School of Medicine

Wayne State University School of Medicine
Jain Foundation awards Dr. Dennis Drescher grant to study disorders of muscle and inner ear
In Headlines on July 28, 2015
Dennis Drescher, Ph.D.

Dennis Drescher, Ph.D.

Wayne State University School of Medicine Professor of Otolaryngology and of Biochemistry Dennis Drescher, Ph.D., was awarded a $121,764 grant from the Jain Foundation of Seattle, Wash., to study how the origins of muscular dystrophy may be related to genetic deafness through specialized proteins known to repair cell membranes, called ferlins. Both skeletal muscle and the inner ear contain ferlins, which are involved in membrane fusion and repair processes.

The Jain Foundation is an organization devoted to research on a form of muscular dystrophy termed LGMD2B/Miyoshi, caused by a defect in a protein called dysferlin. Dr. Drescher’s research offers the potential of better diagnoses of ferlin-based disorders and will provide a deeper understanding of underlying mechanisms.

“The Jain funding presents a great opportunity to examine at the molecular level how nature uses related proteins to accomplish similar purposes across different organs of the body,” Dr. Drescher said. “As specialists, we often don’t consider the investigation of biological systems outside our own particular focus. Jain support will allow us to compare directly the related actions of ferlins in these genetic diseases.”

He is the principal investigator on the grant, “Molecular-Functional Comparisons of the Dysferlin Membrane Repair Complex with the Otoferlin Synaptic Complex,” along with co-principal investigator and Associate Professor of Otolaryngology Marian Drescher, Ph.D. Research Associate Selvakumar Dakshnamurthy, Ph.D., will aid in the experimental investigations.

LGMD2B/Miyoshi muscular dystrophy, or dysferlinopathy, is characterized by progressive skeletal muscle wasting and eventual non-ambulation. Heart and diaphragm muscles are largely unaffected and patients have normal lifespans. Holes formed in muscle membranes through vigorous exercise are normally repaired by dysferlin, but abnormal dysferlin cannot repair these defects, and thus the affected patients lose muscle integrity.  Dysferlinopathy presents in two forms – one producing weakness in the upper arms and thighs (LGMD2B) and the other resulting in weaknesses in the calves and lower arms (Miyoshi). The latter is detected by the patient’s inability to stand on tiptoes.

In the auditory system, one form of inherited deafness, DFNB9, is caused by a defect in a ferlin protein called otoferlin. Otoferlin helps small packets of neurotransmitter fuse with the cell membrane and release a signal that results in the sensation of sound. Otoferlin or related ferlins may aid in repairing inner-ear membranes disrupted after exposure to loud noise. Mutations in the otoferlin gene cause the neurosensory nonsyndromic recessive deafness, DFNB9. A hallmark of diagnosis of DNFB9 deaf patients is that they may be profoundly deaf but their ears continue to generate low-level acoustic signals or otoacoustic emissions, showing that some of the sensory cells of the ear are working while others are severely impaired by the absence of otoferlin.

Dr. Drescher will present his current work on dysferlin and otoferlin at the Jain Foundation Scientific Conference, set for Nov. 4-7 in Toronto.

WSU team shares abroad team visit study on mini nutrition tool in teaching
In Headlines on July 27, 2015
From left, Stephen Bruer, Jennifer Mendez, Ph.D., and Mai Sedki attended the International Academy Nutrition and Aging conference in Spain.

From left, Stephen Bruer, Jennifer Mendez, Ph.D., and Mai Sedki attended the International Academy Nutrition and Aging conference in Spain.

A trio from the Wayne State University School of Medicine visited Spain last month to present the results of research on WSU’s utilization of a tool called Mini Nutrition Assessment in medical education.

Fourth-year medical student Mai Sedki, with support from Medical Education Support Group staff member Stephen Bruer and Assistant Professor and Director of Co-Curricular Programs Jennifer Mendez, Ph.D., presented at the June 18-19 meeting of the International Academy on Nutrition and Aging in Barcelona.

“This is the first time the MNA has been assessed for student learning, and hence was the only student-led presentation at the conference,” said Dr. Mendez, a driving force behind the award-winning Interprofessional Team Visit Program along with the Department of Internal Medicine's Associate Professor and Vice Chair for Education Diane Levine, M.D.

Dr. Levine also co-wrote the presented study but was unable to attend the conference. 

MNA is used globally as a component of a comprehensive geriatric assessment, Sedki said. Screening for malnourishment in older adults allows for early detection and appropriate intervention to counteract any decline in health caused by nutrition deficiencies. The school’s second-year medical students use it during their Interprofessional Team Visits with older adults in the metropolitan Detroit area. The IPTV program, a collaboration between WSU's medical, pharmacy, nursing, social work, physical therapy, occupational therapy and physician assistant programs, serves 450 older adults in the Detroit area annually, and introduces 750 medicine, nursing, pharmacy, occupational therapy, physical therapy, physician assistant and social work students to the demands of assessing older adult health and social needs in a home environment. Each student from the respective fields used a different tool to deliver care to the adults at home. Medical students employed the MNA as their assessment tool.

Results after 812 MNA screenings completed from 2012 to 2015 showed that the vast majority of students surveyed had a positive perception of the MNA’s usefulness, yet third- and fourth-year students were less likely than their second-year colleagues to continue using it in clinical rotations and beyond.

“Presenting at this conference was an excellent opportunity to represent our education program in a wider community,” Sedki said. “It was really nice to contribute to the international conversation on the MNA. Many of the presentations focused on the clinical use of the MNA. By focusing on the MNA as a tool for education, and student perceptions, our presentation contributed something very unique that was missing from the current body of work.”

Sedki is a student researcher who has used the MNA as an IPTV program participant.

“The conference was informative and very diverse in terms of subject matter and international representation. Our medical education system is so different than most in the world that we really needed to translate the level of education a second-year medical student receives in comparison to students in other countries,” she said.

Conference participants included clinical and academic faculty and administration from Australia, Italy, France, Germany, Switzerland, Israel, the United States, Canada and Spain.

Wayne State to lead $4.8 million NIH study that will teach old drug to maintain its tricks
In Headlines on July 23, 2015
Keith Kaye, M.D.

Keith Kaye, M.D.

With the decline of the development of new antibiotics due to the complexity and expense of discovering them, there has been a rapid growth of antibiotic-resistant pathogens that is one of the leading causes of death. With the help of a nearly $4.9 million, five-year grant from the National Institute for Allergy and Infectious Diseases of the National Institutes of Health, Wayne State University School of Medicine researchers are leading a landmark multi-center, international study that will provide essential information to clinicians for use of polymoxin B in critically ill patients when no other treatments will work.

The study, “Optimizing clinical use of polymyxin B: teaching an old drug to treat superbugs,” will focus on Gram-negative bacteria resistant to all other antibiotics except polymyxin B. Keith Kaye, M.D., professor of Infectious Diseases, will lead the study, which includes collaborators from Australia and Singapore.

“Our study will provide urgently needed information to guide clinicians in the proper intravenous dosing of polymyxin B in critically-ill patients,” Dr. Kaye said. “It is critical to have these dosing guides to assure that this agent of last resort is preserved and that these superbugs do not become resistant to it. These guides will aid in minimizing unnecessary toxic side effects of the drug.”

Since its release in the 1950s, there has been no clear definition of the optimal dose of  polymyxin B, nor how to minimize the emergence of resistance to the drug. Recent studies on polymyxins have focused on colistin methanesulfonate, or CMS. These studies have demonstrated that CMS has significant limitations, and therefore dosage recommendations for CMS should not be applied to polymyxin B.  Polymyxin B has fewer limitations than CMS.

The team will focus on defining the optimal dosage regimens by determining the association between dose and the timing of nephrotoxicity and use of next-generation proteomics to identify the most predictive biomarkers of polymyxin B-associated nephrotoxicity. One of the most exciting components of the study is to develop therapeutic drug-monitoring systems to assist physicians in optimizing polymyxin B dose and minimizing toxicity.

“Patients being treated with intravenous polymyxin B will be identified, and will have blood collected at various times surrounding a dose of polymyxin B between days one and five of therapy,” Dr. Kaye said. “Development of nephrotoxicity, clinical response and bacteriological response will be examined. Total and free plasma concentrations of polymyxin B will be determined, and bacterial isolates will be examined for the emergence of polymyxin resistance.”

Life-threatening infections caused by Gram-negative superbugs that become resistant to polymyxin B are practically untreatable. The results from this study will provide critical information that will guide clinicians in the proper intravenous useg of polymyxin B in critically ill patients, ultimately preserving the usefulness of the drug and maintaining its stature as an essential agent of last resort.

Collaborators on the grant include Jason Pogue, PharmD, of Sinai Grace Hospital, DMC; Jian Li, Ph.D., of Monash University, Australia; and Alan Forrest, PharmD, of the University of North Carolina.

The grant number for this National Institutes of Health award is AI119446.

DMC Foundation supports Wayne State's Make Your Date program
In Headlines on July 23, 2015
Sonia Hassan, M.D., speaks at the launch of Make Your Date in 2014.

Sonia Hassan, M.D., speaks at the launch of Make Your Date in 2014.

The Make Your Date program at Wayne State University has received a $100,000 grant from The DMC Foundation that will be used to expand existing processes and services for expectant mothers to reach their due dates and have healthy, full-term deliveries.

Make Your Date was launched in May 2014 as an initiative of Detroit Mayor Mike Duggan to implement evidence-based strategies through partnerships with health systems, universities, foundations and insurance providers to combat the city’s rates of preterm birth and infant mortality. In Detroit, 18 percent of babies are born premature, higher than the national average of 11.5 percent. The rate rivals some developing countries, said program director of Make Your Date, Sonia Hassan, M.D., associate dean of Maternal, Perinatal and Child Health.

“Research shows that coordinated prenatal care and the implementation of evidence-based medical strategies, when necessary, can radically reduce the risks,” said Dr. Hassan, a professor in the School of Medicine’s Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine.

Make Your Date is supported by the mayor's office, major medical institutions, universities including Wayne State University, foundations and insurance companies working together as a team dedicated to turning the tide against preterm birth. Support from partners like the DMC Foundation ensures that the program is successful in its mission. “The partnership with DMC Foundation is integral to the success of the Make Your Date Program due to most births in the city of Detroit occur at DMC’s Hutzel Women’s Hospital,” Dr. Hassan said.

Make Your Date’s mission especially fits the DMC Foundation’s priorities of supporting health and medical research, education, and community benefit activities relating to health outcomes, facilitating the provision of medical, health care and disease prevention services, improving the health in the community and leveraging public and private resources.

“Make Your Date’s collaboration with DMC Foundation has proven to be successful this past year and it is the hope of Make Your Date that the relationship will continue for many years to come in order to adequately serve the mothers and babies of Detroit,” Marisa Rodriguez said, Project Manager for the Make Your Date Program. Grant funds will be used to provide expectant mothers with assistance in signing up for prenatal care, group prenatal care, obtaining cervical length screening and access to progesterone gel treatment to reduce the risk of preterm delivery, prenatal care follow-up services, references for insurance registration, free prenatal education sessions, assistance with transportation, and referrals to services, including home visiting programs.

Expectant mothers can sign up by visiting www.MakeYourDate.org or calling 313-577-1000, regardless of where they may already obtain prenatal care.

The DMC Foundation, a supporting organization of the Community Foundation for Southeast Michigan, promotes the well-being of the metropolitan Detroit community through support of health and medical research, education and community benefit activities.

Journal of the AMA published editorial by Dr. Roberto Romero
In Headlines on July 22, 2015
Roberto Romero, M.D., D.Med.Sci.

Roberto Romero, M.D., D.Med.Sci.

The Journal of the American Medical Association recently published an editorial co-written by Roberto Romero, M.D., D.Med.Sci., chief of the National Institutes of Health’s Perinatology Research Branch at the Wayne State University School of Medicine.

Dr. Romero, who also is a professor of WSU Molecular Medicine and Genetics at Wayne State University and an attending physician at the Detroit Medical Center, co-wrote “Noninvasive Prenatal Testing and Detection of Maternal Cancer” with Maurice Mahoney, M.D., J.D., professor of Genetics, of Pediatrics, and of Obstetrics and Gynecology for the Yale University School of Medicine. Their editorial was published in the July 13 edition of the journal.

The editorial comments on a research article in the same edition titled “Incidental detection of occult maternal malignancies by noninvasive prenatal testing.” The article’s lead author is Diana Bianchi, M.D., founding executive director of the Mother Infant Research Institute at Tufts Medical Center, vice chair for Pediatric Research at Floating Hospital for Children, and the Natalie V. Zucker Professor of Pediatrics and Obstetrics and Gynecology at Tufts University School of Medicine.

“The constellation of findings that would increase the probability of detecting a maternal malignancy is present in only a small fraction of pregnant women,” Drs. Romero and Mahoney write. Noninvasive Prenatal Testing “already challenges the ability of clinicians to have patients understand that NIPT is a screening test, not a diagnostic test, that focuses on a limited set of fetal aneuploidies. The possibility of uncovering information relevant to maternal cancer will be a further challenge, yet may have important therapeutic implications for the patient. At this time, there is insufficient evidence about the benefits, risks and costs of reporting the incidental findings …. Given that it is likely that NIPT will increase in the coming years, an active dialogue among stakeholders (obstetricians, patients, laboratories, ethicists, policy makers, etc.) needs to take place to provide informed advice to potentially affected pregnant women and to guide the care of such patients.”

You can read the full editorial here.

Patient's family donates to Dr. Heath's prostate cancer research
In Headlines on July 21, 2015
The Baker family recently made a significant contribution to Karmanos. Pictured, from left, are daughter Lori Lockhart, the late David Baker, Carol Baker, and daughter, Colette Jasiak.

The Baker family recently made a significant contribution to Karmanos. Pictured, from left, are daughter Lori Lockhart, the late David Baker, Carol Baker, and daughter, Colette Jasiak.

Elisabeth Heath, M.D., F.A.C.P.

Elisabeth Heath, M.D., F.A.C.P.

When those who knew him talk of the late David R. Baker of Schoolcraft, Mich., they mention the word “giving” repeatedly. David started his battle against prostate cancer knowing that it had already advanced to his bones. After being treated at the Barbara Ann Karmanos Cancer Center for nearly eight years, he ended his battle in October 2014 at the age of 69.

David practiced giving back during his treatment process by taking part in multiple clinical trials to help further prostate cancer research. He chose to receive chemotherapy as part of various clinical trials rather than take part in standard treatment protocols.

“His main goal was, ‘I’m going to go somewhere where I can help other people,’” said his wife of almost 50 years, Carol Baker. “He always thought about other people.”

In memory of her husband, Carol, along with her daughters Lori Lockhart of South Lyon, Mich., and Colette Jasiak of Mattawan, Mich., chose to provide a donation to Karmanos. The gift will go specifically to David’s oncologist, Elisabeth Heath, M.D., F.A.C.P., professor of Oncology and of Internal Medicine for the Wayne State University School of Medicine, and the Patricia C. and E. Jan Hartmann endowed chair in Prostate Cancer Research at Karmanos, to further her research efforts to find a prostate cancer cure.

“There are hardly enough words to say how wonderful and knowledgeable that woman is,” Carol said. “She saved my husband’s life for seven and a half years. The years we were given and the support we received while at Karmanos were priceless. I wanted to give her the money for her to get an answer to prostate cancer, to help somebody else and to help those who can’t help themselves.”

Dr. Heath said she was “awestruck” when Carol gave her the check during a lunch meeting they shared after David’s death. “To come up with such a contribution, you can’t help but be overwhelmed by their generosity and that it’s for the continuance of prostate cancer research,” she said. “I was just speechless.”

Dr. Heath said David was a joy to care for and that he played an active role as a patient in helping to advance research by taking part in clinical trials. Funding provided by the Baker family continues his legacy.

“This money will be used for prostate cancer research,” Dr. Heath said. “We recently put out a prostate cancer research team solicitation for new funding to support a prostate cancer project. With the Bakers’ contribution as seed money, we will now be able to do the preliminary research that will hopefully attract additional funding for this project.

“The Baker family’s gift will benefit the efforts of the entire research team and help us make a difference to  the next man diagnosed with prostate cancer.”

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