Every year the Federation of American Societies of Experimental Biologists (FASEB) brings...
Dr. Louis Sullivan, BUSM ’58, will be discussing his newly published autobiography, Breaking Ground: My Life in Medicine, on Monday, Feb. 10, at 4 p.m. in the 670 Albany Street Auditorium, First Floor.
A 1958 graduate of BUSM and former faculty member who currently is a member of the Dean’s Advisory Board, Dr. Sullivan is the founding dean and first president of Morehouse School of Medicine (now president emeritus). He served as Secretary of Health and Human Services during the George H. W. Bush administration. He is chair of the board of the National Health Museum in Atlanta and the Washington, D.C.–based Sullivan Alliance to Transform America’s Health Professionals. He also is author of The Morehouse Mystique: Becoming a Doctor at the Nation’s Newest African American Medical School (with Marybeth Gasman).
Dr. Sullivan has many annecdotes to share about his experiences in Washington, D.C., dealing with the burgeoning AIDS crisis, PETA activists, and antismoking efforts, along with his efforts to push through comprehensive health care reform decades before the Affordable Care Act. His interactions with political figures, including Thurgood Marshall, Jack Kemp, Clarence Thomas, Jesse Helms and the Bushes, capture a time in recent history.
A reception and book signing will follow in the auditorium foyer.
- Breaking Ground: My Life in Medicine, Lecture and book signing
- Dr. Louis Sullivan, BUSM ’58
- Monday, Feb. 10
- 4 p.m.
- 670 Albany Street Auditorium, First Floor
Type 1 diabetes is a genetically-driven autoimmune disease of pancreatic beta-cells, whose origins remain unknown. Researchers at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) discovered that skin cells from patients with type 1 diabetes display abnormal activity triggered by immune response mechanisms to environmental stimuli like a viral infection. These findings currently appear online in PLoS One.
They found that these cells acquire elevated levels of calcium when exposed to either cytokines or fat. In humans, cytokines or cell signalling molecules essential to the body’s immune response, increase with the onset of infection as does an excess of fatty acids when people are sick and stop eating, a common occurrence in children when they get viruses.
“This is significant as it is known that a viral illness usually precedes the development of type 1 diabetes in children but no one knows why it should be related,” says Barbara Corkey, PhD, Zoltan Kohn Professor of Medicine at BUSM and vice chair for Research in the Obesity Research Center at BMC. “Our findings that diabetic cells have a different sensitivity as indicated by higher levels of calcium to an environmental event such as a virus, may help to explain why the onset of type 1 diabetes might be triggered by an environmental stimulus as well as a genetic predisposition.”
In fact, their data showed that skin cells from relatives of people with type 1 diabetes who are not afflicted with type 1 diabetes themselves display an intermediate calcium response to circulating signaling molecules. These data suggest that a unique environmental stimulus may interact with a genetic trait to initiate diabetes.
“Determination of this trait before development of diabetes could help to identify susceptible individuals prior to disease onset,” adds Corkey.
The Medical Student Residence (MSR) has been officially certified by the U.S. Green Building Council as LEED Gold, the second building on the Medical Campus to achieve LEED certification. The first was 670 Albany Street in January 2008. Throughout the University eight buildings have been certified and this is the fifth to achieve Gold.
LEED, an acronym for Leadership in Energy and Environmental Design, is an internationally-recognized green building certification system. Developed by the U.S. Green Building Council (USGBC) in March 2000, LEED provides a framework for identifying and implementing practical and measurable green building design, construction, operations and maintenance solutions. It promotes sustainable building and development practices.
The MSR was designed and built with the goal of reducing waste sent to landfills, conserving energy and water, providing a healthier and safer indoor environment for its occupants, and reducing greenhouse gas emissions. Some highlights of the sustainable building strategies used at the MSR include:
* 18 percent more energy efficient than required by the building code
* Rainwater harvesting for landscape irrigation
* 40 percent water use reduction through efficient plumbing fixtures
* 88 percent of construction waste was recycled
* 33 percent recycled content of all construction material
Students will complete both degrees in six years
BU’s new MD/JD program will appeal to students interested in health care administration, health care legislation, medical licensing, and intellectual property issues focused on medical research.
Boston University will offer a joint Doctor of Medicine (MD) and Juris Doctor of Law (JD) degree program starting next fall, becoming only the second New England university, along with Yale, to offer the dual degree. Simultaneous admission to both the School of Medicine and the School of Law will be required, and applicants must take the LSAT and MCAT exams to be considered. The new program will be highly selective, initially accepting two students a year.
Citing the increasing interaction between the fields of health and law and recent changes to government regulations and health policy, MED and LAW administrators believe that the program will appeal to students interested in health care administration, health care legislation, medical licensing, and intellectual property issues focused on medical research.
“This degree, which combines medical and legal expertise, is excellent preparation for students considering hospital or health care system leadership opportunities or careers in medical policy and academic administration,” says Karen Antman, provost of the Medical Campus and dean of MED.
Megan Sandel, a MED associate professor of clinical pediatrics and program director of the joint degree program for the School of Medicine, says students will spend the first three years in a medical curriculum, focusing on the basic sciences during the first two years and the eight core clerkships, among them surgery, pediatrics, and internal medicine, the third year. They will spend their fourth and fifth years completing the first two years of law school, with some medical clinical experiences built in to maintain skills. The final year of the program will include a mix of elective courses from both MED and LAW that will complement an area of concentration of their choice.
Boston University becomes the 19th university in the country to offer a joint MD/JD program. In addition to Yale, other schools include Duke, the University of Miami, the University of Chicago, Vanderbilt, and Texas Tech. Almost all of the programs, like BU’s, allow students to complete the two degrees in six years, rather than the seven it would take if they were to pursue the degrees separately. Each school structures the program slightly differently. At Duke, for example, students spend the first two years in the MD program and the next two years enrolled in the law school, and then they return to the medical school for elective clinical work tailored to their interests.
“The MD/JD degree program advances the University’s ‘One BU’ philosophy and the law school’s strategic plan to establish dual degree programs,” says LAW Dean Maureen O’Rourke. “We are launching this new degree with the School of Medicine at a time when the growing fields of technology, health care management, and health law need professionals who possess both medical and legal expertise.”
This BU Today story was written by John O’Rourke. He can be reached at email@example.com
Study Shows Reducing Liver Protein SIRT1 Levels Plays a Role in Abnormal Metabolism Related to Fatty Liver and Obesity
A new study led by Mengwei Zang, MD, PhD, associate professor in the Department of Medicine at Boston University School of Medicine (BUSM), demonstrates that the abnormal metabolism linked to obesity could be regulated in part by the interaction of two metabolic regulators, called the NAD-dependent deacetylase SIRT1 and fibroblast growth factor 21 (FGF21). Using experimental models, the researchers found that a lack of SIRT1 protein in the liver led to lower levels of a liver secreted protein FGF21, which resulted in an increased likelihood of developing fatty liver disease and obesity. The study was published in Gastroenterology.
When levels of FGF21 in the liver of experimental models were elevated, some of the white fat cells became brown fat cells, producing more heat and burning calories. White fat stores energy as large fat droplets, while brown fat has much smaller fat droplets and is specialized to burn them, yielding heat. In humans, there is evidence that more brown fat is associated with a lower body weight. Finding a way to turn white fat into brown fat could potentially lead to a decrease in obesity and other metabolic diseases.
In previous experiments, Zang’s laboratory showed that elevated liver SIRT1 protein limited the development of fatty liver in experimental models when the diet was high in fat. However, the mechanism was not known. To determine how this happens, Zang laboratory used a unique mouse model that did not have liver SIRT1 protein, which resulted in an elevation in hepatic fat levels, an increase in body weight, and a decrease in nighttime oxygen consumption. It also led to decreased levels of liver FGF21, which were associated with abnormal fat metabolic changes in liver and adipose tissues.
However, when levels of liver and serum FGF21 were elevated, some white fat cells changed and became brown fat cells, which could increase whole-body oxygen consumption and produce more heat. These changes in the fat cells caused by elevated FGF21 protein could help explain how the experimental mice experienced more weight loss, had less fat mass and slowed the progression of fatty liver.
“Excess abdominal white fat in humans promotes heart disease, diabetes and other metabolic diseases, and it would be potentially therapeutic if we could transform white fat into brown fat by elevating FGF21 levels,” said Zang, the study’s corresponding author.
Funding for this study was provided in part by the National Institutes of Health Grants,the Robert Dawson Evans Faculty Merit Award, and Wing Tat Lee Award.
Tony Godfrey, PhD, associate professor of surgery and associate chair of research in the Department of Surgery at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC), was recently awarded a two-year, $225,000 grant from the DeGregorio Family Foundation for Gastric and Esophageal Cancer Research & Education. Godfrey and collaborators Lincoln Stein, MD, PhD, from the Ontario Institute for Cancer Research (OICR) and Virginia Litle MD, director, Barrett’s Esophageal Program at BMC, will use the funding to study Barrett’s Esophagus (BE). People with BE are at increased risk for a type of cancer called esophageal adenocarcinoma.
Currently, the only way to detect esophageal adenocarcinoma is with an endoscopy requiring a hospital visit. The research team is developing a new approach for esophageal cancer detection that could be performed simply in a primary care physician’s office or even at home. The approach uses a sponge-containing capsule attached to a string. When swallowed, the sponge expands in the stomach and can then be pulled back through the esophagus and out of the mouth. Esophageal cells are rubbed off onto the sponge as it is pulled through the esophagus and can be examined to look for cancerous changes.
“Our project, clinically conducted in our Barrett’s Esophagus Program at Boston Medical Center, will attempt to find cancer cells using a sensitive method to detect mutations that are known to cause esophageal adenocarcinoma,” said Godfrey, who is also principal investigator of the study. “If successful, this project may lead to more wide-spread esophageal cancer screening, earlier detection of tumors and improved survival.”
The DeGregorio Family Foundation seeks to promote and facilitate education and collaborative research on the pathogenesis, early diagnosis and treatment of upper gastrointestinal malignancies.
NFL funds boost brain bank, international data sharing project
Research by scientists at the BU School of Medicine has raised national awareness about the effects of repetitive head trauma on former football players whose brains were studied after their deaths. Now a $6 million cooperative grant from the National Institutes of Health (NIH)—bolstered by major funding from the National Football League (NFL)—will enable researchers at BU’s Center for the Study of Traumatic Encephalopathy (CSTE) to share their results with scientists around the world through a national tissue bank and database. The grant, to be shared with two other institutions, is one of eight new NIH-funded projects aimed at understanding the long-term effects of repetitive brain injury and improving diagnosis of concussions, according to an NIH announcement released last month. At BU, the funds will also help lay the foundation for developing a diagnosis of chronic traumatic encephalopathy (CTE)—the degenerative disease researchers here discovered in the brains of scores of deceased former NFL players—in individuals during their lifetimes.
The new NIH grants are funded largely by a $30 million donation from the NFL, which in 2012 formed the Sports and Health Research Program, a partnership with the NIH and the Foundation for the National Institutes of Health for research on injuries in athletes, chiefly brain trauma. The cooperative grant, which BU will share with brain imaging teams at Washington University in St. Louis and Boston’s Massachusetts General Hospital, will fund the establishment of a national CTE tissue reference bank accessible to experts around the world, says Ann McKee, a MED professor of neurology and pathology and a codirector of the CSTE, based at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass. The CSTE was created in 2008 as a collaborative venture between MED and the Sports Legacy Institute (SLI), which funds concussion research and education. The mission of the CSTE is to conduct research on the neuropathology, pathogenesis, and clinical presentation of CTE, as well as genetic and environmental risk factors and ways to prevent this progressive dementia.
Six years after McKee first identified CTE—at that time believed to occur almost exclusively in “punch-drunk” boxers—in the brain of a former NFL player, the condition still needs to be specifically defined, and clear criteria established to distinguish it from other degenerative brain diseases such as Alzheimer’s, McKee says. The brains of the former NFL players studied all showed severe damage in the frontal cortex, the part of the brain connected with insight, judgment, and intellect. That area was “completely congested and filled up with tau, an abnormal protein that forms tangles that strangle and destroy brain cells,” says McKee.
Diagnosed posthumously, CTE is an insidious degenerative disease with no known cure, so there is widespread and often false hope for experimental tests that might identify the disease in a living person. But before a reliable scan or other test is developed, “we need to validate the criteria” for the disease, says McKee. The new grant will drive this crucial first step. “We’ve been criticized in the past for being too insular,” she says. “Now we’re going to all the experts in the field, asking them to look at the tissue we’ve studied. Eventually there will be a web-based tissue site.”
Traumatic brain injury is a major public health problem and the leading cause of death in young adults, according to the NIH. McKee and her colleagues in the growing field of repetitive brain injury research are not only identifying the long-term brain damage caused by these injuries, they are striving to predict who, among football players and others at risk, is likely to recover and who will go on to suffer the degeneration known as CTE.
The grant provides “the long-awaited chance to fund our brain bank,” says McKee. “We’ve made tremendous progress; now we really need to spread out and study all different aspects of this disease, with researchers from all over the world—a wide net of researchers with different skill sets—addressing issues like genetic susceptibility and the nature of brain degeneration. The broader view is to apply what we know pathologically to clinical complications, to identify this disease in living people.”
This BU Today story was written by Susan Seligson. She can be reached at firstname.lastname@example.org.
A recent study led by Boston University School of Medicine (BUSM) shows that “practice may make perfect” when it comes to caring for patients with severe sepsis. The study showed that patients admitted to academic medical centers that care for more patients with severe sepsis have significantly lower mortality rates than patients cared for at academic medical centers with lower volumes of sepsis patients. Additionally, the superior outcomes at high volume centers were achieved at similar costs compared to the lower volume medical centers.
Published online in the American Journal of Respiratory and Critical Care Medicine, the study was led by Allan J. Walkey, MD, MSc, assistant professor of medicine, BUSM, and attending physician, pulmonary, critical care and allergy medicine, Boston Medical Center.
Analyzing data from academic hospitals across the country, provided by the University HealthSystem Consortium, the researchers identified 56,997 patients with severe sepsis who were admitted to 124 academic hospitals in 2011. The median length of stay for patients was 12.5 days and the median direct cost for each patient was $26,304.
Their data indicate that hospitals caring for more sepsis patients had a seven percent lower mortality rate than hospitals with lower volumes. The high volume medical centers had a 22 percent mortality rate while the lower volume hospitals had a 29 percent mortality rate.
“Given the lack of new drugs to treat severe sepsis, medical professionals must look at other ways to increase patient safety and positive outcomes, including the process of how we deliver care,” said Walkey. “Our study results demonstrate that hospitals with more experience caring for patients with severe sepsis were able to achieve better outcomes than hospitals with less experience with sepsis, possibly due to better processes of care for patients with sepsis.”
Funding for this study was provided in part by the National Heart, Lung, and Blood Institute under grand award number K01HL116768 and the National Cancer Institute under grant award number K07 CA138772. More
Douglas V. Faller, MD, PhD, Grunebaum Professor for Cancer Research and professor of medicine, pediatrics, biochemistry, microbiology, pathology and laboratory medicine; vice-chairman, Division of Medicine; and director of the Cancer Center at Boston University School of Medicine (BUSM), recently was awarded the Marta Marx Award from the Scleroderma Foundation for receiving the top score of all proposals reviewed by the scientific peer-review committee. The award includes a two-year $150,000 grant for his project “PKCs Inhibitors as Targeted Therapeutics for Systemic Sclerosis.”
Scleroderma, or systemic sclerosis (SSc), is a chronic connective tissue disease generally classified as one of the autoimmune rheumatic diseases. Scleroderma is a disease that involves the buildup of scar-like tissue in the skin. It also damages the cells the line the walls of the small arteries. The cause of scleroderma is unknown.
The hallmark features of SSc include vascular damage, immune dysfunction and extensive skin and organ fibrosis. According to Faller, significant strides have been made in understanding the development of SSc and identifying potential therapeutic targets, including a central role for transforming growth factor (TGFb) signaling. “The novel Protein Kinase C isozyme (PKCd) plays a key role in the occurrence of fibrosis and vasculopathy in SSc. My colleague, professor Maria Trojanowska, director of the Arthritis Center has shown that in SSc fibroblasts, PKCd is activated, and fibrosis induced by TGFb is dependent upon PKCd. The TGFb/PKCd pathway is also involved in the fibrotic pathology of multiple other fibrotic diseases. Thus, blocking the TGFb/PKCd pathway could be an attractive therapeutic approach for both the vasculopathy and the fibrosis of SSc,” explained Faller, who also is vice chairman of the Cancer Research Center at Boston Medical Center. “We have now developed novel small molecule drugs to block this pathway,” he added.
Faller believes that a specific small-molecule inhibitor of PKCd would ameliorate the fibrosis and vascular pathology induced by TGFb and other inflammatory mediators in models of scleroderma, and represents a new therapeutic approach to this disease. “Since therapeutic options for SSc are limited, the development of such novel and targeted treatments is of paramount importance,” said Faller.
One of two universities in New England to offer distinctive program
Boston University will begin offering a six-year Doctor of Medicine (MD) and Doctor of Law (JD) degree through a joint program between two of its most prestigious professional schools—the Schools of Law and Medicine. With the implementation of this new dual degree in fall 2014, BU joins Yale as the only two universities in New England to offer this distinctive program.
The complex interactions of medicine and law combined with changes to health policy and government regulation and mandates have created a need for individuals trained in the nuances of each of the areas. Today those trained as both physicians and lawyers may find themselves at the juncture of these forces. Career paths for those holding both degrees may include working in health care administration, on a wide array of health law issues including legislation and programs to end health disparities, on intellectual property issues related to medical research and technologies, or in areas such as medical licensing.
“From the implementation of the Affordable Care Act to patenting innovations in biotechnology to managing the growing complexities of health care organizations, the legal and medical fields have become increasingly intertwined,” says BU School of Law Dean Maureen A. O’Rourke. “We want to prepare future leaders who can manage the rapid changes that are happening in these interdisciplinary fields.”
Students earn both degrees one year sooner than they would if they pursued them independently. They complete the first three years of the medical school curriculum, then spend their fourth and fifth years fully integrated into the J.D. program at the School of Law. They fulfill their remaining medical and law course requirements in the sixth year of the program.
“This degree, which combines medical and legal expertise, is excellent preparation for students considering hospital or health care system leadership opportunities or careers in medical policy and academic administration. By collaborating across the University with our outstanding law school colleagues, we believe that we have designed what will become one of the highest quality, most comprehensive and sought-after MD/JD programs in the U.S.,” says BU School of Medicine Dean and Medical Campus Provost Karen Antman, MD.
The program is conducted under the auspices of both Schools with simultaneous admission to both required for acceptance into the program. Matriculating students will be advised by faculty members from both Schools. Consistent with other MD/JD programs, over the six years students will complete the required coursework in both schools. This will begin with the first three years of medical school, including the eight core clerkships, to gain a foundation of clinical medicine. It then will proceed with the required 58 credits of courses in law over the next two years, and in the final year combine medicine and law electives consistent with the area of concentration of the student’s choice. Applications to the program will be accepted in spring 2014.
For more information, visit www.bu.edu/law/central/jd/programs/dual/medicine/index.html.