June 29, 2012
NIH Podcast Episode #0162
Balintfy: Welcome to episode 162 of NIH Research Radio. NIH Research Radio bringing you news and information about the ongoing medical research at the National Institutes of Health—NIH… Turning Discovery Into Health®. I'm your host Joe Balintfy, and coming up in this episode, a public challenge to help measure the connection between the environment and health, basic research is helping understand how to manage pain, without causing addiction, and recognition for research in rotavirus. But first, this news update. Here’s Craig Fritz.
Fritz: An NIH-supported research network has found that young men being treated for HIV are more likely to experience low bone mass than are other men their age. The findings indicate that physicians who care for these patients should monitor them regularly for signs of bone thinning. The young men in the study did not have HIV at birth and had been diagnosed with HIV an average of two years earlier. Other studies have shown that adults with HIV also have bone loss and increased risk for bone fractures, associated in part with the use of certain anti- HIV medications. Researchers note that the young men in the study had been taking anti- HIV medications for a comparatively short time, yet they still had lower bone mineral density than other men their age. This suggests a short-term impact of HIV therapy on bone at ages when people are still growing and building bone mass and raises concern about the risk of fracture as they age. For the HIV -infected young men, bone density in the hip was 5-8 percent lower, and in the spine 2-4 percent lower, than for participants without HIV. The study was not designed to determine the cause of the bone loss and cannot rule out the possibility that low bone mass preceded the young men's HIV infection.
For this NIH news update – I’m Craig Fritz
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up opioid receptors and seeing how they relate to pain and addition, an award for a rotavirus researcher, and how you could win $100,000 from a research challenge. That’s next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
NIH, EPA announce competition for personal air pollution and health sensors
Balintfy: Have you ever tinkered with electronics; maybe know an engineer or researcher who’s always looking for a puzzle to solve? Well, the NIH and Environmental Protection Agency or EPA, have teamed up to create the My Air, My Health Challenge; that’s a competition to create a personal sensor system that measures air pollution and a persons physiological response. Dr. David Balshaw, a program director at the NIH’s National Institute of Environmental Health Sciences explains the challenge is for the general public, including experts.
Balshaw: So this is kind of intended to stimulate them and drive them to kind of move in a new direction or move things more into a product, but also to bring the community presence in and really develop things that are wanted by the community. So if people have a concern about a particular exposure in their neighborhood, something that's very relevant to them, we want to bring that interest and that particular set of expertise into the challenge.
Balintfy: Dr. Balshaw says current choices are limited so there is a need for this kind of sensor package.
Balshaw: So there are some, not a whole lot that are commercially available, and frankly the ones that are tend to be very expensive. There are also some very boutique examples of kind of do-it-yourself kits where you can actually make your own sensor. So if you're interested in for instance ozone, you can make a sensor that you could use yourself. And there are actually some iPhone apps. You can get an app for that.
Balintfy: Competitors should propose designs for sensors that can be easily worn or carried. In addition to gathering data on chemical and/or particulate air pollutants, these sensors should measure health parameters, such as heart rate and breathing. Dr. Balshaw adds, this is a two-phase challenge.
Balshaw: The first phase is a proposal where we want them to form an interdisciplinary team and kind of put down on paper what they're thinking. So what is the sensor that they have? We don't want them to develop something new. We want them to have something on the shelf, both for air pollution and for a physiological monitor, and then also to bring in that community group and to think about what is it that we're doing.
And then the other critical part of the proposal is a plan, a plan for how they're going to actually build it and how they're going to test it. We're going to take those, we're going to review them, and we're going to choose up to four people who are winners, finalists I guess we're going to call them here. And each of those individuals gets $15,000.
Balintfy: The finalists in the My Air, My Health Challenge will be invited to develop their proposals into working prototypes, to demonstrate how their systems can be integrated for practical use by people, and health and environmental agencies. One finalist will be awarded $100,000 for the most effective solution for integrating physiological and air quality data that is usable and meaningful to long-term health outcomes. Dr. Balshaw adds that the question of how environment and health are connected is a big one.
Balshaw: The short answer is every disease we have has an environmental contribution. Everything that we encounter in our environment is likely to have some effect on our environment at some point. We've been told that our genes are a critical determinant of our health and as we have learned about more genetic susceptibility, it's become clear that much of that is actually due to the interaction between genetic factors and environmental factors contributing to disease.
Balintfy: He says there are clear examples where the environment has a direct link to a person’s health. For example, exposure to particles or allergens is associated with increases in childhood asthma. But often it is a challenge to directly link day-to-day exposure to overall health.
Balshaw: What we ultimately want to be able to do is to use information that we have on how environment influences health to drive identification of the sources of pollution in the environment and to guide policy as well as clinical intervention to really reduce the burden of disease by acting at the point the disease begins.
Balintfy: Thanks to Dr. David Balshaw at the NIH’s National Institute of Environmental Health Sciences. The My Air, My Health Challenge has been open since June 6 and the deadline for proposals is October 5th. To learn more about the challenge visit www.challenge.gov and for more information on environmental health topics visit www.niehs.nih.gov.
Balintfy: Wake up in a good mood this morning? You might have an opiod receptor to thank. Margot Kern brings us this report.
Kern: Athletes often refer to a high that they experience when pushing their bodies beyond normal limits. Dr. Jean Chin is a program director at the National Institute of General Medicinal Sciences at NIH. She says it’s opioid receptors that are responsible for generating that other-worldly sensation.
Chin: The runner's high that you hear about. When people exercise they feel really good afterwards and that's because of the release of endorphins, and endorphins actually bind to these opioid receptors.
Kern: Opioid receptors are proteins imbedded in the membranes of certain cells in the brain, spinal cord, and digestive tract. Specific drugs can bind or stick to these receptors to start biochemical processes involved in mood and pain regulation.
Chin: And so what that means is that the endorphins are released and then they tickle these opioid receptors or we'll call them OR for short, and then they stimulate what they call euphoria or feeling good, and so it elevates your mood and they are also important in reducing pain perception.
Kern: The body’s ability to naturally dull pain through the release of endorphins is important for athletes when pushing their bodies to extremes, but opioid receptors also bind several man-made drugs such as morphine and codeine that are prescribed to people suffering from debilitating pain. Though highly effective, these opiate-based drugs can quickly become addictive. In fact, the illicit drug, heroin, is a derivative of morphine and similarly binds to opioid receptors.
Chen: The hard part about what they call outside drugs or exogenous drugs versus endogenous or your natural or native things like endorphins, these outside things like morphine and heroine, they make you feel so good you want to keep on doing it and so then it becomes addictive. And so that's why it's important to understand how these different agents, whether they're uppers or downers or painkillers or whatever, how they interact with what we call these opioid receptors or ORs.
Kern: Recently, several NIH-funded researchers have made significant strides in understanding these interactions by finding a way to crystallize opioid receptors so that they can then take pictures of them. There are currently four known opioid receptors and while they all bind similar drugs, they do so with different strengths. Dr. Chin explains what these pictures reveal about the different opioid receptors.
Chin: What they all showed is that they all have similar structures, and what's different is the binding pocket which is up of the protein, the membrane protein. They all sort of have different tilts and angles.
And then some of them, when they bind they change a little. It's like breathing. You sort of hit a little marshmallow and then it sort of pushes over and sort of realigns. And so when they bind, they find little changes.
Kern: Dr. Chin says these tiny differences can help researchers understand why some drugs prefer to bind to a certain class of opioid receptors.
Chin: Now they can start to compare, contrast, see how one works differently, why one family, one type of receptor binds this kind of ligand or morphine and another one only binds or prefers to bind like to endorphins and so forth. So these all have important implications in pain relief because they're analgesics so they lessen your pain. And some of them can sedate you. Some of them will elevate your mood. And because most of them are in the brain, that controls a lot.
Kern: Though the new pictures provide valuable information, Dr. Chin says they’re still somewhat limited.
Chin: A picture is worth a thousand words. Everyone says that and it's really true. I think that it's a really terrific start, but we have to keep in mind that it's only one picture. What you really want is a movie. And so this is one state and so you want to see the whole thing from active form all the way through to the inactive form.
Kern: Given these recent advances in opioid receptor research, Dr. Chin is hopeful that scientists will eventually be able to develop less addictive painkillers.
Chin: This is just the beginning, these papers just came out, I think it's going to be pretty exciting what they can do from here. Once they learn more about the mechanisms of binding, I think they'll be able to enable to design better drugs or ligands and also with fewer side effects so that if you want a painkiller you want only a painkiller, not one that will give you highs like morphine. So you want to be able to restrict any future drug ligands to what you want it to do.
Kern: Referring to the scientists involved in these new studies, Dr. Chin was all praise.
Chin: These guys are amazing and they are really hardworking because it's extremely challenging work. For instance, Brian Kobilka has been working with the family of GPCRs for over 20 years and the same for Ray Stevens, both of them, and they've managed to come up with technologies that together just sort of help to break open the field, and it's pretty incredible. So it's really exciting to see how all of these came together.
Kern: For more about opioid receptor research, visit www.nigms.nih.gov. For NIH Radio, this is Margot Kern.
Balintfy: Coming up, recognition for research in rotavirus. That’s next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Pediatric research award
Balintfy: The NIH’s Fogarty International Center director Dr. Roger Glass has been named 2012 recipient of the Program for Global Pediatric Research Award for Outstanding Contributions to Global Child Health. Dr. Glass was cited for his outstanding body of work, his commitment to the health of children throughout the world, and his dedication to mentorship. NIH Radio talked to Dr. Glass about childhood diarrhea, which remains one of the major causes of death in the developing world. Dr. Glass, what was the research for which you are now being honored?
Glass: Well, diarrheal diseases remain one of the major causes of death among children in the developing world and a common problem for all children. This honor recognizes that over the last 30 years we've discovered the most important agent of diarrhea in children, rotavirus. Not only have we discovered it, but it has led to a number of vaccines that have come forward, a recognition of its importance globally, and the first efforts to eliminate and prevent this severe childhood infection through the use of a vaccine both in the United States and in the developing world.
Balintfy: What would you like to see in terms of rotavirus vaccine rollout and related policy globally?
Glass: Well, in the United States, we rolled out rotavirus most recently in 2006, and over the past five years we've seen a tremendous reduction in hospitalizations of children for diarrhea especially in the winter, about a 50% reduction in diarrheal disease, 95% reduction in rotavirus, and this has led to a decrease in hospitalizations that we estimate to be about 5% of all children under five. That is a huge advance and a huge savings to the hospitals and to the public.
Globally we see that there are around a half a million deaths from rotavirus among children in the developing world, mostly in low income countries. The first ever to reduce mortality, deaths, in a developing country was documented in Mexico where the vaccine was introduced, and three years later the Mexicans, together with CDC, were able to document about a 40% reduction in diarrheal deaths in Mexican children. We still have a half a million deaths from rotavirus in the world today and the real goal of these programs will be to see how much of this we can eliminate through the use of the vaccine in the years ahead, and that's the real challenge before us now.
Balintfy: Just to back up a little, what exactly is rotavirus, Dr. Glass?
Glass: Rotavirus is the most common cause of severe diarrhea in children worldwide. It affects every child in the first few years of life. Most kids get a diarrheal episode. And for some of those children, this episode can be severe and can be fatal if they're not properly treated. So it's a huge problem. It's a universal problem. All kids have it, rich or poor, black or white, Chinese or American or African. We all share the same common infection.
Balintfy: Again regarding the research and the award, part of the recognition is your role as a mentor. Can you talk a little bit about the importance of cultivating the next generation of global health scientists?
Glass: Oh, sure. When I began working on rotavirus and diarrheal diseases, it wasn't a sexy topic. It's really hard to picture a child with diarrheal disease. It's not like a child with polio where they have a physical ailment. A child with diarrheal disease is dehydrated, is vomiting, may be covered with poop. It's not a very pleasant sight. And there is not a lot of recognition of its importance.
Over the years we've developed very simple ways to document the importance of rotavirus among hospitalized children, and using that documentation we're able to make a case for the use of the vaccine in the United States and throughout the world. So rotavirus vaccination has been embraced by the World Health Organization as a priority disease, by the Global Alliance for Vaccines and Immunization, and earliest by the Bill and Melinda Gates Foundation which saw this as one of the prime reasons that they began investing in vaccines for child survival.
Balintfy: How does the Fogarty International Center support both the research and the young and American or foreign scientists in terms of becoming researchers and scientists themselves?
Glass: Well, I think I had a very nice transition from working at CDC specifically on rotavirus to coming to Fogarty because what I've learned through working on rotavirus is that we were able to set up surveillance in over 50 countries of the world and train local people to count their own cases and count their own deaths and understand the burden.
Here at Fogarty we're doing the same thing. We invest in capacity building of scientists, young scientists in the developing world to be able to do their own research, to help them with methods, to help them make new discoveries and observations.
And so it's the same idea. I call it early childhood education, getting people who are enthusiastic, idealistic, and empowering them to do research, and from the research really being able to make a difference through their research on the lives of people and the public in their own settings.
This is exactly what Fogarty does. We support training of young people in global health research and we support their careers by linking their institutions with American institutions and bringing up our young scientists together. We really feel that the frontiers of science are not only in the United States but are in all the corners of the world. We share common problems just like rotavirus which is a universal infection.
Balintfy: Dr. Glass, what would you like to emphasize regarding this award and your research?
Glass: Well, I'm quite humbled to receive this honor because over the years at CDC I trained more than 25 epidemiologists who helped with this research. We trained literally over a hundred researchers from the developing world as well as post docs to carry on these activities, and they operate the reference centers around the world. They are the local reference laboratory leaders.
So this isn't really my own research and work. It's the work of a network of people who have been empowered through training to conduct this global effort. And I'm quite certain that in the years ahead they will all be absolutely essential if we're going to have a world free of rotavirus through the use of a vaccine.
Balintfy: And that is possible Dr. Glass?
Glass: Oh, I certainly hope so. Certainly there are hurdles ahead. It's not an easy activity. But we have an understanding of the virus, the disease, ways to make the vaccines effective in low-income countries, and a lot of will and support from the Global Alliance for Vaccines and Immunizations to fund the introduction of these vaccines where they're needed most. So we have a long road ahead of us but we have all the tools that we need to make this happen.
Balintfy: Thank you very much and congratulations Dr. Roger Glass, director of the Fogarty International Center at the NIH. For more about the Fogarty International Center, visit www.fic.nih.gov. And to learn more about rotavirus and rotavirus vaccines, visit www.niaid.nih.gov.
Balintfy: That’s it for this episode of NIH Research Radio. Please join us again on Friday, July 13 when our next edition will be available. If you have any questions or comments about this program, or have story suggestions for a future episode, please let me know. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter @NIHRadio, or on Facebook. Until next time, I'm your host, Joe Balintfy. Thanks for listening.
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