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February 09, 2016

In Brief

What can frogs teach us about tumors?

closeup photo of a tadpole
The School of Medicine and Dentistry houses the largest Xenopus laevis (South African clawed frog) research resource in the world. Jacques Robert, professor of microbiology and immunology, uses the X. laevis model to better understand the minute details of how tumors grow and how the body reacts.

School of Medicine and Dentistry researchers are using South African clawed frogs, Xenopus laevis, as a model to study human diseases because they are very similar to humans on a genetic level.

In a paper recently published in Developmental Biology, Jacques Robert, professor of microbiology and immunology, and his colleagues transplanted tumor cells into tadpoles, which developed into semisolid tumors that spread throughout the tadpole over the course of a few weeks. In mammals, growth and spread of tumors requires reorganization of the structural supports that surround the cells. Robert plans to use the new tumor model in tadpoles to understand how the supports are modified and how tumors spread. Robert’s research may also shed new light on how tumors grow blood vessels, which help tumors grow and thrive by delivering essential nutrients through the bloodstream.

While much of Robert’s research benefits humans, he is also interested in understanding diseases that affect amphibians, fish, and reptiles.

Study details source of cognitive problems with MS

A new study sheds light on the damage in the brain caused by multiple sclerosis (MS), which may explain the slow and continuous cognitive decline that many patients experience. The findings, which appear in the Journal of Neuroscience, show that the brain’s immune system is responsible for disrupting communication between nerve cells, even in parts of the brain that are not normally considered to be primary targets of the disease.

“This study identifies for the first time a new disease mechanism in MS which causes damage to neurons independent of the loss of white matter and demyelination that is the hallmark of the disease,” says lead author Matthew Bellizzi, assistant professor of neurology. “This damage represents another component of the disease and one that is not prevented by the current immunosuppressive drugs employed to treat MS.”

Multiple sclerosis is a disease of the central nervous system that affects an estimated one million people worldwide. While the precise cause of MS is unknown, it has long been understood that the immune system of individuals with MS attacks myelin, a fatty white-matter tissue in the central nervous system that wraps the fibers—or axons—that connect nerve cells. When myelin is lost or damaged (a process called demyelination) signals between nerve cells can be delayed, disrupted, or even blocked.

Most people associate MS with motor and sensory symptoms like muscle weakness, numbness or tingling in arms and legs; difficulty with coordination, walking, and balance; blurred vision; and slurred speech. However, up to 70 percent of people with MS will also go on to develop cognitive problems later in life, such as memory loss and difficulty processing information, concentrating, and finding the right word when speaking.

“For too long, MS has been characterized as a disease that impairs people’s mobility, speech, or vision,” says senior author Harris Gelbard, professor of neurology and director of the Medical Center’s Center for Neural Development and Disease. “However, the aspect of the disease that many patients complain has the greatest impact on their quality of life is the loss of cognitive independence.”

While physicians currently have several frontline drugs that are effective in suppressing the immune system attacks that can lead to myelin damage, the therapies do not prevent progressive cognitive problems.


Chemical exposure in mothers and infants linked to poor vaccine response

Early exposures to toxic chemicals dampen an infant’s response to the tuberculosis vaccine, according to a new study published in the journal Environmental Health Perspectives.

The two primary chemicals in the paper—polychlorinated biphenyls (PCBs) and DE, the main breakdown product of the insecticide DDT—are among the world’s most persistent pollutants and are not easily degraded, thus remaining a health threat long after they were banned.

The significance of the research extends far beyond TB vaccine responses and exposures to the two chemicals, says Todd Jusko, assistant professor of environmental medicine and public health sciences, who led the study. “There are thousands of pollutants similar to PCBs and DDT with unknown health implications,” he says. “Our work provides a foundation for how these types of chemicals affect the developing immune system in
infants around the world.”

PCBs were used in manufacturing and in consumer products in the United States until their ban in 1979. Despite the ban, nearly all people have detectable concentrations in their blood, even those who live in unindustrialized areas around the globe. DDT, though banned in the U.S., is still used in some countries to control malaria spread by mosquitos.


New drug better for leukemia patients

Older adults with chronic lymphocytic leukemia may now have an alternative to toxic chemotherapy as their first treatment, according to a study coauthored by Paul Barr, associate professor of medicine. The paper was published online in The New England Journal of Medicine.

The Phase 3 clinical trial compared a newer targeted drug, ibrutinib, to chlorambucil, a type of chemotherapy usually given to patients as a frontline therapy. Barr, director of the Clinical Trials Office at Wilmot Cancer Institute, supervised trial enrollment for patients in the Rochester and Finger Lakes regions.

Scientists have been searching for an alternative treatment for chronic lymphocytic leukemia because this type of blood cancer often afflicts people in their 70s who have other medical problems and are more likely to be harmed by the toxicity of standard chemotherapy. Ibrutinib is currently approved to treat CLL patients who have already received at least one other drug, but this was the first study to test its use as an initial therapy.

Results showed that ibrutinib was superior to chlorambucil in each measured aspect, including progression-free survival, overall response rate, and overall survival. Ibrutinib also appeared to restore bone marrow function, which is important because bone marrow failure is a significant problem with the disease.


Pitfalls in new teacher certification assessment reported

The first teacher candidates required to pass edTPA, a new teaching performance assessment for certification in New York and Washington, encountered multiple ambiguities, uncertainties, and other obstacles while trying to complete its requirements, two Warner School researchers report.

The tensions created for the test takers, combined with “sparse” feedback in the form of purely numerical ratings, undermined the potential benefits of edTPA, providing “little useful information to edTPA takers for improving their practice,” write Kevin Meuwissen, assistant professor of teaching and curriculum, and Jeffrey Choppin, associate professor of teaching and curriculum, in a paper published in Education Policy Analysis Archives. In 2013, New York and Washington became the first states to require teacher candidates to pass the edTPA in order to be certified. Teacher candidates must prepare a portfolio that includes three to five lesson plans, 20 minutes of video-recorded classroom performance, and at least three student assessment samples, all based on their placements in schools as student teachers. Meuwissen and Choppin interviewed 24 teacher candidates who completed the edTPA the first year it was required.


Recreational ice skating injuries examined

little boy sitting on ice rink
Medical Center researchers say the majority of the 250,000 people who have sought emergency room care for recreational ice skating injuries in the past 10 years were children and teenage girls.

An estimated 250,000 people landed in emergency rooms in the past decade due to recreational ice skating injuries—and the majority of them were children and teenage girls, according to a study from Rochester researchers.

Common injuries included fractures and lacerations to the upper body from attempting to break a fall with arms and hands. Recreational ice skaters were also five times as likely to suffer a concussion as in-line skaters and seven times as likely as roller skaters, the study found.

The research was led by Courtney Jones, assistant professor of emergency medicine and public health sciences and an epidemiologist at the Medical Center. She presented the study recently at the American Public Health Association annual meeting.

Few studies have focused on recreational ice skating injuries.  Most other research has examined injuries among elite figure skaters and ice hockey players, and from the use of temporary ice rinks. The lack of data prompted Jones to estimate recreational skating injuries.


Study establishes international standards for stroke outcomes

A new study by an international team of researchers has established a set of outcome measures that assess a patient’s quality of life after a stroke.

The new measures were developed by a working group—which included Adam Kelly, with the UR Medicine Stroke Center—consisting of stroke patients, neurologists, and specialists in all phases of stroke care. Stroke experts from North and South America, Europe, Australia, and Asia participated in the study, which appeared in the journal Stroke.

Current measures of the quality of care in the United States are primarily based on guidelines established by organizations such as the American Heart Association/American Stroke Association and the Joint Commission that certify hospitals as stroke centers. For the most part, the measures are focused on processes, or steps that providers take in the delivery of care both during and after a stroke. The measures range from timely care in the emergency department to steps taken to reduce stroke risk once the patient is discharged, including controlling their cholesterol, prescribing appropriate blood-thinning medications, and smoking cessation.

The new recommendations expand upon the measures to include outcomes that focus on how an ischemic stroke or intracerebral hemorrhage has affected an individual’s quality of life. They consist of patient-reported measures such as mobility; whether patients need help getting dressed, eating, or going to the bathroom; difficulties with memory or the ability to communicate; and depression or social withdrawal.

The new measures were designed to be both patient centered and universal in nature, meaning that the information was not dependent upon expensive technologies such as MRIs and could therefore be applied to hospitals and clinics across the globe.


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