Splish, splash
At Morgan’s Inspiration Island water park, high-tech, air-powered waterproof wheelchairs provide a place for people of all abilities to play. It is the only water park that offers these innovative wheelchair designs for users.
The 80-pound wheelchair designs are easy to modify and run on compressed air—perfect for mobility and easy use in the wet environment. The water park is a part of Morgan’s Wonderland in San Antonio, an ultra-accessible amusement park built to accommodate people with special needs.
“Mobility has always been my passion,” said Ana Allegretti, Ph.D., OTR, assistant professor of occupational therapy.
Before the waterpark opened in 2017, Dr. Allegretti and her occupational therapy students helped train park employees and volunteers on making adjustments to the three types of waterproof wheelchairs, which include rigid models for those who can propel themselves independently, a reclining style and pneumatic chairs powered by compressed air. The wheelchair valets learn how to seat guests and use accessories properly; each model can be modified to fit any accessories necessary to meet the guests’ needs.
The partnership between the School of Health Professions and the park has continued, and Dr. Allegretti offers training for the wheelchair valets and volunteers for the water park prior to the opening of each summer season.
Dr. Allegretti was recently selected as a Wall of Fame honoree at the park in recognition of her work enabling mobility.
“This is not just a water park that everybody can come to," she said. "It is so much more. The social interactions that happen are just beautiful.”
Ready, set, Go Baby Go!
On a recent Saturday afternoon, the hallways of San Antonio’s Children’s Rehabilitation Institute (CRIT) temporarily took on the look of a mini racetrack. The cheers coming from the spectators could have come from a racetrack, too, as parents and volunteers clapped, cheered and encouraged the young drivers. Bright red and shiny blue battery-powered toy cars zoomed around corners as their drivers mastered the course.
All the children behind the wheels of the toy cars were under the age of 5, none able to move independently. The little cars give a new sense of movement to children who can’t easily get around because of mobility impairments.
“My daughter can’t bear weight on her legs,” said Carlos Sanchez, father of 2-year-old Emery Lynn. “This car is going to help her get around more and gain a sense of independence.”
The fun she is likely to have in the car is a big bonus, too.
“Just to see the smile on her face is amazing,” added Sanchez.
Emery Lynn and several other children are participating in Go Baby Go, a community-based research and outreach program that modifies off-the-shelf, plastic toy cars for children with conditions such as cerebral palsy, spina bifida, Down syndrome or muscular dystrophy.
“For many children, this is their first experience moving independently without being pushed in a stroller or carried by a parent,” said Ana Allegretti, Ph.D., OTR, ATP, assistant professor of occupational therapy at UT Health San Antonio.
Go Baby Go was created in 2006 by Cole Galloway, Ph.D., PT, professor of physical therapy and infant behavior specialist at the University of Delaware. The group’s mission is to get nonambulatory children on the move to help with crucial development skills like hand-eye coordination, spatial awareness, communication and cognition.
“Independent mobility for young children is very important,” said Dr. Allegretti. “They learn by exploring their environment—they scoot, crawl, walk, reach for toys, interact and talk with other children. They are constantly learning by simply moving around.”
After attending a Go Baby Go workshop in Nashville, Tennessee, Dr. Allegretti was inspired to bring the program to San Antonio. In 2015, she partnered with the Children’s Rehabilitation Institute, a pediatric rehabilitation center, to start the local chapter.
With a team of medical specialists from CRIT, Dr. Allegretti and occupational therapy students from UT Health San Antonio host workshops to teach others how to transform toy cars into a low-tech, low-cost source of power mobility.
Basic modifications are made to the seating area of each car using pool noodles, PVC pipes and kickboards to meet each child’s specific posture and stability needs. A large, red on/off button is added to the steering wheel and is used instead of pedal accelerators.
Azalya Hernandez, second-year occupational therapy student, said it just takes some creativity to adapt the cars to fit the needs of each child.
“As occupational therapists, we strive to help our clients achieve their best occupational performance through the use of their own environment,” Hernandez said. “For kids, their occupation is to play, learn, explore and be social.”
Costing around $500 each and paid for through an internal seed grant, each car takes about an afternoon to customize. The modified toy cars are a smaller and cheaper alternative to power wheelchairs, which can often cost several thousand dollars.
The toy cars are not medical devices, but are a way to make basic power mobility accessible to children who need it the most. Families who participate in Go Baby Go workshops can take the cars home free of charge. The team has purchased, modified and given away 20 cars to date.
In addition to hosting build workshops, Dr. Allegretti and her team are conducting research to measure the effectiveness and therapeutic benefits of the adapted toy cars.
“We are looking to see how the ride-on toy car influences social, language and motor skills in the children and will assess the improvements using standardized tests such as the Peabody Developmental Motor Scales and the Battelle Developmental Inventory, along with interviews with parents,” said Dr. Allegretti.
Recently, the team finished up a four-month study with their first cohort of 10 children. The results have been promising.
One family reported that their son’s head control improved after using the car for 30 minutes a day in addition to occupational and physical therapy.
“Her son loved being in the car and in order to drive the car, he has to keep his head up,” Dr. Allegretti said. “Now, his head and neck control has improved, he is eating solid food. His first word was car—he just loves it.”
Another family reported that they have seen a significant increase in their daughter’s self-esteem since she received her car.
“It is very rewarding to see a child go from waiting for others to ask them to play to initiating play with their peers,” Dr. Allegretti added.
Because of Go Baby Go, Jacob Ledesma, a 3-year-old with cerebral palsy, now has a way to keep up with his twin brother, John.
“For me, the car is about Jacob playing and feeling normal,” said John Ledesma, father of the twin boys. “It will help him feel like he is part of the group instead of behind it.”
Cynthia Ledesma, Jacob’s mother, added she is looking forward to seeing her son work on fine motor skills while using the car.
“He has some trouble with hand-eye coordination so I can’t wait to see him learn to use the buckle, get in and out of the car and begin to correlate that when he pushes the button, the car will turn,” she said.
The goal of Go Baby Go is to reach as many children with limited mobility as possible. Videos are posted on YouTube by Dr. Galloway’s team and instructions on how to adapt toy cars are available online. More than 40 chapters in the United States and abroad host workshops for families, teachers, clinicians and community members.
Brian Zita, a second-year occupational therapy student, believes the project is truly making a difference.
“Go Baby Go gives children a means to participate in many purposeful activities they wouldn’t otherwise be able to do without wheeled mobility,” Zita said. “The children aren’t seen as a ‘child in a wheelchair’ but as a child with a really cool toy.”
Go Baby Go is just the first step in providing mobility and a way to let kids be kids, added Dr. Allegretti.
“Imagine if all kids with mobility impairments could get a Go Baby Go car—their lives would be changed because of this project,” she said.
Fungus among us
They’re everywhere. They sometimes appear as mold. Sometimes, yeast. They’re a necessary ingredient in beer, cheese, bread and soy sauce. They’re also used to make industrial chemicals, detergents and antimicrobials.
Simply put, fungi are an essential part of life.
But what happens when things get out of hand? Enter the Fungus Testing Laboratory.
“Although fungi surround us and help maintain our environment of natural growth and decay, they can be harmful to those who are immunocompromised, such as patients with transplants, cancer or HIV,” said Nathan Wiederhold, Pharm.D., associate professor of pathology.
While fungal infections may appear on the skin, oftentimes they are acquired by breathing in the air (not by eating mushrooms). When patients with weak immune systems are unable to fight these infections on their own, their physicians turn to the Fungus Testing Laboratory to help identify and treat the infection.
First, a sample is cultured from a human or animal and isolated by institutions or hospital labs. Then the sample is sent to the Fungus Testing Laboratory, where it is analyzed under a microscope, or at the molecular level to study the sample’s DNA sequence.
Various antifungal compounds are also tested against the fungi in order to help guide in treating the infection. Drug level assays also determine if antifungal compounds are in therapeutic ranges to fight infections in patients.
Thirty years ago, the lab was founded as a one-man shop by Michael Rinaldi, Ph.D. It slowly grew, with the addition of Deanna Sutton, Ph.D., professor of pathology, and Annette Fothergill, M.A., M.B.A., associate clinical professor of pathology. With Dr. Rinaldi’s passion for spreading the word about fungal disease, Dr. Sutton’s talent for fungal identification and Fothergill’s savvy skills for drug susceptibility testing, cases quickly increased and the small research area mushroomed into a bustling lab with 10 employees who occupy more than 2,800 square feet.
The lab now receives more than 5,000 specimens annually for testing and combines both research and clinical care under one roof. Dr. Sutton serves as the administrative director, Fothergill is the technical director and Dr. Wiederhold assumed the directorship of the laboratory after Dr. Rinaldi’s retirement two years ago.
The lab has extended its services to include assisting with drug development and research on the effectiveness of drugs for pharmaceutical companies. Many of the most commonly used antifungals such as Posaconazole, often used to treat thrush, and Efinaconazole, used to treat toenail fungus, were tested early in pre-clinical development in the Fungus Testing Laboratory.
“What sets the Health Science Center’s Fungus Testing Laboratory apart is the high level of expertise and expanse of our testing capabilities,” said Dr. Sutton. “There isn’t another lab in the world that receives the amount or scope of cases and has the number of fungal isolates that we do.”
The laboratory has assisted in cases that have made national headlines. Among them, the deadly 2012 outbreak of fungal meningitis that affected more than 750 patients in 20 states who had received spinal injections with a contaminated steroid from a compounding lab in New England.
“The expertise and service provided by the lab are well-recognized,” said Sean Zhang, M.D., Ph.D., director of the Mycology Laboratory at Johns Hopkins Hospital. “The textbook, Guide to Clinically Important Fungi, edited by the scientists in the lab, is the must-have reference book for almost every clinical lab that offers fungal identification testing. In addition to the excellent clinical service, the lab collaborates with other academic centers in conducting cutting-edge research in the area of fungal diagnostics.”
Researchers in the lab have contributed to the discovery of several new species of fungi, including those causing infections. Among the most recent is Acremoniopsis suttonii, a yellow, slimy cylindrical fungus found in forest soil in Burgos, Spain. It was named in honor of Dr. Sutton’s years of work in fungal taxonomy.
The lab has also trained dozens of researchers in the United States and throughout the world who in turn have established labs in their respective institutions and countries. Collectively, the three directors have published more than 500 papers on fungal research and are frequent presenters at international conferences.
Although there is not a typical day in the lab, the future points to challenges with resistance to drugs, the necessity for early and rapid diagnosis, and changes in taxonomy.
“This is a dynamic time for mycology,” said Fothergill. “There is so much more to learn and discover.”
First patient given novel brain tumor treatment
The idea: tiny radioactive fat particles, only 100 nanometers across, inserted by the thinnest of catheters directly into a tumor where they remain, radiating only a tiny distance, affecting only the tumor.
The target: glioblastoma, the deadliest of brain tumors.
On March 10, David Williams became the first human ever to have the new radiation treatment implanted in the center of his brain tumor.
The technology, developed by scientists from the UT Health Science Center's Cancer Therapy & Research Center, uses radioactive liposomes, or fat particles, and inserts them into a tumor. There they remain, radiating a tiny distance and affecting only the tumor, causing less damage to surrounding healthy tissue.
Conventional radiation therapy, considered the best treatment option to date, has not changed much in 40 years. It also has limitations. It must send its beams through healthy tissue to reach the tumor, and so must be limited in the amount of radiation it delivers.
Days after the procedure, Williams reported feeling well and had not experienced adverse side effects.
“This technology is unique,” said Andrew Brenner, M.D., Ph.D., a neuro-oncologist who is leading the clinical trial. “Only we can load the liposomes to these very high radioactivity levels.”
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David Williams was the first patient to receive a new radiation treatment implanted into the center of his brain tumor.
Doctors inserted radioactive liposomes, or fat particles, directly into the tumor (tan mass), using a tiny catheter (blue cylinder) inserted through a small hole drilled into the skull. The liposomes retain the radiation and keep it from spreading throughout the rest of the brain or blood stream, causing less damage to surrounding healthy tissue. The mass shown in teal was another tumor surgically removed.
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The concept was developed by nuclear medicine physician William T. Phillips, M.D., and biochemist Beth A. Goins, Ph.D., in the Department of Radiology; and Ande Bao, Ph.D., a medical physicist and pharmaceutical chemist formerly in the Department of Otolaryngology.
One of the challenges was getting the highly radioactive nanoliposomes into the brain and directly into the tumor. Past chemotherapy treatments using catheters had limitations because of the catheter design, said neurosurgeon John R. Floyd II, M.D., who worked with Dr. Brenner to apply the first treatment to Williams at University Hospital.
“To effectively deliver this novel therapy and improve our surgical targeting, [we knew] we would need a better catheter. The one we are using is a new design, enabling us to deliver small quantities in precise locations. We are very pleased already with delivery in our first case.”
While not all brain tumors are malignant, the glioblastoma is especially deadly. Moreover, as the tumor advances, it affects the brain in unpredictable ways, often involving radical shifts in personality and behavior.
“It’s a terrible thing for a family to lose a loved one to glioblastoma,” Dr. Brenner said. “It’s tough to lose them to any cancer, but with the brain tumor you see them change right before your eyes.”
The nanotechnology is igniting hope that there will soon be a major step forward in treatment options for brain cancer, and there is potential that it also could be adapted for use in other cancers.
Mays Family Foundation marks CTRC anniversary with $5 million gift
Since its founding more than 40 years ago, the Cancer Therapy & Research Center has grown in stature, scope, funding, patient care and research. But there’s been at least one constant: the support of Lowry and Peggy Mays. The couple has long been involved in the effort to make the CTRC the premier cancer treatment and research center in South Texas.
In January, at the CTRC’s 40th Anniversary Reunion Dinner, the Mays Family Foundation announced a gift of $5 million to endow the Mays Family Foundation Distinguished University Presidential Chair for the director of the CTRC.
“We are delighted to honor the CTRC for its 40 years of life-changing work and support its aspirations for the future,” said Lowry Mays, foundation founder.
CTRC director Ian M. Thompson Jr., M.D., said the family’s support helps ensure the level of excellence that has become expected from the CTRC.
“This endowment is an extraordinary gift that will fuel opportunities for scientific breakthroughs and invest in the best and brightest minds in cancer research,” he said.
In a time of diminishing funding for scientific research, the Mays chair will allow for investment in important programs such as pilot research, faculty recruitment and retention, clinical trials, new technology and cancer prevention, Dr. Thompson added.
“It is a remarkable testament to the family’s continuing commitment to the community and to the important role the CTRC has played herein, that they are not only early supporters and the founders of the CTRC Cabinet, but now have committed to helping us reach ever-higher standards of excellence,” Dr. Thompson said.
“They planted a seed that has grown into a full tree. Now they’re planting again, and we’re soon to have an orchard.”
The CTRC opened in 1974 as a nonprofit corporation providing outpatient radiation therapy. It has evolved into one of only four academic cancer centers in the state to be named a National Cancer Institute designated cancer center. Its Institute for Drug Development conducts one of the largest oncology Phase I clinical drug programs in the world, and participates in the development of cancer drugs approved by the Food and Drug Administration.
David E. Green, managing director of the Mays Family Foundation, said the gift is recognition of the CTRC’s elite status earned through four decades of hard work. It is also a way to support the center’s future.
“We were impressed with the strategic plan and wanted to show our support to kick off the next 40 years of their work,” he said, noting that the previous major gift of $500,000 donated in 2013 established the Mays Family Foundation Rising Star Physician-Scientist Award.
Combined with the Clear Channel Foundation, the Mays Family Foundation has contributed more than $55 million to various causes.
“Our mission is to support the communities in which we live, work and serve through causes that aid, empower, enrich and educate,” Green said. “Investing in the CTRC easily delivers on those goals.”
Cancer-fighting boost
Researchers at the Cancer Therapy & Research Center were awarded more than $5 million in grants from the Cancer Prevention and Research Institute of Texas to help in projects ranging from examining the on/off switch of a cancer-fighting molecule to preventing liver cancer in a majority Hispanic South Texas population.
“I’m not surprised, but I’m delighted,” said CTRC Director Ian M. Thompson Jr., M.D. “These grants demonstrate the breadth and depth of our researchers’ talents at every level.”
More than $3 million will go toward a core facility grant for single cancer cell analysis. Tim Huang, Ph.D., professor and chairman of molecular medicine and deputy director of the CTRC, said the grant, announced in May, will allow the CTRC to acquire key pieces that will complete the services already offered by the core facility. Those services include isolating and studying single cancer cells from urine and saliva to develop non-invasive methods for detecting cancer.
“This will give cancer researchers from throughout the region and beyond access to the latest analytical tools operated by a highly qualified technical team, helping them to develop new ways to diagnose, monitor and treat cancer,” he said.
Three CTRC researchers received $1.9 million to support their work in liver and colon cancer prevention and harnessing the body’s defenses to prevent recurrence of cancer.
The awards come on the heels of $6.6 million in research and product development grants given to researchers by the state-funded agency in February. Those included $4.6 million to support researchers’ work ranging from reducing chemotherapy’s painful side effects to unmasking resveratrol’s potential in managing prostate cancer, and a $2 million product development grant to support a new brain cancer therapy’s transition from a research project to a viable treatment option.
The product development grant is for NanoTX Therapeutics, a company formed to accelerate clinical trials of a highly promising nanotechnology that inserts radioactive isotopes into tiny fat particles, allowing concentrated radiation treatment precisely in the tumor. The process allows doctors to give far higher doses of radiation than current technology while minimizing side effects to healthy tissue.The grant will also help the young company develop a management infrastructure and tackle the regulatory process involved in commercializing a new technology.
Seeds of hope
Like a seed that becomes a tree, pilot grants can help a scientist through the mundane but pricey steps needed to prove an idea has real potential—thus securing the bigger grants to finance the years of work it takes to create the next effective drug.
When Roger and Dot Hemminghaus heard about the pilot research grant program at the Cancer Therapy & Research Center, they chose to support the work of Manjeet Rao, Ph.D., assistant professor of cellular and structural biology.
Their instincts were sound. Their $25,000 pilot gift allowed Dr. Rao to build toward a $900,000 grant from the Cancer Prevention and Research Institute of Texas (CPRIT).
Dr. Rao’s work is with microRNA, small gene-like molecules that can affect cells through subtle regulation of a number of factors and play a critical role in cancer drug resistance. Dr. Rao wants to put them to work against triple-negative breast cancers and find less toxic treatments that aren’t so vulnerable to drug resistance.
“It was a project that we believed would lead to very specific results—and that we could understand, for one thing,” Roger Hemminghaus said with a chuckle. “[Dr. Rao] was working with a breast cancer that wouldn’t respond to the existing treatment, and he was taking a new approach to understanding the chemistry and physiology of that cancer.
“And it appears, according to the size of the grant he just got, we picked a winner,” he said.
The Hemminghaus grant is an example of the bridge that pilot grants can form to help researchers take their work to the next level, said CTRC Director Ian M. Thompson Jr., M.D.
“It’s not necessary to fund a building or endow a chair to make a real difference,” he said. “People can make a powerful, tangible difference at the pilot grant level if they direct it to something that has great potential, which is something we vet when we compile the list of potential research projects. And it’s more meaningful to everyone if they know exactly what they’re funding.”
Barbara and George Williams recently chose two projects to fund: Gail Tomlinson, M.D., Ph.D., interim director of the Greehey Children’s Cancer Research Instit
ute, is researching liver blastomas in children. And Karen Block, Ph.D., assistant professor of nephrology, and Denis Feliers, Ph.D., assistant professor of cell biology, are working on kidney cancer.
A blastoma is a type of tumor that comes from immature or embryonic tissue. Dr. Tomlinson is searching for akey similarity between liver blastomas and hepatocellular cancer in adults, which is the most common type of liver cancer. Finding the similarities is critical to designing a clinical trial that could help both, she said. While hepatocellular cancer is a looming threat for an increasing number of adults, pediatric blastomas are much rarer. Funding national clinical trials to develop drugs to treat them alone is difficult, Dr. Tomlinson said.
She has identified a possible key element that appears in both cancers, and the next step involves intensive analysis to develop a drug to target it.
The gift to Dr. Block and Dr. Feliers will be used to develop a therapy for kidney cancer, among the most malignant cancers in the U.S. with a high incidence in South Texas. The researchers are examining what drives the process at the cellular level. When the wrong protein is present in kidneys, it gives rise to kidney cancer, and oxidative stress is what allows the wrong protein to be present.
“Current therapies aren’t touching this protein,” Dr. Block said. “If we can silence the enzymes that produce oxidative stress, it reduces renal tumor growth by 70 to 80 percent.”
The next step is crafting a therapy that targets the key players producing oxidative stress that can be used in combination with other therapies for the treatment of renal cancer.
The Williamses, who have lost family members to cancer, said the ongoing research is a long way from the cancer treatments of the past. Contributing to moving new therapies forward is an opportunity they’re happy to have. They’ve already pledged to fund two additional pilot grants. They will select one later this year and one next year.
“Cancer is such a scourge in our society,” Barbara Williams said. “We felt that if we could attack it on the front lines—that, to us, was just really important.”
HSC researchers receive support from cancer institute
Nearly $8 million in cancer-related research grants and faculty recruitment funds were awarded to the Health Science Center by the Cancer Prevention & Research Institute of Texas (CPRIT), surpassing previous amounts awarded by the same group.
HSC faculty competed with nearly 600 grant applicants to receive the highly competitive funds. They are:
- Amelie Ramirez, Dr.P.H., professor and director of the Institute for Health Promotion Research and associate director of Cancer Prevention and Health Disparities at the CTRC, with co-investigators Kipling Gallion, M.A., and Patricia Chalela, Dr.P.H., received $1.4 million.
- Ricardo Aguiar, M.D., Ph.D., associate professor of medicine and biochemistry, received $854,740.
- Devalingam Mahalingam, M.D., Ph.D., oncologist and assistant professor of medicine, received $825,285.
- Patricia Dahia, M.D., Ph.D., associate professor of medicine, received $881,146.
- Manjeet Rao, Ph.D., assistant professor of cellular and structural biology at the Greehey Children’s Cancer Research Institute, received $900,000.
- Thomas Boyer, Ph.D., professor of molecular medicine, received $200,000.
- Daisy Morales-Campos, Ph.D., instructor/research of epidemiology and biostatistics at the Institute for Health Promotion Research, with Deborah Parra-Medina, Ph.D., M.P.H., professor of epidemiology and biostatistics, received $149,985.
- Deborah Parra-Medina, M.P.H., Ph.D. and principal investigator Meizi He, M.D., M.Sc., Ph.D., at The University of Texas at San Antonio, received $573,095.
- A recruitment grant for a potential faculty member was also awarded. Tim Huang, Ph.D., professor and chairman of molecular medicine, prepared this recruitment proposal that received $2 million.
Spice for life
As cancer rates rise, researcher goes back to the basics of medicine
A gathering place for traditional healers in the Republic of Guinea is in Kankan, one of that West African country’s largest cities—but making the 250-mile trip from the coast means 19 hours of bone-jarring travel over deeply rutted roads.
Michael Wargovich, Ph.D., trekked those miles recently to meet with a local healer who ran his office out of a container that had been "liberated" from a freighter. He managed to interview the healer about traditional medicine by speaking English to his wife, Joan Cunningham, Ph.D., who spoke French to a student, who spoke Maninka to the healer, who replied in Susu.
"That actually worked," said Dr. Wargovich, who holds the Cancer Therapy & Research Center’s Cancer Center Council Distinguished Chair in Oncology and is a professor of molecular medicine in the Long School of Medicine at the UT Health Science Center San Antonio.
Dr. Wargovich is a colon cancer researcher who has become a bioprospector of traditional plants and medicines, searching for the ways to reintegrate old wisdom into new science. The journey, which has taken him to Africa, South America and India, was a slow evolution fueled by keeping an eye on the big picture.
And the big picture has been revealing some stark patterns.
"I have watched the shift in patterns of cancer rates across the world," said Dr. Wargovich. "Not only of cancer, but of all kinds of chronic diseases that have become common in the United States and other Westernized countries."
Cancer is still dominant in Westernized countries, he said, but it is showing an increase in Africa and Asia, as well.
The latest report by the World Health Organization notes that "many developing countries find themselves in the grip of cancers from two vastly different worlds. Those associated with the world of poverty, including infection-related cancers, are still common, while those associated with the world of plenty are increasingly prevalent, owing to the adoption of industrialized lifestyles, with increasing use of tobacco, consumption of alcohol and highly processed foods, and lack of physical activity."
This is the paradoxical price of prosperity, Dr. Wargovich said, but it’s not inevitable.
Price of Prosperity
The World Health Organization reports that as developing countries adopt more prosperous lifestyles, cancer rates are steadily increasing and mortality rates are following suit. The biggest rates of increase are in developing and newly industrialized countries.
Source: GLOBOCAN 2012 (IARC), World Health Organization
"All the demographics suggest that the lower socioeconomic classes are going to be replaced by a huge middle-income demographic across the world. As people become more affluent, they start to depart from traditional ways that kept them healthy for so long and begin to acquire the chronic diseases—diabetes, heart disease, cancer and the like.
"We’re trying to stem the huge tsunami of chronic diseases headed across the world."
The "how" of this also took shape over time, Dr. Wargovich said. It’s clear that chronic inflammation plays a contributing role in chronic disease, but the anti-inflammatory drugs currently available are too harsh for the population as a whole to take in a preventive manner.
Also, health-related campaigns to include more fiber or vegetables in the diet have not been as effective as was hoped over the past couple of decades, he said. Modest health gains have been offset in part by people’s unwillingness to stay on the programs, and Dr. Wargovich believes the focus was wrong, anyway.
"At the macroscopic level, we were probably missing where all the action was. Now that we know about inflammation, the target’s been redefined, so the intervention’s been redefined."
That led him to believe the picture is more complex, and includes much smaller players with bigger impacts than was previously understood.
Those smaller players are the anti-inflammatory agents that in many cases give spices their flavor. Turmeric, chile and green tea, among many others, taken in small amounts but integrated daily into diets, work against inflammation in the body and help ward off sickness that would have to be treated by harsher methods if it were to take hold, he said.
The same is true of traditional medicines still used in developing societies. Wargovich returned from his travels with samples of bark, leaves and roots that healers use to treat inflammatory conditions, whether they are malaria-related fevers, menstrual cramps, headaches or arthritis.
"They would send the patients home with tea bags, essentially," he said. "The healer would include a combination of plants that he knew were anti-inflammatory—plants only collected and ground during the dry season, because that’s when they have the highest concentration of the healing ingredients."
Bringing those samples back to the Health Science Center means he can access the brainpower and facilities throughout the campus to make the most of his research. Since coming to the Health Science Center from Charleston, S.C., in late 2012, he has embarked on new partnerships, following new questions down the path of discovery.
One line of questioning is taking him through the School of Dentistry. The neem tree is known as the "poor man’s toothbrush" in India, Dr. Wargovich said, and he’s working with Spencer W. Redding, D.D.S., M.Ed., chairman of the Health Science Center’s Department of Comprehensive Dentistry, and Cara Gonzales, D.D.S., Ph.D., an assistant professor in the Department of Comprehensive Dentistry, on the properties in neem that might prevent or potentially treat oral cancer.
Another experiment "that I think could be done very few other places" is in collaboration with CTRC Deputy Director Tim Huang, Ph.D., an expert in genomic and epigenetic research.
"We are looking at the green tea antioxidant EGCG using the Health Science Center’s high-throughput screening technology," Dr. Wargovich said. "We are looking at gene-on and gene-off status in over 14,000 genes, and seeing how the EGCG affects them."
When genes accumulate methyl groups, they cannot produce a protein. In the chronic inflammatory process, there is an enzyme that puts methyl groups onto genes and stops them from acting. EGCG knocks out that activity by eliminating the enzyme, which allows the genes to work.
"The genes do a lot of things," Dr. Wargovich said, "but one of those things is control inflammation. I like to use the analogy of putting brakes back on a car."
While everyone can incorporate foods with anti-inflammatory properties into their diets right now, Dr. Wargovich is excited about the new knowledge being developed and the possibilities for further inspiration that the current work brings.
"I think it’s still a story that’s being written," Dr. Wargovich said. "I’ve been absolutely surprised to find the way the research has changed in terms of what we do in our laboratory. We were focused on the biology of colon cancer and that morphed into more of an inflammation laboratory. It’s very exciting to think about where we will go from here."
Thousands of men could avoid cancer diagnosis
The American Society of Clinical Oncology has designated a Health Science Center researcher’s work as among the most significant practice-changing studies of 2013.
The long-term follow-up to a groundbreaking finasteride study of 19,000 men, both of which were led by Cancer Therapy & Research Center Director Ian M. Thompson Jr., M.D., confirms that a drug developed for hair growth has no impact on lifespan but reduces the risk of prostate cancer by more than a third.
Reducing the risk of prostate tumors by about 30 percent - and low-grade tumors by 43 percent - means thousands of men can avoid a cancer diagnosis and subsequent treatments that significantly affect quality of life, Dr. Thompson said.
"If you look at the number of prostate cancers that are diagnosed annually and multiply that by 30 percent, that’s the number of cancers we might be able to prevent each year," he said.
"That’s more than 71,000 men. That’s more than 175 jumbo jets full of men who won’t get cancer, who won’t face treatments with side effects like sexual dysfunction," Dr. Thompson said.
"There’s nothing like disease prevention. Nothing comes close," he added.
The Prostate Cancer Prevention Trial, funded by a National Cancer Institute grant, began in 1993. It was coordinated by SWOG, an international network of research institutions. Researchers were at first concerned that it increased some deadlier prostate cancers.
The follow-up study, published in theNew England Journal of Medicine, showed that finasteride did not increase mortality rates, and it decreased low-grade prostate cancer even more than originally thought. It was chosen for ASCO’s Clinical Cancer Advances 2013: ASCO’s Annual Report on Progress Against Cancer, an independent annual review of the advances in clinical cancer research that have the greatest potential to improve patients’ survival and quality of life.
In today’s medical climate, many men with low-grade tumors are unnecessarily treated, Dr. Thompson noted, and those treatments carry a considerable burden for the patient and for society.
"If we can free thousands of men each year from that burden," he said, "we could use those resources for other important medical interventions, reducing death and suffering from disease."