UR Medicine Experts Host Lupus Education Program Oct. 15

Thursday, September 29, 2016

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People living with lupus and caregivers can learn more about latest therapies and research during UR Medicine’s Lupus Education Day from 9 a.m. to 12:30 p.m. Saturday, Oct. 15, at the University of Rochester Medical Center.

“This is a great opportunity for people with lupus to learn about new therapies and research, and network with others,” said Jennifer Anolik, M.D., Ph.D., director of UR Medicine’s Lupus Clinic, which is nationally recognized for clinical expertise and research. Anolik works with adult rheumatologists R. John Looney, M.D., and Ummara Shah, M.D.

As part of the 10th annual program, international lupus expert Richard Furie, M.D., of Northwell Health, formerly North Shore-Long Island Jewish Health System, will address “Blocking interferon — New breakthroughs in lupus treatment.” Other sessions will center on research and clinical trial updates, pain management in lupus and the popular patient panel.

Registration for the free event is requested; call Lindsey Junge at (585) 273-4670.

Lupus is an autoimmune disorder that can vary from a mild condition to a life-threatening illness. It can cause joints to swell and attack the kidneys, heart, lungs and liver, leading to pain, dysfunction, and sometimes permanent damage to healthy tissues.

More than 1.5 million Americans suffer with the potentially fatal disease. About 90 percent of patients are women who were diagnosed during their childbearing years. The disease can be a challenge to diagnose, but detecting it early is essential to minimize damage to the organs and improve quality of life.

Most people with lupus can control the disease with medication and consistent monitoring by physicians. A smaller set of patients, however, suffer a more extreme disease course, sometimes facing life-threatening problems.

University of Rochester Medical Center lupus researchers lead laboratory and translational research programs to advance patient care. The team of scientists and clinicians were recently selected to join the National Institutes of Health Accelerating Medicines Partnership in Rheumatoid Arthritis and Lupus Network. The program is a partnership between the NIH, biopharmaceutical companies, advocacy organizations and academic scientists to more rapidly identify promising drug targets and develop much-needed new treatments for patients with these conditions.

To learn more about UR Medicine’s Lupus Clinic, go to http://www.urmc.rochester.edu/medicine/allergy/patients-families/lupus-clinic.cfm.

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URMC Researchers Discover Rare Flu-Thwarting Mutation

Wednesday, September 28, 2016

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An influenza virus attacks a respiratory tract cell

A rare and improbable mutation in a protein encoded by an influenza virus renders the virus defenseless against the body’s immune system. This University of Rochester Medical Center discovery could provide a new strategy for live influenza vaccines in the future.

A new approach to the live flu vaccine would be particularly advantageous right now after the Centers for Disease Control and Prevention stopped recommending use of the live attenuate flu vaccine, FluMist® earlier this year. Several studies found that the pain-free nasal spray, which was used in about one-third of young children in the U.S., offered no protection to that especially vulnerable population. The flu shot, on the other hand, performed well and the CDC recommends using this vaccine in place of FluMist®.

“There is a need to understand what's happening with the existing live vaccine and potentially a need to develop a new one,” said David Topham, Ph.D., Marie Curran Wilson and Joseph Chamberlain Wilson Professor of Microbiology and Immunology at URMC and author of the study. “We proposed that the mutation we found could be used to create a live vaccine.”

David Topham, Ph.D.

The mutation weakens the flu virus by making the flu-encoded protein, called Non-Structural 1 (NS1), defunct. Flu virus needs NS1 to prevent interferon, the immune system’s front line against viruses, from alerting the host cell that it has been infected. Inhibiting interferon affords the virus time to multiply and spread before the immune system can mount an attack.

Most people have healthy interferon responses and would quickly and easily fend off this weakened mutant strain of flu, but, “this virus somehow managed to find the one person that had an interferon defect that allowed it to replicate,” said Topham.

The probability of this virus surviving and infecting a human is so low – it is as if Topham and lead study author, Marta Lopez de Diego, Ph.D., research assistant professor of Microbiology and Immunology, found a needle in a haystack. The pair isolated the mutated virus from a nasal swab of a single flu sufferer who happened to be among the small percentage of people with inadequate interferon responses. When they looked for the NS1 mutation in a national database, it showed up in just 0.03 percent of all flu strains reported.

This naturally-occurring “attenuating” flu mutation could provide a new way to make live flu vaccines, which contain viruses that are alive, but “attenuated”, or weakened, so the vaccine itself does not cause illness in humans. Topham and Lopez de Diego suspect their NS1 mutation could be a great way to prevent viruses in the live vaccine from infecting anyone who has normal interferon responses, which is most people.

The study, published online in the Journal of Virology, also highlights the importance of flu virus surveillance – conducting studies like Topham’s to see how the flu is changing, what flu mutations are circulating in humans and animals, and how those mutations affect virus function.

Topham believes health leaders are not doing enough of that research. “The influenza field is largely fixated on studying pandemic or potential pandemic viruses, but those viruses only infect a few dozen people every year whereas seasonal flu infects millions – and yet we don't study human influenzas closely enough.”

In fact, the World Health Organization estimates 1 billion flu infections each year, causing 300,000 to 500,000 deaths.

Until recently, researchers believed that proteins like NS1 did not change much from strain to strain and season to season, but Topham’s study and others show that NS1 mutations occur naturally and can affect its ability to suppress immunity. Monitoring for these mutations in nature could help us produce better vaccines that save more lives.

The University of Rochester Medical Center is home to approximately 3,000 individuals who conduct research on everything from cancer and heart disease to Parkinson’s, pandemic influenza, and autism. Spread across many centers, institutes, and labs, our scientists have developed therapies that have improved human health locally, in the region, and across the globe. To learn more, visit http://www.urmc.rochester.edu/research.

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Nelson Receives International Honor for HIV Disparities Research

Tuesday, September 27, 2016

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LaRon Nelson was recognized for his work improving HIV care, being named the inaugural Research Chair in HIV Program Science for African, Caribbean and Black (ACB) Communities by the Ontario HIV Treatment Network.

The Ontario HIV Treatment Network (OHTN) has selected University of Rochester Assistant Professor of Nursing and UR Center for AIDS Research Associate Director of International Research LaRon E. Nelson, Ph.D., R.N., F.N.P. to be its inaugural OHTN Research Chair in HIV Program Science for African, Caribbean and Black (ACB) Communities.

In order to better provide integrated health services for populations most affected by HIV, the OHTN has launched a new program to promote health service innovation, naming three new applied HIV research chairs.

“Each of these research leaders has a unique vision for improved HIV care,” said Tony Di Pede, chair of the OHTN Board of Directors. “The review process identified leaders with the proven ability to work with people and communities across the health care system to investigate and implement solutions.”

Nelson will be appointed as a scientist with the Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto, where he will build on his previous successful implementation of a self-determination-theory-based public health strategy to support HIV pre-exposure prophylaxis uptake and adherence among Black men who have sex with men in three U.S. cities (Los Angeles; Washington, D.C.; and Durham, N.C.). In Ontario, Nelson will lead research focused on reducing HIV disparities in ACB communities across the HIV continuum of care, from prevention to care outcomes, such as symptom management and viral suppression.

This is the second major honor for Nelson in Canada. In 2011, the Canadian government named him one of the nation’s Rising Stars in Global Health.

“I am excited for the opportunity to continue applying my expertise in public health nursing and HIV research to reduce racial and ethnic disparities in HIV infection and care outcomes in communities outside of the United States” said Nelson.

Sixty percent of all African, Caribbean and Black Canadians live in the province of Ontario, which is home to Toronto, the fourth largest metropolitan area in North America. ACB communities in the province are disproportionately affected by HIV. Although these communities make up less than 5 percent of Ontario’s population, they accounted for 25 percent of all new HIV diagnoses in 2015, according to the OHTN.

As the newly appointed OHTN Research Chair in HIV Program Science for African, Caribbean and Black Communities, Nelson will lead program science research on the design, evaluation, translation, and implementation of evidence-based interventions and public health strategies. He will work with regional health departments, community partners, policy makers, and an interdisciplinary team of scientists to implement multilevel prevention packages that are optimized to the needs of ACB communities in the Greater Toronto Area (GTA), which can then be replicated in other Ontario communities.

Nelson’s work in the GTA will start with ACB communities, individuals living with HIV, community service and public health providers in the Region of Peel. The team will help efforts to improve upon coordination and integration of HIV prevention, diagnosis and care for the rapidly growing ACB communities who are migrating west to the region. The new program will use customized mobile technology to address common barriers to prevention and care. Nelson will also develop and mentor a network of early-stage ACB Canadian researchers across Ontario.

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Nuclear Protein Causes Neuroblastoma to Become More Aggressive

Tuesday, September 27, 2016

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Aggressive forms of neuroblastoma contain a specific protein in their cells’ nuclei that is not found in the nuclei of more benign forms of the cancer, and the discovery, made through research from the University of Rochester Medical Center (URMC), could lead to new forms of targeted therapy.

EYA1, a protein that contributes to ear development, is present in the cytoplasm of many neuroblastoma tumors, but this protein migrates to the nucleus in the cells of more aggressive forms of the disease. The research, recently published in two medical research journals, allows for the development of targeted drugs that will work to prevent the neuroblastoma from reaching this more aggressive stage; researchers at URMC and elsewhere have already begun testing some of these potential treatments in a laboratory setting.

“Neuroblastoma is one of the most common and deadly forms of childhood cancer, and this discovery allows us to identify drugs that prevent the change in EYA1 structure and potentially minimize the danger to a child who has this disease,” said Nina Schor, M.D., Ph.D., professor of Pediatrics and Neuroscience and the William H. Eilinger Chair of Pediatrics at URMC.

The EYA1 protein enters the cancer cell’s nucleus due to the presence of an enzyme called PRMT1. The presence of this enzyme also results in the increased hardiness of a second protein, N-MYC, which has long been known to increase the aggressiveness of neuroblastoma when it is present in higher-than-normal amounts.

So by limiting the effectiveness of the PRMT1 enzyme, researchers believe they can decrease the damage done by both proteins at once.

“Inhibitors of PRMT1 may deliver a ‘one-two punch’ to neuroblastomas before they become deadly,” said Schor.

The research was published in the Journal of Cancer Research & Therapy and Oncotarget. Schor’s collaborators include co-lead-author Xingguo Li, Ph.D., as well as Jeanne Hansen, Ph.D., Louis T. Lotta, Jr., and Allison Eberhart of URMC; Linda J. Valentijn, Ph.D., and Jan Koster, Ph.D., of the Academic Medical Center of the University of Amsterdam; and Yujun George Zheng, Ph.D., and Kun Qian, of the College of Pharmacy of the University of Georgia. The work was funded by Crosby's Fund for Pediatric Cancer Neuroblastoma Research, Strong Children's Research Center Small Grant Program, and the William H. Eilinger endowment of UR Medicine's Golisano Children's Hospital.

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UR Medicine Launches Outpatient Lactation Medicine/Breastfeeding Practice

Wednesday, September 21, 2016

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UR Medicine is launching the area’s first physician-led outpatient practice dedicated to lactation medicine and breastfeeding. The practice will provide women with medical care and support for breastfeeding issues before conception, during pregnancy, and after childbirth.

Casey Rosen-Carole, M.D., M.P.H., MSEd, is Medical Director of UR Medicine’s Lactation Services and Programs and will lead the new UR Medicine Breastfeeding practice. Two office locations will be offered for outpatient breastfeeding consultations: University OB/GYN at 125 Lattimore Road and Strong Perinatal Associates, 500 Red Creek Drive. Rosen-Carole also provides inpatient consultations at Strong Memorial Hospital for mothers and newborns.

“Establishing this practice fills a need for patients who require breastfeeding help after their hospital discharge,” said Rosen-Carole, who specializes in breastfeeding medicine and pediatrics. “Rochester hospitals do a good job of helping mothers establish breastfeeding, but often issues surface later, when mom and baby are in the home environment. Growing a robust outpatient support community in Rochester is critical to help these women.”

The practice also provides essential medical supervision and support for complex medical issues that can make breastfeeding challenging. Some of these include babies born prematurely, or with cleft palate or ankyloglossia (“tongue-tie”), and mothers undergoing treatment for chronic illnesses, including cancer, who still wish to breastfeed.

“We know the benefits of exclusive breastfeeding for the optimal health and well-being of babies, mothers, and communities,” Rosen-Carole said. “But each woman has her own unique goals and challenges for breastfeeding her child. My role is to provide the appropriate medical services and support to help her reach those goals.”

Rosen-Carole is the first physician to complete a formal fellowship in the still-evolving field of breastfeeding medicine. The specialized training was developed by Ruth A. Lawrence, M.D., the Northumberland Trust Professor of Pediatrics at the University of Rochester and an internationally recognized expert in breastfeeding medicine.

Rosen-Carole earned her joint medical degree and master’s degree in public health at New York Medical College School of Medicine and completed a residency in Pediatrics at Yale New Haven Children’s Hospital. She was a practicing community pediatrician and residency faculty from 2008-2009 at Yale, then directed a pediatric practice and served as Chair of Pediatrics in New York's Hudson Valley as faculty for the Mid-Hudson Family Medicine Residency program from 2009-2014. She relocated to Rochester to pursue the fellowship in Breastfeeding Medicine and General Academic Pediatrics.

Rosen-Carole’s research focus has been in systems change for breastfeeding education and support. Other areas of interest include community organizing to address social determinants of health, programming for diversity and equity, and obesity prevention and management. She is fluent in Spanish and French.

To schedule an appointment, call UR Medicine Breastfeeding at (585) 276-MILK (276-6455).

For more information, visit UR Medicine Breastfeeding’s web site: www.urmc.edu/breastfeeding.

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