PHILADELPHIA INTERNATIONAL MEDICINE® NEWS BUREAU
Contact: Leonard N. Karp
215-575-3720
lkarp@philadelphiamedicine.com
February 23, 2006
For immediate release:
In this month's issue:
- Fox Chase Cancer Center Begins Ovarian Cancer Proteomics Study To Identify Biologic "Fingerprint" of the Disease
- Penn Researchers Create Technique to Engineer Nerve Tissue "Jumper Cables" to Repair Spinal Cord Injury, in Animal Model; Technique Holds Promise for Spinal-Cord Repair in Humans
- Experts Head New Jefferson Program Specializing in the Diagnosis and Treatment of Movement Disorders
Editors note: Research, new techniques and improved facilities by Philadelphia International Medicine hospitals and physicians may lead to new ways to treat some of our most challenging diseases. Below are just some examples from our hospitals.
Fox Chase Cancer Center Begins Ovarian Cancer Proteomics
Study To Identify Biologic "Fingerprint" of the Disease
Philadelphia – Fox Chase Cancer Center researchers are participating in a study to search for a biologic "fingerprint" of ovarian cancer using a technology called proteomics.
Proteomics is the study of protein patterns in blood or other tissues used to determine cancer probabilities. In a previously published study, researchers used proteomics to successfully differentiate blood samples from women with and without ovarian cancer. This new study is sponsored by the National Cancer Institute and involves Fox Chase and 11 other U.S. institutions.
"Proteomics offers significant hope as a cancer diagnostic tool, but while the earlier study appears promising, the results must be validated," explained Mary Daly, MD, PhD, a world-renown medical oncologist and co-investigator of the study at Fox Chase. "To do this, we’ll begin studying proteomics using blood from women who have had ovarian cancer to see if we can identify a specific protein pattern in those women whose cancers may later recur." Over 80 percent of advanced-stage ovarian cancer patients in remission have recurrence of their disease.
Researchers say proteomics offers the future hope of allowing doctors to diagnose cancer at an early stage when it is most curable. In addition, proteomics could allow physicians to diagnose ovarian cancer without the need for a biopsy or surgery.
"As of now, the only way to confirm that a woman has ovarian cancer is to surgically remove the ovaries," explained Mitchell Edelson, MD, chief of the section of gynecologic oncology at Fox Chase and co-investigator of the study. "Before a new blood test can be offered as a way to detect ovarian cancer, we must first confirm that there is a pattern of proteins specific to ovarian cancer. Any test for ovarian cancer must be proven to be reliable and dependable so that women don’t get needless surgeries because of a false-positive result."
The clinical trial also is open to women who have had peritoneal and fallopian tube cancers. Women in the study must have had Stage III or IV disease at diagnosis, and must have completed initial standard treatment within 12 weeks of enrolling in the proteomics study. Participants will be asked to give blood every three months for four years (unless the disease recurs). The results of the blood tests will not be given to the participants because an accurate protein pattern for ovarian cancer has yet to be determined.
Researchers nationwide hope to enroll 400 women in this study. As part of this study, physicians will monitor all women for recurrent disease in the same way as those who are not on this study. No anti-cancer treatment will be offered unless a cancer has recurred (as determined by current tests including a CT scan, CA-125 blood test or physical exam).
Epithelial ovarian cancer is diagnosed in approximately 22,200 American women each year. In 2005, it is estimated that 16,210 women in the U.S. died of the disease, making it the fifth most common cancer in women in the United States. Currently, there is no standard screening available for the disease. When ovarian cancer is diagnosed at an early stage, the survival rate approaches 90 percent. However, the vast majority of ovarian cancers are not identified until late stages, when the survival rate drops to only 30 to 40 percent.
More information about proteomics can be found at:
www.nci.nih.gov/newscenter/pressreleases/ProteomicsOvarian and
www.nci.nih.gov/cancertopics/factsheet/proteomicsqa
Fox Chase’s Specialized Program of Research Excellence (SPORE) in Ovarian Cancer is funding the study. Fox Chase is one of a select few institutions in the U.S. to receive an ovarian cancer SPORE grant from the National Cancer Institute (NCI). The NCI created SPORE grants to support innovative, multidisciplinary research approaches that potentially may have an immediate impact on improving cancer care and prevention.
Penn Researchers Create Technique to Engineer Nerve Tissue "Jumper Cables" to Repair Spinal Cord Injury, in Animal Model; Technique Holds Promise for Spinal-Cord Repair in Humans
Researchers at the University of Pennsylvania Medical Center have created - in a rodent model - a completely new way to engineer nerve structures, or constructs, in culture. This proof-of-principle research has implications for eventually becoming a new method to repair spinal cord injury in humans. The work appears in the latest issue of Tissue Engineering.
"We have created a three-dimensional neural network, a mini nervous system in culture, which can be transplanted en masse," explains senior author Douglas H. Smith, MD, Professor, Department of Neurosurgery and director of the Center for Brain Injury and Repair at Penn. Previously, Dr. Smith’s group showed that they could grow axons by placing neurons from rat dorsal root ganglia (clusters of nerves just outside the spinal cord) on nutrient-filled plastic plates. Axons sprouted from the neurons on each plate and connected with neurons on the other plate. The plates were then slowly pulled apart over a series of days, aided by a precise computer-controlled motor system.
In this study, the neurons were elongated to 10mm over seven days - after which they were embedded in a collagen matrix (with growth factors), rolled into a form resembling a jelly roll, and then implanted into a rat model of spinal cord injury.
"That creates what we call a nervous-tissue construct," says Smith. "We have designed a geometrical arrangement that looks similar to the longitudinal arrangement that the spinal cord had before it was damaged. The long bundles of axons span two populations of neurons, and these neuron constructs can grow axons in two directions - toward each other and into the host spinal cord at each side. That way they can integrate and connect the ‘cables’ to the host tissue in order to bridge a spinal cord lesion."
After the four-week study period, the researchers found that the geometry of the construct was maintained and that the neurons at both ends and all the axons spanning these neurons survived transplantation. More importantly, the axons at the ends of the construct adjacent to the host tissue did extend through the collagen barrier, penetrating into the host tissue. Future studies will measure neuronal electrical conductivity across the newly engineered bridge and restoration of motor activity.
"The really great news - and there’s still much work to be done - is that the construct survives and also integrates with host tissue," says Smith. "We find this very promising. In particular, this new technique provides a means to bridge even very long spinal lesions that are common in humans with spinal cord injury. Now we have to test whether the transplanted constructs convey a signal all the way through, and we’re developing and testing a new animal model to allow us to test whether this new technique improves function."
Study co-authors are Akira Iwata, Kevin D. Browne, Bryan J. Pfister, all from Penn; and John A. Gruner, from Cephalon Inc. The National Institutes of Health and the Sharpe Trust funded the research.
Experts Head New Jefferson Program Specializing in
the Diagnosis and Treatment of Movement Disorders
More than 40 million Americans — nearly one in seven, and twice as many as those with diabetes -- are affected by movement disorders such as Parkinson’s disease, Huntington’s disease and Tourette’s syndrome. Because symptoms can be difficult to distinguish, many patients feel helpless and frustrated as they visit numerous doctors over the course of many years before receiving an accurate diagnosis.
Thomas Jefferson University Hospital in Philadelphia is now offering a movement disorders program directed by recently recruited specialists Tsao-Wei Liang, MD, assistant professor of neurology, and Daniel Erik Kremens, MD, JD, assistant professor of neurology. Both are experienced clinicians and researchers in the field of neurology who have dedicated their careers and training to movement disorders. The program is located at the Jefferson Hospital for Neuroscience.
The new program within the Department of Neurology is designed to ensure proper diagnosis and treatment for what are chronic and often debilitating symptoms in patients with myoclonus, ataxea, dystonia, essential tremor and other tremor disorders, tic disorders, gait disorders and others.
"A large, state-of-the-art, tertiary care facility like Jefferson is the perfect center to develop a program devoted solely to those with mobility conditions," said Dr. Liang. "Those of us working on Jefferson’s new movement disorders program recognize the unique challenges facing these people and aim to offer them comprehensive, specialized clinical care, focusing on accurate diagnosis and treatment."
Dr. Kremens added that the goal is to provide convenient, prompt access to the highest quality patient care. "At one central location, patients will be evaluated, diagnosed and treated with a complete roster of medical, physical, occupational and psychological therapies. Most importantly," added Dr. Kremens, "patients will have access to highly trained specialists in the field."
Abdol Mohamad Rostami, MD, PhD, professor and chair of neurology at Jefferson, said he is proud to include a movement disorders program among the list of comprehensive services available through the Department of Neurology.
"The movement disorders program is just one example of our ongoing efforts to focus on superior patient care and the treatment of a wide variety of neurodegenerative diseases. Under the direction of Drs. Liang and Kremens the program has the potential to help thousands of patients lead more normal lives," Dr. Rostami said.
Movement disorders encompass various neurological and neurodegenerative conditions that lead to either slowed down movement and mobility or sped up movements that can make people’s daily lives difficult, if not unbearable. Recurring, random twitches and jerking of many muscles, writhing or twisting postures, isolated muscle jerks, stiffness of the muscles and disturbances in gait are just some of the many symptoms that make it difficult to perform, what might normally be thought of as mundane routines like getting out of a car, bathing, speaking, brushing one’s teeth or even holding a fork. Not only can these tasks be physically demanding, but psychologically daunting as well, leading to a fear of going out in public, due to embarrassment over one’s appearance.
Among the innovative treatment options available through the program are botulinum toxin injections for the treatment of dystonia, including hemifacial spasm (chronic twitching/spasms of one side of the face), torticollis (twisting of the neck that causes the head to rotate and tilt) and blepharospasm (abnormal blinking, eyelid tics or twitching), as well as for spasticity.
Patients also will have the opportunity to participate in clinical studies for new therapeutic agents. If a patient is a candidate for surgery, referrals can be made to a Jefferson neurosurgeon to discuss options thanks to a partnership with the Department of Neurosurgery and the expertise of neurosurgeon Ashwini Sharan, MD.
Drs. Liang and Kremens will supervise a team of neurologists, speech therapists, rehabilitation specialists and mental health counselors with expertise in diagnosing, treating and managing both common and rare disorders. They will also focus on basic and clinical research in pursuit of new knowledge of neurodegenerative diseases and disorders, leading to better treatments and possible cures.
The Department of Neurology’s leading specialists deliver full-service, comprehensive care for a wide variety of diseases such as multiple sclerosis, Alzheimer’s disease, Parkinson’s disease and other dementia and movement disorders. Members of the department have particular expertise in such areas as neuromuscular disease, headache, neurogenetics, stroke and epilepsy. These clinicians take advantage of the most advanced technologies in diagnostics.