Researcher isolates new target for leukemia treatment

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SAN ANTONIO (February 11, 2014) – There are potentially effective treatments for acute myeloid leukemia (AML), but they only work in 20 to 40 percent of cases. In a paper published today in Leukemia, a Nature journal, a UT Health Science Center researcher has pinpointed a protein that could play a key, previously unknown role in the development of pediatric AML — promising new information in the quest to treat and cure childhood leukemias.

AML starts at the point when cells mature into different kinds of blood cells. In AML, the cancerous cells grow and proliferate in an abnormal way, and they fail to develop, or differentiate, into normal functioning white blood cells. Also, high levels of a protein called WTAP contribute to abnormal cell behavior, observed Sanjay Bansal, Ph.D., a researcher at the Greehey Children’s Cancer Research Center at The University of Texas Health Science Center at San Antonio, and his team.

Dr. Bansal and his team, working with leukemia cells, used a laboratory technique to “knock down” WTAP expression in AML cells. What resulted was, in the research world, a resounding success.

“Knocking down this protein, WTAP, greatly suppressed proliferation and induced differentiation,” said Hima Bansal, Ph.D., senior research associate at the Health Science Center and lead author of the paper. “It took care of both problems.”

But they needed to understand how WTAP levels get so high in AML in the first place.

The researchers turned to another protein called Hsp90, a so-called “molecular chaperone” that helps stabilize more than 200 other proteins, known as Hsp90 “clients”.

“When we suppressed Hsp90, we reduced WTAP,” Dr. Bansal said. “So we have discovered two things: WTAP’s role in AML and the mechanism underlying its overexpression.”

Many of Hsp90’s other client proteins are known targets in oncology, and “WTAP joins the list,” Dr. Bansal said.

This discovery could open the door to more effective therapies for children and adults with newly diagnosed AML or for patients who have failed currently available treatments.

 

The Cancer Therapy & Research Center (CTRC) at The University of Texas Health Science Center at San Antonio is one of the elite academic cancer centers in the country to be named a National Cancer Institute (NCI) Designated Cancer Center, and is one of only four in Texas. A leader in developing new drugs to treat cancer, the CTRC Institute for Drug Development (IDD) conducts one of the largest oncology Phase I clinical drug programs in the world, and participates in development of cancer drugs approved by the U.S. Food & Drug Administration. For more information, visit www.ctrc.net.

700 Edgewood students receive sealants, fluoride mouth rinses

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Travis Kern, fourth-year dental student, prepares to paint sealant on Edgewood ISD second-grader Dana Marie Contreras’ teeth.

San Antonio (Feb. 10, 2004) – “I think this is great for our kids,” said Estefana Martinez, a board member of the Edgewood Independent School District in San Antonio, as Edgewood second-graders filed into the Dental School at The University of Texas Health Science Center at San Antonio. “These little ones need to know how to take care of their teeth.”

The second-graders were at the Dental School to receive free oral exams, sealants for potential cavity areas, fluoride mouth rinses, battery-powered toothbrushes and educational literature as part of a program that aims to prevent oral health problems in Edgewood students. The project is a public service of the Dental School, the Methodist Healthcare Ministries of South Texas Inc., Procter & Gamble’s Oral Care Division and the Edgewood ISD.

On two mornings in February, about 700 children from 12 Edgewood elementary schools took the field trip to the Dental School. This year’s program was in conjunction with the American Dental Association’s national “Give Kids a Smile” program.

“This is meant to be a positive experience for the kids,” said Gary F. Guest, D.D.S., director of predoctoral clinics at the Dental School. “It is part of their health education. If a child needs more invasive treatment, we identify that for the parents in a follow-up form indicating that their child was observed to have problems necessitating additional dental care. Rather than having sealants placed, some children are referred to the Ricardo Salinas Dental Clinic in Southwest San Antonio and other dental programs around the city for necessary care.”

Last year, more than 1,300 sealants were placed in the project. The children in this year’s activity, through the support of Crest Healthy Smiles 2010, received a “Spin Brush” and educational literature to take home.

A sealant is estimated to be worth $25 in a dentist’s office. Last year’s program provided more than $30,000 in free care to the children, many of whom are from low-income families.

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(From Left) Gary Guest, D.D.S., director of predoctoral clinics at the Dental School; Julia Garcia, director of health services in the Edgewood ISD; Joe Babb, director of clinics and community benefits for Methodist Healthcare Ministries; and Estefana Martinez, Edgewood ISD board member, participated in the dental sealant program on Feb. 6.

“The Edgewood community is very grateful and pleased to have this partnership with the Health Science Center Dental School and Methodist Healthcare Ministries,” said Julia Garcia, director of health services in the Edgewood ISD. “The dental services provided to our students, including an oral exam, fluoride and sealant application, if needed, and dental health education will help prevent dental disease and promote good oral health. This type of assistance helps our students come to school in good health and better able to learn.”

Ninety percent of all tooth decay in schoolchildren occurs in tiny pits and fissures of the teeth, according to a report from the U.S. surgeon general. The good news is that those pits and fissures can be filled with sealants to prevent the decay. The procedure is minimally invasive and highly beneficial – at least two-thirds of sealants continue to protect against decay five years after placement, studies show. “It is an effective public health measure,” Dr. Guest said.

Joe Babb, director of clinics and community benefits for Methodist Healthcare Ministries, said: “We have seen firsthand the direct correlation between dental health, overall health and a child’s ability to learn. It’s one of the most critical programs we support in terms of a good investment in the future of these children and in our community.”

Methodist Healthcare Ministries, the largest non-public funding source for community health care in South Texas, commits $2.6 million annually to its own and other community dental programs for the underserved. This is Methodist’s third year of collaboration with the Dental School and Edgewood on the dental sealant program.

Last year, 25 to 30 children were identified with serious oral problems, Dr. Guest said.

Martinez, who was a teacher and early childhood supervisor in the Edgewood ISD for 33 years, remembers writing letters to obtain toothbrushes and toothpaste for her students. She taught many students how to brush. The trip to the Dental School is a wonderful learning experience for the second-graders, she said.

“Paying Till It Hurts” author speaks on high cost of medical care

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New York Times correspondent Elisabeth Rosenthal, M.D., to deliver annual Bryant Lecture on Feb. 11

SAN ANTONIO (Feb. 7, 2014) — New York Times correspondent Elisabeth Rosenthal, M.D., whose yearlong “Paying Till It Hurts” series investigates the complex reasons why the United States leads the world in medical spending, will speak Tuesday, Feb. 11, at The University of Texas Health Science Center at San Antonio.

Her lecture, “Medical Prices in the U.S.: A Problem We Can’t Ignore,” is scheduled for 5:30 p.m. in the UT Health Science Center’s Holly Auditorium at 7703 Floyd Curl Drive in San Antonio. The event is free and open to the public.

It is the 11th annual Frank Bryant Jr., M.D., Memorial Lecture in Medical Ethics, organized by the Center for Medical Humanities & Ethics at the Health Science Center.

A physician with 20 years’ experience at one of the world’s most influential newspapers, Dr. Rosenthal seeks to bring new understanding to a looming challenge facing the United States: unsustainably high medical costs, which threaten the health and finances of individuals and the nation.

Her investigation has led to a half-dozen lengthy front-page stories in the New York Times, with more on the way. The stories tease apart the tangled reasons for the nation’s $2.7 trillion annual health bill: a fragmented system, opaque pricing, lack of regulation, item-by-item billing, hospital mergers and more.

The series considers the largest segments of medical spending: hospital and physician charges, prescription drugs, medical devices, procedures and tests. All the while, it asks why Americans pay so much more when studies have repeatedly shown that they do not get better care than residents of other developed countries.

“The intent of ‘Paying Till It Hurts’ is to start a national conversation about what medical care is costing us, and this country,” said Dr. Rosenthal, whose series notes that the Congressional Budget Office found if medical costs continue to grow, they will eventually account for the nation’s entire economic output. “Many Americans, and especially those with good insurance, are unaware of the true cost of medical care. But it’s inescapable. We’re all paying for it.”

And, Dr. Rosenthal’s series asserts, everyone shares responsibility for creating the current reality. That includes a health care industry chasing profits but also encompasses patients who do not consider whether a test or procedure is necessary because insurance covers it; politicians who have often shied away from finding solutions; and physicians who, by necessity or for profit, have become more focused on return on investment.

Ruth Berggren, M.D., director of the Center for Medical Humanities & Ethics, said the discussion is critically important to every American and especially significant for Health Science Center students, who soon will be confronted with this system while trying to make the best decisions for patients.

“Being an ethical health professional means recognizing how the cost of health care affects patients,” said Dr. Berggren, an infectious disease specialist and professor in the School of Medicine at the Health Science Center. “Those costs have restricted access to care for some patients, bankrupted others and consume a growing share of household and public budgets. We need to be conscious of how the decisions we make are influenced by this system, and how they reinforce it.”

The lecture series is named for Frank Bryant Jr., M.D., an advocate for the medically underserved in East San Antonio and strong proponent of access to health care for all people. Dr. Bryant co-developed the East San Antonio Medical Center and co-founded the Ella Austin Health Clinic, where he was the first medical director. He was the first African-American president of the Bexar County Medical Society and the first president of the C.A. Whittier Medical Society.

Dr. Bryant died in 1999. To honor him, the Texas Medical Foundation provided the Health Science Center with funding for this lecture series in 2002.

 

The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 3 percent of all institutions worldwide receiving National Institutes of Health funding. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced more than 29,000 graduates. The $765 million operating budget supports eight campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.

New website cultivates healthy changes for Latino kids nationwide

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SAN ANTONIO (Feb. 5, 2014) — Want to fight Latino childhood obesity, but don’t know where to start or how you can make a change?

Start at Salud America! Growing Healthy Change.

The new website is a clearinghouse of Latino-focused resources and stories to promote changes – healthier marketing, improved access to healthy food and physical activity options – for Latino kids in your neighborhood and across the nation.

Right now at the site, you can:

• Create maps at the level of school, city, county, state or nation to see what changes are growing for Latino kids, or search by topic (e.g., healthier school snacks, active spaces);

• Find resources to start a change;

• Watch and read about real-life “Salud Heroes” of change; and

• Become a “Salud Hero” by uploading your own stories.

The site was created by Salud America!, a national program of the Robert Wood Johnson Foundation based at the Institute for Health Promotion Research (IHPR), part of the School of Medicine at The UT Health Science Center at San Antonio. The site is part of the Community Commons platform.

“We believe this website is a critical tool to showcase the latest healthy changes for Latino kids that are popping up across the country, and also to educate and motivate people to start creating changes of their own, like opening playgrounds to the public after school hours or starting up a community garden,” said Amelie G. Ramirez, Dr.P.H., director of Salud America! and the IHPR. “What’s great is that you can find what changes are happening in your own backyard, or see what’s happening 1,000 miles away and how you might be able to make that happen in your area.”

Latino kids suffer disproportionately from weight problems: 39.1 percent of Latino kids ages 2-19 are overweight or obese, compared to 31.8 percent for U.S. children overall.

Research also indicates that Latino kids tend to have more limited access to physical activity options and healthy food, and are increasingly the target of unhealthy food and drink marketing.

The new website offers three steps on how to address these issues.

Step 1: Find Changes

The website features the latest Latino-focused healthy changes taking place across the country in six areas: healthier school snacks, better food in the neighborhood, active play, active spaces, sugary drinks, and healthier marketing.

Step 2: Learn to Make Change

The website has continuously updated feeds of evidence-based reports, toolkits and other resources to learn or model how to make healthier changes.

“Salud Heroes” stories – articles often accompanied by original videos – highlight steps people have taken to successfully spark a healthy community change. Stories follow one change, from idea development through implementation.

Salud Heroes include:

• San Antonio school district cooks up healthier concession stand menus: In a mostly Latino school district in San Antonio, a school board president drove a policy change to implement healthier menu options – such as grilled chicken wraps – at concession stands during after-school events, like football games, for students and parents.

• San Antonio Latina sisters start a neighborhood fitness program: Makayla, 9, and Alyssa Esparza, 8, saw a weight-loss contest on TV and decided to get active and help others do the same. But they didn’t know of any after-school programs to join, and they didn’t have anyone to be active with. This led to their big idea: Make a Craigslist ad and invite local kids for a 90-day get fit challenge.

• Houston doctor helps open a farmer’s market at her clinic’s front doorM: In a mostly Latino neighborhood in Houston that lacked access to fresh fruits and vegetables, a doctor worked with community members to bring healthy, affordable foods to clinic patients: a farmers’ market right at the door of the doctor’s office lobby.

• California high school uses “aquaponics” to grow fresh veggies for the community: In Santa Ana, Calif., a high school that serves at-risk youth offers a first-period gardening class that started as a campus beautification project but ended in students growing healthy food for their community in a sustainable way using “aquaponics.”

Step 3: Be a Salud Hero

Upload stories, photos and more about a new, in-progress, or successful change to your community, and Salud America! may write up your story, possibly film it, and share it with our national audience.

“This is really a one-stop shop to catalyze efforts, from the grassroots level up to the federal level, to reduce and prevent Latino childhood obesity,” Dr. Ramirez said.

The website was conceptualized by Salud America! and funded by the Robert Wood Johnson Foundation. The site was developed in collaboration by Salud America! and the team behind Community Commons, a free data-sharing initiative for healthy communities powered by the Institute for People, Place and Possibilities (a partnership including the University of Missouri’s Center for Applied Research and Environmental Systems [CARES]).

 

For news from Salud America! and the IHPR at the UT Health Science Center, visit the SaludToday blog and follow @SaludToday on Twitter and Facebook.

The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 3 percent of all institutions worldwide receiving National Institutes of Health funding. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced approximately 29,000 graduates. The $736 million operating budget supports eight campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.

Salud America! is a national program of the Robert Wood Johnson Foundation (RWJF). The program aims to unite and increase the number of Latino researchers and stakeholders engaged in research and community change to reduce and prevent Latino childhood obesity. The network is directed by the Institute for Health Promotion Research at The UT Health Science Center at San Antonio. Visit Salud America! online at www.salud-america.org.

The Institute for Health Promotion Research (IHPR) at The UT Health Science Center at San Antonio investigates the causes and solutions to the unequal impact of cancer and chronic disease among certain populations, including Latinos, in South Texas and the nation. The IHPR was founded in 2006. Visit the IHPR online at http://ihpr.uthscsa.edu.

Finding could explain age-related decline in motor function

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SAN ANTONIO (Feb. 5, 2014) — Scientists from the School of Medicine at The University of Texas Health Science Center at San Antonio have found a clue as to why muscles weaken with age. In a study published today in The Journal of Neuroscience, they report the first evidence that “set points” in the nervous system are not inalterably determined during development but instead can be reset with age. They observed a change in set point that resulted in significantly diminished motor function in aging fruit flies.

“The body has a set point for temperature (98.6 degrees), a set point for salt level in the blood, and other homeostatic (steady-state) set points that are important for maintaining stable functions throughout life,” said study senior author Ben Eaton, Ph.D., assistant professor of physiology at the Health Science Center. “Evidence also points to the existence of set points in the nervous system, but it has never been observed that they change, until now.”

Dr. Eaton and lead author Rebekah Mahoney, a graduate student, recorded changes in the neuromuscular junction synapses of aging fruit flies. These synapses are spaces where neurons exchange electrical signals to enable motor functions such as walking and smiling. “We observed a change in the synapse, indicating that the homeostatic mechanism had adjusted to maintain a new set point in the older animal,” Mahoney said.

The change was nearly 200 percent, and the researchers predicted that it would leave muscles more vulnerable to exhaustion.

Aside from impairing movement in aging animals, a new functional set point in neuromuscular junctions could put the synapse at risk for developing neurodegeneration — the hallmark of disorders such as Alzheimer’s and Parkinson’s diseases, Mahoney said.

“Observing a change in the set point in synapses alters our paradigms about how we think age affects the function of the nervous system,” she said.

It appears that a similar change could lead to effects on learning and memory in old age. An understanding of this phenomenon would be invaluable and could lead to development of novel therapies for those issues, as well.

Joel Rawson, Ph.D., of the University of Alaska at Anchorage, formerly a postdoctoral fellow in Dr. Eaton’s lab, is a study co-author.

Department of Neurosurgery performs 3,000 spine cases, 350 brain tumor cases and 190 spine tumor cases in 12 months

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SAN ANTONIO (Feb. 3, 2014) — Neurosurgeons, clinical staff and residents from the Department of Neurosurgery at the UT Health Science Center at San Antonio cared for thousands of patients with spine conditions and injuries, brain tumors, traumatic injuries and stroke during the 2012-13 academic year, according to data released today. The Department of Neurosurgery is in the School of Medicine at the Health Science Center.

Faculty, residents and support personnel from the Department of Neurosurgery took care of nearly 3,000 spine cases, 350 adult and children’s brain tumors, and 190 spine tumors, the data show. Additionally, the team of skilled surgeons performed a host of procedures including minimally invasive carpal tunnel repair, endoscopic craniosynostosis repair to correct infant skull deformities, deep brain stimulation to treat Parkinson’s disease, and vagal nerve stimulation to treat epilepsy through University Hospital’s Level 4 South Texas Comprehensive Epilepsy Center. The group also provides the city’s only neuro-endovascular service.

Over the 12 months, the team performed hundreds of procedures at University Hospital’s Level I Trauma Center and treated hundreds of stroke patients at University Hospital and the Baptist Health System’s Brain & Stroke Network. Methodist Healthcare and the South Texas Veterans Health Care System are other affiliated sites. In addition, some of the neurosurgeons are members of UT Medicine San Antonio, the clinical practice of the School of Medicine, and some patients are seen at the Cancer Therapy & Research Center (CTRC) at the UT Health Science Center at San Antonio, one of four National Cancer Institute-designated Cancer Centers in Texas.

Residency expansion and spine fellowship

In other news, David F. Jimenez, M.D., FACS, professor and chairman of the Department of Neurosurgery and physician with UT Medicine, announced that the Accreditation Council for Graduate Medical Education (ACGME) has approved the expansion of the department’s neurosurgery residency program to 17 residents. “We will have one of the largest residency programs in the country,” Dr. Jimenez said. “Of note, ours is one of only three approved military residency training sites for neurosurgery in the country. We have four military residents currently and a fifth will join us in July.”

In another development, the Committee on Advanced Specialty Training (CAST) of the Society of Neurological Surgeons approved the Department of Neurosurgery’s first spine fellowship. The first fellow is expected to start this summer, Dr. Jimenez said.

“These are significant accomplishments in medical education,” said Francisco González-Scarano, M.D., dean of the School of Medicine and vice president for medical affairs of the Health Science Center. “These new opportunities were approved by the national governing bodies for neurosurgery training. Both happened because of the number of patients who are operated on here and the comprehensive offering of neurosurgical services in all subspecialties.”

Dr. Jimenez joined the School of Medicine in June 2004 from the University of Missouri. The year before his arrival, the Health Science Center’s neurosurgery residency program had been placed on inactive status after the departure of all the faculty neurosurgeons. Dr. Jimenez, an internationally recognized pediatric neurosurgery expert, took the required steps to regain ACGME approval for the residency training program. This was announced in July 2005. Today, neurosurgery is a full-fledged department in the School of Medicine with 70 faculty, staff and residents.

 

The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 3 percent of all institutions worldwide receiving National Institutes of Health funding. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced more than 29,000 graduates. The $765 million operating budget supports eight campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.