Latest news from UNC Health Care

Scientists map out regulatory regions of genome, hot spots for diabetes genes

tom_hughes — 2010-02-02T19:08:14Z

Media contacts: Les Lang, (919) 966-9366, llang@med.unc.edu or Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Tuesday, Feb. 2, 2010

CHAPEL HILL – Together with colleagues in Barcelona, researchers at the University of North Carolina at Chapel Hill have generated a complete map of the areas of the genome that control which genes are “turned on” or “off.” The discovery, made in pancreatic islet cells, opens new avenues for understanding the genetic basis of type 2 diabetes and other common illnesses.

“Most of the human genome is uncharted territory – entire stretches of sequence with no clear function or purpose,” said Jason Lieb, Ph.D., associate professor of biology at UNC, a member of the UNC Lineberger Comprehensive Cancer Center and one of the senior authors of the study. “In fact, the majority of the DNA sequences associated with disease found thus far reside in the middle of nowhere. Here we have developed a map that can guide scientists to regions of the genome that do appear to be functionally relevant, instead of a dead end.”

The research, published online Jan. 31, 2010, in the journal Nature Genetics, presents the first high-resolution atlas of these regulatory elements in the most studied cell type for treatment and prevention of type II diabetes.

The completion of the human genome project has spurred a flurry of research into the exact genetic changes underlying disease. But while these studies have discovered thousands of sequences associated with human illness, pinpointing which sequence variations are the true culprits has proven difficult. That is because the underlying genetic sequence – the A, C, T, and G that code for your entire being – is only part of the story. It is not just the message, but the packaging – whether those four letters are laid out like an open book or tightly packaged like a message in a bottle – that determine which genes are active and which are not.

Using a new method developed in the Lieb laboratory called FAIRE-seq, Lieb and his colleagues isolated and sequenced a total of 80,000 open chromatin sites within pancreatic islet cells. They then compared these sites to those in non-islet cells to narrow the number down to 3,300 clusters of sites specific to this cell type. Each cluster typically encompassed single genes that are active specifically in islet cells. Twenty of these genes are known to harbor gene variants associated with type II diabetes.

The researchers decided to continue their studies on the variant most strongly associated with the disease, a single nucleotide polymorphism – or SNP – occurring in the TCF7L2 gene. They found that the chromatin is more open in the presence of the high risk version of the gene (a T) than in the presence of the non-risk version (an A). Further analysis demonstrated that the risk variant enhanced the activity of the gene, indicating that it may possess functional characteristics that could contribute to disease.

Lieb says his map is likely to help others within the diabetes research community identify new targets for understanding – and ultimately treating – the disease more effectively. But the approach is not limited to diabetes, or even pancreatic islet cells. He plans to use FAIRE-seq to chart the open chromatin regions present within other cells, such as the immune system’s lymphocytes.

The UNC research was funded in part by the National Institutes of Health. Study co-authors from UNC include Kyle J. Gaulton, Jeremy M. Simon, Paul G. Giresi, Marie P. Fogarty, Tami M. Panhuis, Piotr Mieczkowski, and Karen L. Mohlke. Collaborators from outside UNC include Takao Nammo, Lorenzo Pasquali, , Antonio Secchi, Domenico Bosco, Thierry Berney, Eduard Montanya, and Jorge Ferrer. Co-senior author Dr. Ferrer conducts his research in the Department of Endocrinology, Hospital Clínic de Barcelona.

NC TraCS Institute at UNC joins first national research study recruitment registry

tom_hughes — 2010-02-01T14:23:45Z

Media contact: Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Monday, Feb. 1, 2010

CHAPEL HILL –The University of North Carolina at Chapel Hill has joined more than 51 research institutions around the United States in making information about its clinical research trials available on ResearchMatch, the country’s first registry for recruiting research participants.

ResearchMatch.org, which is a not-for-profit Web site, is designed to provide people who are interested in participating in research the opportunity to be matched with studies that may be appropriate for them. The secure site offers a free and safe way for volunteers to connect with thousands of scientists who are conducting research on a wide range of diseases.

The site is a collaborative effort of the national network of medical research institutions affiliated with the Clinical and Translational Science Awards (CTSAs). The CTSA program, which is led by the National Center for Research Resources (NCRR), a part of the National Institutes of Health, is focused on expanding local and national efforts to enhance the translation of laboratory discoveries into treatments for patients. The North Carolina Translational and Clinical Sciences (NC TraCS) Institute is the academic home of the CTSA at UNC and was established in 2006.

“ResearchMatch.org promises to be an important tool in our ongoing efforts to improve recruitment to clinical trials,” says Etta Pisano, M.D., director of the NC TraCS Institute. “If successful, ResearchMatch will make a difference in how we conduct research. It offers a new and innovative tool for us to use in transforming the research environment at UNC and in the state of North Carolina to improve the health of our citizens through faster and better implementation of research findings.”

Although other Web sites list available clinical trials, ResearchMatch places the burden of connecting the right volunteers with the right study on the researchers. Clinicaltrials.gov, in contrast, asks volunteers to identify the trials that could work for them.

“Participant recruitment continues to be a significant barrier to the completion of research studies nationwide. Recent NIH data indicates that just four percent of the U.S. population has participated in clinical trials,” said NCRR director Barbara Alving. “ResearchMatch is a tool that can improve the connection and communication between potential participants and researchers providing opportunities for the public to contribute to advancing new treatments.”

Currently 53 institutions representing 41 of the 46 CTSAs are listed as participating sites through ResearchMatch, including the NC TraCS Institute. A complete list of these institutions may be viewed at http://www.researchmatch.org/partners/.

For questions and information about the NC TraCS Institute contact TraCS central at nctracs@unc.edu or call (919) 966-6022, or toll-free 1-866-705-4931. Visit TraCS at http://tracs.unc.edu.

ResearchMatch is accessible at: www.researchmatch.org.

UNC medical students hold memorial service for donated cadavers

tom_hughes — 2010-01-28T21:15:39Z

Media contact: Ginger Moore, (919) 962-0168, gmoore2@unch.unc.edu

Thursday, Jan. 28, 2010

CHAPEL HILL -- On Friday, Jan. 22, first-year medical students in the UNC School of Medicine held a memorial service for the cadavers donated to their anatomy class.

The service, which is a long-standing tradition at UNC, was held in the auditorium of the Medical Biomolecular Research Building. More than 300 people attended the hour-long service.

Each year, 160 medical, physical therapy and dental students use 40 cadavers to learn about the human body in their anatomy class. Half of the cadavers are used by medical students, who take the lead in organizing the service.

“The students have spent the last semester studying anatomy, and the cadaver has been essentially their first patient and their first experience dealing with death,” said Kurt Gilliland, Ph.D., a professor in the Department of Cell and Developmental Biology and co-director of the anatomy course.

Gilliland says the memorial service serves three purposes: it celebrates the lives of patients who donated their bodies to UNC, it’s a way to say thanks to the donors and families for the sacrifice they’ve made, and it’s an opportunity for students and families to draw closure.

A Celebration of Life

The first-year medical class presidents organize the ceremony each year and call upon fellow students to participate.
“We asked them to access their inner space, their creatives, to reflect on how this process changed them, to show their thanks to donor families through music, through poetry, however they thought was appropriate, really,” said Jacob Wang, a first-year co-president.

This year, there were seven performances by medical students. Many of them were musical. The MedUNCedoos, the medical school’s a capella group performed “One Sweet Day” by Mariah Carey and Boyz II Men. Several students played instrumental pieces on keyboard, flute and violin. Many of them performed more than once. One student, Brittany Johnson, read a poem entitled, “A Lesson in Gratitude.”

In addition to the student performances, Gilliland gave a short speech and read a letter written in 1983 by a donor to UNC. Shirley Massey, a chaplain at UNC Hospitals, gave the closing remarks.

“I make a point to go each year because it’s actually very moving,” said Edward Kernick, D.P.M., an assistant professor in the Department of Cell and Developmental Biology and the second co-director of the anatomy course. “I’m always impressed with the medical students, their talents and the collegiality of the event.”

After the ceremony, a reception was held in the lobby. Much of the crowd gathered around a particular item – a bulletin board that held photos of several donors – all smiling and very much alive.

One of the photographs was of William Medford. His wife, Becky, who works in the School of Medicine, said her husband loved Carolina and loved sports. In retirement, he worked at Finley Golf Course. Becky said she and her husband made the decision to donate 30 years ago, and chose to give their bodies to UNC because they loved the school. “He was the type of person who just wanted to help people in any way he could,” she said.

A “Thank You” to Donors and Families

If there was one overwhelming sentiment at the memorial service, it was gratitude. “The opportunity to do this, to learn in this way that’s so profound and so significant – it’s something every doctor says sticks with them,” said Nancy Wang, the second first year class co-president. “You always remember the cadaver that you learned from. It was your first teacher.”

Anatomy is a required class for medical students. It is taken the first year of medical school and is the foundation for knowledge of the human body. And while there is a lecture portion of the class, books and overheads can only go so far. Cadaver dissection is a learning method as old as the practice of medicine, and it is looked upon as a rite of passage for future doctors. Every muscle, organ, tendon, nerve, and bone is studied. At UNC, eight students dissect one cadaver for the eight – nine weeks they are in lab.

“The amount of knowledge that they learn from [the donor] is incredible and probably unparalleled and unmatched in their future education,” said Kernick. “[The service] is a way of saying thank you to the family and the individual for that tremendous gift.”

Closure for Students and Families

Gilliland and Kernick say that the students are often very apprehensive about dissection at first, but grow very comfortable over the course of the lab. Nancy and Jacob agree. Some students, they said, were excited and eager from the beginning, while others never dissected the cadavers at all, and chose to learn by seeing and touching rather than cutting.

“For me, walking into the lab for the first day and realizing that these are, you know, people,” said Nancy, “these are people’s grandmothers and daughters and husbands, it was really kind of overwhelming. I felt like I didn’t deserve it. ”
“You kind of look at it as a cadaver and not a donor because you need to study,” she said. “You’ve got to let the science take over,” she said.

So the ceremony is a time for the student to reflect on their experience – the hours they spent with each donor. “The students very quickly entered the anatomy course in October and they probably had very little opportunity to reflect on death because they were so immersed in academics,” Gilliland said.

For the families who had gone for months unable to lay their loved ones to rest, the service was especially a point of closure. All the donors have been cremated, and the families will now be able to have inurnment ceremonies in their hometowns.

The students are not given any personal information on their cadavers. But sometimes, aspects of their lives were still apparent. One woman’s fingernails were painted. Another woman’s left hand had a mark where a wedding ring had been.

At the ceremony, the humanity of the donors was made especially poignant by the presence of many of the donor’s families. If any of the students hadn’t yet considered the cadavers as people – people with children, grandchildren, spouses – then the memorial service was the time for that.

North Carolina’s $49 million investment in tobacco reduction programs led to substantial health improvements from 2006-2009, UNC evaluation finds

tom_hughes — 2010-01-28T13:38:16Z

Media contact: Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Thursday, Jan. 28, 2010

CHAPEL HILL – A comprehensive evaluation of North Carolina’s three major tobacco reduction programs from 2006-2009 concludes that they resulted in substantial reductions in tobacco use and secondhand smoke exposure for youth, young adults and adults across the state. The program has also resulted in model policies the rest of the nation may now follow.

One striking example cited in the report by University of North Carolina at Chapel Hill researchers: North Carolina leads the nation in the number of colleges and universities that have adopted tobacco-free campus policies.

“It is clear that North Carolina’s investment in its comprehensive tobacco programs, funded by the Health and Wellness Trust Fund, has resulted in thousands of healthier and longer lives and tens of millions of dollars in health care costs saved,” said Adam Goldstein, M.D., M.P.H., director of UNC’s Tobacco Prevention and Evaluation Program (TPEP), which prepared the evaluation.

TPEP previously released evaluations of the HWTF programs from 2003-2006. The second evaluation covers the period 2006-2009, during which the HWTF spent $49 million on its three major programs: the Teen Initiative, the Tobacco-Free Colleges Initiative and QuitlineNC, a call-in telephone support service for people trying to quit tobacco use.

Other major findings of the three-year evaluation include:

Awareness among youths of the HWTF’s “TRU” (Tobacco. Reality. Unfiltered.) ad campaign increased from less than 50 percent to more than 80 percent.
More than 30 colleges, universities and community colleges have adopted tobacco-free campus policies, which provide protection from secondhand smoke to more than 130,000 people a year.
More than 10,000 calls have been made to the N.C. Tobacco Quitline from every county in the state since that program launched in 2005.

The most serious threat to the tobacco programs in the next two years identified in the evaluation is a potential loss of program funding. The report recommends that the state increase funding by $7 million a year.

“Currently North Carolina invests only 17 percent of what the Centers for Disease Control and Prevention recommend for tobacco control funding,” said Leah Ranney, Ph.D., associate director of TPEP. “Greater investment would improve programs, save more lives and positively impact North Carolinians in every county.”

Other recommendations of the report include expanding the program to cover all at risk North Carolina adults, supporting additional policy measures aimed at reducing tobacco consumption and exposure to secondhand smoke and maintaining continuous media-based activities to support the Tobacco Initiative programs.

The N.C. General Assembly created the HWTF in 2001 with 25 percent of the state’s share of the Tobacco Master Settlement Agreement. HWTF launched the Teen Initiative in 2003, began funding components of QuitlineNC in 2005, and expanded to the College initiative in 2006. HWTF completed its second three year program funding cycle in 2006-2009.

A copy of the report is available at http://www.tpep.unc.edu/index.htm.

NC Health and Wellness Trust Fund Web site: http://www.healthwellnc.com/

Prevención del SIDA con el uso de antivirales en ratones humanizados

tom_hughes — 2010-01-21T17:35:29Z

Contacto de UNC Enfermedades Infecciosas: Lisa Chensvold, (919) 843-5719, lisa_chensvold@med.unc.edu
Contacto de UNC Health Care: Clinton Colmenares, (919) 966-8757, ccolmena@unch.unc.edu

20 de Enero 2010

CHAPEL HILL – La administración profiláctica de medicamentos antiretrovirales proporciona protección contra la transmisión por vía intravenosa y rectal del VIH en ratones con sistema inmunológico humano, según un nuevo estudio publicado 21 de enero 2010 en la revista en linea PLoS ONE.

“Estos resultados proporcionan evidencia de que la prevención de la transmisión del VIH con el use de antivirales es posible” dijo el Doctor J. Víctor García-Martínez, Ph.D., Director del estudio y Profesor del Departamento de Medicina de la Universidad de Carolina (University of North Carolina o UNC por sus siglas en Ingles).

“Esto podría facilitar enormemente la implementación de un programa, capaz de prevenir la infección de casi todos los grupos de personas con alto riesgo para la transmisión del VIH. Según los datos de los Centros para el Control y la Prevención de Enfermedades de los Estados Unidos, la incidencia del VIH aumentó en un asombroso 15 por ciento entre el 2004 y 2007. Exposición rectal es la causa principal de transmisión del VIH entre varones que tienen sexo con varones y desde el principio de la epidemia en los Estados Unidos más de 500,000 hombres han sido diagnosticados con VIH y aproximadamente 300.000 han muerto de SIDA. En Latinoamérica cerca de 1.7 millones de personas sufren de infección con el VIH. Estadísticas de ONUSIDA indican que en México hasta 200,000 personas están viviendo con VIH y que posiblemente un 57% de las infecciones ocurren entre varones que tienen relaciones sexuales con varones.

Este nuevo estudio demostrando el uso profiláctico de antivirales en modelos de infección del VIH, representa una buena noticia sobre todo en luz de que después de que un estudio clínico de vacuna contra el SIDA en Tailandia, no mostró éxito y otro estudio clínico internacional a gran escala de un microbicida vaginal tampoco encontró ninguna evidencia de reducción en el riesgo de infección por VIH.

La investigación, pre-exposición profiláctica (PrEP, por sus siglas en inglés) con antivirales, se llevó a cabo utilizando un modelo de ratón humanizado desarrollado previamente por el científico Mexicano García-Martínez y colegas en la Universidad de Texas Southwestern Medical Center. Estos ratones son conocidos como “BLT” (por sus siglas en inglés), porque son construidos vía trasplante de células madre sanguíneas, hígado y timo, lo que resulta en el desarrollo de un sistema inmunológico humano.

“Aunque los resultados obtenidos con los ratones humanizados no pueden extrapolarse directamente a los seres humanos, nuestros datos indican que una intervención podría bloquear múltiples rutas de transmisión del VIH en las personas,” dijo el Doctor Paul Denton, Ph.D. co-autor del articulo, que es un Instructor de Investigaciones en el departamento de medicina en la Escuela de Medicina de UNC.

A los ratones humanizados se les administró el tratamiento farmacológico con antivirales comúnmente recetados en el medicamento Truvada y despues fueron expuestos al VIH - bien por vía rectal o intravenosa. Ninguno de los nueve ratones BLT recibiendo antiretrovirales expuestos por vía rectal al VIH mostró signos de infección con el virus. El 63% (12 de 19) de los ratones BLT que no recibieron medicamento fueron infectados con el VIH.

Entre los ratones humanizados expuestos por vía intravenosa, una vía de transmisión que es más difícil de bloquear, el 100% del grupo de control fueron infectados. Sin embargo, tan solo el 10% del grupo que recibieron los medicamentos desarrollaron la infección. Estos resultados confirmaron que PrEP también puede prevenir la trasmisión intravenosa del VIH.

El equipo de el Dr. García-Martínez demostró previamente que PrEP es también altamente eficaz contra la transmisión vaginal del VIH y con este estudio, sus investigaciones demuestran que PrEP puede prevenir la propagación del VIH por las tres modalidades que representan más del 90 por ciento de todas las infecciones del VIH en el mundo.

Los resultados de este estudio no sólo tienen importantes implicaciones clínicas en humanos, pero también podría mejorar significativamente los estudios de drogas. Ya hay estudios clínicos de PrEP en humanos, pero su futuro está amenazada debido en parte a las preocupaciones éticas sobre la administración de fármacos a personas sanas sin pruebas concluyentes de eficacia.

“Ahora el director de un estudio clínico puede presentar estos resultados a un ministerio de salud o la Junta de Revisión de Estudios Clínicos y decir, ‘…tenemos evidencia experimental de que si hacemos esto bien tiene la oportunidad de ser efectivo y prevenir la trasmisión del VIH,’” señaló el Dr. Denton.

El Dr. Mark Wainberg, Ph.D., quien es profesor de microbiología y virología de la Universidad McGill en Montréal y Director del Centro del SIDA en McGill, dijo, “Este es un trabajo excelente que ayuda a avanzar en el campo de la ciencia de prevención del VIH. Esta investigación proporciona apoyo excelente para la continuación de los ensayos clínicos PrEP.”

“Es claro que el tratamiento del VIH por sí solo no va a disminuir el progreso de la epidemia del SIDA,” dijo García-Martínez, también investigador en el Centro para la Investigación sobre el SIDA de UNC. “Hay una necesidad muy grande de desarrollar intervenciones preventivas que puedan prevenir nuevas infecciones y reducir o controlar la epidemia.”

La investigación fue financiada por los Institutos Nacionales de Salud de los Estados Unidos y por la Fundación para la Investigación sobre el SIDA (AMFAR, por sus siglas en inglés). Los autores del estudio de UNC incluyen a los Drs. John F. Krisko, Francisco Martínez-Torres y Wei Zou.

PrEP treatment prevented HIV transmission in humanized mice

tom_hughes — 2010-01-28T16:20:03Z

UNC Center for Infectious Diseases contact: Lisa Chensvold, (919) 843-5719, lisa_chensvold@med.unc.edu
UNC Health Care contact: Clinton Colmenares, (919) 966-8757, ccolmena@unch.unc.edu

Thursday, Jan. 21, 2010

CHAPEL HILL -- Systemic pre-exposure administration of antiretroviral drugs provides protection against intravenous and rectal transmission of HIV in mice with human immune systems, according to a new study published Jan. 21, 2010 in the online journal PLoS ONE.

“These results provide evidence that a universal approach to prevent all forms of HIV transmission in all settings might be possible,” said J. Victor Garcia-Martinez, Ph.D., professor in the department of medicine at the University of North Carolina at Chapel Hill School of Medicine and senior author of the study. “This could greatly facilitate the implementation of a single program capable of targeting virtually all groups of people at high risk of HIV infection.”

According to data from the national Centers for Disease Control and Prevention, HIV diagnoses increased by a staggering 15 percent between 2004 and 2007. Rectal exposure is the leading cause of HIV transmission among men who have sex with men, and since the beginning of the epidemic, more than 500,000 have been diagnosed with HIV in the United States alone and more than 300,000 have died.

These latest findings are welcome news after the recent announcements that an AIDS vaccine trial in Thailand showed only marginal success and a large international trial of a vaginal microbicide found no evidence that it reduces the risk of HIV infection.

The research, using pre-exposure prophylaxis (PrEP) with antiretrovirals, was conducted using a humanized mouse model developed by Garcia-Martinez and colleagues at the University of Texas Southwestern Medical Center. The animals are known as “BLT” mice, because they are transplanted with human bone marrow, liver and thymus cells, which results in a fully functioning human immune system.

“Although results from humanized mice cannot be extrapolated directly to humans, our data indicate that one intervention approach could potentially block multiple routes of HIV transmission in people,” said the paper’s lead author, Paul Denton, Ph.D., who is a research instructor in the department of medicine at the UNC School of Medicine.

The humanized mice were either control mice and received no drugs or were administered the commonly prescribed antiretroviral drug therapy Truvada and then exposed to HIV – either rectally or intravenously – at a level much higher than would occur in typical human exposure. None of the nine treated BLT mice that were exposed rectally showed any sign of the virus after exposure; they were completely protected. However, 12 of the 19 control BLT mice became HIV positive following rectal exposure.

Among humanized mice exposed intravenously, a transmission route which is more difficult to block, all six of the control BLT mice became infected, but seven of the eight treated BLT mice – 90 percent – were protected against the virus.
Garcia-Martinez’s team previously demonstrated that PrEP is also highly effective against vaginal HIV transmission and with this study their research shows that PrEP can prevent HIV spread by the three modes that account for over 90 percent of all HIV infections worldwide.

Results of this study not only have important human clinical implications, but also could significantly improve drug studies. There are already PrEP trials in humans, but their continuation is threatened due in part to ethical concerns over administering drugs to healthy people with no hard evidence that they will work.

“Now the head of a clinical trial can take this research to a ministry of health or review board and say, ‘Look, we have positive experimental evidence that if we do this right it has a chance to work,’” Denton said.

Mark Wainberg, Ph.D., who is professor of microbiology and virology at McGill University in Montréal and director of the McGill AIDS Centre, said, “This is outstanding work that helps to advance the field of HIV prevention science. This research provides excellent rationale for the continuation of PrEP clinical trials.”

“It is painfully clear that treatment alone will not put a dent in the progression of the AIDS epidemic,” said Garcia-Martinez, also an investigator in the UNC Center for AIDS Research. “There is a strong need for interventions like PrEP that could prevent new infections and slow the epidemic.”

The research was funded by the National Institutes of Health and the Foundation for AIDS Research (AmFAR). Study co-authors from UNC include John F. Krisko, Francisco Martinez-Torres and Wei Zou.

UNC Lineberger research provides new insights into deadly brain cancer

tom_hughes — 2010-01-22T20:23:25Z

Media contact: Ellen de Graffenreid, (919) 962-3405, edegraff@med.unc.edu

Tuesday, Jan. 19, 2010

CHAPEL HILL, NC – New findings by researchers at UNC Lineberger Comprehensive Cancer Center suggest that the most common form of malignant brain cancer in adults, glioblastoma multiforme (GBM), is probably not a single disease but a set of diseases, each with a distinct underlying molecular disease process. The study, published by Cell Press in the January issue of the journal Cancer Cell, provides a solid framework for investigation of future targeted therapies that may improve the near uniformly fatal prognosis of this devastating cancer.

“Previous work has established that gene expression profiling can be used to identify distinct subgroups of GBM,” says senior study author, Dr. D. Neil Hayes from the Division of Hematology/Oncology at the University of North Carolina at Chapel Hill. “However, the exact number and clinical significance of these was unclear.” Dr. Hayes and colleagues at UNC Lineberger expanded on previous GBM classification studies and used expression profiling techniques to comprehensively analyze hundreds of GBM patient samples. The group was able to reliably identify four distinct molecular subtypes of GBM tumors.

The researchers then went on to perform a unique integrative analyses across multiple platforms to look for defining characteristics associated with each subtype. Their findings were quite striking, implying that there are distinct types of GBM and that each one is associated with a specific molecular process. “We discovered a bundle of events that unequivocally occur almost exclusively within a subtype,” explains Dr. Hayes.

The researchers also report that the nature of these events indicate that the underlying disease process for each subtype may involve distinct cells of origin at a specific stage of differentiation. This is finding has potential clinical significance as determining the cells of origin of GBM is critical for establishing effective treatment regimens. Clearly, given this new information, it makes sense that some drug classes would be expected to work for some tumor subtypes and not other. In support of this conclusion, Dr. Hayes’s group found that response to aggressive chemotherapy and radiation differed by subtype.

Taken together, the findings represent an important step towards more rational therapies for GBM. “It appears that the simple classification into these four subtypes carries a rich set of associations for which there is no existing diagnostic test,” says Dr. Hayes “This comprehensive genomic and genetic-based classification of GBM should lay the groundwork from an improved molecular understanding of GBM pathway signaling that could ultimately result in personalized therapies for groups of patients with GBM.”

Significant work on this project was shared by Dr. Roel Verhaak of the Broad Institute of MIT and Harvard in Boston and Dr. Katie Hoadley of UNC Lineberger and the Department of Genetics at UNC-Chapel Hill. Other UNC Lineberger team members include postdoctoral fellow Matthew Wilkerson, Dr. Ryan Miller, and Dr. Charles M. Perou. Other collaborating institutions include the Dana-Farber Cancer Institute in Boston, MA; The Genome Center at Washington University School of Medicine in St. Louis; MO, the Lawrence Berkeley national Laboratory in Berkeley, CA; the University of California, San Francisco; Mayo Clinic, Rochester, MN; SRA International, Fairfax, VA; and the Walter and Eliza Hall Institute, Victoria, Australia.

This February, make creativity the heart of your fitness routine

tom_hughes — 2010-01-14T19:20:55Z

Media contact: Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Thursday, Jan. 14, 2010

Written by Sara Peach for UNC Health Care

CHAPEL HILL - For Judy Hinderliter, taking care of friends means refusing to talk to them on the phone.

Instead, when friends want to chat, Hinderliter, a dietitian and personal trainer at the UNC Wellness Center at Meadowmont, encourages them to join her for a brisk, heart-healthy walk.

That's just one of the creative strategies for maintaining a healthy cardiovascular system that Hinderliter and her husband, Alan, a cardiologist at the University of North Carolina at Chapel Hill School of Medicine, share with their patients.

Despite advances in medical care, heart disease has remained the leading killer of Americans for the past 80 years. Each year, about 650,000 Americans die from heart disease, a term that refers to problems such as heart arrhythmias, heart failure and coronary artery disease, which can lead to heart attacks.

Alan Hinderliter said mortality from heart disease has decreased in the past decade because of better treatments and lifestyle changes.

"People are less likely to smoke than they were 20 years ago," he said. "They're a little more likely to exercise."

But he cautioned that the rise in obesity and diabetes, important risk factors for heart disease, has cut into these gains. Meanwhile, children exercise less than they did in previous generations, thanks to the prevalence of video games and cuts to physical education classes.

Exercise has a myriad of benefits to the heart. It strengthens the heart and cardiovascular system and can help people lose weight. Significantly, exercise can also improve mood.

"That in turn can affect how we feel about ourselves and affect a lot of our lifestyle choices," Alan Hinderliter said.

In other words: Exercise helps you fight the blues, which means you'll be less likely to eat unhealthy comfort foods.

But surprisingly, while researchers know that exercise is beneficial, they have not yet untangled how it causes positive changes in the body.

"We don't fully understand the mechanism," Alan Hinderliter said.

Most current knowledge about exercise and heart disease has been determined from observational studies, in which scientists track the eating and exercise habits of large groups of people over many years. Such studies enable researchers to show that exercise habits and heart disease are related, but can not directly show how one causes effects in the other.

When such experiments are done, Alan Hinderliter said, researches will better understand the optimal forms and quantities of exercise to get.

In the meantime, the Hinderliters advise people starting a new exercise program to consult a physician and to start slowly.

"A lot of people try to do too much at once and fail or become injured," Judy Hinderliter said. "I really encourage people to start out gradually with any changes in eating and exercise, so it becomes part of their lifestyle."

Other tips:

Turn social occasions into fitness time. (The Hinderliters went on a run for their first date, redefining the meaning of "heart-pounding.")
Schedule exercise into your day, just as you do with other appointments.
Vary the type and intensity of exercise to avoid boredom.
Play games, such as tennis, racquetball or squash. Such games are "a way to keep it fun and interesting, but also a great workout," Alan Hinderliter said.
If you can afford a personal trainer, get one. A professional can help you design an effective exercise program and show you how to avoid injuries.
If you can, try walking to work. "Instead of a 15-minute commute, make it a half-hour walk," Alan Hinderliter said.
Don't forget to eat a heart-healthy diet: whole grains, lean meat and low-fat dairy products, plenty of fruits and veggies, and few saturated fats. For an average person, the caloric content of a tablespoon of butter requires a mile of walking to burn off, Judy Hinderliter said.
Get a minimum of 30 minutes of moderate exercise, such as brisk walking, at least five times a week, or 30 minutes three times each week of vigorous exercise such as running, swimming, bicycling or playing basketball.
The bottom line on exercise? "The more the better, for the most part," Alan Hinderliter said.

Five things every woman should know about heart health

tom_hughes — 2010-01-22T15:12:59Z

Tuesday, Jan. 19, 2010

Nearly 500,000 women in the U.S. die from heart disease each year. It is the number one killer of all women. However, women who have heart attacks tend not to seek help from doctors as quickly as men do. Women often wait an hour longer than men to seek help, and that hour can sometimes be too late. Dr. Paula Miller, Cardiac Rehabilitation Director of the UNC Heart Center, says it's time that women take heart and take care of their cardiovascular health. In this video, she explains five things every woman should know about heart health.

Family House Diaries: Taking One Day at a Time Post-Bone Marrow Transplant

tom_hughes — 2010-01-13T20:22:28Z

Wednesday, Jan. 13, 2010

Written by Elizabeth Swaringen for the UNC Medical Center News Office

CHAPEL HILL, N.C. – For Lilly Parillo, a bone marrow transplant at UNC Hospitals rid her 19-year-old body of chronic myelogenous leukemia.

Now, it’s the mandatory, non-negotiable 100-day post-transplant stay in Chapel Hill that’s taking its toll.

Parillo, of Asheville, had the bone marrow transplant on Oct. 8 for chronic myelogenous leukemia, a condition she was diagnosed with in November 2005. The transplant may also rid her body of juvenile dermatomyositis, an immune system condition that attacks muscles and was diagnosed when Parillo was seven years old. Her 100 days post-transplant end Jan. 15.

“This confinement is a temporary thing, but a long temporary,” said Parillo, who has standing appointments for a doctor’s visit and blood work twice weekly at UNC Hospitals. “I understand the need to stay close to the hospital and the SECU Family House has been the perfect home-away-from-home, but there’s no place like home.

“Still, I’m grateful for the excellent care I received here, the generosity of the unknown international donor who gave the cells for transplant, and a God who has watched over me every step of the way.”

The odyssey leading to the transplant began in Spring 2009. Lilly had been taking Gleevec for a number of years, and surprisingly the chemotherapy drug had kept her juvenile dermatolmyositis in check, but had failed to control her chronic myelogenous leukemia.

“I felt fine and still wasn’t convinced I had leukemia, but all the tests showed that my blood was sick,” Parillo said, “very sick.”

Her oncologist in Asheville, Christopher Chay, M.D., referred her to UNC Hospitals where he had completed his residency after earning his medical degree at the UNC School of Medicine. Jennifer Jaroscak, M.D., assistant professor of pediatric hematology and oncology at the UNC School of Medicine, leads Parillo’s treatment team.

The blood test done in preparation for finding a donor match for Parillo revealed that her lineage included Caucasian of Polish ancestry, Hispanic, African-American, American Indian and Asian-Pacific Islander ethnicities. “I’ve always said she is ‘one in a million’,” said Coco, Lilly’s mother, and an elementary school teacher. “I realized those words took on new meaning in trying to find a donor.”

Caucasians have the greatest chance of finding a perfect match in an unrelated donor, so Lilly’s transplant team knew that the search for a donor would likely have to be international, said Dr. Jaroscak, adding that Lilly’s story reinforces the growing need for people of all ethnicities to have their blood typed and registered with the National Marrow Donor Program (www.marrow.org).

“The process of being typed is easy – a simple blood draw and a swab of the cheek – but the potential for the good that can come from being registered is enormous,” Dr. Jaroscak said. UNC Hospitals sponsors blood typing drives for the registry once or twice a year, free of charge.

(For persons interested in becoming a donor, it is easy to get registered. Register online at http://www.marrow.org/JOIN/index.html, or in person at a local registry drive. Check for the location of the closest drive on the same Web site.)

On May 22, word came that a perfect 10-for-10 match had been found in an international donor, a woman in her 30s with two children. “She’s our needle-in-a-haystack angel,” Coco said.

A tentative date for the bone marrow transplant was scheduled for Aug. 10, but a case of strep throat in June and a common cold in August delayed the transplant until Oct. 8.

In preparation, Lilly was admitted to UNC Hospitals on Sept. 30 and given chemotherapy to kill her sick immune system. She also had her waist-length wavy chestnut hair cut off and her head shaved. “At least my head is a nice shape,” Lilly recalls, “but I want to have hair like that again.”

Over the course of about 90 minutes, Lilly received the donated bone marrow. Within five minutes, it was accepted by her body. The staff sang “Happy Birthday” in recognition of Lilly’s new life.

On Oct. 25 – Day +18 – no leukemic cells were detected in Lilly’s blood and she was released to SECU Family House, a 40-bedroom hospital hospitality house minutes from UNC Hospitals that provides comfortable, convenient and affordable housing for adult patients undergoing treatment for critical illness and trauma and their family member caregivers. Coco – who had stayed by Lilly’s side the 25 days she was hospitalized – joined her there and they settled in for the next 100 days.

“The 100-day post-transplant stay is necessary because with bone marrow transplants, it takes a minimum of 100 days for the body and its immune system to be back to minimum performance levels, barring any complications,” said Dr. Jarosack. “Complications from bone marrow transplants – specifically graft vs. host disease and the risk of infection – can become life-threatening if not tended to immediately. Patients have to be near a bone marrow transplant unit in case a complication arises. It’s not negotiable.”

SECU Family House is the perfect location for bone marrow transplant patients and their families, Dr. Jaroscak said, because beyond the comfortable accommodations and cheerful surroundings, it is five minutes from the hospital and a shuttle provides door-to-door service. “It’s a huge comfort and convenience to our patients – and their families – that enhances their ability to heal and move forward,” Dr. Jaroscak said.

Lilly has experienced some complications – nausea, vomiting, mouth sores, some fever, fatigue – that are common among bone marrow transplant patients, but she continues to improve. And she’s found a wig that will do until her own hair grows back.

“She’s doing remarkably well,” said Dr. Jaroscak. “Patients don’t usually engraft – start growing their own cells – until three to six weeks after transplant. Lilly was engrafting at Day +14. Some of the complications may keep her in Chapel Hill a little past that 100-day mark, but all things considered, she’s doing well.”

Lilly has spent her days enrolled in on-line courses through Blue Ridge Community College, teaching herself Spanish and cross-stitching. Fatigue is still an issue, but when she feels like it, Lilly works out with the Wii Fit in the suite she shares with Coco at SECU Family House. “That work-out is good for both of us,” the mother-daughter duo said, almost in union.

A career in sales and marketing interests Lilly and she’s a fanatic for reggae music and Latin dancing. She danced long into the night before arriving in Chapel Hill on Sept. 30. She hopes to be back on the dance floor soon.

“Lilly’s never been a stay-at-home kind of gal,” said Coco, “but we can’t be home soon enough. And from here on, we’ll look forward to celebrating two birthdays with Lilly – July 2, her original birthday, and Oct. 8, the beginning of her new life.”