SOGR Cancer_HIV Story

Discovering New Knowledge: News and Breakthroughs from Meharry Medical College

Case Study Published in NEJM Finds Lung Damage in Soldiers; Genetic Mutation Predisposes African-Americans to HIV-related Kidney Disease; Link Between Sleep Quality and Adverse Pregnancy Outcomes Examined; Budding Research Brings New Perspective to Breast Cancer Treatment; Access Barriers Prevent Diabetes Self-Management; Preventing Oral HIV Transmission; Study of AIDS-Defining Illness Spurs Related Research of Pelvic Organ Prolapse


CASE STUDY PUBLISHED IN NEJM FINDS LUNG DAMAGE IN SOLDIERS

Matthew King, M.D., assistant professor in the Division of Pulmonary and Critical Care Medicine at Meharry, is lead author of a ground-breaking article published in the New England Journal of Medicine.

The article titled "Constrictive Bronchiolitis in Soldiers Returning from Iraq and Afghanistan," is a case study of lung damage found in soldiers who served in Iraq and Afghanistan.

King and Robert Miller, M.D. of Vanderbilt University Medical Center, spent six years compiling a descriptive case series examining soldiers referred from the Ft. Campbell military base in Kentucky who had shortness of breath.

King has testified before the U.S. Senate to raise awareness of the issue.


GENETIC MUTATION PREDISPOSES AFRICAN AMERICANS TO HIV-RELATED KIDNEY DISEASE

A genetic mutation discovered in African Americans, only two years ago, has been found to predispose carriers to a HIV-associated kidney disease known as HIVAN.

Mutations in the APOL1 gene, which are linked to the high incidence of the disease focal segmental glomerulosclerosis (FSGS), are present in about 12 percent of the African-American population. Adults with this mutation are more likely to get some form of kidney disease even if they are not infected with HIV/AIDS.

Waldemar Popik, Ph.D., of the Center for AIDS Health Disparities Research at Meharry, and his team of researchers, has discovered a way to identify the presence of this mutation in urine samples. They have also made significant strides in identifying how HIVAN is caused.

These breakthroughs have placed Meharry researchers on track to identify a simple process to diagnose patients with FSGS and discover a treatment that can slow down or cure HIVAN. Currently, a kidney transplant is the only available treatment option.

"Finding a cure to this disease is really important," Popik said. "Right now, there are no tests to look for this mutation. Anyone who is African American and has HIV needs to be tested so they can take precautions."


LINK BETWEEN SLEEP QUALITY AND ADVERSE PREGNANCY OUTCOMES EXAMINED

Hormonal changes and physical discomforts can disrupt sleep during pregnancy.

But, can poor sleep quality in pregnancy actually increase the risk for complications such as gestational diabetes and macrosonia (newborns that are large for gestational age)?

Meharry researcher Sanika Chirwa, Ph.D., working in conjunction with co-investigators Gwinnett Ladson, M.D., Janice Whitty, M.D. and John Clark, Ph.D., predicts that abnormal maternal sleep quality is associated with hyperglycemia (high blood glucose) in mothers and excessive birth weight in infants.

His research suggests that poor sleep quality contributes to impaired glucose tolerance leading to hyperglycemia and, conversely, altered maternal blood glucose control can lead to poor sleep quality.

A pilot study has begun to evaluate sleep quality in pregnancy and determine if poor sleep quality is associated with maternal hyperglycemia, gestational diabetes mellitus or macrosomia.

The findings could serve as the basis for establishing evidence-based guidelines for healthy sleep during pregnancy.


BUDDING RESEARCH BRINGS NEW PERSPECTIVE TO BREAST CANCER TREATMENT

A novel protein discovered in breast cancer patients has the potential to serve as a new method for diagnosis and prevention.

Smita Misra, Ph.D., instructor and researcher in the Meharry School of Graduate Studies and Research, recently discovered a novel protein she named ZAR2. She is studying its role in regulation of the BRCA2 gene expression found in breast cancer patients.

Based on preliminary data, Misra suspects early onset and aggression of breast cancer, particularly in African Americans, occurs, at least in part, due to overexpression of ZAR2 in cell growth.

She is in the process of collecting tissue samples and studying the mechanism to regulate ZAR2 trafficking and function as a prevention method.

Misra is one of the first researchers in the country to study the link between ZAR2 and BRCA2 in breast cancer.


ACCESS BARRIERS PREVENT DIABETES SELF-MANAGEMENT

The prevalence of type-2 diabetes has significantly increased in the past decade and is expected to continue to grow at an even faster rate among minority women.
Unfortunately, this population is less likely to follow through with self-management intervention techniques that have been proven to be effective treatments for diabetes management.

A Meharry study conducted by Sylvie Akohoue Ph.D., CNS assistant professor in the Department of Family and Community Medicine, found that low income minority women faced barriers that prevented them from adhering to diabetes self management procedures.

For example, some of the women did not eat the recommend healthy foods because of high food costs, some missed physician appointments because they could not take time off work and others didn't take their medication because it interfered with their sleep schedules.

A new study by Akohoue is examining whether education, combined with a patient outreach strategy, can help women overcome these barriers.

Low-income diabetic women are being recruited for a 12-month intervention study that focuses on empowering women to gain the knowledge, skills and motivation for diabetes self-care. It will examine whether intervention techniques result in better outcomes such as improved blood pressure, lipid profile and body mass index.


PREVENTING ORAL HIV TRANSMISSION

Meharry researcher Hua Xie, D.D.S., Ph.D., has discovered that the beneficial bacterium Streptococcus cristatus, which occurs naturally in the mouth, can play an important role in preventing colonization of Porphyromonas gingivalis, an important causative pathogen of periodontitis (gum diseases).

African Americans have a higher incidence of Porphyromonas gingivalis than whites, a condition which makes African Americans more susceptible to periodontitis.

Xie is gathering samples from patients and she will compare the levels of Streptococcus cristatus and Porphyromonas gingivalis in African Americans and Caucasians in hopes of understanding their link and what can be done to eliminate Porphyromonas gingivalis.

In a separate study, Xie is also investigating the role bacteria plays in transmitting HIV through the mouth and what can be done to impede the transmission.

She hypothesizes that interaction of Porphyromonas ginigivalis and infectious particles of the HIV virus cause a reaction that leaves the mouth susceptible to an HIV infection.

The goal of this research is to develop new therapies that will impede mucosal HIV infection.


STUDY OF AIDS-DEFINING ILLNESS SPURS RELATED RESEARCH OF PELVIC ORGAN PROLAPSE

Kaposi sarcoma (KS), a cancer which disproportionately affects African Americans and often develops in people who are infected with HIV and pelvic organ prolapse, which primarily affects white women and occurs when the muscles supporting a woman's pelvic organs weaken, may seem unrelated but, new research may indicate that their causes are linked.

Donald Alcendor, Ph.D., of the Meharry Center for AIDS Health Disparities Research, is comparing tissue from individuals with KS. He has shown that members of the fibulin family of proteins appear to reduce production of VEGF, a protein required for tumor growth.

These studies could lead to the development of a biomarker for early diagnosis or a new treatment strategy for KS patients. His research was recently published in the American Journal of Pathology.

While doing research for this study, Alcendor noted that fibulin-3 and -5, when deleted from cell systems by DNA manipulation, results in a condition nearly identical to Pelvic Organ Prolapse in humans.

His lab was recently funded for one year to investigate fibulins and the link to Pelvic Organ Prolapse.

"The same fibulins that are suppressed in Kaposi sarcoma are suppressed in Pelvic Organ Prolapse," he said.

# # #