hematology oncology - medicine › wp-content › uploads › 2017 › ... · osf mychart....
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Department of PediatricsHematology Oncology
Dr. Pedro de AlarconDepartment Head
Research Interests:• Newborn megakaryocytopoiesis• Thrombocytosis in iron deficiency• Mitochondrial mutations, in Autism,
Alzheimer’s, Parkinson’s • Chemotherapy induced mutations in
Neuroblastoma cell lines • Hodgkin lymphoma/BMT Therapy in
Central and South America • Molecular biology and genetics of
ALL in Guatemala • opsoclonus-myoclonus-ataxia
syndrome
Dr. Kay Saving
Sickle Cell Trait and Disease Clinical Research
Active Projects: • Education to patients and families
about trait and disease• Transition from pediatric to adult
care, including self-efficacy• Adherence to therapy, mainly
hydroxyurea in sickle cell disease• Education of primary care
providers on trait and disease
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Dr. James HockerActive Project:Developmental Follow-up of ELBW Infants
Neonatology
Dr. Praveen KumarActive Project: Feeding Practices in Extremely Low Birthweight (ELBW) Premature Infants
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Dr. Mark Miller Active Project:Improved Transparency and Communication with Families via Utilization/Enrollment in OSF MyChart
Endocrinology
Dr. Anu VishwanathActive Project: TSH Elevation Among Children with Obesity
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Cardiology
Pediatric Cardiac MRIs
Dr. Matthew BramletActive Project:Virtual Reality Technology in Medical Education
Invasive CardiacCatheterization and Devices
Dr. Priti PatelActive Project:Use of Milrinone in Prevention of Post-PDA Ligation Cardiac Syndrome
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Acute Kidney Injury
Dr. Vimal RajActive project:• Urinary Alpha Klotho in
Sickle Cell Patients• Urinary Salt and Blood
pressure in children
Quality Improvement
Dr. Keith HansonActive project:• PEWS scoring and reduction
of PICU transfers• Propofol dosing in pediatric
sedation• PICC line safety
Nephrology Hospitalist
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Critical CareQuality Improvement and Safety
Dr. Sandeep TripathiActive Projects:• QI in Critical Care Units
Medical Education
Dr. Girish DeshpandeResearch Interests: • Simulation based education
and clinical outcomes• Pediatric CPR• Device Inventions (prototyping
and development)• Pediatric Pain and Sedation
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Ban Al-Sayyed, MD
George Johnson, MD
Margaret Heger, PharmD
Antibiotic stewardship Inpatient stewardship issuesOutpatient antibiotic stewardship Imaging and laboratory utilization
Infection Control and Prevention
Staphylococcal infections at the CHOI
MRSA active surveillance in the NICU
Staphylococcus epidermidis in the NICU
Pediatric Infectious Diseases
Barry Gray, MD
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Dr. Amy ChristisonPediatric Obesity and Clinical Outcomes Research
Active Projects:• Rural Health ECHO Illinois: building
weight management capacity by telehealth learning collaboratives
• POWER: national registry work• Transition to Health: ALL Survivorship
and Wellness• Composition of gut microbiota in
children with various weight status’
General PediatricsResident Projects:• Renal insufficiency in
children born to mother’s with pre-eclampsia
• Neonatal Screening processes in the NICU
• Down’s Syndrome Guideline Adherence QI
• HFNC usage in patients with bronchiolitis
• PEWS scoring and reduction of PICUtransfers
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Center for Outcomes Research (COR)University of Illinois College of Medicine at Peoria
Carl V. Asche, PhDDirector, Research Professor
Jinma Ren, PhDResearch Assistant Professor
August 17, 2017
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Exists to conduct multidisciplinary, collaborative research in health systems, health services, and health outcomes.
Will work with clinical departments, affiliated hospitals, and community organizations to conduct and publish the outcomes of interventions intended to improve the quality of healthcare in the community.
Mission of COR
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COR
Internal Customers at the UICOMP
Demand for
Services
Residencies
ClinicalDepartments
Fellows
Medical Students
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COR
External Partners
Demand for
Services
OSF-SFMC
Illinois Neurologic
Institute
UnityPoint HealthIllinois Institute for
Addiction Recovery
JUMP
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What the COR Does?
• Provision of outcomes research services.• Mentorship of faculty, students, residents, and
fellows.• Generation of publications for faculty,
students, fellows, and residents.
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Skills Base (it takes a village)
• The COR has expertise in o Health economics o Modeling o Various clinical specialties o Statistical analysiso Programming o Database management
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The COR Faculty
Dr. Asche’s research focuses on the use ofcomparative effectiveness research and cost-
effectiveness analysis in health care decision making. In addition to the present book, his academic work has comprised authoring or co-authoring over 75 papers appearing in the medical and economic literature. He is the editor of the book, “Applying Comparative Effectiveness Data to Medical Decision Making: A Practical Guide” (Adis, 2015). He has presented his research at seminars and conferences both nationally and internationally. He has served on numerous national and international health economics-focused boards and committees, including editorial, grant review and advisory bodies.
Carl V. Asche, M.B.A., M.Sc., Ph.D.Director, Center for Outcomes ResearchResearch Professor of Internal Medicine
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The COR Faculty
Dr. Kim is responsible for data management and statistical analysis to support outcome researches, and participates in the development of the research program for the Pulmonary Critical Care Fellowship Program.
Minchul Kim, Ph.D. Research Assistant Professor
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The COR Faculty
Dr. Ren is responsible for data management and statistical analysis to support outcome researches, and participates in the development of the research program for the Gastroenterology Fellowship Training Program.
Jinma Ren, Ph.D. Research Assistant Professor
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Active Funded ResearchPatient Centered Outcomes Research Institute (PCORI) Tier 1
Community Involvement Grant
American Cancer Society (ACS) Populations Sciences Grant
Cancer Control and Population Grant, Illinois Cancer Care (ICC) Foundation Grant
Center for Disease Control (CDC) and Prevention
American Physical Therapy Association (APTA)
Technology Evaluation in the Elderly Network (TVN)
U of Illinois Discovery Grant
OSF Foundation / Central Illinois MS Clinic Fund / Caterpillar Foundation Matching Grant
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Most Recent Funded Projects
“Developing a Patient-Led Multiple Sclerosis Research Community” o PI: Carl Ascheo Sponsor: PCORI Tier III award
“Long-term Effectiveness of the ‘Don’t Gamble Away our Future’ Program”o PI: Jinma Reno Sponsor: UnityPoint Health/ Par-A-Dice
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INTERACTIVE TECHNOLOGY SUPPORT
FOR PATIENT MEDICATION SELF-MANAGEMENT
Dan Morrow, Mark Hasegawa-Johnson, Thomas Huang, Suma Bhat, Renato Azevedo, Kuangxiao Gu, Yang Zhang (UIUC)James Graumlich, Victor Sadauskas (UIC Peoria, OSF) & Ann Willemsen-Dunlap, Don Halpin (UIC Peoria, Jump Simulation and Education Center/OSF)
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Background• Chronic illnesses often require medication therapy to
avoid symptoms, disability, hospitalization, or death• Medication non-adherence by patients occurs often and
contributes to adverse outcomes• Low health literacy is a contributing factor to medication
non-adherence• Health literacy is the capacity to obtain, understand, and
use information and services needed to make health decisions
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Project Goals
• Improve use of Electronic Medical Record (EMR) System for supporting patient/provider collaboration and patient self-care
• Develop tools to translate EMR information into language that supports collaboration, and to present this information in ways that inform and engage patients for self-care.
• Overcome barriers to medication adherence for patients with low health literacy
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Specific AimsDevelop Natural Language Processing tool that
generates patient-centered language from nonstandard and technical medication
information in EMR.
Integrate patient-centered language into Conversational Agent (CA)-based ‘medication adviser’ system supporting collaboration. CA
presents medication information, emulating best practices from face-to-face communication.
Enhance CA ability to engage patients by developing interactive capability, such as using “teachback” when communicating with patients.
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Specific AimsDevelop Natural Language Processing tool that
generates patient-centered language from nonstandard and technical medication
information in EMR.
Integrate patient-centered language into Conversational Agent (CA)-based ‘medication adviser’ system supporting collaboration. CA
presents medication information, emulating best practices from face-to-face communication.
Enhance CA ability to engage patients by developing interactive capability, such as using “teachback” when communicating with patients.
2 tabs b.i.d.
Take 2 tablets 2 times a day,in the morning and evening
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Specific AimsDevelop Natural Language Processing tool that
generates patient-centered language from nonstandard and technical medication
information in EMR.
Integrate patient-centered language into Conversational Agent (CA)-based ‘medication adviser’ system supporting collaboration. CA
presents medication information, emulating best practices from face-to-face communication.
Enhance CA ability to engage patients by developing interactive capability, such as using “teachback” when communicating with patients.
2 tabs b.i.d.
Take 2 tablets 2 times a day,in the morning and evening
“Take 2 tablets 2 times a day,in the morning and evening”
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Please rank: Which computer agent (CA) would you prefer to deliver your health messages? 1 = Highest ranking (most preferred) to 5 = Lowest rank (least preferred)
Cartoon
Realistic
23.3%
8.3%
30.8%12.5%
25.0%
m = 2.49
m = 4.31
m = 2.61
m = 2.98
m = 2.62
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Please rank: Which computer agent (CA) would you prefer to deliver your health messages? 1 = Highest ranking (most preferred) to 5 = Lowest rank (least preferred)
Cartoon
Realistic
22.5%
20.0%
23.3%10.8%
23.3%
m = 2.73
m = 3.78
m = 2.82
m = 3.18
m = 2.48
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Cancer ResearchDepartments of Internal Medicine, Surgery and Pathology
Christopher S Gondi PhD
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Overcome Chemo and radiation therapy resistance
Cancer Research
Pediatric Intra cranial
Extra cranialAdult
Pancreatic
Intra cranial
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Therapeutic targets
SPARC
uPA
TOP-1
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The uPA Enigma
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TX1111 MIA Paca-2 cells (p<0.001, n=12) and by 40% in PANC cells (p=0.002, n=12)
Suppress Chemoresistance
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microRNA loaded Circular RNA
Acknowledgements: Hojin Sun, Manu Gnanamony PhD
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What can you achieve?
• The 'SPARC' of life: Analysis of the role of osteonectin/SPARC in pancreatic cancer (Review). Rossi MK, Gnanamony M, Gondi CS. Int J Oncol. 2016 May;48(5):1765-71. doi: 10.3892/ijo.2016.3417. Epub2016 Mar 4. PMID: 26983777
• TX1111: a peptide homologue of Topoisomerase-1 sensitizes pancreatic cancer cells to gemcitabine. Manu Gnanamony, Victoria Stepanova, Lily Criscione, Jerusha Boyineni, Stephen J. Marshall, AiXuan Holterman, Christopher S. Gondi. Abstract Number: 2154, Monday, Apr 18, 2016, 1:00 PM - 5:00 PM; American Association for Cancer Research 2016.
• Topoisomerase-1 peptide homologue TX1111 decreases gemcitabine resistance in pancreatic cancer cells, Lily Criscione, Manu Gnanamony, Stephen Marshall, Pushpa Joseph, Christopher S. Gondi, Symposia on Cancer Research 2016: “Cancer Evolution: Mechanisms of Vulnerability and Resistance”, to be held in Houston, Texas on October 6-7, 2016
• Therapeutic options for the management of pancreatic cancer. Rossi ML, Rehman AA, Gondi CS. World J Gastroenterol. 2014 Aug 28;20(32):11142-59. doi: 10.3748/wjg.v20.i32.11142. Review. PMID: 25170201
• Brief overview of selected approaches in targeting pancreatic adenocarcinoma. Samore WR, Gondi CS. Expert Opin Investig Drugs. 2014 Jun;23(6):793-807. doi: 10.1517/13543784.2014.902933. Epub 2014 Mar 27. Review. PMID: 24673265
• Cathepsin B Inhibitors for Targeted Cancer Therapy, Chad M Lampe and Christopher S Gondi, J Cancer Sci Ther, 2014, 6:417-421. doi:10.4172/1948-5956.1000302
• Gemcitabine Naïve Pancreatic Ductal Adenocarcinoma Primary Cells Acquire Chemoresistance when Exposed to Urokinase Plasminogen Activator, M. L. Rossi, N. Kalva, A. Holterman, C. Gondi; 9th Annual Academic Surgical Congress Abstract Submission ASC20141183, February 4 - 6, 2014, Manchester Grand Hyatt, San Diego, California
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UIC collaborators• Neurosurgery (Julian Lin MD)• Pediatrics (Pedro de Alarcon, M.D.)• Surgery (J Stephen Marshall, MD)• Pathology (Pushpa Joseph MD)
External Collaborators• National Cancer Institute, NIH (Perwaz Hussain PhD)• University of Pennsylvania (Douglas B. Cines MD, Victoria
Stepanova PhD)
Acknowledgements• Manu Gnanamony PhD• Jerusha Boyineini PhD• Smita Tanpure MS• Maria Rossi MD• Wesley Samore MD• Azeem A Rehman• Chad M Lampe MD• Lily Criscione MD• Monica Rossi MD candidate• Danny Ge MD candidate
Acknowledgements
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Other projects in the Department of Medicine• Case reports• Meta-analysis• Colonoscopy registry• Cardiovascular disease• Cystic fibrosis
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Research in Emergency MedicineUNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AT PEORIA
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Role of StudentsCreation of a Student Project◦ Requires early approach◦ Generating a question◦ IRB submission◦ Data collection◦ Data analysis◦ Presentation◦ Manuscript generation◦ Publication
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Role of StudentsAssistance with a Faculty Lead Project◦ IRB Requirements◦ Data capture◦ Data entry◦ Limited analysis◦ Role in presentation and manuscript formation
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OverviewMultiple interesting areas of research
EMS
Resuscitation
Pediatrics
Injury Prevention
Clinical EM
Education
Ultrasound
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Types of StudiesRetrospective Chart Reviews
Surveys
Educational interventions
Limited RCTs
Public Health Interventions
Review Articles/Book Chapters
Write-ups of previously done research
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Research OpportunitiesUICOMP and INI
Neuroscience, Neurology, Neurosurgery
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Faculty
Neurology 22 faculty 16 residents Neurosurgery 9 faculty 10 residentsNeuroradiology 6 faculty 1 fellowNeuropathology 1 facultyNeuroscience 5 faculty three laboratories
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Specialty Centers
Cerebrovascular-strokeBrain TumorSpineEpilepsyMovement DisordersNeuromuscular DiseaseMultiple SclerosisHeadache Cognitive DisordersPediatric Neurology and NeurosurgeryFunctional NeurosurgeryNeurological population health and outcomes
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Laboratories
Brain tumor biology-Velpula, TsungBrain Ischemia and Injury -Veeravalli,
KlopfensteinDegenerative Brain Processes-Fukuchi,
Biernot
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Research Opportunities
Laboratory Research Clinical Research-Specialty CentersOutcome and Quality StudiesEducational process studiesSimulation, VR and AR in educationBioengineering projects
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Finding an Opportunity
INI Web Site-Medical Student Opportunitieshttps://www.osfhealthcare.org/services/neuroscienc
es/medical-professionals/medical-student-opportunities/
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Infrastructure and Funding
INI Medical Editor Stanca Iacob MD, PhDStatisticians H Wang PhD, Y Wang PhDINI Research Work Group supports study developmentINI Neuroscience Medical Student Research Fund
Short term 3 month awardsYear long or greater awards
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Contact InformationPatrick Elwood, Professor of [email protected]@uic.edu309-303-4296Joanna Fleckenstein INI Research [email protected]
J
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LIBRARY
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• Books, including eBooks & open reserves• Journals, including online journals & articles• Study Space – open seating, study rooms• Learning Lab – computers, printers, scanner, charging
station• Databases - PubMed, Scopus, Web of Science, etc.• Point of Care Tools – DynaMed Plus, Essential Evidence • Online Resources – ClinicalKey, AccessMedicine• Research Guides – Peoria Medical Students Guide,
Mobile Medicine @ UIC, Evidence Based Medicine Guide• Information Experts – Library Faculty & Staff
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Swapna Asuthkar PhDAssistant Professor
Department of Cancer Biology and PharmacologyOffice – C wing, C-211
Email: [email protected]
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MedulloblastomaMedulloblastoma is most common childhood malignant brain tumor.
Treatment; complete surgical removal of tumor, followed by craniospinal (brain and spine) radiation (Delayed in patients < 3 yr) and/or chemotherapy.
Recurrence; Despite improved multimodal therapy, medulloblastoma remains incurable in a significant proportion of patients.
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Medulloblastoma (MB) Research
I. Targeting the immune compartment of the tumor microenvironment
II. Targeting histone modifiers in MB tumor growth and progression
a. B7-H3 expression in medulloblastoma and its regulation by c-MYC.
b. Role of B7-H3 in MB angiogenesis.
a. Role of Histone-lysine N-methyltransferase (HMTs) in MB.
b. HMT/transcription factor interactions as crucial players in MB tumor growth.
Matthew LawM2 student
Ian Purvis Jose CastellanosM3 student
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I. Immune compartment of TME; B7-H3 promising immune checkpoint
Jose R Castellanos et al., 2017
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B7-H3 immune checkpoint as the novel target in Medulloblastoma
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Nature Reviews., 2012
II. Epigenetic modifiers in medulloblastoma pathogenesis
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Collaborations
Dr. Rajeev Vibhakar, MD, PhD, Univ. of ColoradoDr. Sujatha Venkataraman, PhD, Univ. of ColoradoDr. Kiran K Velpula, PhD, UICOMPDavid J Daniels, MD, PhD, Mayo ClinicDr. Julian Lin, MD, INIDr. Rama D Sanam, PhD, GVK bio, IndiaSarah E. Martin, MD, OSFDr. Andrew J Tsung, MD, INIDr. Justin Lathia, PhD, Cleveland Clinic
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The microbiota of bloodstream infections in
patients with acute leukemia
Peter GyarmatiUniversity of Illinois College of Medicine PeoriaDepartment of Cancer Biology and Pharmacology
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Microbiota = microorganisms inhabiting the human body
Wikipedia
- Neglected organ- ~2 kg body mass- More bacterial cells
than human- >500x more bacterial
genes- Physiological
functions
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Microbiota in health and disease
Belkaid & Hand, 2013
• Commensal• Symbiotic• Pathogenic
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Blood microbiota in leukemia
• BSI is a major cause of mortality• Cancers of the hematopoietic
system, which results in non-functional white blood cells (blasts)
• Derived from two hematopoietic stem cell lineages: myeloid (granulocytes, erythrocytes, thrombocytes, macrophages, mast cells) and lymphoid (B, T, NK and plasma cells)
• Due to the circulatory and immune systems, these problems are closely related and often overlap
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Blood microbiota - in health
• “Sterile” in physiological conditions• Mitochondrial DNA derived from circular bacterial
genomes• Viruses / viral segments / phages are often present in
healthy people
HHV7 (Guerrero&Bacon) TTV (Itoh et al., 2000)
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Blood microbiota in leukemia
• Bacteremia, viremia, fungemia can all occur
• External or internal origin• Immune barrier failure• Often induced by chemotherapy
/ antibiotics• Lack of colonization resistance• Bloodstream infection may
lead to sepsis
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Metagenomics in leukemia
1. Evaluate antibiotics efficacy2. Recommendations for more specific treatment (avoid
antibiotic misuse, shorten hospital stay, decrease healthcare costs)
3. Narrow-spectrum or pathogen-specific antimicrobial treatment instead of broad-spectrum antibiotics
4. Preserve the indigenous microbiota
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Cellular Signaling &Therapeutic Opportunities
Sang-Oh Yoon
Department of Cancer Biology & Pharmacology
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Cancer treatment
+
Traditional cancer treatment
Radiotherapy Surgery Chemotherapy Targeted therapy
New generationcancer treatment
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Targeted Cancer Therapies
Normal Cancer
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Targeted Cancer Therapies
Normal Cancer
Small moleculesAntibodies
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Basis of targeted therapy: Understanding signaling
Simplified cancer cell signaling
Nutrients
Growth factors/Hormones
Cytokines
Extracellular matrix
Other cells (immune cells, fibroblasts, etc)
Stress
Outer environment(hypoxia, acidity, etc)
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Signaling and tumor progression
Output
Nat Reviews Immunology, 2015
NutrientsGrowth factors/
HormonesCytokines
Extracellular matrixOther cells (immune cells,
fibroblasts, etc)Stress
Outer environment(hypoxia, acidity, etc)
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Targeting signaling molecules- Therapeutic potentialsOutput
NutrientsGrowth factors/
HormonesCytokines
Extracellular matrixOther cells (immune cells,
fibroblasts, etc)Stress
Outer environment(hypoxia, acidity, etc)
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Input
Tumor growth
Tumor survival
Tumor
invasion/metastasis
Angiogenesis
Anti-cancer drug
resistance
Inflammation
Kinases: Major mediators of signal transduction
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Kinases: Major mediators of signal transduction
Normal Cancer
Small molecules (26 inhibitors)Antibodies (7 antibodies)
FDA-approved kinase inhibitorsfor targeted cancer therapy
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PI3K/Akt/mTOR & Ras/Raf/ERK signaling networks
Tumor growth/survival/Invasion/metastasis
Overexpression
OverexpressionMutation
OverexpressionMutation
Mutation
Overexpression
OverexpressionMutation
ERK
Ras/Raf
MEK
mTOR
Akt
PI3K
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Signaling mediators
Research focus 1: Cancer metabolism- Protein synthesis
?
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Signaling mediators Metabolic stress
Research focus 1: Cancer metabolism
?
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Research focus 2: Anti-cancer drug resistance
No cancer
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Research focus 2: Anti-cancer drug resistance
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Research focus 2: Anti-cancer drug resistance
J Clinical Oncology 2011
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Research focus 2: Anti-cancer drug resistance
Mechanisms
OvercomingResistance
No cancer
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Goal Understanding signaling networks for basis of targeted cancer therapies
Specific aims
Tumor metabolism
Signalingmediators
Metabolic stress
Overcoming drug resistance
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Pain-sensing TRP channels regulate hormonal signaling in response to endogenous nociception
Eleonora ZakharianUniversity of Illinois College of Medicine
Peoria IL 61605
Students OrientationAugust 17th, 2017
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Stimuli activate TRP channels on skin and signal propagates to CNS
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TRP channels involved in nociception
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The role of TRPM8 channels as a cold and menthol receptor is well established in the framework of somatosensory nervous system, and widely used in therapeutics.
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Ca2+ imagining fluorescent microscopy
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Planar Lipid Bilayer measurements
-+
Planar lipid bilayers were formed froma solution of synthetic 1-palmitoyl-2-oleoyl-glycero-3-phosphocoline(POPC) and 1-palmitoyl-2-oleoyl-glycero-3-phosphoethanolamine(POPE) in ratio 3:1 in n-decane. Thesolution was used to paint a bilayer inan aperture of ~150µm diameter in aDelrin cup between symmetric aqueousbathing solutions.
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Steroid sensitivity of TRPM8
2 μM Progesterone
100 pM BSA-Testosterone
5 μM Estradiol
100 pM Testosterone
L. Demirkhanyan et.al, submitted
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Role of TRPM8 channels in prostate cancer
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TRPM8 targeted for degradation in PC
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Testosterone
Channel open Channel closed
Ca2+
Ca2+
Ca2+
MitochondriaMCU
Ca2+ overload
Apoptosis
PM
TRPM
8
TRPM
8
Normal Prostate Cell
Cell Growth
Cell growth/proliferation ≈ Apoptosis
PIP2 PIP2PIP3
PI3K/AKT
T
T
T
T T
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TestosteroneCa2+ Ca2+
MitochondriaMCU
Ca2+ low
Apoptosis
PM
TRPM
8
Prostate Cancer Cell
Cell growth/proliferation >>> Apoptosis
Ubiquitin degradation
Ubiquitin
Loss of TRPM8 = No rapid Ca2+ uptake+ increased testosterone
Protea-some
Lyso-some
ER Ca2+
store
Ca2+
T
T
T
T
T
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TRPM8 knockout mice exhibit altered sexual behaviors Mounting duration
WT TRPV1-/- TRPM8-/-
Copulation
*
Intromission
*
Mounting frequency
**
TRPM8-/-
45%
55%WT
84% 16%
TRPV1-/-
15%85%
Ratio of long vs. short mounts
L. Demirkhanyan et.al, submitted
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Aggression
**
Blood testosterone
*
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TRPM8-KO mice exhibit altered sexual preference
Male to female mating Male to male mating
** ****
**
****
Num
ber o
f mou
ntin
gsTo
tal m
ount
ings
Time, hrs. Time, hrs.
Time, hrs. Time, hrs.
MF M
M
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Vomeronasal Organ
Accessoryolfactory
bulb
OB
AONAmygdala
Hypo
OE
OT PirVNO
AOB
OlfactorybulbOlfactory
epithelium
Anterior olfactory nucleus
Pheromones
TRPM8 Hypothalamus
TRPM8
Endocrine responseSexual behavior
Olfactory tuberclePiriform cortex
TRPM8 expression along the olfactory-amygdala pathway
TRPM8
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Testosterone is a highly potent and specific agonist
of the TRPM8 channel
TRPM8 regulates testosterone-dependent behavioral
repertoire
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TRPV1 is a direct ionotropic oxytocin receptor.
This finding suggests an existence ofendogenous regulatory pathways that modulatenociception via direct action of oxytocin onTRPV1, implying its analgesic effect via thechannel’s desensitization.
Studies of oxytocin-TRPV1 in regulation of pain
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Oxytocin interacts with TRPV1 at the same domain as RTX/DkTx
Y. Nersesyan et.al., under review
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Study on novel roles of homopolymers, polyhydroxybutyrate (PHB) and inorganic polyphosphate (polyP)
Mitochondria from healthy cardiomyocytes
PHB PolyP Merged
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Study on novel roles of homopolymers, polyhydroxybutyrate (PHB) and inorganic polyphosphate (polyP)
PHB PolyP Merged
Mitochondria from diabetic cardiomyocytes
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Contact information:
Eleonora Zakharian
C-wing, office C118, lab C126Office Ph: 309-680-8621Lab Ph: 309-680-8634
E-mail: [email protected]
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Research Projects in Fukuchi Lab(Aβ metabolism & neuroimmunology in Alzheimer’s disease)
Dr. Ken-ichiro FukuchiDr. Junling Yang
University of Illinois College of Medicine Peoria
Peoria, IL 10/01/2017Liberty Park
UICOMP WALKERS
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Reasons for Alzheimer’s research
• 6th leading cause of death in the US: Deaths from AD increased 89% from 2000-2014 while other major diseases have decreased (ex. 1st Heart disease by14%).
• AD is the only top 10 killer that cannot be prevented, cured or slowed.
• Currently, 5.5 million living with AD, 14 million by 2050. AD will cost the U.S. $259 billion in 2017 and more than $1.1 trillion in 2050 (in 2015 dollars). (The federal budget is $3.8 trillion in 2015)
Breast Cancer
Prostate Cancer
Heart Disease
Stroke HIVCause of Death
Alzheimer Disease
+89%
-54%
-14%
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Research is fun!
• We formulate a hypothesis. • We design the experiments to test
our hypothesis. • We carry out the experiments to
find if our hypothesis is correct.
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Amyloid cascade hypothesisFamilial Alzheimer’s Disease Sporadic Alzheimer’s Disease
Mutations in the APP or presenilin genes Genetic risk factors: ApoE4, other risk genes. Aging & environmental risk factors
Life-long increase in Aβ42 production Failure of Aβ clearance
Aβ accumulation and oligomerization
Gradual deposition of Aβ42 oligomers as diffuse plaques
Microglial and astrocytic activation, with attendant inflammatory response
Altered neuronal ionic homeostasis and oxidative stress
Altered kinase/phosphatase activity.Tangles, synaptic dysfunction, neuron loss.
DEMENTIA
1. Microglia (Innate immunity) 2. Aβ efflux transporters at BBB
Modified from: K. Blennow, et.al. The Lancet, 368:387, 2006 and Selkoe & Hardy EMBO Mol Med 8:595, 2016
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Risk factors of Alzheimer’s disease (AD) Age: risk doubles about every 5 years after age 65 Genetic risk factors including ApoE, TREM2, etc.
~25 genetic variants include many immune loci Cardiovascular risk factors
Hypertension Hyperlipidemia (high cholesterol) Obesity Diabetes Depression
Systemic/peripheral inflammation Lifestyle risk factors
Low education Sedentary, low physical activity Smoking and alcohol Saturated fats
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Aβ clearance from the brain across the blood-brain barrier (BBB)
BBBEndothelialcells
Brain
Blood
Glut1
LRP1
ABCB1 ABCC1 ABCG2
Claudin-5
Claudin-12
Occludin
miR-34a
miR-34a
Glut1
miR-34a
ZO1
ZO1
ZO1
Potential target of miR-34aIndirect regulation
Aβ
LRP1
VEGFa
Our hypothesis: Blood exosomal miR-34a in diabetes, obesity and inflammation increases Alzheimer risk by decreasing/targeting Aβ transporters at the BBB
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Experimental design: AD animal models
Alzheimer mouse model
Aim 1. Create a miR-34a-deficient (Mir34a-/-) AD mouse model
Aim 2. Prepare exosomes loaded with miR-34a or its inhibitor, inject the exosomes into AD mice
outcome measures 1. Aβ efflux
transporters
2. Evaluate AD-like pathophysiological and behavioral changes
3. Brain expression profiling
At age 8 months
miR-34a knockout mouse model of Alzheimer disease
At age 12 months
At age 16 months
age 4 months
age 12 months
miR-34a injection
inhibitor injection
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Research projects in Fukuchi lab
• Alzheimer’s Disease (AD)
a. Role of miR-34a in the AD pathogenesis b. Altered exosomal microRNAs and proteins
associated with inflammation, obesity and diabetes increase the risk of AD
c. Innate immune dysfunction: altered toll-like receptor signaling in microglia
d. Roles of brain cytokines (IL-17A) in regulating brain glucose metabolism and Aβ transporters at the BBB
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Krishna Veeravalli, PhD
Ischemic Stroke: From Mechanisms to Therapeutic Implications
Failure ofblood circulation to the brain
Blockade of Blood Flow
Bleeding
ThrombosisEmbolismStenosis
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Time is Brain
blood circulation to the brain fails?
Each minute the treatment is delayed, ~2 million brain cells will be lost
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Current treatment Options
TreatmentPreventive Treatment
Carotid Endarterectomy
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Current treatment Options
Treatment Preventive Treatment
Carotid Endarterectomy
Angioplasty/stents
tPA
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Limitations
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No
Trea
tmen
t
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NECROSIS
ARTERIALOCCLUSION
Increased Intracellular Ca2+
Na+ and Cl-
Mitochondrial Failure
INFLAMMATION
APOPTOSISOXIDATIVESTRESS
BBB disruptionand edema
LIPIDPEROXIDATION
Release of Glutamate
Aggarwal et al., Int J of Pharma and Bio Sciences 2010; 1: 1-24
Reduction in Blood flow
Failure of Energy metabolism
Water Accumulation
Anaerobic Glycolysis
AcidosisMembrane
Degradation
Expression of CellAdhesion Molecules
LeukocyteRecruitment
Activation ofCOX2
Causes depression
ExtracellularK+
Cell membrane Depolarization
Na+/K+-ATPase pump failure
Activation ofIP3 pathway
Cell LysisProduction of
Cytokines
Bursting
Release ofArachidonic Acid Increased NO
Production
Formation ofFree radicles
Cell MembraneDisruption
Cytotoxicedema
Phospholipase A2 activation
NO Synthaseactivation Failure of
Free radicalscavenging
Activation of- Endonucleases- Calpains- Calmodulin
Activation of- Kinases- Proteases- Lipases
Ca2+
overloadmitochondria
ActivationCyt c
BAD, BAX
Activation ofNMDA, AMPA
Activation ofMetabotropic
receptors Ca2+ release from Intracellular stores
Burst of free radicalsfrom mitochondrial
transition pore
Depletion of GSHCatalase, SOD,
Ascorbate, Tocopherol
InflammatoryMediators
Cytokines (IL-1,6,TNFa)
Release of Pro-apoptotic Molecules like
Cytochrome c, CaspasesSMAC/DIABLO
AIF
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Dirnagl and Endres. Stroke. 2014;45:1510-1518
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Research Focus
Mitigate the brain injury caused by Ischemia & Reperfusion
Facilitate the recovery process after ischemic stroke
COMBO Therapy
Gene Silencing Stem Celltransplantation
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Molecular Neuro-Oncology LaboratoryVelpula Lab
Kiran Velpula, PhDPrincipal Investigator
Assistant Professor,Department of Cancer Biology and Pharmacology,
Department of Neurosurgery, UICOMP
Associate Professor,Department of Microbiology,
Yogi Vemana University,Kadapa, India
Metabolic alterations in glioblastoma: The Warburg
Effect
C-Wing; [email protected]
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Laboratory Mission
Research Medical Student Education
Drug Discovery Service to University
Professional Academic services Community Service
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Brain Cancers
Breast Cancer
Glioblastoma(Grade IV)
Our targets
EGFR, EGFRvIII, PDK1, Glut, FAK
PDK4, HIF1, miR211
Our Approach at UICOMP
1. Big data analysis (data mining approach)
2. Metabolic analysis3. Validation via Cancer
Stem Cell, crisp cas-9, and miRNA approach
4. Homology modelling5. Nanoparticle
mediated drug delivery system development
6. Pharmacokinetic testing in animal models
7. Development of a mice model to highlight our findings using RCAS model
Targeting metabolism
Medulloblastoma OTX2, c-Myc
HYPOTHESISThe idea
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Map of metabolic pathways
Principles of Biochemistry, Lehninger
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Hallmarks of Cancer
Hanahan et al., Cell 2011
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The Warburg effect
“most cancer cells predominantlyproduce energy through a high rateof glycolysis followed by lactic acidfermentation, rather than throughoxidative phosphorylation in themitochondria”
Otto Warburg, Science 24 Feb 1956
Dr. Otto H. Warburg
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Glioblastoma
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EGFRTarget
PDK1Target
EGFR+PDK1Combined targeting
EGFRvIII+PDK1Combined targeting
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Ongoing projectsresearch
01 Glioblastoma:1. Targeting EGFR/EGFRvIII in understanding altered metabolism2. Methylation regulate HEY1 expression in GBM3. GLUT1, tubulins and glucose availability: Reversing the Warburg effect in glioblastoma4. Identification of novel drugs that regulate mitochondrial metabolism in EGFR over expressing cells5. Characterizing extra-metabolic roles of PDK1 in mesenchymal subtype in GBM6. Co-stimulatory targets in PDK1 mediated immunotherapy in glioblastoma
02 Medulloblastoma:Otx-2 interacts with c-Myc to determine the pathogenicity of medulloblastoma subtypes
03 Breast Cancer:Nano conjugated miR-211 reduce the proliferation of triple negative breast cancers
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VELPULA-TSUNG’S RESEARCH GROUPMeet the lab
Andrew J. Tsung, MD
Maheedhara R. Guda, PhDVisiting Research Scholar
Collin LabakMD Candidate, 2019
Yining LuMD Candidate, 2019
James Scholar
Jacob Stewart
Kiran K. Velpula, PhD
Neha JainMD Candidate, 2019
Pooja AgarwalMD Candidate, 2020
David AnsonMD Candidate, 2020
Michael PajorMD Candidate, 2020 MD Candidate, 2021
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Laboratory MissionMedical Student Education
Publications – 5; Abstracts – 10; Grants from INI - 3
1. Tsung, AJ., Guda, MR., Asuthkar, S., Labak, CM., Purvis, I., Lu, Y., Jain, N., Bach, SE., Durbaka, PV., Velpula, KK*. “Methylation regulates HEY1 expression in glioblastoma”. Oncotarget. 2017 May 16. doi: 10.18632/oncotarget.17897.
2. OTX2 expression contributes to proliferation and progression in Myc-amplified medulloblastoma. Lu, Y., Labak, CM., Jain, N., Purvis, I., Guda, MR., Bach, SE., Tsung, AJ., Asuthkar, S., Velpula, KK*. Am J Cancer Res. 2017 Mar 1;7(3):647-656. eCollection 2017.
3. Glucose transport: meeting the metabolic demands of cancer, and applications in glioblastoma treatment. Labak, CM., Wang, PY., Arora, R., Guda, MR., Asuthkar, S., Tsung, AJ. and Velpula, KK*. American Journal of Cancer Research. 2016 Aug 15.
4. Yuen, CA., Asuthkar, S., Guda, MR., Tsung AJ. And Velpula, KK*. Cancer stem cell molecular reprogramming of the Warburg effect in glioblastomas: A new target gleaned from an old concept. CNS Oncology. 2016 Apr 5(2):101-8.
5. Prabhakar, S., Asuthkar, S., Lee, W., Chigurupati, S., Zakharian, E., Tsung, A. J and Velpula, KK*. Targeting DUSPs in Glioblastomas – wielding a double-edged sword? Cell Biology International. 2013 Oct 23.
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Our CollaboratorsMeet the team
Glioblastoma
1. Justin D. Lathia, Cleveland Clinic
2. Jeremy N. Rch, Cleveland Clinic
3. Jann Sarkaria, Mayo Clinic
4. Craig Horbinski, Northwestern
5. Michael Olin, Univ. of Minnesota
6. Ichiro Nakano, Univ. of Alabama
7. Jack Tuszynski, Univ. of Alabama
8. Neil Greg, NIH
9. John Kuo, Univ. of W.Madison
10. Krishna Bhatt, MD Anderson, TX
Medulloblastoma
1. Swapna Asuthkar, UICOMP
2. David Daniels, Mayo Clinic
3. Sarah E. Bach, UICOMP
4. Durbaka Prasad, YVU, India
Breast Cancer
1. Sudipta Seal, Univ. of Florida
2. Satish Mungamuri, Mount Sinai
3. Neil Price, USDA, Peoria
4. Goverdhan Das, JNU, India
Thank you!
William E. Mc ElroyFoundation
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Neurotoxicity of Environmental Chemical Exposures
Stephen M. Lasley, Ph.D.
Cancer Biology and PharmacologyUICOM-P
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Model of Neuroinflammation
“Sickness behavior” Impaired cognition Fatigue Depression Muscle/joint pain GI disturbances
↑ expression of inflammatory mediators – IL-1β, TNF-α
Relation to Gulf War Illness? Pesticide applicators?
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Mouse Model
OP AChase inhibitors (sarin, DFP, chlorpyrifos) → small ↑ brain inflammatory mediator expression
Period of stress hormone → ‘priming’ of inflammatory mechanisms; cellular immune pathways?
Stress hormone + single dose OP → huge ↑ in inflammatory response
Repeated intermittent stress hormone + OP enhances neuroinflammation – LPS as immune stimulus
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Mouse Model
Peak in cytokine/chemokine gene expression occurs 6-12 hr post-OP
Peak in protein expression within 24 hr(?) Neuroinflammation → impaired cognition
What is time course of inflammation effects on synaptic plasticity genes?
What is duration of the cognitive impairment?
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Model Components
CORT + AChE inhibitor
↑↑ Neuroinflammation
‘sickness behavior’↓ neurogenesis,CNS plasticity
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Gulf War Illness Project
Establish stress + OP (+ LPS) regimen that → enduring behavioral effect (spatial learning paradigms)
Assess neurogenesis Determine electrophysiological capacity for
plasticity and related expression of plasticity genes
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Future Steps
Test experimental therapies for GWI Drugs to enhance neurogenesis Unconventional anti-inflammatory agents
Extend findings to general exposures to pesticides and exposed individuals
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Uncovering the Molecular Mechanisms Underlying
Development of Pediatric Brain Tumors
Sergey Malchenko MD, PhDand
Marcelo Bento Soares, Ph.D.
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Radial Glia
Radial glial (RG) cells are a pivotal cell type in the developing central nervous system (CNS) involved in key developmental processes, from patterning and neuronal migration to their recently discovered role as precursors during neurogenesis. They arise early in development from neuroepithelial cells.
(Malchenko, S., et al., (2013). Onset of rosette formation during spontaneous neural differentiation of hESC and hiPSC colonies. Gene)
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State of the art stereotactic mice brain surgery instruments
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GFP labeling of choroid plexus in different brain sections of mice ventricular system.
Ventricular systemThe ventricular system is a set of four interconnected cavities (ventricles) in the brain, where the cerebrospinal fluid (CSF) is produced. Within each ventricle is a region of choroid plexus, a network of ependymal cells involved in the production of CSF. The ventricular system is continuous with the central canal of the spinal cord (from the fourth ventricle) allowing for the flow of CSF to circulate.
(Mendez-Gomez et al,. Molecular Therapy-Methods & Clinical Dev. 2015 )
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A. Cerebellum. B. Motor cortex. C. SVZ of 3rd ventricle. (The images were taken from Harvard Medical School High Resolution Mouse brain Atlas)
Orthotopic transplantation sites (red arrows)
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The differentiation of GFP positive RG cells after being injected into motor cortex of NOD-SCID mice (15 weeks post-injection)
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Orthotopic transplantation of the wild type RG cells to SVZ of 3rd ventricle
Dr. H. Hashimoto - Osaka University, Japan
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MBs and CNS-NB-FOXR2 HGG EPN Embryonal brain tumors
Dr. M. Kool - German Cancer Research Center, Heidelberg, Germany
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PNET• PNET (primitive neuroectodermal tumor) is a name used for
tumors which appear identical under the microscope to medulloblastoma, but occur primarily in the cerebral hemisphere
• PNETs contain underdeveloped brain cells, are highly malignant, and tend to spread throughout the central nervous system.
• Surgery is the standard initial treatment for these tumors. Because of their large size, tendency to spread, and extensive blood supply, total removal is rarely possible. Very young children are usually not treated with chemotherapy until they are older.
• Comprehensive set of diagnostic/prognostic markers as well as development of new drugs and delivery systems are needed to tailor the individualized therapeutic strategies
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PNET-BTIC
• There is growing evidence that brain tumorigenesis is driven by alterations that occur in neural stem cells (NSCs), which ultimately give rise to brain tumor initiating cells (BTICs)
• However, despite the key role in tumor maintenance, tumor relapse, metastatic dissemination and drug resistance, there is no comprehensive characterization of CNS-PNETs BTICs up to date
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Brain tumors harvested 4-12 weeks
post-inoculation
Histopathological analyses revealed hallmarks of tumor of neuroectodermal origin: CNS primitive neuroectodermal tumors (PNETs)
RG cells injected into the subventricular zone of the 3rd ventricle of the brain in immunocompromised mice
Tumor cells were dissociatedinto single-cell suspensionand then incubated in thesame neural stem cell cultureconditions as RG cells
1o neurospheres are dissociated and the process is repeated to ensure that 1o
neurospheres can form 2o neurospheres.
Human radial glial (RG) cells incubated in neural stem cell culture conditions
RG cells with stem cell self-renewing abilities proliferated to form neurospheres in nonadhesive free-floating conditions
Tumor cells with stem cell self-renewing abilities proliferated to form neurospheres in nonadhesive free-floating conditions
Tumor
Upon differentiation, both Tumor and RG cells neurospheres generate neurons, astrocytes, and oligodendrocytes
COMPARATIVECHARACTERIZATION
Characterization of CNS-PNET BTICs
Yulia Kostenko (M2 student)
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BTIC self-renewal and differentiation
1 2 3 4
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PCA of RNA-seq data
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Brain tumors harvested 4-12 weeks
post-inoculation
Histopathological analyses revealed hallmarks of tumor of neuroectodermal origin: CNS primitive neuroectodermal tumors (PNETs)
RG cells injected into the subventricular zone of the 3rd ventricle of the brain in immunocompromised mice
Tumor cells were dissociatedinto single-cell suspensionand then incubated in thesame neural stem cell cultureconditions as RG cells
Human radial glial (RG) cells incubated in neural stem cell culture conditions
Tumor
Experimental design
Tumor cells injected into the subventricular zone of the 3rd ventricle of the brain in immunocompromised mice
Brain tumors harvested 4-12 weeks
post-inoculation
Histopathological analyses revealed hallmarks of tumor of neuroectodermal origin: CNS primitive neuroectodermal tumors (PNETs)
Tumor cells were dissociatedinto single-cell suspensionand then incubated in thesame neural stem cell cultureconditions as RG cells
First gen. Second gen.
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Cell Proliferation
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Epi-drug screening of RG and BTIC
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Apoptosis
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PNET-Nanotech.
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PNET-Nanotech.
EGF directed killing of cancer cells using single walled carbon nanotube (SWCNT)-cisplatin delivery vector. Nanotubes coated with EGF ligand bind to the cognate EGF receptor on the cancer cell surface and internalize via receptor-mediated endocytosis. Quantum dot nanoparticles (Qdots) allow detection of the nanotubes
(Patel et al,. Pharmaceutics 2011)
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PNET-Nanotech.
Courtesy of Blake Galeazzi and Dustyn Uchiyama
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PNET - Liquid Biopsy Markers
Clotilde Théry .The Scientist . 2011
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PNET - Liquid Biopsy Markers
Exosome Diagnostics Inc.
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Lab techniques involved in studying PNET animal modeling
• Human neural stem cell derivation• Different Stem Cell culturing and immunohistochemistry
techniques• Exosome, DNA, RNA isolation, cDNA construction, RT-PCR,
Western Blot, etc.• Apoptosis, invasion, cell proliferations, drug screening assays • Mice breeding, stereotactic brain surgery, etc.