- WSU breakthrough research of essential molecule reveals important targets in diabetes and obesity
In Headlines on June 18, 2013
Assia Shisheva, Ph.D.
Insulin is the most potent physiological anabolic agent for tissue-building and energy storage, promoting the storage and synthesis of lipids, protein and carbohydrates, and inhibiting their breakdown and release into the circulatory system. It also plays a major role in stimulating glucose entry into muscle tissue, where the glucose is metabolized and removed from the blood following meals. But gaps exist in understanding the precise molecular mechanisms by which insulin regulates glucose uptake in fat and muscle cells.
A research team led by Assia Shisheva, Ph.D., professor of physiology in Wayne State University’s School of Medicine, has made breakthrough advancements on a molecule that may provide more answers to this mystery.
The conserved phospholipid enzyme PIKfyve was discovered in Shisheva’s lab in 1999. Based on studies in cultured cells, the lab has implicated PIKfyve in the insulin-regulated glucose transport activation, which led to the development of a unique mouse model with PIKfyve removal in muscle, or MPlfKO, the tissue responsible for the majority of postprandial glucose disposal.
In Dr. Shisheva’s recent paper, “Muscle-specific PIKfyve gene distribution causes glucose intolerance, insulin resistance, adiposity and hyperinsulinemia but not muscle fiber-type switching,” published online in the American Journal of Physiology - Endocrinology and Metabolism, she and her research team characterize whether this new model exhibits metabolic defects.
“Our team found a striking metabolic phenotype in the MPIfKO mice consisting of glucose intolerance and insulin resistance at an early age and on a normal diet,” Dr. Shisheva said. “We also revealed that PIKfyve is essential for normal insulin signaling to GLUT4/glucose transport in muscle and provided the first in vivo evidence for the central role of PIKfyve in the mechanisms regulating healthy blood glucose levels, or glucose homeostasis.”
In addition, the research team found that these metabolic disturbances were followed by increased animal fat (adiposity) and elevated levels of insulin (hyperinsulinemia), but not abnormal amounts of lipids or cholesterol in the blood (dyslipidemia).
“The combined phenotype manifested by the MPlfKO mouse closely recapitulates the cluster of typical features in human pre-diabetes, including systemic glucose intolerance and insulin resistance, hyperinsulinemia and increased visceral obesity without dyslipidemia,” she said. “Therefore, our mouse model, in addition to providing novel mechanisms of insulin resistance, represents a valuable tool for exploring new preclinical strategies to improve treatments in individuals with pre-diabetes.”
Funding for this research was provided by the National Institute of Diabetes, Digestive and Kidney Disease of the National Institutes of Health (R01 DK058058), Wayne State University’s Office of the Vice President for Research and the School of Medicine, and the American Diabetes Association. In-house instrumentation available at the Institutional Center for Integrative Metabolic and Endocrine Research ensured a more complete mouse metabolic phenotyping.
- Journal of Child Neurology publishes results of epilepsy workshop in Africa organized by Dr. Harry Chugani
In Headlines on June 17, 2013
Harry Chugani, M.D.
Delegates and speakers at the first African Child Neurology workshop addressed the topic of children with epilepsy in Africa.
The results of a training workshop in Sub-Saharan Africa organized by Wayne State University School of Medicine physician and researcher Harry Chugani, M.D., have been published in the Journal of Child Neurology.
Dr. Chugani, the Rosalie and Bruce Rosen professor of neurology and chief of pediatric neurology for the School of Medicine and Children’s Hospital of Michigan, organized “Epilepsy in Children in Developing Countries,” which was held Feb. 1-4, 2012, in Entebbe, Uganda.
The aim of the meeting was to develop an active lobbying body to identify strategic goals in the management of children with epilepsy in Africa. Doctors from 19 countries in Africa and five countries outside Africa attended. Speakers taught basic diagnosis and treatment of epilepsy in children. Dr. Chugani gave opening and concluding remarks, and lectured on the role of neuroimaging in epilepsy.
“People were very enthusiastic, and they’ve kept in touch and asked us questions,” he said. “They didn’t just learn from us and we didn’t just learn from them. They learned from each other.”
A follow up, "Children with Epilepsy in Africa: Recommendations from the International Child Neurology Association/African Child Neurology Association workshop," is an open-access article included in the journal’s April 2013 issue. In it, Dr. Chugani and co-author Jo Wilmshurst of the University of Cape Town, South Africa, outline the need for epilepsy specialists trained to advocate for better care of the continent’s children diagnosed with the chronic neurological disorder characterized by recurrent seizures.
The authors write that the viability of international guidelines for the management of children with epilepsy should be reviewed within each African country, and adapted to comply with regional capacity, which can be used to lobby for resources. They recommend more training centers be developed in Africa, in collaboration with visiting specialists, so future advocates can educate themselves within the country in skills relevant to the needs of the continent, Dr. Chugani said.
Those needs include the ability to navigate and overcome the country’s stigma, prejudice and misconceptions about epilepsy. Epilepsy teams, including traditional healers, would enable management of increased numbers of children with epilepsy. These teams should also challenge policy, allowing for reliable access to appropriate anti-epileptic drugs, support and health care equity between the continent’s rural and urban settings.
The World Health Organization estimates that as many as 10 million people in Africa have epilepsy. While that amount is not rationally higher than any other part of the world, physicians treating epilepsy in developing African countries face several challenges specific to the continent, including lack of available health resources, medication shortages – especially anticonvulsants – as well as the social stigma attached to the disease, which is incorrectly viewed as a mental illness of which to be ashamed, Dr. Chugani said. Close to 90 percent of Africans with epilepsy receive no treatment at all, he added. Epilepsy responds to treatment about 70 percent of the time, yet 75 percent of affected people in developing countries do not get the treatment they need, according to the WHO.
“The treatment gap in Africa is very high. It is an immense problem,” he said. “Most Sub-Saharan Africa countries don’t even have a single pediatric neurologist. In fact a lot of the care is provided by nurses, and some pediatricians who have some knowledge, but not a lot.”
Dr. Chugani is president of the International Child Neurology Association. The ICNA is a voluntary organization with free membership. He organized the workshop as his presidential project.
“I wanted to target Africa because that’s where I saw the most need,” he said, adding that epilepsy, his research topic of interest, is one of the country’s largest health problems.
The group recommended at least one child neurology specialist per 100,000 people. Internet resources could be used as a central forum to present unusual patients, especially for second opinions and expert advice. The group recognized the need to strategize the random system of “advice seeking” to ensure good clinical practice is maintained and optimal care is offered. Telemedicine could also be utilized for review of electroencephalogram and magnetic resonance imaging scans when an on-site specialist isn’t available locally.
“If we get funding for it, we could do it (here),” he added.
Dr. Chugani is senior author on the journal paper, with contributions from researchers in Kenya, South Africa, England, Nigeria, Malawi and at the U.S. National Institute of Neurological Disorders and Stroke.
A grant awarded to Dr. Chugani and the School of Medicine from the NINDS (NIH 3 R13 NS077658) provided the majority of the funding for the 2012 meeting, with contributions from the World Federation of Neurology, the Japanese Child Neurology Society, the Child Neurology Society, Children’s Hospital of Michigan and the Segawa Foundation.
Follow up meetings are planned, as are other educational workshops like it for a variety of regions across the world, organized by the ICNA, including past and upcoming lectures in Sri Lanka, Myanmar, Mongolia, Kaunas (in the Baltic region), India and China.
“We go to these countries, talk to them, educate them, and teach them to advocate to legislatures for their patients,” he said. “We teach them how to lobby and how to set up patient support groups. We see patients in the wards with them.”
The ICNA recently launched its own electronic journal and offers a variety of open-access lectures, includes those from the epilepsy meeting in Uganda, at www.ICNApedia.org.
“We are totally nonprofit and totally voluntary. We really want to get to the African countries and the developing nations,” he said.Donations are needed to cover travel expenses for workshop participants living in Africa and traveling within the continent, which Dr. Chugani said is cost-prohibitive for most, including physicians. Those interested may donate to the Positron Emission Tomography Research and Development Fund, Wayne State University School of Medicine Development and Alumni Affairs, 540 E. Canfield, Detroit, MI 48201. Donations will not be used to cover Dr. Chugani’s travel expenses. Please indicate the fund name in the memo line.
- WSU Family Medicine teams up with Detroit Lions Living for the City program
In Headlines on June 14, 2013
Members of the Food Medicine Interest Group, who are WSU School of Medicine students, volunteer at the showing of “A Place at the Table.”
Dana Rice, Dr.P.H., left,with other guests at the event.
Panelists included, from left, Craig Fahle of WDET; Joe Nader, executive chef, Levy Restaurants- Ford Field; Sara Gold, director of Michigan No Kid Hungry, United Way for Southeastern Michigan; Margit Chadwell, M.D.,WSU Department of Family Medicine and Public Health Sciences; Kami Pothukuchi, Ph.D., associate professor of WSU Urban Planning; and Dan Carmody, president of Eastern Market Corp.The Wayne State University School of Medicine’s Department of Family Medicine and Public Health Sciences teamed with the Detroit Lions Living for the City initiative to call attention to the issues of food insecurity and hunger in the region.
The Detroit Lions and the WSU department, along with Levy Restaurants, Eastern Market Corp., and Gleaners Community Food Bank, hosted a June 11 charity screening of the film “A Place at the Table” at Ford Field. The documentary investigates incidents of food insecurity in America.
After the film, a moderated panel discussion with some of Michigan’s food economy experts, public health, policy advocates, researchers and physicians took place. Margit Chadwell, M.D., F.A.A.F.P., assistant professor of family medicine and public health sciences, served as a panelist. Dr. Chadwell is co-principal investigator of the federally-funded Bridges to Equity Program housed in the department. The program develops and implements educational programming to engage medical students in inter-professional collaboration with public health students and faculty on community-based projects to reduce health disparities.
Launched in 2012, the Detroit Lions Living for the City philanthropic effort focuses on sustainable community health, wellness and development. Its goals include supporting transformational efforts that improve the well-being of metropolitan Detroit’s underserved. The initiative supports organizations that pursue integrated approaches to physical fitness, healthy eating, housing, land use and environmental planning, public transportation and community infrastructure.
“This collaborative effort is in keeping with our department’s strategic goals, which include increasing our current level of high quality educational presence and community collaboration through service and engagement and contributing to a healthier Detroit and Michigan,” said Juliann Binienda, Ph.D., assistant professor of family medicine and public health sciences, and co-principal investigator of the school’s Bridges to Equity Program. “When we learned that one of the goals of the Living for the City initiative was to improve access to and promote the health and wellness of the residents of the metropolitan Detroit region, we felt that a formal relationship would only help to strengthen both of our goals.”
The Bridges to Equity program, in addition to seeking to increase medical student knowledge and active involvement in reducing health disparities through public health initiatives, works to expand existing integrated population health educational program curriculum in all four years of training in the School of Medicine, and enhance and modify the scope and sequence of the current M.D./M.P.H. degree to emphasize health care equity.
Following the launch of the Living for the City program, Dana Rice, Dr.P.H., adjunct assistant professor of family medicine and public health sciences and wife of former Detroit Lions safety Ron Rice, began meeting with team officials to discuss ways in which the department could partner with the community program.
“Based on those conversations, we both felt that the relationship between our major academic medical institution and our local NFL team could only enhance both missions,” Dr. Rice said. “We came to the mutual conclusion that formalizing our relationship would ensure the creation of a sustainable partnership for years to come.”
- Medical student Jannel Lee-Allen wins scholarship named for 1958 graduate Dr. Charles Vincent
In Headlines on June 14, 2013
Jannel Lee-Allen, right, meets Martha Vincent, wife of Charles C. Vincent, M.D., at the Wayne County Medical Society of Southeast Michigan’s annual meeting in May 2013.
Married mother of two Jannel Lee-Allen spends the majority of her days and nights studying to become a doctor. But when the Wayne State University School of Medicine student earns the title of physician in 2016, it won’t be her first stint as a working professional.
The Wayne County Medical Society of Southeast Michigan Foundation awarded Lee-Allen the Charles C. Vincent, M.D., Memorial Scholarship at the society’s 2013 annual meeting, held May 22 at the Detroit Athletic Club. She will use the $2,500 scholarship for summer living expenses.
The award is given annually to a WSU medical student who reflects the work of its namesake, a 1958 graduate and former associate dean of admissions for the School of Medicine. Lee-Allen, mother to an 8-year-old son and 6-year-old daughter, was once a typical 20-something career professional, working for seven years in nonprofit and public housing development in Detroit after earning her master’s degree in urban planning from WSU.
She had a chance to speak with Dr. Vincent’s wife, Martha, after receiving the scholarship.
“She said she felt like her husband would be pleased with the choice,” she said. “He was committed to the African-American community.”
Dr. Vincent, an obstetrician and gynecologist, received the School of Medicine’s distinguished alumni award in 1981. The Wayne County Medical Society established the scholarship in 2000 to honor his work as an advocate for the health and well-being of the Detroit community, including his efforts to combat teen pregnancy. It is presented annually to a WSU medical student on the basis of financial need and academic merit, once the students have qualified for admission to the School of Medicine.
Assistant Dean of Student Affairs Lisa MacLean, M.D., recommended Lee-Allen for the scholarship at the suggestion of De’Andrea Wiggins, interim director of the Office of Diversity and Inclusion.
“Her (urban planning) degree speaks to her interest in policies as it relates to urban issues, which is of particular interest if she is to be a culturally-competent physician,” Wiggins said.
Lee-Allen, a resident of Detroit, was raised in New York City’s Harlem neighborhood in upper Manhattan. Her mother, a state nursing aide, encouraged her to pursue medicine as an undergraduate student at the University of Pittsburgh, where Lee-Allen majored in neuroscience. She moved to Detroit to study urban planning after graduation. Years later, after funding to the Detroit nonprofit for which she worked was cut, she thought about starting a new career. “I began to soul search for a little bit,” she said.
The 32 year old will enter her second year of medical school this fall. She recently completed one-week externships shadowing a gastroenterologist and a neurologist with St. John Providence Health System, and was one of only 13 first-year students picked to prepare cadavers – termed prosecting – this summer for the incoming Class of 2017’s general anatomy courses. She will serve as external vice president of the Black Medical Association for 2013-2014.In addition to receiving the scholarship, Krishna Sawhney, M.D., offered to sponsor Lee-Allen’s student membership in the Wayne County Medical Society, which includes membership in the Michigan State Medical Society and American Medical Association.
- Dr. Horn appointed chair of Physical Medicine and Rehabilitation - DMC
In Headlines on June 12, 2013
Lawrence Horn, M.D., M.R.M.Lawrence Horn, M.D., M.R.M., has been appointed chair of the Wayne State University School of Medicine’s Department of Physical Medicine and Rehabilitation at the Detroit Medical Center - Rehabilitation Institute of Michigan.
Valerie M. Parisi, M.D., M.P.H., M.B.A., dean of the School of Medicine, announced the appointment June 12. The appointment is effective immediately.
Dr. Horn has served as interim chair of the department since mid-2010.
“While serving as interim chair, Dr. Horn has proven to be a strong leader, and due to his outstanding performance and leadership, the faculty of the department unanimously elected to forgo a national search and recommended that he be appointed chair. The school’s executive committee of the faculty senate and the university administration also supported this decision,” Dean Parisi said. “I, too, am convinced Dr. Horn is the appropriate person to lead the department as we continue building the future of our School of Medicine.”
A professor with the department since 2005, Dr. Horn previously served 12 years as professor and the Coughlin Chair of the Department of Physical Medicine and Rehabilitation at the Medical College of Ohio, which is now the University of Toledo School of Medicine.
“It is an honor to continue the rejuvenation of the reputation of the department to national prominence once again,” said Dr. Horn, a resident of Monroe, Mich. “We are fortunate to have the support of the dean and the administration of the Rehabilitation Institute of Michigan in this endeavor.”
One of his immediate goals, he said, is to recruit mid-career physiatrist-scientists to the department.
Dr. Horn’s specialty interests include traumatic brain injury and spasticity. He received a bachelor’s degree in medicine from Northwestern University, and a medical degree from the same university in 1978. He earned a master’s degree in rehabilitative medicine from the University of Washington in 1981. His post-graduate experience includes a combined internship and residency at University of Washington Affiliated Hospitals in Seattle and a fellowship in rehabilitation of traumatic brain injury at the Santa Clara Valley Medical Center, a Stanford affiliate. He is subspecialty certified in spinal cord injury medicine.
He has served as the WSU Department of Physical Medicine and Rehabilitation residency program director since 2006, and is the service chief for physical medicine and rehabilitation at the Barbara Ann Karmanos Cancer Institute, and medical director of the Neuroscience Program at the Rehabilitation Institute of Michigan. In addition, he is an advisory board member for the WSU Department of Bioengineering and previously served as vice chair for the Neurological Rehabilitation Program Planning Committee of the American Academy of Physical Medicine and Rehabilitation.
Twice a winner of the Frank M. Blumenthal Award for Excellence in Teaching from the Wayne State University- Detroit Medical Center Department of Physical Medicine and Rehabilitation, Dr. Horn has continuously been named to the Bester Doctors in America list.
- Michigan GEAR UP visits the School of Medicine
In Headlines on June 7, 2013
GEAR UP students get a close-up look at the Kado Clinical Skills Center.Thirty-two eighth-graders from Earhart Middle School in the Michigan Gaining Early Awareness and Readiness for Undergraduate Programs visited the Wayne State University School of Medicine on June 3.
GEAR UP is a federally-funded grant program that offers college exposure and support services to inner-city middle and high school students.
The morning program began with a welcome from De’Andrea Wiggins, Ph.D., interim director of the Office of Diversity & Inclusion, who discussed the pipeline between high school and becoming a physician.
Next, the students visited the Kado Clinical Skills Center, where Phil Gilchrist, director of Operations for the center, led half of the students on a tour of the facility while Joe Weertz, outreach coordinator, led the other students in a hand-washing demonstration.
Joining the morning’s activities were Lori McParlane, standardized patient supervisor, and Peter Durham, Pipeline site coordinator.