CTSI welcomes new trainees and scholars

researchOn July 1, 3 new KL2 scholars and 8 new CTSI Year Out trainees began their projects that are funded by the CTSI’s KL2 Career Development Program and Year Out (ART) Program for Medical Students.

KL2 scholars

Beau Abar, PhD
Mentor: Manish Shah, MD, MPH
Project Title: “Examining Barriers to Treatment for Depression among Older Adults”

Megan Lytle, PhD
Mentor: Vincent Silenzio, MD, MPH
Project Title: “Lesbian, gay, bisexual, and transgender (LGBT) health disparities/suicide prevention”

Suzannah Iadarola, PhD
Mentor: Tristram Smith, PhD
Project Title: “Parent-Focused Intervention for Parents of Children with Autism Spectrum Disorders”

Year Out trainees

Josef Bartels
Mentor: Ronald Epstein, MD
Project: “The Qualities of Science”

Michael Geary
Mentor: Regis O’Keefe, MD, PhD
Project: “Modulation of the prostanoid receptor EP4 to reduce scarring during flexor tendon healing”

Trevor Hansen
Mentor: Richard Phipps, PhD
Project: “Thy1 Expression as a Marker and Therapeutic Target for Scar Formation in Capsular Contracture following Reconstruction Mammoplasty”

Kelly Makino
Mentor: Anton Porsteinsson, MD
Project: “Advance Care Planning in Early Dementia Study”

Kyle Rodenbach
Mentor: George Schwartz, MD
Project: “Crystatin-C-based renal reserve in children with history of hemolytic uremic syndrome-associated acute kidney injury”

Lauren Roussel
Mentor: Howard Langstein, MD
Project: “Evaluating Upper Extremity Function Following Mastectomy in Reconstructed and Non-Reconstructed Women with Breast Cancer”

Elizabeth Saionz
Mentor: Jeffrey Bazarian, MD, MPH
Project: “Post-concussion progesterone decline in female athletes”

Lindsay Wahl
Mentor: Patricia Sime, MD
Project: “One Protein, Multiple Functions: The Role of Tissue Transglutaminase in Pulmonary Fibrosis”

CTSI Incubator Grant Furthers Psoriatic Arthritis Studies

Patients who develop psoriatic arthritis usually have some warning. Psoriasis, a skin condition characterized by splotchy patches of redness, typically precedes the arthritis by about 10 years.

Chris Ritchlin, M.D., M.P.H.

Chris Ritchlin, M.D., M.P.H.

But even with all that lead time, addressing the disease — which occurs in 30 percent of psoriasis patients — has proved challenging. So in the hopes of advancing treatments or even preventing the condition, researchers at UR Medicine are now studying a specific molecule on the surface of the cells that lead to the crippling form of arthritis, which results in joint inflammation in 50 percent of patients within two years of diagnosis.

The research, led by Chris Ritchlin, M.D., M.P.H., chief of the Department of Allergy, Immunology, and Rheumatology at UR Medicine, is supported by a 2-year, $250,000 incubator grant from the CTSI, which began on July 1.

“If we can identify targets that we can inhibit, we can block the formation of these bone-resorbing cells,” said Ritchlin. “We can develop new medications to stop bone-resorbing diseases like arthritis, osteoporosis, metastatic cancer.”

The molecule being studied, DC-STAMP, is responsible for cell fusion, and winds itself through the cell membrane on osteoclast precursors. Minsoo Kim, Ph.D., associate professor of microbiology and immunology at UR Medicine and co-principal investigator for the project, devised a sequence of rhodopsin molecules that would fuse to DC-STAMP. This allows researchers to activate the molecule and study its properties, a critical advance, since the molecule that binds to DC-STAMP remains unknown.

Minsoo Kim, Ph.D.

Minsoo Kim, Ph.D.

But advancing the basic science behind DC-STAMP is merely one of the three goals of Ritchlin’s research.

The second aim is to determine whether DC-STAMP-expressing cells can drive inflammation as well as bone damage. To accomplish this, Ritchlin is taking mice that don’t possess any DC-STAMP molecules and placing two different kinds of cells — DC-STAMP- and DC-STAMP+ — from healthy mice into the bone marrows of irradiated mice prone to arthritis.

If his hypothesis is accurate — that DC-STAMP-expressing cells trigger arthritis — then the would-be arthritic mice won’t develop the disease after transplant when given DC-STAMP- cells but would show joint inflammation when given DC-STAMP+ cells.

Ritchlin is also working alongside Brendon Boyce, M.B.Ch.B, vice chair for anatomic pathology and co-principal investigator in the project, for the third prong of the research, which studies patients who already have aggressive psoriatic arthritis.

Brendan Boyce, M.B.Ch.B.

Brendan Boyce, M.B.Ch.B.

Patients with psoriatic arthritis don’t always respond to certain medications, so Ritchlin and Boyce are studying another important cell molecule called TRAF3. By measuring the level of TRAF3 in a patient’s blood  cells, the researchers believe they can determine whether anti-Tumor Necrosis Factors (TNF) agents, costly but effective drugs in about 60% of psoriatic arthritis patients, are likely to relieve joint inflammation and damage before starting the drug.

They are also following  the level of DC-STAMP+ cells in the blood after starting anti-TNF agents since this marker drops rapidly in patients who respond clinically.

“There are a lot of drugs we can treat patients with,” said Ritchlin. “By identifying those early response markers, we can say ‘This drug is working, we should keep them on it,’ or we can switch them to another drug.”

Eddie Schwarz, who was on the committee that selected Ritchlin’s work from an array of proposals, said that the project exemplified what the CTSI was looking for it was seeking a match for its incubator grant.

“It starts with a highly-significant problem with unmet clinical needs, as well as several remarkable discoveries,” said Schwarz, associate director for funding programs at the CTSI. “What we’re looking for in the incubator as much as anything, is integrated projects by two or more PIs that really have the potential to synergize and accelerate the pace of basic science, clinical research, and translation to human health.”

The CTSI recently released requests for applications for both the CTSI Incubator Program and the CTSI Pilot Awards Program.

CTSI Welcomes Informaticist Jack Chang

In 2009, Jack Chang went to the leadership of the Henry M. Jackson Foundation for the Advancement of Military Medicine and told them that there was a need for a program that did one thing and one thing only: managed information.

“Researchers were using old-fashioned ways to manage data. The majority was on discrete spreadsheets and word/pdf documents, and they were buried in massive data files that couldn’t be discovered or integrated with any other data sources,” said Chang. “Things were handled individually by different departments and there was no centralized mechanism to support research.”

Jack Chang, M.S.

Jack Chang, M.S.

So Chang got the go-ahead to create an information management program. Five years later, the program had grown to over 10 staffers, including a programmer, an administrator, and several bioinformaticians, biostatisticians and clinicians, all of whom were dedicated to make sure information was easily accessible and usable.

“People were dying for that kind of setup,” said Chang. “But they didn’t even know we could do it, because they all had different expertise.”

In June, Chang joined the CTSI, and working with researchers across the University, he’s hoping to help create a similar infrastructure. Tim Dye, director of biomedical informatics at the CTSI, said that Chang has a wealth of experience in several key areas.

“He will help us jumpstart some use-cases that show our institution’s capacity to tackle technical challenges, like handling very large, complex datasets, amassing and reusing administrative and clinical data for research purposes, and assuring that privacy and security are priorities in the management of research data,” said Dye.

Data management systems have been created by other departments, of course, so Chang has spent much of his first few months on the job meeting with other researchers and informaticists within the University, to ensure he isn’t duplicating the efforts of others.

“Instead, we should try to integrate those efforts,” said Chang, senior associate of biostatistics and computational biology and senior research informaticist for the CTSI.

Data management has become a priority for the CTSI and other areas of the university because making data accessible is only the first step. The data also needs to be catalogued and well described.

For example, many university labs have been collecting blood or tumor samples for years, but the sample quality can vary wildly according to specific study requirements. So the mere knowledge that those samples exist isn’t helpful to a researcher unless it comes with a lot of additional information.

“You have to know what kind of specimens you have,” said Chang. “Is there enough blood? Are there enough tumor samples? How are the specimens being processed? Have they been well preserved, and how? High quality samples lead to high quality research, but poorly managed samples are worthless.”

When Chang isn’t at the CTSI, you might find him working on his golf game or watching classic American cinema — Roman Holiday starring Audrey Hepburn is one of his favorites. His office is within the CTSI Director’s Suite; stop by and say hello.

CTSI Announces 2014 Faculty Pilot Funding Awardees

2014 Pilot Funding Awardees: R. Eliseev, R. Looney, E. Guancial, S. Spinelli, C. Morrell, E. Messing

2014 Pilot Funding Awardees: R. Eliseev, R. Looney, E. Guancial, S. Spinelli, C. Morrell, E. Messing

Six URMC faculty members are beginning new research projects funded by CTSI pilot awards for 2014-2015. The CTSI’s pilot program offers faculty members one-year awards for up to $50,000 to facilitate new research and future funding. Multidisciplinary research is strongly encouraged, as well as clinical and community based research, practice-based research, and health services research. The CTSI is currently accepting applications for the 2015 pilot awards, abstracts are due by September 2nd, 2014 and the full RFA can be found here. The 2014 faculty awardees are:

Roman Eliseev, MD, PhD
Assistant Professor of Orthopaedics
Project: Improving mitochondrial function in MSCs to accelerate fracture repair in aging

Elizabeth Guancial, MD
Assistant Professor of Medicine (Hematology/Oncology)
Project: Chemoprevention of bladder cancer through estrogen receptor modulation

Richard J. Looney, MD
Professor of Medicine (Allergy, Immunology, and Rheumatology)
Project: Role of the Gut Microbiome in Preventing Allergic Disease

Edward Messing, MD
Chair of Urology
Project: Exosomes from bladder cancer patients can serve as biomarkers of disease

Craig Morrell, DVM, PhD
Associate Professor of Medicine (Aab Cardiovascular Institute)
Project: Novel microRNA Based Therapy to Improve CD4+ T-cell Responses to Vaccination

Sherry Spinelli, PhD
Research Associate Professor of Pathology and Laboratory Medicine
Project: The Role of Microparticle-Derived Thy-1 (CD90) in Type 2 Diabetes Mellitus

Congratulations to all of the awardees!!!!!

CTSI Pilot Grant Leads to $3.6M in NIH Funding

As schoolchildren enter their teenage years, they tend to start making more of their own health care decisions. But that transition can be challenging, and certain behaviors — such as making sure they take their daily asthma medication — can sometimes fall through the cracks.

In an attempt to help urban teens keep their asthma symptoms in check, Jill Halterman, M.D., M.P.H., associate professor of pediatrics at UR Medicine’s Golisano Children’s Hospital, has developed a study which combines giving students their medications at school with motivational counseling specifically designed for teens.

Jill Halterman, M.D., M.P.H.

Jill Halterman, M.D., M.P.H.

“We plan to encourage the teens to reflect on how good they feel when they’re using their preventive medication routinely,” said Halterman. “For example, if the student is an athlete, they might notice better performance in their sport. We’ll help them think about that so they can decide, on their own, whether they want to be independent with taking their medication.”

The 5-year study, which was developed in partnership with the Rochester City School District and the district’s nurses, is supported by a $3.6 million grant from the National Institutes of Health. A pilot study, which generated initial data used in the application to NIH, was funded by the CTSI.

“Dr. Halterman’s study is a fascinating project that has the potential to improve health for teens across the country, and it’s also a perfect example of what our Pilot Program is designed to do,” said Kathleen Jensen, executive director of finance for the CTSI.  “Relatively small investments from the CTSI can be used to generate the early stage data that can lead to big awards like this one.”

The most common chronic childhood illness, asthma affects an estimated 1 in 10 children and teenagers in the United States. Low-income and minority youth develop asthma even more often, and Halterman has spent the past decade attempting to improve outcomes for this population.

The team’s School-Based Asthma Therapy trial for younger children, which began in 2006 and involved 530 children in the City School District, showed reduced asthma morbidity and decreased absenteeism for students who took their daily medication in the presence of a school nurse.

The new study will modify and expand on some of these methods, randomly assigning teens to three different conditions. For the first six to eight weeks of the school year, some teens will take their medication in front of a school nurse, who can provide instruction, if necessary. The hope is that the teen can then transition to independent medication use after receiving a special counseling intervention that emphasizes the benefits of daily preventive therapy.

The study, which aims to enroll 430 teenagers starting in the 2014-2015 school year, will compare the teens’ adherence and asthma outcomes to groups of teens that receive alternate levels of intervention. The ultimate goal of the program is develop an effective new system of care for urban teens that can be continued in the city school district and disseminated to other sites.

Director’s Update – July 2014

Every month, the CTSI Stories Blog will post excerpts from ongoing conversations with the institute’s co-directors.

Below, Harriet Kitzman offers her takeaways from the Mini Summer Research Institute, which was held on June 19.

On the Mini Summer Research Institute:

HarrietKitzman2

Harriet Kitzman, co-director of the CTSI

Overall, I thought it went very well, and many of the presentations were exceptionally good. The morning session covered a significant amount of new methodological information, and it had the grand design in terms of community-centered health, which Nana Bennett covered. Tim Dye addressed new sources of quantitative data — new sources of big data. Sally Norton offered new approaches to qualitative research, unfamiliar to many in the room but increasingly called for by new funding mechanisms. This was combined with the example from Helena Temkin-Greener, that was very helpful to many. And, Sally Thurston, of course, did a very clear job in discussing the challenges of design and analysis.

On why it’s important to involve collaborators early when putting together a study design:

Sally Thurston’s talk contributed to the spirit of collaboration by describing the worst thing that can happen; it occurs when people are working on a grant, and they sit and talk amongst themselves for an entire year. They get this grand design of what they’re going to do, but then they get to the budget and they realize as they’re doing it that they can’t write a budget description, because they haven’t been clear on how they will conduct the work and analyze the data.  And then, they go to biostatistics and they hear, “For this to be a credible piece, your sample has to be three times as large as it is,” and they know it is unrealistic to obtain the sample with the funds available. So, the notion of getting those pieces together early and working on the steps in design and implementation collaboratively is really important.

On improvements for next year:

I always think of things in terms of what one could have been done, but during lunch, there was a nice dialogue. So I think the lunch break could have been longer — maybe one less presentation in the afternoon and a little more time for dialogue would have been good. But all in all, it was the first time we’d done this, and I think what it showed is that there are a lot of people interested in the questions about where these fields are going and who might be willing to join in the pursuit.


Previous director’s updates:

June 2014 – Karl Kieburtz gives an overview of the CTSI’s six pillars.