with cell receptors.

“The kids really enjoyed it!” said Alex LeMay, middle- and high-school science teacher at the Durham School of the Arts. “They also mentioned that the grad students were really good at explaining ideas in a simple way, while still not talking down to them.”

That’s the ultimate trick with science communication: simplifying what we do, but not talking to people like they’re stupid.

I’m sure you’ve heard the old saying, “dumb it down.” But it really doesn’t work that way. These kids were bright, and often we found them asking questions we’re actively researching in our work. We don’t need to talk down to them, we just need to talk to them without all of the exclusive trappings of science. That was one thing the grad students picked up on too.

“It’s really useful to take a step back from the minutia of our projects and look at the big picture,” said Shannon McNulty, a PhD candidate in Molecular Genetics and Microbiology.

The kids also loved the enthusiasm we showed for our work! That made a big difference in whether they were interested in learning more and asking questions. Take note, fellow scientists: share your enthusiasm for what you do, it’s contagious!

Another thing that worked really well was connecting with the students in a personal way. According to Ms. LeMay, “if the person seemed to like them, they wanted to learn more.” Several of the grad students would ask each student their names and what they were passionate about, or even talk about their own passions outside of their research, and these simple questions allowed the students to connect as people.

There was one girl who shared with me that she didn’t know what she wanted to do when she grew up, and I told her that’s exactly where I was when I was in 8th grade too. We then bonded over our mutual love of baking, and through that interaction she saw herself reflected in me a little bit; making a career in science seem like a possibility, which is especially important for a young girl with a growing interest in science.

Making the rounds in these science classrooms, we learned just as much from the students we spoke to as they did from us. Our lesson being: science outreach is a really rewarding way to spend our time, and who knows, maybe we’ll even spark someone who loves Superman to figure out how to make the first photosynthesizing super-person!

Guest post by Ariana Eily , PhD Candidate in Biology, shown sharing her floating ferns at left.

 

Science Meets Policy, and Maybe They Even Understand Each Other!

As we’ve seen many times, when complex scientific problems like stem cells, alternative energy or mental illness meet the policy world, things can get a little messy. Scientists generally don’t know much about law and policy, and very few policymakers are conversant with the specialized dialects of the sciences.

A screenshot of SciPol’s handy news page.

Add the recent rapid emergence of autonomous vehicles, artificial intelligence and gene editing, and you can see things aren’t going to get any easier!

To try to help, Duke’s Science and Society initiative has launched an ambitious policy analysis group called SciPol that hopes to offer great insights into the intersection of scientific knowledge and policymaking. Their goal is to be a key source of non-biased, high-quality information for policymakers, academics, commercial interests, nonprofits and journalists.

“We’re really hoping to bridge the gap and make science and policy accessible,” said Andrew Pericak, a contributor and editor of the service who has a 2016 masters in environmental management from the Nicholas School.

The program also will serve as a practical training ground for students who aspire to live and work in that rarefied space between two realms, and will provide them with published work to help them land internships and jobs, said SciPol director Aubrey Incorvaia, a 2009 masters graduate of the Sanford School of Public Policy.

Aubrey Incorvaia chatted with law professor Jeff Ward (center) and Science and Society fellow Thomas Williams at the kickoff event.

SciPol launched quietly in the fall with a collection of policy development briefs focused on neuroscience, genetics and genomics. Robotics and artificial intelligence coverage began at the start of January. Nanotechnology will launch later this semester and preparations are being made for energy to come online later in the year. Nearly all topics are led by a PhD in that field.

“This might be a different type of writing than you’re used to!” Pericak told a meeting of prospective undergraduate and graduate student authors at an orientation session last week.

Some courses will be making SciPol brief writing a part of their requirements, including law professor Jeff Ward’s section on the frontier of robotics law and ethics. “We’re doing a big technology push in the law school, and this is a part of it,” Ward said.

Because the research and writing is a learning exercise, briefs are published only after a rigorous process of review and editing.

A quick glance at the latest offerings shows in-depth policy analyses of aerial drones, automated vehicles, genetically modified salmon, sports concussions and dietary supplements that claim to boost brain power.

To keep up with the latest developments, the SciPol staff maintains searches on WestLaw, the Federal Register and other sources to see where science policy is happening. “But we are probably missing some things, just because the government does so much,” Pericak said.

Post by Karl Leif Bates

Brain Makes Order From Disorder

A team of scientists from Duke, the National Institutes of Health and Johns Hopkins biomedical engineering has found that the formation and retrieval of new memories relies on disorganized brain waves, not organized ones, which is somewhat contrary to what neuroscientists have previously believed. Brain waves, or oscillations, are the brain’s way of organizing activity and are known to be important to learning, memory, and thinking.

Alex Vaz is a Duke MD/PhD student and biomedical engineering alumnus.

Although brain waves have been measured and studied for decades, neuroscientists still aren’t sure what they mean and whether or not they help cognition, said Alex Vaz, an M.D.-Ph.D. student at Duke who is the first author on the paper.

In a study appearing Jan. 6 in NeuroImage, the neuroscientists showed that brain activity became less synchronized during the formation and retrieval of new memories. This was particularly true in a brain region known as the medial temporal lobe, a structure thought to play a critical role in the formation of both short-term and long-term memories

Excessive synchronization of brain oscillations has been implicated in Parkinson’s disease, epilepsy, and even psychiatric disorders. Decreasing brain wave synchronization by electrical stimulation deep in the brain has been found to decrease the tremors of Parkinson’s. But the understanding of brain waves in movement disorders is ahead of the understanding of human memory.

The researchers had neurosurgeons at the National Institutes of Health implant recording electrodes onto the brain surface of 33 epileptic patients during seizure evaluation and then asked them to form and retrieve memories of unrelated pairs of words, such as ‘dog’ and ‘lime.’

They found that  during memory formation, brain activity became more disorganized in the frontal lobe, an area involved in

A graphical abstract from Alex’s paper.

executive control and attention, and in the temporal lobe, an area more implicated in memory and language.

“We think this study, and others like it, provide a good starting point for understanding possible treatments for memory disorders,” Vaz said. “The aging American population will be facing major neurocognitive disorders such as Alzheimer’s disease and vascular dementia and will be demanding more medical attention.”

CITATION: “Dual origins of measured phase-amplitude coupling reveal distinct neural mechanisms underlying episodic memory in the human cortex,” Alex P. Vaz, Robert B. Yaffe, John H. Wittig, Sara K. Inati, Kareem A. Zaghloul. NeuroImage, Online Jan. 6, 2017. DOI: 10.1016/j.neuroimage.2017.01.001

http://www.sciencedirect.com/science/article/pii/S1053811917300010

Post by Karl Leif Bates

Karl Leif Bates

Totally Tubular! Fluid forces that affect the development of biological tubes

Have you ever wondered how something as simple as fluid can impact the development of a large organism? How about the way tubes form in relation to each other? Or maybe you’ve wondered how it is possible for something as rigid as a spine to be formed from fluid?

Zebrafish embryos are relatively transparent, making them easier to study.

Zebrafish embryos are relatively transparent, making them easier to study.

Dr. Michel Bagnat and his lab work to analyze each of these questions and more in their research about how biological tubes are formed and how pressure exerted by these fluids affects the formation of these tubes.

Dr. Bagnat, an associate professor of cell biology, uses ‘forward genetics,’ a process by which genes are modified in order to see the effect and function of each gene in the organism. The technique enables them to identify and analyze the role of fluid secretion in zebrafish. Fluid secretion also plays a role in many human diseases, including cystic fibrosis and polycystic kidney disease.

The void in a blood vessel is called the lumen. Bagnat studies the cells lining the lumen.

The void in a blood vessel is called the lumen. Bagnat studies the cells lining the lumen.

One of the most interesting aspects of tubal formation is that biological tubes often form in relation to each other. Dr. Bagnat and his lab study this type of tubal formation through studying the lumen, or the thin membrane lining the intestinal tubes of zebrafish. There are many cellular mechanisms that can affect the formation of the lumen, and extensive research is conducted in order to better understand these mechanisms.

These same sorts of forces can even help build a structure as complex as the spine. Dr. Bagnat’s research covers this specific field. The notochord of zebrafish, or the scaffold which will develop into a spine, is heavily affected by the growth of vacuoles, or fluid-filled sacs in the cell. Dr. Bagnat’s research explores the deeper mechanisms behind the filling of these fluid vacuoles in cells and how each cell’s vacuole stops and starts filling with fluid.

This image of fluid-filled sacs forming a fish notochord was on the cover of a journal.

This image of fluid-filled sacs forming a fish notochord was on the cover of a journal.

Overall, Dr. Bagnat’s research holds strong implications for how we understand the development and formation of biological tubes not just in zebrafish but in our own human bodies.

Guest Post by Vaishnavi Siripurapu, North Carolina School of Math and Science, Class of 2018

bagnatselfie

 

 

 

Treating Traumatic Brain Injury

After a traumatic brain injury (TBI), the brain produces an inflammatory response. This prolonged swelling is known as cerebral edema and can be fatal. Unfortunately, the only medications available just address symptoms and cannot directly treat the inflammation.

Daniel Laskowitz

Daniel Laskowitz, M.D. M.H.S, is a professor of neurology.

Some people can walk out okay after suffering from this injury, yet others can become comatose or may even die. This raises the intriguing question: why do people with similar injuries end up with vastly different outcomes? TBI affects nearly 2 million Americans every year and nearly 52,000 of these injuries are fatal.

“To a certain extent, the way the body responds to injury is probably genetically hardwired,” said Dr. Daniel Laskowitz, a neurologist at Duke who has been working on the mysteries of traumatic brain injuries for two decades. He said in medical school, he preferred the approach of treating the whole body and not super specializing. He chose to work specifically with brain injury because he could treat patients with other conditions along with brain injury.

One of Dr. Laskowitz’s first publications was about brain injury. As a fellow training in neurology in the mid-1990s, he looked at genetic factors that could make a difference in the outcome of a brain injury and found that genetic variation in a protein called apolipoprotein E (apoE) played a role.  ApoE comes in three slightly different flavors, and one of the common forms of apoE (apoE4) was associated with bad outcomes after brain injury. This raised the question of what apoE was doing in the brain to affect outcome after injury.

In 1997, he published an article about the effect of apoE on mice suffering a stroke and found that mice with the apoE allele had a better recovery than mice with an apoE deficiency. These findings were later repeated in an article in 2001,which found that following traumatic brain injury, animals with apoE had better outcomes than animals without this protein.

Since it was found that apoE could improve an injured patient’s neurologic outcomes, it became a model for medication to treat brain injuries. However, apoE does not easily cross the blood-brain-barrier, making it a challenging molecule to dispense as a drug.

Dr. Laskowitz’s lab has spent almost a decade looking at how apoE works. They have recently developed a peptide made of 5 amino acids, CN-105, that is based off of this protein and is able to cross the blood-brain-barrier, giving it the potential to be distributed as a treatment. This has been tested in mice and shown to improve outcomes.

In July, CN-105  completed a first phase clinical trial and found that  drug administration was safe and well tolerated. In the coming year, a phase 2 study will look at whether  CN-105 improves outcomes in patients with brain hemorrhages.

The plan is to give the peptide through an IV every six hours for three days, the time period when most of the swelling happens after injury.

Dr. Laskowitz’s research has already had a significant impact on the treatment of brain injury, and hopefully, this new medication could be another great contribution to this field.

Ryan SheltonGuest Post by Ryan Shelton, North Carolina School of Math and Science, Class of 2017

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