October 7, 2011
NIH Podcast Episode #0144
Balintfy: Welcome to episode 144 of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health – the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode studies show an online course can help reduce harmful college drinking, we’ll hear from a couple NIH grantees: one explains a promising study in preventing arthritis, another how new uses for existing medications are being found with new technology, and we’ll get a personal perspective on working in science:
“I think that things are very different for my generation of women than the women before me.”
But first, this news update. Here’s Craig Fritz.
Fritz: A new research program funded by the National Institutes of Health will explore the role that a changing climate has on human health. The program will research the risk factors that make people more vulnerable to heat exposure; changing weather patterns; and changes in environmental exposures, such as air pollution and toxic chemicals. Children, pregnant women, the elderly, people from low socioeconomic backgrounds, and those living in urban or coastal areas and storm centers may be at elevated risk. This program will also help to develop data, methods, and models to support health impact predictions. Researchers note that governments and policy makers need to know what the health effects from climate change are and who is most at risk. The research from this program will help guide public health interventions, to ultimately prevent harm to the most vulnerable people.
A large study of the daughters of women who had been given the first synthetic form of estrogen, during pregnancy has found that exposure to the drug while in the womb is associated with many reproductive problems and an increased risk of certain cancers and pre-cancerous conditions. Beginning in 1940, the first synthetic form of estrogen, known as DES, was used clinically to prevent certain complications of pregnancy. In the 1950s, clinical studies showed DES was ineffective for this purpose. The FDA notified physicians that DES should not be prescribed to pregnant women. However, between 5 million and 10 million pregnant women and babies had been exposed to the drug. Researchers found that the daughters with exposure to DES while in the womb had an increased risk of 12 medical conditions, including a twofold higher risk of infertility and a fivefold increased risk of having a preterm delivery.
For this NIH news update – I’m Craig Fritz
Balintfy: News updates are compiled from information at http://www.nih.gov/news. Coming up a type of arthritis that may be preventable; saving money by finding new uses for existing drugs; highlights from a woman scientist, and a study on reducing college drinking among freshmen, that’s next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
NIH-supported studies show online course helps reduce harmful college drinking
Balintfy: An online alcohol prevention course can help reduce harmful drinking among college freshmen, but the benefits in the fall don’t last through the spring. This is according to a study supported by the NIH’s National Institute on Alcohol Abuse and Alcoholism. Wally Akinso brings us the details.
Akinso: Research studies have shown that freshman year is an especially risky time for hazardous drinking among college students. Researchers point out that each year nearly 2,000 college students die from alcohol-related unintentional injuries; 696,000 students are assaulted by another student who has been drinking; and 97,000 students are victims of alcohol-related sexual assault or date rape. Now new research findings are showing that an online alcohol prevention tool can help reduce harmful drinking among college freshmen.
Hingson: The tool is called AlcoholEdu.
Akinso: Dr. Ralph Hingson is from the National Institutes of Health.
Hingson: It’s a web based intervention that’s administered to incoming freshmen to try to reduce and prevent college drinking problems.
Akinso: The course consists of five modules, four of which are typically offered in the late summer before freshmen arrive on campus, and one module that students complete during the early fall semester.
Hingson: One is an introduction that talks about the need to take the course. Introduces students to what’s called standard drink size for different alcohol beverages. Second module deals with getting facts about alcohol. And then there’s a module about deciding for themselves what they want their own behavior to be. They try to identify students’ goals in college and strategies to achieve those goals and then harm reduction strategies in dealing with alcohol like limiting how many drinks one has on an occasion.
Akinso: Researchers conducted a randomized trial of the course at 30 public and private universities in the United States. Incoming freshmen at half of the universities took the course, while students at the other schools received whatever alcohol prevention programs those schools normally provide to new students. The study also included surveys that assessed the students’ past-30-day alcohol use, average number of drinks per occasion, and binge drinking frequency. Dr. Hingson explains that the course helped, to a point.
Hingson: What the study found was that there were in fact reductions in past 30 day alcohol use in binge drinking and experiencing alcohol problems with the trouble with police or school authorities, and victimization either crime or sexual victimization. But unfortunately the beneficial effects were seen only during the fall semester of freshmen year.
Akinso: The researchers say their findings show that this Internet-based prevention course can be a useful component of an overall strategy. They conclude that use of the course should be reinforced with effective environmental prevention strategies, for example reducing alcohol availability, raising prices, and limiting alcohol promotions and advertising on and around campus. For more information on this study and the course, visit http://www.niaaa.nih.gov . This is Wally Akinso at the NIH, Bethesda, Maryland.
NIH study shows promise in preventing osteoarthritis
Balintfy: The next couple stories feature NIH-grantees. In this first, an NIH-funded study from MIT suggests that a commonly used steroid drug used to treat inflammation, may also help prevent a type of arthritis called osteoarthritis. Arthritis is a large and growing public health problem, and continues to be the most common cause of disability in the United States.
Grodzinsky: The word arthritis typically refers to joint disease, but there are many, many forms of arthritis.
Balintfy: Dr. Alan Grodzinsky is an NIH-funded researcher and professor at MIT. He says the most common form of arthritis is osteoarthritis.
Grodzinsky: Estimates now are that about 27 million Americans suffer from osteoarthritis.
Balintfy: Osteoarthritis occurs most often in older people. Yet younger people sometimes get osteoarthritis, primarily from joint injuries. This type of arthritis breaks down cartilage.
Grodzinsky: That's a soft kind of resilient tissue that covers the bony ends of our joints.
Balintfy: Healthy cartilage absorbs the shock of movement. Without it, bones rub together. Over time, this rubbing can permanently damage the joint. Osteoarthritis causes pain, swelling and reduced motion in joints. Dr. Grodzinsky points out that there are currently no drugs available to treat osteoarthritis, only medications that try to alleviate pain.
Grodzinsky: In contrast, rheumatoid arthritis, which is an autoimmune inflammatory disease and that affects fewer people than osteoarthritis – but it can be very aggressive and debilitating – there have been some terrific drugs discovered over the past 10 to 15 years that can actually halt the progress of disease in 60% to 65% of those patients.
Balintfy: Now a new NIH-funded study at MIT suggests that a steroid drug currently used to treat inflammatory diseases could also prevent osteoarthritis from ever developing in those people who have had a joint injury.
Grodzinsky: The drugs that we've been interested in are a class of drugs called glucocorticoids such as dexamethasone; and these have been used in older patients that have a fairly longstanding disease, osteoarthritis or rheumatoid arthritis, really to alleviate pain. But we've been pursuing the idea that immediate intervention at the time of injury even in young folks might be able to stop the progression of cartilage degradation right after the injury and that might reduce the risk of developing arthritis.
Balintfy: Grodzinsky explains that experiments in the lab have shown that the steroid drugs stop the break-down of cartilage when given even a day or two after the tissue is damaged.
Grodzinsky: It seems like this could be a very effective approach to treating the cases relatively quickly after injury.
Balintfy: But he emphasizes that more research is needed.
Grodzinsky: We don’t know whether drugs like dexamethasone can actually reverse the cartilage damage that's already occurred.
Balintfy: Grodzinsky adds that further studies will also have to show whether a single treatment shortly after injury would be sufficient or how many treatments would be necessary to maintain the protective effects. But he is optimistic that after further testing, these drugs could be used to prevent osteoarthritis fairly soon.
Grodzinsky: In a sense, it's repositioning or repurposing an existing drug, but using it in a new and different way to try to halt the progress of cartilage degradation leading to osteoarthritis soon after joint injury. The issue here since physicians can already use this drug, it's really a question of identifying whether or not it's possible to use this drug at an early stage.
Balintfy: For more information on this research and arthritis, visit http://www.niams.nih.gov .
Computational method predicts new uses for existing medicines
Balintfy: In this story, we learn how for the first time ever, scientists are using computers and genomic information to predict new uses for existing medicines. An NIH-funded computational study has analyzed genomic and drug data to find new uses for medicines that are already on the market. Dr. Atul Butte, an NIH grantee at Stanford University says a computational study is when computers are used to address a biomedical need; and in this case:
Butte: Not just using computers, but also using publicly available data.
Balintfy: Dr. Butte explains that a computer program searched through publicly available data on drugs and diseases. An algorithm compared thousands of possible combinations to find drugs and diseases whose gene expression patterns essentially cancelled each other out – a genetic “opposites attract” search on a molecular level.
Butte: If we could find 5 diseases that were similar to each other now in a molecular level -- you know never mind what the doctors say, if they look like each other at a molecular level -- and along came a 6th disease, but those 5 diseases are treated the same way, maybe that 6th disease could be treated the same way too.
Balintfy: Dr. Butte’s group focused on 100 diseases and 164 drugs. While many of the drug-disease matches were known, and already in clinical use adding to the credibility of this computational study, others were surprises. Dr. Butte says out of the hundreds of predicted matches, his group chased down two.
Butte: One prediction was that the anti-seizure drug Topiramate – it’s a seizure drug, we thought that should have efficacy against Crohn’s Disease which is a kind of inflammatory bowel disease. The second prediction we had was even more astounding in some ways. The over-the-counter drug Tagamet or Cimetidine, we thought should have efficacy against lung cancer, specifically lung adenocarcinoma.
Balintfy: He says animal models show the drugs work, but cautions that more research is needed.
Butte: We still have a while to go before we can show this actually works in human clinical trials.
Balintfy: But researchers are optimistic that this method of finding new ways to repurpose drugs that are already approved could improve treatments and save both time and money. Experts point out that bringing a new drug to market typically takes about $1 billion and many years of research development.
Butte: The beauty of using existing drugs with known safety profiles is that the potential for getting these to patients is that much quicker.
Balintfy: Dr. Butte adds there is another potential.
Butte: If we didn’t find these uses for these drugs I would argue that nobody would ever find these uses for these drugs.
Balintfy: He explains that biotech or pharmaceutical companies might not pursue existing drugs for other treatments because of low financial incentive. That could be because the drugs are already off-patent, meaning low-cost generics exists; or the treatment might be for a so-called orphan disease that has relatively few patients.
Butte: Those are businesses decisions more than scientific ones.
Balintfy: Dr. Butte notes that this research has since expanded to 300 diseases and over 1,500 different drugs; and in addition to these two medications, described in the online issue of Science Translational Medicine, a third and fourth are also showing promise. For more information on this computational study and this kind of research, visit http://www.nigms.nih.gov . Coming up…“So given that I don’t really have the right body build to be an Olympic ice skater, genetics was pretty much going to be it.”
That’s next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Women in science
Balintfy: Welcome back to NIH Research Radio. In this program we talk a lot about the research and science of medicine and health. We get the details of discovery directly from the scientists and researchers who make this fascinating journey of bringing therapies from the lab to patients, or as they say, bench to bedside. Today, we’re going to look at the more personal journey, which often parallels the research. In partnership with the Anita Roberts Lecture Series, which highlights the work of outstanding female researchers at NIH, today, we’re talking with Dr. Elaine Ostrander. She’s Chief of the Cancer Genetics Branch at NIH’s National Human Genome Research Institute. First, can you tell us briefly what your main area of research is?
Ostrander: Sure. I’m interested in the genetics of growth regulation so I’m interested in exploring the genome and finding where there are DNA sequences that control how cells grow and what they decide to be when they grow up.
Balintfy: Dr. Ostrander, how did you become a scientist? Had you considered pursuing a different career or was science what you were always interested in?
Ostrander: I really was interested in being a scientist from about seventh grade. In seventh grade I took a biology class that had a large genetics component and it was just so interesting to me. Genetics was a puzzle. You really had to think about the puzzle and think about the big picture and think about the little picture, and it was just so much more intriguing to me than anything else.
Balintfy: What successes can you highlight from your career?
Ostrander: I had the privilege of putting together the first dog genome meetings which were about 10 people at my house arguing about how the dog chromosomes should be numbered, if you can imagine that, and now of course we have sequence of dogs; and it’s just been so wonderful to be part of that entire growth process and to be steering it and molding it and putting my fingerprints on it. And I’m sure other people could have done the same and it would look different than it is today, but it’s been such a joyous process.
Balintfy: What about failures?
Ostrander: It really depends on how you define failure. So I always tell my students and my post-docs that if 80% to 90% of what you’re doing isn’t working, then you’re not at the cutting edge. If you’re at the cutting edge, most of what you’re doing on any given day really isn’t working, you can’t figure it out, there’s a piece of data that doesn’t make sense, there’s a cutting-edge technique that isn’t quite working well enough yet. And so to really be at the cutting edge, you have to comfortable in that milieu of failure.
Balintfy: What are you looking forward to? What other ambitions do you have?
Ostrander: I’m really excited about the work we’re doing in morphology as we figure out sort of piece by piece how variation occurs, how the genome has allowed there to be such an amazing amount of variation in the single species, and it hasn’t done the same thing in other species.
And then once we understand what those genes are and we’re understanding who they are rapidly, understanding what else they do, what happens when they go array, what disease processes are they associated with.
Balintfy: Has your research career impacted your personal life and vice versa?
Ostrander: I guess you’d have to ask my personal life if they feel impacted, but yeah, sure, of course it does. I’m very fortunate that my husband is also a scientist and he really understands the work ethic and the struggles and the disappointments and the successes; and he has always been my biggest champion and I like to think I’m his biggest champion.
I have two daughters and they’re pretty young still, 6 and 8. So I go to dog shows and I bring them along. And they probably know more about dogs than any first and third grader possibly could ever know about dogs.
And NIH is a very family-friendly place in a lot of ways. And so they just get a sense of “This is fun and this is cool and my parents have a cooler job than most people’s parents do.”
The hard part is of course I’m busy and I travel and I have meetings, and fortunately, my husband and I have been able to arrange thing so that they’re never without one or the other of us.
Balintfy: As a woman in science can you comment on the advantages and disadvantages that you have encountered in your career?
Ostrander: I think that things are very different for my generation of women than the women before me. I think the women in the generation before me really had it tough, really faced discrimination, really struggled, really did not get equal pay for equal work. I think from talking a lot to those women, it was really very, very difficult.
I think my generation of women, there’s a certain baseline level of rules that get followed in terms of equal pay for equal work or equal space, or those kinds of things happen in an automatic way or a pretty automatic way.
I think where it’s hard is the time management issues. So when I was a tenure tracker it seemed like I was on every single committee and my male colleagues were not on any committees; and I remember thinking, “I’m just on this committee because I’m a woman. They needed a woman on this committee.”
And I like to think that there are now enough women going through the system that women aren’t as burdened with that anymore, but women tell me they still are. If you’re in math and physics and engineering, yup, it’s a huge problem. If you’re in more of the biological end of things, it’s actually a lot less of a problem.
Balintfy: How does mentoring fit in with that? Do you think mentoring is something important for young scientists?
Ostrander: Sure. I mean nobody would say mentoring is not important. It’s important for men and it’s important for women.
I think the issue now that I spent time thinking about is how much mentoring? I mean people have to have a fire in their belly and they have to want it really bad, and there are a certain number of nights alone struggling with your data or struggling with the words of a paper or a grant, and being frustrated and near tears and throwing it at the window that you just have to go through by yourself to get to where you need to be in terms of wanting it, understanding it, and mastering it.
And sometimes it’s of course important to be there for our junior faculty, to have committees that guide them, that protect them, that give them advice when they need it; but I think sometimes it’s important to step back and let them struggle a little bit.
Balintfy: Dr. Ostrander, how would you summarize your experience with science?
Ostrander: I think the way we do science is changing. It used to be science was one of those ivory tower professions. You went and you did your thing and the people around you and your community maybe only had the vaguest understanding of what you were doing. And now with the genome being sequenced and everybody wants to know what it means to them and to their health. I don’t think any science is really ivory tower science anymore.
And so I think scientists have this additional responsibility to be communicators and to be educators, and that’s something I think to take seriously and add to our roster of tasks, but the ivory tower is being dismantled very quickly, very, very quickly. It’s a Berlin Wall coming down.
Balintfy: Thanks to Dr. Elaine Ostrander at the National Human Genome Research Institute. To learn more about her work which was featured in the Anita Roberts Lecture Series, visit the website http://sigs.nih.gov/wsa/ .
Balintfy: And that’s it for this episode of NIH Research Radio. Please join us again on Friday, October 23 when our next edition will be available. I'm your host, Joe Balintfy. Thanks for listening.
Announcer: NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.