School of Medicine

Wayne State University School of Medicine
Annual Palliative Care Conference set for Oct. 11
In Headlines on September 16, 2013
Timothy Quill, M.D.

Timothy Quill, M.D.

Gail Elliot Patricolo

Gail Elliot Patricolo

The seventh annual Palliative Care Collaborative Regional Conference presented by the Wayne State University Department of Internal Medicine and the WSU Center to Advance Palliative Care Excellence will take place Oct. 11 at the Dearborn Inn.

The target audience for the conference, which begins with registration and breakfast at 7 a.m. and runs until 3:30 p.m., includes hospital leadership, palliative care teams, clinicians, hospice leadership, nurses, social workers, physicians, psychologists, counselors, chaplains, volunteers, educators, administrators and students.

This year’s keynote speakers are Timothy Quill, M.D., and Gail Elliott Patricolo.

Dr. Quill is the Thomas and Georgia Gosnell Distinguished Professor in Palliative Care at the University of Rochester School of Medicine and Dentistry, where his also is professor of medicine, psychiatry, medical humanities and nursing. He is the director of the Palliative Care Division within the Department of Medicine, a board certified palliative care consultant, and the immediate past president of the American Academy of Hospice and Palliative Medicine.

Dr. Quill has published and lectured widely about various aspects of the doctor-patient relationship, with special focus on end-of-life decision-making, including delivering bad news, non-abandonment, discussing palliative care earlier and exploring last-resort options. He is the author of several books on end-of life, including “Physician-Assisted Dying: The Case for Palliative Care and Patient Choice” (Johns Hopkins University Press, 2004), “Caring for Patients at the End of Life: Facing an Uncertain Future Together” (Oxford University Press, 2001) and “A Midwife Through the Dying Process: Stories of Healing and Hard Choices at the End of Life” (Johns Hopkins University Press, 1996). His new book, co-edited with Franklin Miller, “Palliative Care and Ethics: Common Ground and Cutting Edges,” will be published by Oxford University Press early in 2014. He is also an author of more than 150 articles published in major medical journals, including “Death and Dignity: A Case of Individualized Decision Making,” published in 1991 in the New England Journal of Medicine. Dr. Quill was the lead physician plaintiff in the New York State legal case challenging the law prohibiting physician-assisted death that was heard in 1997 by the U.S. Supreme Court (Quill v. Vacco).

Patricolo is director for Integrative Medicine at Beaumont Health System. Her role has been to design, implement and direct holistic medicine services for patients, caregivers and staff at multiple locations in the hospital system.

Under her guidance the program is one of the largest of its kind in the nation. She has a graduate degree from Oakland University in Complementary Medicine and Wellness, and has studied and worked in the area of integrative medicine. She is a stress reduction expert and a guided imagery specialist. Patricolo is known for being extremely passionate about the integration of mind-body approaches to health and healing with conventional medicine. She will lead a guided imagery exercise at the conclusion of the conference.

Cost of the conference is $125 for physicians, $75 for nurses and other health care professionals, and $25 for students.

To register, visit http://capewayne.med.wayne.edu/pdfs/registration_brochure_pc_conference_2013_1.pdf.

For additional information, contact Michael Stellini, M.D., at 313-319-3340 or mstellini@med.wayne.edu.
WSU Postdoc Appreciation Week launches Oct. 14
In Headlines on September 12, 2013
Philip Clifford, Ph.D.

Philip Clifford, Ph.D.

The Wayne State University Postdoctoral Association will celebrate WSU’s first Postdoc Appreciation Week Oct. 14-18.

The WSU-PDA has planned activities on campus to honor and appreciate postdocs and recognize the contributions they make to research and development at WSU during the weeklong celebration. The events include a movie night, doughnut and cider socials, a vendor show with lunch, postdoc appreciation gifts and the first of what will become an annual Postdoctoral Research Symposium.

For detailed information on the week’s events, including the symposium, visit PAW-2013 information at http://gradschool.wayne.edu/postdoc/pda/paw.php.

Set for Oct. 18, the symposium will feature professional and career development opportunities for postdocs at WSU, an elite panel of invited guests to discuss career pathways for postdocs in academia, industry, science communication and entrepreneurship, and a keynote address by Philip Clifford, Ph.D., associate dean of the Graduate School of Biomedical Sciences and professor of anesthesiology and physiology at the Medical College of Wisconsin.

Dr. Clifford is an outspoken advocate for postdoctoral education at local and national levels and a strong proponent of career planning for doctoral scientists. In addition to inaugurating the Office of Postdoctoral Education at the Medical College of Wisconsin, he helped initiate national reform by participating in the establishment of both the National Postdoctoral Association and the Association of American Medical College’s Graduate Research Education and Training Group Postdoctorate Leaders Section. In 2012, he received the NPA’s Distinguished Service Award. He contributed to the development of key documents used in the postdoctoral community, including the Federation of American Societies for Experimental Biology Individual Development Plan for postdoctoral fellows, the AAMC GREAT Group’s “Compact Between Postdoctoral Appointees and Their Mentors” and the NPA Postdoctoral Core Competencies. He is a coauthor of the recently launched career website http://myidp.sciencecareers.org/.

The symposium also will feature postdoctoral research work at WSU. All postdocs are encouraged to submit abstracts for poster presentation. The top six presenters will receive awards. Additionally, the WSU-PDA announced two new awards to be presented at the symposium: Outstanding Paper by a WSU postdoc, either published or in press within the past two years; and Mentor of the Year, to be awarded to a faculty member who has demonstrated exceptional support for postdoctoral training at WSU.

The call for poster abstracts and request for outstanding paper submissions is now open. A call for nominations for the Mentor of the Year Award will be announced soon.
School of Medicine campus REMAINS OPEN Sept. 12
In Headlines on September 11, 2013

To all School of Medicine students, faculty and staff:

Although Wayne State University’s main campus is closed due to a power outage, the School of Medicine has power and remains open and operational Sept. 12, per School of Medicine Dean Valerie M. Parisi, M.D., M.P.H., M.B.A. Classes will continue as scheduled.

Human remyelination study in MS launched at WSU and Harper University Hospital
In Headlines on September 10, 2013
Omar Khan, M.D.

Omar Khan, M.D.

A groundbreaking study in multiple sclerosis focusing on “remyelination in the brain” has been initiated by Omar Khan, M.D., professor and chair of neurology at the Wayne State University School of Medicine.

"This is a novel approach in the treatment of multiple sclerosis, which is characterized by diffuse demyelination and axonal loss in the central nervous system,” said Dr. Khan, who also serves as director of the Multiple Sclerosis Center and director of the Sastry Foundation Advanced Imaging Laboratory. “In this study, we are targeting remyelination in the central nervous system.”

Dr. Khan noted that there are 10 United States Food and Drug Administration-approved treatments for multiple sclerosis, none with any well-characterized reparative or remyelinating potential. Those treatments primarily focus on altering the behavior of the immune system and target inflammation.

However, this new approach targets remyelination in the central nervous system using a humanized monoclonal antibody that binds to the semaphorin 4D, a member of the semaphorin family of proteins and an important mediator of axonal growth cone guidance. Semaphorin-induced signaling also has been shown to induce growth cone collapse of neurons and apoptosis of neural precursors, and to induce process extension collapse and apoptosis of oligodendrocytes. Semaphorins consist of a family of soluble and membrane-bound proteins that were originally defined as axonal-guidance factors. These proteins play important roles in establishing precise connections between neurons and their appropriate targets.

“Therefore, it is a plausible target with the realistic goal of achieving remyelination,” Dr. Khan said. “This is a paradigm shift and the start of the next generation of therapies to treat multiple sclerosis that will change its focus to repair rather than inflammation.”

The brain can largely be divided into gray and white areas. Neurons are located in the gray area, and the white parts are where neurons send their axons – similar to electrical cables carrying messages – to communicate with other neurons and bring messages from the brain to muscles. The white parts of the brain are white because a cell type called oligodendrocytes makes a cholesterol-rich membrane called myelin that coats the axons. The myelin’s function is to insulate the axons, similar to the plastic sheath coating electrical cables. In addition, the myelin speeds communication along axons and makes that communication more reliable. In patients with MS, their immune system attacks the myelin sheathing. The subsequent degradation leads to the messages from the brain to other parts of the body leaking and derailing from their intended target.

Restoring the myelin sheathing is the goal of Dr. Khan’s new study.

The Wayne State University Multiple Sclerosis Center, in collaboration with Vaccinex, a privately-held biotechnology company headquartered in Rochester, N.Y., initiated this early stage dose-defining study.

“If successful, this will lead to large scale studies with this molecule targeting remyelination in the brain as a primary focus, detected by advanced imaging techniques such as magnetization transfer ratio,” Dr. Khan said. “The real challenge will be to reverse or reduce conduction blocks in the demyelinated nerve that may translate into neurologic improvement. If we could achieve that with this approach, it opens the door for hundreds of thousands of multiple sclerosis patients for whom no therapy is currently effective. This may also provide a unique opportunity in combining therapies with different mechanistic approaches.”

WSU is home to the largest MS center in Michigan and among the 10 sites in the world undertaking this translational initiative. The center is among the top five MS centers in the U. S., with more than 4,000 patients. The center is involved in cutting-edge immunologic, genetic, MR imaging and therapeutic studies.

Dr. Khan said only three molecules in the world, including this monoclonal antibody, are being investigated in patients with multiple sclerosis that focus on remyelination.

“It is humbling to lead such a unique groundbreaking effort and that Wayne State University is one of the few centers in the world that are participating in this next true generation translational research,” he said. “The patients are observed over night at Harper University Hospital, which has been a great partner in facilitating this research endeavor.”

Multiple sclerosis affects more than 500,000 people (or one in 600) in the U.S. and more than 2 million worldwide. After trauma, it is the most common cause of disability in young adults. While there is no cure, several treatments are approved for the relapsing form of multiple sclerosis that reduces the frequency of flare-ups and slows disease progression.

WSU study on MS named one of Top 10 published in 2012
In Headlines on September 6, 2013
Robert Lisak, M.D.

Robert Lisak, M.D.

A study by a team of Wayne State University School of Medicine researchers was named one of the 10 best papers on multiple sclerosis research published in 2012 in an article in the Multiple Sclerosis Journal.

“The 'best' basic science paper on multiple sclerosis in 2012,” written by Dr. Don Mahad of the Centre for Neuroregeneration, University of Edinburgh, and published in the July 2013 issue of  the Multiple Sclerosis Journal, recognized a study headed by Robert Lisak, M.D., professor of neurology, among the best articles on MS. The WSU study, “Secretory products of multiple sclerosis B cells are cytotoxic to oligodendroglia in vitro,” was published in the May 2012 issue of the Journal of Neuroimmunology.

“The detection of immunoglobulin-independent secretory products of B cells that were cytotoxic to oligodendrocytes by Lisak and colleagues raised interesting avenues for further exploration of the contribution of B cells to the GM pathology of MS,” Dr. Mahad wrote. “Having proposed a potential role for B cells in GM pathology, the next challenge in translating the findings to patients that attend MS clinics is to develop relatively non-invasive techniques to identify MS patients with B cell aggregates.”

“We think that our approach to investigating a novel and unexpected mechanism of how B lymphocytes might contribute to the development of damage to the cerebral cortex in different stages of multiple sclerosis is important and could lead to more focused forms of treatment,” Dr. Lisak said. “We are gratified to see that others are in agreement on the potential importance of this work.”

B cells, a subset of lymphocytes (a type of circulating white blood cell), mature to become plasma cells and produce immunoglobulins, the proteins that are antibodies. The B cells appear to have other functions, including helping to regulate other lymphocytes, particularly T cells, and helping to maintain normal immune function when healthy.

In patients with MS, the B cells appear to attack the brain and spinal cord, possibly because there are substances produced in the nervous system and the meninges – the covering of the brain and spinal cord – that attract them. Once within the meninges or central nervous system, Dr. Lisak said, the activated B cells secrete one or more substances that do not seem to be immunoglobulins, but that damage oligodendrocytes, the cells that produce a protective substance called myelin.

The B cells appear to be more active in patients with MS, which may explain why they produce these toxic substances and partially why they are attracted to the meninges and the nervous system.

The researchers took B cells from the blood of seven patients with relapsing-remitting MS and from four healthy patients. They grew the cells in a medium, removed the cells from the culture, then collected the material produced. After adding the material produced by the B cells to the brain cells of rats, including the cells that produce myelin, the scientists found significantly more oligodendrocytes died when compared to material produced by the B cells from the healthy control group. The team also found differences in other brain cells that interact with oligodendrocytes in the brain.

The team is now working to identify the toxic factor or factors produced by B cells responsible for killing oligodendrocytes. Identification of the substance could lead to new therapeutic methods that could switch off the oligodendrocyte-killing capabilities of B cells, which, in turn, would help protect myelin from attacks.

In addition to Dr. Lisak, the research team includes Joyce Benjamins, Ph.D., professor of neurology; Samia Ragheb, Ph.D., assistant professor of neurology and of immunology and microbiology (now assistant professor of Biomedical Sciences at Oakland University William Beaumont School of Medicine); Liljana Nedelkoskaa, research assistant in neurology; and Jennifer Barger, research assistant in neurology; as well as researchers at the Montreal Neurological Institute and McGill University in Montreal.

Dr. Smitherman to discuss Affordable Care Act on MSNBC this Saturday
In Headlines on September 6, 2013
Herbert Smitherman Jr., M.D., M.P.H.

Herbert Smitherman Jr., M.D., M.P.H.

Herbert Smitherman Jr., M.D., M.P.H., F.A.C.P., assistant dean of Community and Urban Health and associate professor of internal medicine for the Wayne State University School of Medicine, will appear as a guest Sept. 9 on the “Melissa Harris-Perry Show” on MSNBC.

The live program runs from 10 a.m. to noon. Dr. Smitherman will discuss the Affordable Care Act, and its status in terms of implementation.

“The Affordable Care Act, or ‘ObamaCare,’ is comprehensive health care reform that will significantly reduce insurers’ practices that limit care and bring more stability to our nation’s families’ insurance coverage,” Dr. Smitherman said. “This is the right thing to do, the right side of history and the right policy direction for a civil society, and therefore our nation.”

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