UPMC Physician Resources

Archives for UPMC

UPMC Named Among ‘Most Wired Advanced’ Health Systems in Nation

UPMC has been named one of the nation’s “Most Wired Advanced” health systems by Hospitals & Health Networks (H&HN), the journal of the American Hospital Association, continuing the health system’s 18-year run on the annual list.

The survey measures information technology use and adoption among hospitals nationwide and examines how they are leveraging technology to improve performance and value for patients. The 2016 results are based on a survey completed by almost 750 participants, representing 2,200 hospitals, or almost 40 percent of those in the US

Although UPMC has achieved “Most Wired” recognition for 18 consecutive years, the recently added “Advanced” designation is based on stricter verification procedures and advanced levels of performance across four focus areas: infrastructure, business and administrative management, clinical quality and safety, and clinical integration

“This recognition is a testament not only to our information technology team but to our excellent clinicians and business leaders, who play a vital role in ensuring that our use of technology improves the lives of patients and UPMC Health Plan members,” said UPMC Chief Information Officer Ed McCallister. “In this rapidly changing health care landscape, the innovative use of technology is essential to improving quality and lowering costs.”

Over the past five years, UPMC has invested more than $1.5 billion in technology to support clinical excellence and administrative efficiency. UPMC is one of the nation’s earliest and most sophisticated users of electronic medical records (EMRs). More than a dozen UPMC hospitals, as well as UPMC outpatient facilities, are at the highest levels of EMR use, as measured by the Healthcare Information and Management Systems Society Analytics.

The July H&HN cover story detailing Most Wired results is available at www.hhnmag.com.

CMS Selects UPMC Oncologists and UPMC Health Plan to Participate in New ‘Oncology Care Model’ Pilot

UPMC CancerCenter oncologists and the UPMC Health Plan have been selected as one of nearly 200 physician group practices and 17 health insurance companies to participate in an innovative federal program designed to enhance quality and coordination of care for cancer patients, while lowering costs.

The five-year Oncology Care Model (OCM) pilot payment project, overseen by the Centers for Medicare and Medicaid Services (CMS), aims to align physician incentives with improvements in the effectiveness and efficiency of cancer care delivery.  As part of CMS’s broader move to pay physicians for “value” instead of volume, the program aims to reduce unnecessary hospitalizations and emergency room visits by helping patients with improved coordination of and access to key services.

The participating UPMC practice, Oncology Hematology Associates (OHA), is one of the largest integrated community networks of cancer care specialists in the country, providing the latest advances in cancer prevention, detection, diagnosis and treatment. OHA has more than 19 sites throughout western Pennsylvania and has over 168,000 patient visits a year.

“As one of the largest integrated health care provider-payer systems in the country, UPMC has been a leader in developing new models of accountable, patient-focused care,” said Peter Ellis, M.D., deputy director for clinical services at UPMC CancerCenter. “By taking part in this pilot, we believe that UPMC CancerCenter can also play a leading role in developing a model for affordable, high-quality cancer care that can be replicated across the country.”

The UPMC Health Plan is supporting the new model through its own incentives and support services, part of a systemwide effort to transform the delivery of care.

“The UPMC Health Plan, as part of an integrated delivery system, is committed to partnering with CMS to demonstrate how value-based cancer care can improve quality and effectiveness for our members,” said Stephen Perkins, MD, chief medical officer of commercial and Medicare services for the UPMC Health Plan.

Cancer is one of the most common diseases in the United States, with more than 1.6 million individuals receiving a cancer diagnosis each year. According to CMS, a large majority of those diagnosed are over 65 and are Medicare beneficiaries.

To participate in the OCM, oncology providers and insurers must meet multiple requirements, including robust patient navigation, advanced use of an electronic health record, round-the-clock access to clinicians and enhanced outcomes reporting.

The UPMC CancerCenter already meets the majority of the requirements and is enhancing programs to ensure patients receive well-coordinated cancer care. Every cancer patient will receive a detailed cancer care plan to guide his or her treatment. This will cover diagnosis, treatment goals, quality-of-life considerations, care coordination and psychosocial concerns. Following treatment, patients will be provided a survivorship care plan, which includes a summary of treatment delivered and ongoing care, schedules for future visits and testing, as well as management of treatment-related effects. OHA is also improving a nurse triage function and implementing additional management tools to reduce unnecessary hospitalizations and emergency room visits.

The names of the practices and payers participating in the OCM, and more information about the model, can be found on the model’s website: http://innovation.cms.gov/initiatives/Oncology-Care/. The Oncology Care Model begins on July 1 and runs through June 30, 2021.

UPMC Mercy Trauma and Burn Centers Offer Tips for a Safe Summer

Summer is the time to have fun, but many times it can be filled with dangers. UPMC Mercy Trauma and Burn Centers and the UPMC Office of Prehospital Services, offer some important summertime injury prevention and education tips.

Fireworks
Fireworks are spectacular to watch and a great American tradition. However, these explosive devices are very dangerous. Even seemingly harmless sparklers pose a serious injury risk—they can reach temperatures as high as 1,800˚F, a temperature that easily burns skin and can create permanent, devastating injuries. According to the U.S. Consumer Product Safety Commission, there are on average 230 fireworks-related injuries near and on the 4th of July each year.

“Each year we treat many people, especially children and teens, around 4th of July celebrations who have been injured by fireworks. Many of those injuries involve an amputation of a limb or loss of vision,” said Jenny Ziembicki, MD, medical director, UPMC Mercy Burn Center. “We want to remind everyone that fireworks should only be handled by professionals and enjoyed at a safe distance.”

For more information, view these 4th of July Injury Prevention Tips and Information.

Household Burns/Fires
House fires do not have a season. The danger is real and present throughout the year. More than 2,500 people die and nearly 13,000 are injured in home fires every year, yet many people aren’t aware of the potential fire hazards that exist in their own homes. The kitchen stove, a burning candle, or festive lights are among the common household items that can turn dangerous very quickly. In an effort to prevent such a tragedy, the UPMC Mercy Trauma and Burn Centers have donated 100 smoke detectors to the City of Pittsburgh Fire Department for distribution to city residents.

Kitchen Fires
Whenever you are working with hot food and liquids, ensure the cooking area is free of obstacles and distractions, and that pot handles are turned toward the middle of the stove or grill to avoid accidental spillage. Use oven mitts when handling hot items.

If a grease fire occurs, turn off the heat source. If it is contained to a pan or pot, cover it with a lid or cookie sheet. NEVER attempt to extinguish with water. Do not attempt to move the pan. If the grease fire is not contained to a pot, a chemical fire extinguisher can be used. If you are unable to safely extinguish the fire, evacuate and call 911.

UPMC Mercy Trauma and Burn Centers also have donated burn safety items for distribution by local EMS agencies, including glow sticks to be used instead of sparklers, oven mitts for cooking and barbeque burn prevention, as well as water temperature “duckies” to prevent bath-time scald injuries in children.

Campfires and Bonfires
Every year in the U.S., thousands of people are injured in accidents involving recreational fires. Many of these accidents involve camp fires and their impact can be devastatingly debilitating.

The most important tip is to stop the burning process quickly by removing any clothing or substance involved in the burn injury. Cool the area immediately with cool water. Do not apply ice, ointment or other home remedy. Apply a dry dressing and go to the nearest urgent care center or emergency department for evaluation.

UPMC Mercy Trauma and Burn Centers wish you a happy and healthy summer of fun! View these additional Summer Safety Tips and enjoy the season.

For more information concerning community events at which injury prevention and safety tips can be shared, call UPMC Mercy Trauma Services at 412-232-8375.

As the region’s only combined Level I Regional Resource Trauma and American Burn Association (ABA) Verified Burn Center, UPMC Mercy delivers both emergency trauma treatment and longer-term burn care. UPMC Mercy has been a leader in providing comprehensive care to patients of trauma and burn injuries. Opened in 1967, UPMC Mercy was the first burn center in Pennsylvania and the 17th in the United States. The American Burn Association (ABA) verification program is a joint program between the ABA and the American College of Surgeons. It is a rigorous review process designed to verify a burn center’s resources required for the provision of optimal care to burn patients from the time of injury through rehabilitation. The combination of burn and trauma care services gives UPMC Mercy the unique ability to care for the most critically ill and injured patients.

UPMC First in Region to Use Next Generation Gamma Knife for Brain Tumors

UPMC is the first hospital in the region and the third institution in the United States to treat patients with the Leksell Gamma Knife Icon®. Using a stereotactic radio surgery system (SRS), a type of radiation therapy that condenses the Gamma Knife’s high-power energy on a small area, the machine enables physicians to perform non-invasive, computer-driven, bloodless brain surgery to destroy tumors and vascular malformations once considered inoperable. Despite the name, SRS does not require surgical incisions.

“UPMC’s history of innovation in radiosurgery began in 1987 when we installed North America’s first unit, which we have used to treat more than 14,000 patients,” said L. Dade Lunsford, MD, director of the Center for Image-Guided Neurosurgery. Dr. Lunsford trained in Sweden under Professor Lars Leksell, the inventor of SRS and the Gamma Knife.

“Each of the five previous generations of Gamma Knife units has improved efficiency and allows us to provide a highly effective option for the many patients who receive treatment each year at UPMC,” Dr. Lunsford said. “With the option of a frame-based or frameless approach for non-invasive cranial immobilization, Icon gives us a new way to treat a wide array of complex neurological conditions, including brain tumors, vascular disease, facial nerve pain and functional disorders.”

The Icon’s SRS uses MRI and other radiological images to identify and target precise locations within the brain to ensure dosage is appropriately distributed to the area, regardless of the position of the patient’s head. This minimizes side effects and enables treatment of larger tumors and those close to critical brain structures.

The Center for Image-Guided Neurosurgery began treating patients with the Leksell Gamma Knife Icon in May. The Center serves as an international training and outcomes analysis site, using the latest generation of radio-surgical technologies and treats more than 650 patients per year. UPMC has trained more than 2,000 surgeons, radiation oncologists, medical physicists and other health care providers in the use of brain radiosurgery during the past 20 years.

Dr. Lunsford is a consultant for and stockholder in Stockholm, Sweden-based Elekta AB, maker of the Gamma Knife Icon system.

Broccoli Sprout Extract May Protect Against Oral Cancer Recurrence

Potent doses of broccoli sprout extract activate a “detoxification” gene and may help prevent cancer recurrence in survivors of head and neck cancer, according to a trial by the University of Pittsburgh Cancer Institute, partner with UPMC CancerCenter, confirming preliminary results presented last year at the American Association for Cancer Research Annual Meeting.

It is the first study demonstrating that the extract protects against oral cancer, with the results of human, animal and laboratory tests reported today in the journal Cancer Prevention Research. This research is funded through Pitt’s Specialized Program of Research Excellence grant in head and neck cancer from the National Cancer Institute.

“With head and neck cancer, we often clear patients of cancer only to see it come back with deadly consequences a few years later,” said lead author Julie Bauman, MD, MPH, co-director of the UPMC Head and Neck Cancer Center of Excellence. “Unfortunately, previous efforts to develop a preventative drug to reduce this risk have been inefficient, intolerable in patients and expensive. That led us to ‘green chemoprevention’—the cost-effective development of treatments based upon whole plants or their extracts.”

Cruciferous vegetables, such as broccoli, cabbage and garden cress, have a high concentration of the naturally occurring molecular compound sulforaphane, which previously has been shown to protect people against environmental carcinogens.

Dr. Bauman and her colleagues treated human head and neck cancer cells in the laboratory with varying doses of sulforaphane and a control, and compared them to normal, healthy cells that line the throat and mouth. The sulforaphane induced both types of cells to increase their levels of a protein that turns on genes that promote detoxification of carcinogens, like those found in cigarettes, and protect cells from cancer.

In a small preclinical trial, 10 healthy volunteers drank or swished fruit juice mixed with broccoli sprout extract for several days. The volunteers had no significant problems tolerating the extract and the lining of their mouths showed that the same protective genetic pathway activated in the laboratory cell tests was activated in their mouths, meaning that the sulforaphane was absorbed and directed to at-risk tissue.

Dr. Bauman also collaborated with senior author Daniel E. Johnson, PhD, professor of medicine at Pitt and a senior scientist in the UPCI Head and Neck Cancer Program, to see how the extract performed in mice predisposed to head and neck cancer. The mice who received the sulforaphane developed far fewer tumors than their counterparts who did not receive the extract.

The results of the mouse, human and lab studies have been so successful that Dr. Bauman has started a larger clinical trial in volunteers previously cured of head and neck cancer. These participants are taking capsules containing broccoli seed powder, which is more convenient to take regularly than the extract mixed with juice.

“Head and neck cancers account for approximately 3 percent of all cancers in the US, but that burden is far greater in many developing countries,” said Dr. Bauman. “A preventative drug created from whole plants or their extracts may ease the costs of production and distribution, and ultimately have a huge positive impact on mortality and quality of life in people around the world.”

Additional authors on this research are Yan Zang, PhD, Malabika Sen, PhD, Changyou Li, PhD, Lin Wang, MD, Daniel P. Normolle, PhD, and Thomas W. Kensler, PhD, all of Pitt; Patricia A. Egner, MS, and Jed W. Fahey, ScD, both of Johns Hopkins University; and Jennifer R. Grandis, MD, FACS, of the University of California at San Francisco.

This work was supported by National Institutes of Health grants P50CA097, R01CA190610, and P30 CA4747904; and by the Lewis B. and Dorothy Cullman Foundation.

Blacks with Atrial Fibrillation at Greater Risk for Adverse Outcomes

Blacks with atrial fibrillation (AFib) have nearly double the risk than their white counterparts of stroke, heart failure, coronary heart disease (CHD) and mortality from all causes, according to a study published today in JAMA Cardiology.

The study, funded by a grant from the Doris Duke Foundation and led by Jared Magnani, MD, associate professor of medicine, Division of Cardiology, University of Pittsburgh School of Medicine, and cardiologist at the UPMC Heart and Vascular Institute, analyzed data from the Atherosclerosis Risk in Communities (ARIC) Study to examine racial differences in adverse outcomes associated with AFib.

AFib is the most common heart rhythm problem in the US It affects approximately 1 percent of the adult population and more than 5 percent of those 65 years old and older. It also is known to be strongly associated with increased risks of stroke, heart failure and mortality.

“We knew blacks were likely to have an increased risk of stroke, but the findings for heart failure, CHD and mortality are novel and important,” Dr. Magnani said. “This should put the focus on improving prevention efforts for adverse outcomes in blacks with atrial fibrillation, and drive further studies into the reasons behind why this is happening.”

The ARIC Study, sponsored by the National Heart, Lung, and Blood Institute, recruited 15,792 men and women, 45 to 64 years old, from four communities in the United States—Forsyth County, North Carolina; Jackson, Mississippi; the northwest suburbs of Minneapolis, Minnesota; and Washington County, Maryland. The community-based cohort was designed to investigate causes of atherosclerosis and cardiovascular disease, and included baseline examinations in 1986 and more than 20 years follow up.

“ARIC provided an opportunity to examine racial differences in outcomes related to atrial fibrillation. In general, most large studies of individuals with atrial fibrillation are predominantly of white participants,” Dr. Magnani said. “We know that atrial fibrillation is associated with adverse outcomes, but these data provided important insights into differences by race.”

After exclusions, 15,080 participants (8,290 women and 3,831 blacks) were included in the new analysis. Noteworthy racial differences at baseline examination included a body mass index of 27 percent for whites and 29.6 percent for blacks. Black participants also had a higher prevalence of hypertension and diabetes.

During analysis of the 20-year follow-up, 2,348 cases of AFib were identified—1,914 in whites with an incidence rate of 8.1 per 1,000 person-years, and 434 in blacks, with an incidence rate of 5.8 per 1,000 person-years. Researchers found that adverse outcomes in black participants were almost double that for whites.

The incidence rate of strokes in black participants was 21.4 compared to 10.2 in their white counterparts. For heart failure and CHD, the rate difference was almost two-fold higher in blacks than whites. Blacks also had a rate difference of 106 for mortality compared to 55.9 in whites.

Researchers also believe the results are enough to warrant an addition to the current guidelines for the management of patients with AFib developed by the American College of Cardiology, American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society to include the significant difference in adverse outcomes between blacks and whites with AFib.

Limitations of the study noted by researchers included that ARIC participants were from only four geographic regions and that the study is biracial. The researchers are careful to note that generalizability to other geographic regions or to other races and ethnicities may be limited.

“There needs to be further investigation,” said Dr. Magnani, who completed his research while at Boston University School of Medicine. “It’s going to be important to dissect the mechanisms behind why blacks with atrial fibrillation are highly more likely to have adverse outcomes than whites.”

The mission of the Doris Duke Charitable Foundation is to improve the quality of people’s lives through grants supporting the performing arts, environmental conservation, medical research and child well-being, and through preservation of the cultural and environmental legacy of Doris Duke’s properties.

Children’s Hospital of Pittsburgh of UPMC Ranked in National Top 10 Seven Years in a Row

PrintChildren’s Hospital of Pittsburgh of UPMC, for the seventh consecutive year, has been named to the US News & World Report Honor Roll of America’s Best Children’s Hospitals.

The hospital is ranked seventh on the 2016-17 Honor Roll of America’s Best Children’s Hospitals, which was released today. The Best Children’s Hospitals rankings highlight the top 50 US pediatric hospitals in each of 10 specialties: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; neonatology; nephrology; neurology and neurosurgery; orthopedics; pulmonology; and urology.

“We’re very proud to once again be recognized as one of the top children’s hospitals in the country,” said Christopher Gessner, president, Children’s Hospital. “Patients and families with complex medical conditions and needs increasingly are choosing our hospital because our physicians, nurses, and staff, who are among the leaders in their fields, are committed to providing the highest quality pediatric healthcare in the world every single day.”

The 2016-17 Best Children’s Hospitals rankings will be released online today and also will be published in the U.S. News “Best Hospitals 2017” guidebook, available in September.

US News introduced the Best Children’s Hospitals rankings in 2007 to help families of children with rare or life-threatening illnesses find the best medical care available. The rankings open the door to an array of detailed information about each hospital’s performance.

Children’s tied with one other hospital for seventh place. The 11 hospitals named to US News’ Honor Roll of Best Children’s Hospitals for 2016-17 are:
1. Boston Children’s Hospital
2. Children’s Hospital of Philadelphia
3. Cincinnati Children’s Hospital Medical Center
4. Texas Children’s Hospital, Houston
5. Seattle Children’s Hospital
6. Ann and Robert H. Lurie Children’s Hospital of Chicago
7. Children’s Hospital of Pittsburgh of UPMC
7. Children’s Hospital Los Angeles
9. Children’s Hospital Colorado, Aurora
10. Lucile Packard Children’s Hospital at Stanford, Palo Alto, California
10. Nationwide Children’s Hospital, Columbus, Ohio

University of Pittsburgh’s Rocky Tuan, PhD, Receives Research Award to Conduct Studies on International Space Station

Rocky S. Tuan, PhD, has received a research grant from the Center for the Advancement of Science in Space (CASIS) to continue his work on a 3D microphysiological system (MPS) to be conducted on board the International Space Station (ISS) to evaluate the accelerated aging and degeneration process of bones that occurs in space.

“Studying such rapid progression of the disease offers great advantages to developing treatments for osteoporosis faster and more effectively, in ways that are not possible on Earth,” said Dr. Tuan. “Our research will benefit not only the health of astronauts for long stays in space on the ISS or a future journey to Mars, but also will help people on Earth, providing capabilities for the screening of drug therapies, enhancing personalized medicine, and developing  bioreactor technologies for tissue engineering.”

The award is part of the 3D Microphysical Systems for Organs-On-Chips Grand Challenge by CASIS, which was chosen by NASA in 2011 to be the sole manager of the ISS U.S. National Laboratory. Monday’s announcement was made at the White House Organ Summit.

Dr. Tuan is director of the Cellular and Molecular Engineering Lab and Distinguished Professor in the Department of Orthopaedic Surgery at the University of Pittsburgh School of Medicine. He is internationally known for his research in stem cell biology, musculoskeletal tissue engineering, regenerative medicine, and for his innovative leadership role in biomedical education. He also is associate director of Pitt’s McGowan Institute for Regenerative Medicine and director of the Center for Military Medicine Research.

“We are particularly appreciative of the research award from CASIS as recognition of our work on developing veritable models for skeletal tissues that may be used to understand the mechanisms of disease and to expedite drug screening for degenerative conditions such as osteoporosis and osteoarthritis,” Dr. Tuan said.

The award was accepted by Peter Alexander, PhD, and Riccardo Gottardi, PhD, on behalf of Dr. Tuan and the University of Pittsburgh research team.

Under Dr. Tuan, Pitt’s Center for Cellular and Molecular Engineering focuses on the science of treating injuries and diseases of the musculoskeletal system, utilizing nanotechnology and mechanobiological principles in combination with bioreactor and biomaterials technologies, including 3-dimensional printing, for functional skeletal tissue engineering and regeneration.

The MPS project has been partially funded by the Ri.MED Foundation, a collaboration between Italy’s government, the University of Pittsburgh, and UPMC. The foundation, based in Palermo, Italy, promotes, supports and leads biomedical and biotechnological research projects, with emphasis on the translation of innovative results into clinical practice.

Leading International Expert in Metabolic Liver Disease to Direct Hepatology Program at Children’s Hospital of Pittsburgh of UPMC

PrintPatrick McKiernan, MD, a leading expert in metabolic liver disease, has been appointed director of the Pediatric Hepatology Program at Children’s Hospital of Pittsburgh of UPMC, part of the Division of Pediatric Gastroenterology, Hepatology, and Nutrition. Dr. McKiernan will also join the staff of the hospital’s Center for Rare Disease Therapy.

Dr. McKiernan specializes in treating children with inherited metabolic disease and has an interest in developing less invasive therapies to help patients avoid or delay the need for liver transplantation. His research focus covers the clinical aspects of inherited metabolic liver disease, portal hypertension, novel endoscopic techniques, non-invasive markers of hepatic fibrosis, and immunosuppression following liver transplantation. He is actively involved in research on stem cell therapy for metabolic liver diseases and recently was the UK principle investigator on a stem cell study involving children with urea cycle disorders and Crigler-Najjar syndrome.

“Dr. McKiernan is among the world’s leading physician-scientists with expertise in pediatric hepatology, specifically inherited metabolic disease,” said Mark Lowe, MD, PhD, chief of the Division of Pediatric Gastroenterology, Hepatology and Nutrition at Children’s Hospital. “His appointment enhances Children’s ability to provide care for children from around the world with complex metabolic conditions in need of the highest level of care.”

Dr. McKiernan also has a special interest is tyrosinemia, an inherited disorder caused by an enzyme deficiency that can lead to life-threatening liver and kidney failure. In a study published in 2014, Dr. McKiernan and his colleagues found that children whose tyrosinemia was identified at birth through newborn screening and started on the drug nitisinone developed normally and showed no signs of liver or kidney disease.

Dr. McKiernan comes to Children’s from Birmingham Children’s Hospital in the United Kingdom, where he was a hepatologist in the liver unit since 1994. He trained in medicine and pediatrics at Queen’s University in Belfast.

Dr. McKiernan is a member of the British Medical Association, British Society of Pediatric Gastroenterology, Hepatology and Nutrition, British Association for the Study of the Liver, and American Association for the Study of Liver Diseases. He also is an associate professor at the University of Pittsburgh School of Medicine.
As an international expert in metabolic disease, Dr. McKiernan is part of the Center for Rare Disease Therapy at Children’s, an integrated team of experts who have developed innovative therapies to treat a multitude of rare diseases.

Children’s has performed more than 330 liver transplants for patients with metabolic disease, which is more than any other center, including adult facilities. In addition, Children’s is a leading center for liver transplantation as a therapeutic option for children with maple syrup urine disease (MSUD). Children’s developed the first liver transplant protocol for MSUD in 2004 and since then has successfully performed more liver transplants in patients with MSUD than any other center in the world with 100 percent patient and graft survival.

For more information on Dr. McKiernan and the Pediatric Hepatology Program at Children’s Hospital of Pittsburgh of UPMC, please visit www.chp.edu/hepatology.

Pitt-Developed Test Holds Potential to Diagnose Myriad Conditions with Drop of Blood

Researchers at the University of Pittsburgh have developed a unique method for detecting antibodies in the blood of patients in a proof-of-principle study that opens the door to development of simple diagnostic tests for diseases for which no microbial cause is known, including auto-immune diseases, cancers and other conditions.

The results, reported in the Journal of Immunological Methods and funded by the Bill & Melinda Gates Foundation, are the first evidence that it is possible to develop blood tests for any infectious disease by screening random libraries of non-biological molecular shapes.

“This ‘needle-in-a-molecular haystack’ approach is a new way to develop diagnostic assays,” said senior author Donald S. Burke, MD, Pitt Graduate School of Public Health dean and director of Pitt’s Center for Vaccine Research. “The method does not rely on starting with known viral components. This is important because there are conditions for which there isn’t a known antigen, such as newly emerged epidemics, autoimmune diseases or even responses to traumatic injury.”

When a person’s immune system is faced with an antigen or foreign invader, such as an infectious disease, or even an injury with tissue damage, it responds by producing antibodies. Like puzzle pieces, specific parts of the surface of these antibodies fit to the shape of the molecules on the invader or the damaged tissue.

The Pitt researchers used a technique pioneered by co-author Thomas Kodadek, PhD, of the Scripps Research Institute, that synthesizes random molecular shapes called “peptoids” hooked onto microscopic plastic beads. The technique can produce millions of molecular shapes. The peptoids are not organic, but if they match to the corresponding shape on an antibody, that antibody will connect to them, allowing the scientist to pull out that bead and examine that peptoid and its corresponding antibody.

Using this technique, Dr. Burke’s team chemically generated a huge library of random molecular shapes. Then, using blood from HIV-infected patients and from non-infected people, the researchers screened a million of these random molecular shapes to find the ones that bound only to antibodies present in the blood of HIV-infected patients, but not the healthy controls. No HIV proteins or structures were used to construct or select the peptoids, but the approach, nonetheless, successfully led to selection of the best molecular shapes to use in screening for HIV antibodies.

The team then resynthesized that HIV-antibody-targeting peptoid in mass and tested it by screening hundreds of samples from the Multicenter AIDS Cohort Study (MACS), a confidential research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men (supported by the National Institutes of Health). Study co-author Charles Rinaldo, PhD, chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology and director of the Pittsburgh arm of the MACS, selected the samples, but blinded the testers to which samples were HIV-positive or -negative.  The test distinguished between the samples of HIV-positive blood and HIV-negative blood with a high degree of accuracy.

“This technology means that we may be able to take a single drop of blood from a patient and detect antibodies to all manner of infections, cancers or other conditions they may be carrying or been exposed to. We hope that this is the first step toward development of an ‘Epi-chip’ that can be used to reconstruct a person’s entire exposure history,” said Dr. Burke, who also holds the UPMC-Jonas Salk Chair of Global Health at Pitt.

Additional co-authors on this study are Tricia L. Gearhart, PhD, Ronald C. Montelaro, PhD, Mark E. Schurdak, PhD, Yongseok Park, PhD, Kazi Islam, Raymond Yurko and Ernesto T.A. Marques Jr., MD, PhD, all of Pitt; and Chris D. Pilcher, MD, of the University of California, San Francisco.

This work was funded by Bill & Melinda Gates Foundation grant OPP1068374. In addition to the MACS, the Consortium for the Evaluation and Performance of HIV Incidence Assays also provided blood samples.

Page 3 of 66:« 1 2 3 4 5 6 »Last »