Tag: Research

Brain Disruptions Similar In Many Emotional Disorders

Dr. Scott Langenecker, Dr. Olusola Ajilore and Lisanne Jenkins pose in front of an image of the brain in UIC’s Electronic Visualization Laboratory. Photo: Vibhu Rangavasan.

Dr. Scott Langenecker, Dr. Olusola Ajilore and Lisanne Jenkins pose in front of an image of the brain in UIC’s Electronic Visualization Laboratory. Photo: Vibhu Rangavasan.

Researchers have long known that emotional disorders have a lot in common. Many often occur together, like depression and social anxiety disorder. Treatments also tend to work across multiple disorders, suggesting shared underlying elements. But perhaps the most common shared characteristic is that almost all emotional disorders involve persistent negative thinking.

In an analysis of existing studies that used MRI images to study the brain’s white matter, researchers from the University of Illinois at Chicago describe common brain abnormalities found in multiple emotional disorders. Their findings are published in the journal NeuroImage: Clinical.

“This study provides important insights into mechanisms shared across multiple emotional disorders, and could provide us with biomarkers that can be used to more rapidly diagnose these disorders,” says Dr. Scott Langenecker, associate professor of psychiatry and psychology in the UIC College of Medicine and senior author of the paper. Those disorders, he said, can sometimes take many years to be diagnosed accurately.

The most common difference in white matter structure that Langenecker’s group found — present in every emotional disorder they looked at — was disruption in a region of the brain that connects different parts of the “default-mode network,” which is responsible for passive thoughts not focused on a particular task. That area is the left superior longitudinal fasciculus. The superior longitudinal fasciculus, or SLF, also connects the default-mode network and the cognitive control network, which is important in task-based thinking and planning and tends to work in alternation with the default-mode network.

The constant negative thoughts or ruminations associated with most emotional disorders appear to be due to a hyperactive default-mode network, Langenecker said.

“If the part of the brain that helps rein in the default-mode network isn’t as well-connected through the SLF, this could explain why people with emotional disorders have such a hard time modulating or gaining control of their negative thoughts,” he said.

The researchers systematically searched the scientific literature for studies that performed whole-brain “diffusion tensor” imaging on adults with major depressive disorder, bipolar disorder, social anxiety disorder, obsessive-compulsive disorder, or posttraumatic stress disorder, as well as healthy control participants. Thirty-seven studies met those criteria and included a combined 962 participants with emotional disorders and 892 healthy control subjects.

The researchers then performed a meta-analysis to determine which white-matter alterations may be common across multiple mood disorders and which are unique for a particular mood disorder. White matter includes the long nerve fibers called axons that transmit electrical signals.

Diffusion tensor imaging, or DTI, measures the degree to which water molecules move in one direction rather than randomly diffusing in all directions. It provides “an indirect measurement of the microstructure of white matter, and can give information about connectivity of different parts of the brain,” said Lisanne Jenkins, postdoctoral research fellow in psychiatry in the UIC College of Medicine and first author on the paper.

“If you think of white matter as the highways of the brain, connecting all the different regions and networks,” Jenkins said, an area with highly directional water movement “could be a major superhighway where all the cars are moving along quickly with little traffic.” An area with less-directed water movement could be “a two-lane road, with several exits and stop signs, maybe even some potholes, which slow down traffic.”

Brain regions connected by these slower pathways “may not communicate as well as they would in someone where this road looks more like a superhighway,” said Dr. Olusola Ajilore, associate professor of psychiatry in the UIC College of Medicine and a co-author on the paper.

In the 37 studies the researchers looked at, participants with emotional disorders had less directed water movement in their white matter compared to participants who did not have emotional disorders.

One of the most surprising findings to Langenecker was that people with obsessive-compulsive disorder shared the most brain abnormalities with people with other emotional disorders.

“We would have expected … OCD to look very different from other emotional disorders, because the symptoms are so unique and distinct,” Langenecker said. “But this kind of flips how we see OCD, which clearly has more in common with other emotional disorders than we think.”

The traditional diagnosis for OCD, he said, is repetitive thoughts about specific objects or tasks — thoughts that pertain to the world outside the self. The thoughts can also be internally-directed.

“Other emotional disorders, like depression, social anxiety, and panic disorder — the repetitive thoughts are directed at the self,” Ajilore said. “So our finding that OCD is more like the other emotional disorders makes sense, and we may now be able to further examine commonalities between these disorders that could improve our treatment of them individually.”

The disorder that stood out and shared the fewest white-matter characteristics with the others was post-traumatic stress disorder.

PTSD is triggered by a traumatic event and involves being reminded of that event at unwelcome times, not unlike the repetitive negative thinking in other emotional disorders. But people with PTSD had several areas of low white-matter connectivity that weren’t seen in the other emotional disorders, Langenecker said.

“While milder forms of trauma is common in other conditions, like major depression or generalized anxiety, it is possible that the brain regions we saw that were distinctly affected in PTSD participants are related to the experience of severe trauma or the re-experiencing of that trauma,” he said.

In bipolar disorder, characterized by periods of both depression and mania, the researchers saw generally decreased water-directionality in the right side of the brain, including the right SLF, the area that connects the default-mode network and the cognitive control network.

“All emotional disorders had disruptions more so in the left hemisphere, but for bipolar disorder, we saw disruptions in white matter in both the right and left sides of the brain,” Langenecker said.

Older studies of stroke patients have shown that abnormalities in the right hemisphere are associated with externally-focused symptoms, like mania, while left hemisphere involvement — which the current study found in most emotional disorders — was more often associated with inwardly-focused symptoms, like depression. Langenecker said the bilateral changes his team observed in bipolar disorder may reflect vulnerability to mania and to depression and anxiety.

Alyssa Barba, Miranda Campbell, Melissa Lamar, Stewart Shankman and Dr. Alex Leow, all of UIC, are the remaining co-authors on the paper.

By Sharon Parmet
sparmet@uic.edu


Can Olive Oil And Wine Help Us Think Better?

Marian_4x6-172x258

Dr. Marian Fitzgibbon, deputy director of the Institute for Health Research and Policy

Researchers at the University of Illinois at Chicago School of Public Health received a $3.8 million grant from the National Heart, Lung and Blood Institute to study the effect of the Mediterranean diet and weight loss on cognitive function in obese older adults.

The study, which is led by the school’s Institute for Health Research and Policy, will follow a group of 180 ethnically diverse men and women for eight months to determine whether adherence to the Mediterranean diet—with and without weight loss—improves performance on cognitive tasks, such as memory and attention. Dr. Marian Fitzgibbon, deputy director of the IHRP and professor of pediatrics in the UIC College of Medicine, is principal investigator on the study.

“We know there is an association between obesity and cognitive decline, but we do not know the extent to which changes in diet can lead to better cognitive health,” Fitzgibbon says. “By looking at the Mediterranean diet in a randomized, controlled clinical trial, we will be able to learn if diet is the driver of improved cognitive function, or if the mechanism is the combination of diet and weight loss.”

The Mediterranean diet includes a high intake of vegetables, fruits, whole grains, unsaturated fatty acids and modest alcohol consumption — usually wine — with meals. Previous studies have shown the Mediterranean diet to be associated with reduced risk of cognitive impairment and dementia. But there have been no randomized, controlled trials to determine causality or suggest specific clinical recommendations.

“Identifying lifestyle-based interventions that could delay the onset of cognitive decline is a critical public health priority,” Fitzgibbon said, because there are no drug treatments to offset the mental deterioration of Alzheimer’s. An effective dietary approach, she said, would be “an incredible boon for people as they age and look for ways to prevent or slow the onset of cognitive decline.”

Co-investigator Dr. Melissa Lamar, director of cognitive aging and vascular health at UI Health and associate professor of psychology and psychiatry in the UIC College of Medicine, says cognitive neurodegeneration and the risk of dementia is a significant challenge in the U.S. and worldwide, particularly when it comes to minority groups in the U.S.

More than 20 percent of older adults exhibit signs of cognitive impairment, and the Alzheimer’s Association estimates that the prevalence of Alzheimer’s disease in African Americans over 65 is approximately twice that of non-Hispanic whites. The prevalence in Hispanics is approximately 50 percent greater than in whites.

To participate in the study, obese adults 55 and older will undergo an initial screen and baseline measurements, both physical and cognitive, before being randomized into one of three groups. One group will be assigned to follow the Mediterranean diet with active weight loss strategies; another group will be assigned to follow the Mediterranean diet without attempting to lose weight; and a third group will serve as a control and not make any dietary changes. During the eight-month trial, participants assigned to follow a Mediterranean diet will attend group intervention sessions and classes through the Chicago Park District that focus on changing lifestyle patterns.

Researchers will conduct an assessment of physical and cognitive health at the end of the trial and a follow-up assessment six months later. Both assessments will be compared with the baseline to determine if cognitive function has improved.

Fitzgibbon and Lamar will work with UIC College of Medicine colleagues Drs. Lisa Tussing-Humphreys, Marcelo Bonini, Giamila Fantuzzi and John Tulley.


Medication Costs Likely to Jump Higher This Year

medicine-money-372x258Prescription medication costs are expected to rise at least 11 percent, and possibly up to 13 percent, in 2016, according to a new report on national trends and projections in prescription drug expenditures.

The report, by a team of experts led by researchers at the University of Illinois at Chicago College of
Pharmacy, reviews recent cost changes and future factors likely to influence drug costs in the current year, using the IMS Health National Sales Perspectives (NSP) database.

Contributing to the overall increase, drug spending in clinics will increase 15 percent to 17 percent, while spending in nonfederal hospitals will grow 10 percent to 12 percent, said Glen Schumock, professor and head of pharmacy systems, outcomes and policy at UIC and lead author of the report.

“These estimates for growth are considerably higher than those we have made in the past but consistent with recent trends and other forecasts,” Schumock said. “We have observed consistent increases in growth over the past three years in hospital settings.”

In 2015, drug prices continued a steep climb that began in 2013 in both clinics and nonfederal hospitals. More than $419 billion was spent on prescription drugs last year, an 11.7 percent increase over the previous year. The increase resulted from higher prices for existing drugs (8.4 percent), spending on new drugs (2.7 percent) and changes in the volume of drugs used (0.5 percent), and was higher than anticipated, Schumock said.

“Individual drugs with the greatest increases in expenditures in 2015 were specialty agents and older generics,” he said. “These agents are likely to continue to influence total spending this year.”

The dual combination hepatitis C drug ledipasvir-sofosbuvir was the top drug, accounting for $14.3 billion in expenditures in 2015. It was followed by the rheumatoid arthritis drug adalimumab ($10.6 billion); insulin glargine for diabetes ($9.2 billion); and etanercept (for autoimmune diseases) and rosuvastatin (a statin used to treat high blood pressure to prevent cardiovascular disease), each at about $6.5 billion.

The increase in the number and use of high-priced specialty medications could cause costs to rise even higher this year, Schumock said. These pharmaceuticals will constitute a significant portion of new medications on the market in the future.

Forty-five new medications for complex, chronic or rare diseases such as metastatic breast cancer, plaque psoriasis, cystic fibrosis and pulmonary arterial hypertension were approved by the U.S. Food and Drug Administration in 2015, and more could be on the way, he said.

In the future, medication costs will also be influenced by an aging patient population, a growing U.S. economy, and greater patient access to healthcare from the Affordable Care Act, Schumock said.

One factor that could inhibit the rising cost of drugs is the introduction of “biosimilars” — biologic products that are nearly identical to an original product that is manufactured by a different company. “Drug spending will be reduced only when there are a sufficient number of these products on the market to create competition and drive down prices,” Schumock said.

The new report is published in the American Journal of Health-System Pharmacy. The forecast is “widely anticipated by hospital and health-system pharmacists each year who use it to help project drug spending and develop drug budgets in their own institutions,” Schumock said.

Co-authors include Edward Li of the University of New England; Katie Suda of UIC and the Edward Hines Jr. VA Hospital; Michelle Wiest of the University of Cincinnati; Jo Ann Stubbings of UIC; Linda Matusiak and Robert Hunkler of IMS Health in Plymouth Meeting, Pennsylvania; and Lee Vermeulen of the University of Wisconsin, Madison.

By Sam Hostettler
samhos@uic.edu


New Procedure That Helps Prevent Stroke

UIH_primary_logo_notext_1cThe University of Illinois Hospital & Health Sciences System is offering a new procedure that helps prevent stroke and significantly improves quality of life for patients with atrial fibrillation who can’t be treated with a blood thinner.

Atrial fibrillation is a condition in which the heart quivers or beats irregularly, allowing blood clots to develop in the heart. These blood clots can dislodge and travel to the brain, causing a stroke. People with atrial fibrillation have a five-fold increased risk of stroke, according to the American Stroke Association.

“Atrial fibrillation is a manageable condition, but for patients who are not candidates for normal treatments, stroke is a serious risk and top concern,” says Dr. Adhir Shroff, associate professor of cardiology at the University of Illinois at Chicago and physician at UI Health.

In the new, minimally invasive procedure, physicians access the heart through a vein in the leg and implant a device that permanently seals off a small section of the heart in which clots form and enter the bloodstream.

“With this new treatment, we are able to help an increasing number of patients reduce their risk of stroke from AFib and experience a profound improvement in their quality of life,” said Dr. Henry Huang, assistant clinical professor of cardiology at UIC and physician at UI Health, who leads the UIC team implanting the devices.

Patients are able to return home and resume normal activity the next day and are not limited by the lifestyle and dietary restrictions that blood-thinning medications require.

Huang notes that the patients most likely to benefit from this treatment are the frail, the elderly, those with other conditions, and those whose professions or lifestyle make them poor candidates for blood-thinning medications.

The Centers for Disease Control and Prevention estimate that anywhere from 2.7-6.1 million people in the United States have atrial fibrillation and that the condition contributes to approximately 130,000 deaths each year. With the aging of the population, the CDC expects the number of cases to increase.

For more information about the department of cardiology at UI health visit: hospital.uillinois.edu.

By  Jacqueline Carey
jmcarey@uic.edu


Breakthrough Research: New Solar Cell Makes Fuel out of Carbon Dioxide

Solar Cell

Amin Salehi-Khojin (left), UIC assistant professor of mechanical and industrial engineering, and postdoctoral researcher Mohammad Asadi with their breakthrough solar cell that converts atmospheric carbon dioxide directly into syngas.

Researchers at the University of Illinois at Chicago have engineered a potentially game-changing solar cell that cheaply and efficiently converts atmospheric carbon dioxide directly into usable hydrocarbon fuel, using only sunlight for energy.

The finding is reported in the July 29 issue ofScience and was funded by the National Science Foundation and the U.S. Department of Energy. A provisional patent application has been filed.

Unlike conventional solar cells, which convert sunlight into electricity that must be stored in heavy batteries, the new device essentially does the work of plants, converting atmospheric carbon dioxide into fuel, solving two crucial problems at once. A solar farm of such “artificial leaves” could remove significant amounts of carbon from the atmosphere and produce energy-dense fuel efficiently.

“The new solar cell is not photovoltaic — it’s photosynthetic,” says Amin Salehi-Khojin, assistant professor of mechanical and industrial engineering at UIC and senior author on the study.

“Instead of producing energy in an unsustainable one-way route from fossil fuels to greenhouse gas, we can now reverse the process and recycle atmospheric carbon into fuel using sunlight,” he said.

While plants produce fuel in the form of sugar, the artificial leaf delivers syngas, or synthesis gas, a mixture of hydrogen gas and carbon monoxide. Syngas can be burned directly, or converted into diesel or other hydrocarbon fuels.

The ability to turn CO2 into fuel at a cost comparable to a gallon of gasoline would render fossil fuels obsolete.

Chemical reactions that convert CO2 into burnable forms of carbon are called reduction reactions, the opposite of oxidation or combustion. Engineers have been exploring different catalysts to drive CO2 reduction, but so far such reactions have been inefficient and rely on expensive precious metals such as silver, Salehi-Khojin said.

“What we needed was a new family of chemicals with extraordinary properties,” he said.

Solar Cell 2

Simulated sunlight powers a solar cell that converts atmospheric carbon dioxide directly into syngas.

Salehi-Khojin and his coworkers focused on a family of nano-structured compounds called transition metal dichalcogenides — or TMDCs — as catalysts, pairing them with an unconventional ionic liquid as the electrolyte inside a two-compartment, three-electrode electrochemical cell.

The best of several catalysts they studied turned out to be nanoflake tungsten diselenide.

“The new catalyst is more active; more able to break carbon dioxide’s chemical bonds,” said UIC postdoctoral researcher Mohammad Asadi, first author on the Science paper.

In fact, he said, the new catalyst is 1,000 times faster than noble-metal catalysts — and about 20 times cheaper.

Other researchers have used TMDC catalysts to produce hydrogen by other means, but not by reduction of CO2. The catalyst couldn’t survive the reaction.

“The active sites of the catalyst get poisoned and oxidized,” Salehi-Khojin said. The breakthrough, he said, was to use an ionic fluid called ethyl-methyl-imidazolium tetrafluoroborate, mixed 50-50 with water.

“The combination of water and the ionic liquid makes a co-catalyst that preserves the catalyst’s active sites under the harsh reduction reaction conditions,” Salehi-Khojin said.

The UIC artificial leaf consists of two silicon triple-junction photovoltaic cells of 18 square centimeters to harvest light; the tungsten diselenide and ionic liquid co-catalyst system on the cathode side; and cobalt oxide in potassium phosphate electrolyte on the anode side.

When light of 100 watts per square meter – about the average intensity reaching the Earth’s surface – energizes the cell, hydrogen and carbon monoxide gas bubble up from the cathode, while free oxygen and hydrogen ions are produced at the anode.

“The hydrogen ions diffuse through a membrane to the cathode side, to participate in the carbon dioxide reduction reaction,” said Asadi.

The technology should be adaptable not only to large-scale use, like solar farms, but also to small-scale applications, Salehi-Khojin said. In the future, he said, it may prove useful on Mars, whose atmosphere is mostly carbon dioxide, if the planet is also found to have water.

“This work has benefitted from the significant history of NSF support for basic research that feeds directly into valuable technologies and engineering achievements,” said NSF program director Robert McCabe.

“The results nicely meld experimental and computational studies to obtain new insight into the unique electronic properties of transition metal dichalcogenides,” McCabe said. “The research team has combined this mechanistic insight with some clever electrochemical engineering to make significant progress in one of the grand-challenge areas of catalysis as related to energy conversion and the environment.”

“Nanostructured transition metal dichalcogenide electrocatalysts for CO2 reduction in ionic liquid” is online at http://www.eurekalert.org/jrnls/sci/ or by contacting scipak@aaas.org.

Co-authors with Asadi and Salehi-Khojin are Kibum Kim, Aditya Venkata Addepalli, Pedram Abbasi, Poya Yasaei, Amirhossein Behranginia, Bijandra Kumar and Jeremiah Abiade of UIC’s mechanical and industrial engineering department, who performed the electrochemical experiments and prepared the catalyst under NSF contract CBET-1512647; Robert F. Klie and Patrick Phillips of UIC’s physics department, who performed electron microscopy and spectroscopy experiments; Larry A. Curtiss, Cong Liu and Peter Zapol of Argonne National Laboratory, who did Density Functional Theory calculations under DOE contract DE-ACO206CH11357; Richard Haasch of the University of Illinois at Urbana-Champaign, who did ultraviolet photoelectron spectroscopy; and José M. Cerrato of the University of New Mexico, who did elemental analysis.

By Bill Burton
Burton@uic.edu


Hops Extract Studied To Prevent Breast Cancer

hops2-172x258An enriched hops extract activates a chemical pathway in cells that could help prevent breast cancer, according to new laboratory findings from the UIC/NIH Center for Botanical Dietary Supplements Research at the University of Illinois at Chicago.

Natural botanical dietary supplements such as hops have become increasingly popular among women for postmenopausal symptoms, as they are perceived as a safer alternative to hormone therapy, which has been linked to increased risk of breast cancer. However, the efficacy and potential toxicity of botanicals are still being studied.

Researchers led by Judy Bolton, professor and head of medicinal chemistry and pharmacognosy in the UIC College of Pharmacy, applied hops extract to two different breast cell lines to see if they would affect estrogen metabolism, a key mechanism in breast cancer. One compound, 6-prenylnarigenin, or 6-PN, increased a detoxification pathway in the cells that has been linked to a lower risk for breast cancer.

“We need to further explore this possibility, but our results suggest that 6-PN could have anti-cancer effects,” Bolton said.

In addition to 6-PN, Bolton and her colleagues studied 8-prenylnarigenin (8-PN), isoxanthohumol (IX) and xanthohumol (XH) for their effects on estrogen metabolism in breast cells. According to Bolton, 8-PN showed only a slight increase of metabolism in breast cells, while the other two compounds did not have significant effects in either cell line.

Breast cancer is one of the most commonly diagnosed cancers in women in the U.S.; about one in eight U.S. women will develop invasive breast cancer over their lifetime. An estimated 246,660 new cases of invasive breast cancer and 61,000 new cases of non-invasive breast cancer are expected in women in the U.S. this year, according to the American Cancer Society.

The incidence of breast cancer began decreasing in 2000, after increasing during the previous two decades. Just from 2002 to 2003, the incidence declined by 7 percent. Some think the drop was partly due to reduced use of hormone replacement therapy, or HRT, after results of the Women’s Health Initiative suggested a link between HRT and increased breast cancer risk. Estrogen exposure has long been linked with postmenopausal breast cancer risk, especially since the 2002 report, Bolton said.

The new research is published in the journal Chemical Research in Toxicology.

By Sam Hostettler
samhos@uic.edu


UIC To Enroll Participants in President’s Precision Medicine Initiative

UI Health photoThe University of Illinois at Chicago, Northwestern University, the University of Chicago and their affiliated hospitals and clinics have been selected to enroll 150,000 Illinoisans in the national Precision Medicine Initiative Cohort Program. The Illinois consortium is one of several such groups across the nation that will help bring one million or more U.S. participants over the next five years into a research effort to improve the prevention and treatment of disease based on individual differences in lifestyle, environment and genetics.

The Illinois Precision Medicine Initiative Cohort Program consortium will receive $4.3 million in fiscal year 2016 and a total of approximately $45 million over 5 years pending progress and availability of funds from the National Institutes of Health to meet its participant enrollment goal.

The Precision Medicine Initiative, announced by President Obama in his 2015 State of the Union address, launched in 2016 with a $215 million budget. It aims to enable a new era of medicine in which researchers, providers and research participants work together to develop individualized care.

Most prevention strategies and medical treatments are designed for the average patient. This one-size-fits-all approach means that strategies to stay healthy and treatments for illnesses are successful for some people, but not others.

Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person. While some advances in precision medicine have been made, the practice is not currently commonplace.

“Illinois, as just a single state, very closely resembles the rest of the U.S. combined because we have such diversity in terms of our populations and types of communities,” says Dr. Robert Winn, associate vice chancellor for community based practice at the University of Illinois Hospital & Health Sciences System, director of the University of Illinois Cancer Center and a principal investigator on the grant.

Dr. Robert Barish, vice chancellor for health affairs at UIC, says that “for precision medicine to work for everyone, we need to know how prevention strategies, medicines and therapies work in a broad range of populations. With UIC’s unique ability to reach diverse communities through our clinics throughout Chicago, and through our regional College of Medicine campus in Peoria, we are well-positioned to help answer the questions that will help bring precision medicine to everyone.”

UI Health’s 13 Mile Square Health Centers are federally qualified neighborhood clinics located in some of Chicago’s most underserved communities, said Winn.

“Our Mile Square Health Centers reach into communities that carry an exceptionally heavy burden of disease,” said Winn, noting they serve African-American neighborhoods on the city’s south and west sides where cancer, diabetes, heart disease and asthma rates can be more than twice as high as in other populations.

Volunteer participants in the Precision Medicine Initiative Cohort Program will be asked to contribute a wide range of health, environment and lifestyle information. The participants will also answer questions about their health history and status, share their genomic and other biological information through simple blood and urine tests, and grant access to their clinical data from electronic health records. In addition, mobile health devices and apps will provide lifestyle data and environmental exposures in real time. All this will be accomplished with essential privacy and security safeguards. As partners in the research, participants will have ongoing input into study design and implementation, as well as access to a wide range of their individual and aggregated study results.

The knowledge gained from the Precision Medicine Initiative Cohort Program will extend the success of precision medicine in some cancers to many other diseases. Importantly, the program will focus not just on disease, but also on ways to increase an individual’s chances of remaining healthy throughout life.

“The range of information at the scale of one million people from all walks of life will be an unprecedented resource for researchers working to understand all of the factors that influence health and disease,” said NIH Director Dr. Francis Collins.

Dr. Martha Daviglus and Denise Hynes of the UIC College of Medicine are co-principal investigators on the grant. Dr. Jerry Krishnan, Maria Argos, Dr. Frederick Behm, Dr. Ben Gerber, Timothy Johnson, Robin Mermelstein, Dr. Terry Vanden Hoek and Karriem Watson of the UIC College of Medicine and Marcelo Bento Soares of the University of Illinois at Peoria College of Medicine are co-investigators on the grant.

UIC will coordinate efforts to enroll individuals at UI Hospital; Mile Square Health Center; University of Illinois at Peoria College of Medicine; Southern Illinois University Healthcare; Memorial Medical Center, Springfield; Blessing Health System, Quincy; Sarah Bush Lincoln Health Center, Matoon; OSF Saint Francis Medical Center, Peoria; Cook County Health and Hospitals System; and Mount Sinai Hospital, Chicago.

By Sharon Parmet
sparmet@uic.edu


Orphan drug allows kidney transplant from relative with mismatched blood type

Dr. Enrico Benedetti

Dr. Enrico Benedetti, professor and head of surgery at the University of Illinois Hospital & Health Sciences System

Surgeons at the University of Illinois Hospital & Health Sciences System have — for the first time — used an orphan drug to prevent rejection of a kidney transplanted from a living donor with a mismatched blood type.

Michelle Lee, 47, had been on dialysis for almost six months due to kidney failure from high blood pressure. When her doctors told her she would need a kidney transplant, her three sons immediately stepped up.

“We got worked up, and it looked like I was the best match for my mom,” said Marlon Lee, 22.

Except he wasn’t quite a perfect match.

Marlon has type A blood, while his mother is type O. Without treatment, antibodies in her blood would attack the mismatched organ and cause rejection.

About 15 to 20 percent of people who need a kidney transplant have a living relative who is a perfect tissue match except for the blood group, said Dr. Enrico Benedetti, professor and head of surgery at the UIC College of Medicine.

Many such patients can nevertheless get transplanted, Benedetti said. The recipient must undergo several days of plasma exchanges to remove antibodies from the blood. Usually, this pretreatment, called plasmapheresis, reduces the level of antibodies enough to allow transplantation, though some patients patients must have their spleen — a major producer of antibodies — removed during the surgery.

But for some, plasmapheresis leaves their antibody level still too high. Lee was one such patient.

“This would have caused us to cancel the transplant, except we had experience using a drug called eculizumab, which blocks the blood antibodies from reacting,” Benedetti said.

He and colleagues at UI Health had pioneered the use of eculizimab in three kidney patients with unusually high antibody levels who received cadaver organs. One patient had very high antibodies due to numerous blood transfusions; the other two had not responded adequately to plasmapheresis. All three were transplanted successfully with eculizimab.

Lee was given a dose of eculizumab the day before her May 5 transplant, during which surgeons did not remove her spleen. Just five days after transplant, she went home.

Lee will need a few more doses of eculizumab over the next few weeks, Benedetti said, and she will need to take traditional antirejection medications for the rest of her life. But her prognosis is good.

“If we can protect the organ for the first two to three weeks after transplant, we’re mostly out of the woods,” said Benedetti. “The body and organ will acclimate to each other, and antibody interactions aren’t as serious a concern.”

Benedetti said he hopes this technique will allow for more blood-type-incompatible kidney transplants to take place.

“Eculizumab can help prevent rejection among patients that have a living donor and would have otherwise been turned down for the transplant,” he said.

By Sharon Parmet
sparmet@uic.edu


How White Principals Navigate Predominantly Non-White Urban Schools

Michael-Beyer-260x260Recent research from the Center for Urban Education Leadership examined standardized test achievement for Illinois students under No Child Left Behind. The results are stark: although scores are improving for Black and Latino students, those populations still lag behind White students.

The root causes of this are varied and deep and certainly not explained by race, but the Center’s Jason Swanson, PhD, research specialist, argues in new research that urban principals are limited in designing strategies to address educational gaps when these groups are not even identified by race.

His research, “White Principals Attempting to Lead Race-Conscious School Improvement: A Distributive Perspective,” is set to be published in the journal Urban Education. The article argues sidestepping the issue of race restricts principals’ ability to address systemic inequities.

“It’s a really uncomfortable conversation for a lot of people,” Swanson said. “There are a lot of people who want to help all students, so they say I don’t see race, there’s only one race, the human race. This turns a blind eye to the racial world we live in, a world that Black and Latino Americans experience all the time.”

The paper explores the efforts of two principals attempting to create critical conversations and curricular changes to address educational gaps between racial groups. Both principals faced resistance to their efforts: in one case, a group of White teachers ‘hijacked’ a meeting at which these issues were to be discussed; in a second case, a principal only addressed issues of race obliquely because the school district had been sued over racial disparities in school outcomes and teachers were weary of heavy-handed policies on race.

These situations are an illustration of the disparities in the makeup of teaching and student bodies in Illinois. In the district studied, approximately 80-85 percent of teachers are White while 60 percent of students are non-White. Just 15 years ago, 80 percent of those students were White and only 20 percent were low-income. In Chicago, however, there is a greater disparity. While more than half of the teachers are White, over 90% of the student body identifies as a student of color.

“You have teachers who are teaching just as they were 15 years ago wondering what the heck is going on here, why aren’t these kids learning?” Swanson said. “So we have to ask, to what extent are districts deliberately creating spaces where principals and teachers can explore issues like culturally responsive pedagogy and issues of social justice to accommodate this rapidly changing demographic?”

Both principals in the study launched strategies to exercise whatever political capital they possessed. One principal realized he might not be the most qualified candidate to bring up issues of race, so he built capacity in teacher leaders to take a more active role in facilitating conversations. He also formed a social action committee, providing space for students to name the injustices they saw in their school. Teachers took these grievances back to the whole staff body for conversation.

One outgrowth of the committee was an event called “Fourth Monday Meetings,” in which staff members participated on one of four committees focused on areas of social justice highlighted by the student body.

The second principal attempted to frame issues of race openly at staff development meetings, specifically naming racial injustices and gross disparities between White students and Black, Latino and English language learner students.

The schools also focused on ways in which equity and diversity were building a sense of community. Prior to the social action committee, within the hallways, the majority of posters across the school featured mostly famous White people. And within the classrooms, most of the texts and curriculum only focused on the successes of White people. Swanson says when students of color don’t see themselves reflected in curriculum and the school environment they tend to check out.

“To solve systemic problems, you have to have systemic solutions,” Swanson said. “This is just a very first step in trying to name the problem. Principal preparation programs often treat issues of race so lightly that novice leaders don’t have models or tools to handle these inevitable situations.”

By Rob Schroeder
rschroe9@uic.edu


Redefining Narratives About Young Black Men

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Sakeena Everett, PhD, director of research and outreach for the UIC College of Education’s Black Male Early Literacy Impact Project

One phrase at the UIC College of Education  is the axiom “Black children are brilliant.”  Research from the College’s Sakeena Everett, PhD, director of research and outreach for the College’s Black Male Early Literacy Impact Project, is detailing what this brilliance looks like in schooling contexts.

Everett defined traits of Black male success in secondary education settings as part of her doctoral dissertation, which was recently awarded the 2016 Outstanding Dissertation Award from the Critical Educators for Social Justice Special Interest Group within the American Educational Research Association.

“When we typically think of Black male students, we just don’t assume they are bright,” Everett said.

Everett says research indicates Black males face barriers to achievement through negative profiling and stereotyping, to the extent that their presence is sometimes feared in the classroom.  Her study began in an academic enrichment summer program for rising juniors that focused on understanding Black male success through narrative.  Participants possessed GPAs of 3.0 or better, high ACT scores and eventual full-ride scholarships to college.  Students engaged with critical theories of education to compose narratives describing their experiences in education, essays that in some cases served as college application material.

After the summer program, she built on these writing experiences, working to equip her students with language to defend and define themselves.  Her students read Paulo Freire’s “Pedagogy of the Oppressed” and scholarly journal articles, examining how research reflected—and did not reflect—their experiences as students.

“I wanted them to tap into who they were as raced and gendered beings,” Everett said. “They were able to redefine narratives about young Black men, and they felt really proud of being able to do that.”

Everett tracked these students as they completed their high school education, interviewing students, teachers, administrators, friends and family to gain a nuanced understanding of how the students conceptualized their academic success and what informed and sustained these successes.  She witnessed students’ confidence as writers growing as they progressed through these experiences.

Students in the study represented a broad swath of socioeconomic backgrounds, one from a single-parent home with his mother on public assistance, students from middle class homes and a student from a home in which both parents were educators.  Regardless of socioeconomic status, these students all recognized low expectations society held for them.

These students understood how fragile their position as successful students was because of these expectations.  Everett says they sensed that at any given moment in time, their high grades and scholarships could be taken away at a moment’s notice.  This equipped them with a sense of responsibility to serve as agents of change within their own communities; for example, one student started a writing club in his school, mentoring young Black males who sought careers as journalists and writers.

“I’m particularly proud that this project is very student-centered,” Everett said. “I tried very hard to make sure this project was mutually beneficial, so that students were enriched personally as well as academically.”

By Rob Schroeder
rschroe9@uic.edu