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INSIDE THIS ISSUE FA L L 2 0 1 0 VO LU M E 9, N U M B E R 2

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Partners for Discovery

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Alcohol Research Center

SPEEDING LAB DISCOVERIES TO PATIENT CARE

by: Anne Buckley

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Healthcare Policy and Research

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Research Notes

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Anything is Possible

n July, Virginia Commonwealth University was the first research center in the state to be named a nationwide consortium of research institutions working to turn laboratory discoveries into treatments for patients. The accompanying $20 million grant from the National Institutes of Health is the largest federal award in the universitys history. The academic research institutions that make up the nationwide network are all funded by Clinical and Translational Science Awards. The awards were conceived as a tool for accelerating the transformation of laboratory discoveries into treatments for patients, engaging communities in clinical research and training a new generation of clinical and translational researchers. The CTSA award is not only a significant achievement for VCU, but also for Virginia and the country as our research moves from the laboratory to the bedside to save and improve lives, said Michael Rao, Ph.D., president of VCU and the VCU Health System. Nine institutions were selected this year, bringing membership to 55 centers in 28 states and the District of Columbia. When the program is fully

JOHN N. CLORE, M.D., IS PRINCIPAL INVESTIGATOR OF THE LARGEST FEDERAL GRANT AWARD IN VCUS HISTORY: A $20-MILLION CLINICAL AND TRANSLATIONAL SCIENCE AWARD. HE SAYS IT IS THE CULMINATION OF THE LAST FIVE TO TEN YEARS OF EXTRAORDINARY GROWTH IN RESEARCH AT THE UNIVERSITY.

This award is a recognition of VCUs strengths as well as an opportunity to grow as a research enterprise. Its a real opportunity for VCU to make a broader imprint on the community, demonstrating that we are committed to community-engaged research, meeting the needs of the community and being a partner with the community. :: John N. Clore, M.D.
V i r g i n i a C o m m o n w e a l t h U n i v e r s i t y

Deans Discovery Initiative School of Medicine Development Office VCUs Medical College of Virginia Campus P.O. Box 980022 Richmond, VA 23298-0022
A D D R ESS S E RV I C E R EQ U EST E D

NONPROFIT ORGANIZATION U.S. POSTAGE PAID PERMIT NO. 869 RICHMOND VA

JOHN N. CLORE, M.D., SPEAKS WITH PATIENT COLLEEN A. THOMA, AS SHE UNDERGOES A TEST TO MONITOR BRAIN WAVE ACTIVITY IN THE GENERAL CLINICAL RESEARCH CENTER.

(continued from cover)

SPEEDING LAB DISCOVERIES

implemented, it will support approximately 60 CTSAs across the nation. VCU will bring additional talent and expertise to the CTSA consortium in such areas as substance abuse, womens health and rehabilitation science, outreach to communities and systems to share research information, said Barbara Alving, M.D., director of the NIHs National Center for Research Resources. The award supports the universitys Center for Clinical and Translational Research, a comprehensive matrix center that will support VCUs efforts to strengthen ties with affiliates and community partners to better share resources and respond to community health needs. Principal investigator for the grant is John Clore, M.D., associate vice president for clinical research. He expects the Center for Clinical and Translational Research at VCU will train the next generation of clinical investigators to pool medical informatics, genetics, basic science, clinical research together and working with the community to develop a whole new way to do research with a whole new group of investigators that are trained differently, and uniquely, to answer the needs of the 21st century. Researchers will benefit from centralized management, Web-based data sharing, training and access to a rich array of resources, including biostatistics, ethics, research study and regulatory support. In addition, students can pursue a transdisciplinary education through the centers M.S. and Ph.D. degree programs in clinical and translational science. This award will engage academic units across the university in a common purpose, said Jerome F. Strauss III, M.D., Ph.D., dean of the VCU School of Medicine. Effective translational research requires the combined expertise of multiple disciplines and a culture of collaboration. With its outstanding health system and distinguished health and biomedical sciencerelated schools, VCU is uniquely positioned to make significant contributions to the health of all Americans, Strauss said.

MAKING MEDICAL HISTORY

NIH

1960s| 1960s| 1970s| 1970s| 1980s| 1990s| 2000s|

Dr. David Hume pioneers kidney transplantation, furthering understanding of transplantation through his immunology studies Dr. Richard Lower lays foundation of cardiac transplantation, improving immune suppression and developing techniques for protecting the heart

Drs. Donald Becker and St. George Tucker develop microsurgical techniques for removing pituitary tumors; the techniques remain todays gold standard, eliminating the need to remove the entire pituitary and saving more lives Using antibodies from patients who had a form of hepatitis, researchers in the liver group developed the first test for the diagnosis of what is now known to be the hepatitis C virus Dr. Barry Wolf identifies biotinidase deficiency as an inborn metabolism error, leading to a screening test that allows diagnosis before the onset of severe neurological dysfunction that is the hallmark of the disease Drs. Marc Posner and Robert Fisher break new ground in the field of organ transplant, performing what is believed to be the countrys first living donor liver transplant between unrelated adults Dr. Steve Grant leads national studies of bryostatin, a promising new chemical derived from a marine organism resembling algae, in some of the first trials combining experimental compounds with standard chemotherapy to attack cancer cells signaling pathways

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PARTNERS FOR DISCOVERY Privately funded endowments support faculty, new discoveries
David Cifu, M.D. Herman J. Flax professor and chair of the Department of Physical Medicine and Rehabilitation National director for the U.S. Department of Veterans Affairs PMR Program
One of Cifus favorite roles is that of educator and advocate, inspiring medical students and residents to devote themselves to the rehabilitation specialty that he loves. But a chairmans schedule is often dominated by research, patient care or administrative duties, and it can be hard to find the time to mentor your fields youngest members. Even when its your favorite thing to do. For Cifu, the Flax Professorship makes it possible. When Herman J. Flax graduated from MCVs medical school in 1940, physical medicine and rehabilitation was not yet a recognized specialty. Nevertheless, he threw himself into learning about rehabilitation. Visiting World War I veterans, polio survivors and the geriatric set, he began training with physicians who would become giants in the emerging field. Cifu recalls meeting Flax in the late 1980s. By then, Flax had established himself with a 40-year career spent in Puerto Rico growing the rehab field from obscurity into a recognized specialty. Cifu was just at the start of his own career, completing his residency training at Baylor. Nevertheless, Flax spent time with the young resident, and Cifu recalls the inspiration he took from that exchange. Flax established the professorship that carries his name in 1996. Cifu is its second holder. The Flax Endowments annual payout makes it possible for Cifu to set aside time that he devotes to teaching and mentoring students and residents. The fund that Dr. Flax established provides the financial resources that make this possible, said Cifu. But he also provided me with the motivation to follow his example when he made time for a young resident back in the 80s. For students and residents, the time spent with Cifu gives them a unique view into the rehabilitation field. In addition to his responsibilities as professor and chair in the medical school, Cifu also serves as national director for the U.S. Department of Veterans Affairs PMR program. In that role, he provides guidance, leadership and oversight to 150 VA hospitals and to the 3,500 employees involved in providing rehabilitation care to veterans and active-duty service members injured in Iraq and Afghanistan. These soldiers come to the VA with multiple disabling injuries including traumatic brain injury. Shaping systems of care for these polytrauma patients, as theyre known, is a priority for Cifu. The medical school has a longstanding partnership with the nearby McGuire VA, where Cifu has created a clinical laboratory of sorts. Now considered the VAs premiere polytrauma program, McGuire tests approaches to healing these difficult to treat patients and then shares what works throughout the VA system. This national and international perspective is what Cifu shares with his students and residents as he seeks to close the circle that Flax set in motion. I believe in investing time with students and residents wholl one day be the leaders of our field. Dr. Flax and my chairman supported me when I was at the beginning of my career.

Research to Direct Has Potential Decision Treatment s

Cifu is pr inc Departm ipal investigator o ent of De fense gra n two nearly $4 nts totali million. ng The first active du will ty mild brain service men who follow 750 have sus in ta percent o jury. In the civil ian world ined f such pa , 97 tients wo function uld retur within a n to full yea study, th e military r. In this first-ofits kind will learn related in w itial injur y dictate hether a blastoutcome sad fo what am r servicemen who ifferent ounts to have rec a mild co ncussion eived . The seco nd grant funds a s effective tudy of th ness of h e yp thought to have th erbaric oxygen, w hich is e anti-infl regenera am tiv healing fo e effects needed matory and to promo r brain in te juries. E not been ven thou proven e gh it has ffective fo some ser r brain in vic juries, avenue o e members have f treatme p nt. Cifus ursued this enroll 60 pil active-du ty Marine ot study will suffered s who ha the effec ve ts o more tha n three m f a mild brain inju onths. In ry for intra-ser vice coop a eration, th n example of travel to e Marine the Navy sw s largest Pensaco dive cente ill la Naval Institute r, the receive tw , wher o institutes months of treatm e they will e eight-per son hype nt in the rbaric ch amber.

A front page article in the July 29 edition of USAToday took a look at the success that the VA is seeing at its four emerging consciousness programs in Minneapolis, Richmond, Tampa and Palo Alto, Calif.

New Partnership Forged from Historic Strengths in Substance Abuse and Genetics
ALCOHOL RESEARCH CENTER
by A.J. Hostetler
Bolstered by a recent $2.4 million federal grant, a new research center that is focused on the study of alcoholism and its causes provides a hub for scientists from multiple disciplines at the School of Medicine.

Young Investigator Honored

The arrival of last falls four-year grant from the National Institute on Alcohol Abuse and Alcoholism put VCU among the ranks of 27 centers nationwide funded by the NIAAA for research that focuses on particular aspects of alcohol abuse, alcoholism or other alcoholrelated problems. In the United States, about 1 in 12 adults abuse alcohol or are alcohol dependent, according to the NIAAA. Long viewed as a moral failure, alcohol dependency is now understood as a chronic disease with complex genetic and environmental triggers. The VCU Alcohol Research Center brings together several aspects of the universitys research into alcohol and alcoholism, from the psychiatric genetics research by faculty at the Virginia Institute for Psychiatric and Behavioral Genetics together with neurobiological, pharmacological and molecular biological research in the Department of Pharmacology and Toxicology on the MCV Campus. Co-directors of the center are Kenneth S. Kendler, M.D., director of the Virginia Institute for Psychiatric and Behavioral Genetics and a professor of psychiatry and of human and molecular genetics in the School of Medicine, and Michael Miles, M.D., Ph.D., professor of pharmacology and toxicology and of neurology. The center focuses on complex networks of genes that are involved in the response to alcohol using four model organisms: humans, mice, the worm C. elegans, and that workhorse of genetics labs, the fruit fly. Kendler said the project is naturally synergistic.
In the United States, about 1 in 12 adults abuse alcohol or are alcohol dependent.

Danielle Dick, Ph.D.

The Research Society on Alcoholism recognized Danielle Dicks work with its 23rd annual Young Investigator award at its annual meeting this June in San Antonio. Dick, an associate professor of psychiatry, psychology, and human and molecular genetics with the Virginia Institute for Psychiatric and Behavioral Genetics, joined the medical schools faculty in 2007. Dick said she initially grew interested in psychiatric disorders as a pre-med student at the University of Virginia. She went on to study the genetics of schizophrenia before being drawn to the complexities of alcohol dependence, in which genetic and environmental factors play out along with developmental issues.

Weve been laying the groundwork for trying to develop comprehensive, multi-species approaches to the study of alcoholism for several years, he said. Animal models allow you to study genes in details in a matter of weeks in fruit flies, or a few months in rats or mice. We can manipulate the genes in those animal models in ways we cannot in human studies. Understanding genetic variation in humans is the target, but the kinds of biological tools that you have at your disposal with animal model systems are light-years ahead of what is available to us in humans. Miles said that a better understanding of the networks of genes at work in alcohol dependency may someday lead to better intervention methods or help identify genes that work in concert to put people at greater risk for alcoholism. NIAAAs award of the center startup grant is considered an acknowledgment of VCUs robust, innovative cross-species analysis and its historically strong research programs in substance abuse and genetics, Miles said. The NIAAA award also recognized the schools commitment to attracting new talent, such as Danielle Dick, Ph.D., an associate professor of psychiatry, psychology and human and molecular genetics, who studies alcohol dependence among some 10,000 twins in Finland, where a national population-based register makes it possible to study entire birth cohorts. With Dick came the opportunity for the university to become the tenth site for the federally-funded Collaborative Study on the Genetics of Alcoholism. The $500,000, five-year COGA grant was awarded last fall. Along with Kendlers ongoing gene identification project in Ireland, this grant makes VCU home to two of the biggest gene identification projects for alcohol dependence in the United States. This is an incredible, exciting place to be doing this research, Dick said. We have a unique, broad spectrum of research: the genetic epidemiology piece that includes Dr. Kendlers studies of Virginia twins along with my Finnish twin studies, the human gene identification projects aimed at finding risk genes, the model organism research to characterize how genes function, and then the longitudinal, community-based samples of kids to study how risk unfolds across development and how environmental factors can alter genetic risk. All here, under one umbrella.

In her work focused on risk pathways for alcohol dependence, she has found that children who carry genes associated with adult alcohol dependence display many other behavior problems long before they ever use alcohol, such as aggression and more serious rule-breaking.
What ultimately hooked me is that studying the development of alcohol dependence represents so many of the challenges that make psychiatric conditions fascinating, she said. Different people can end up with the same disorder through different pathways, and its our job to figure out what those risk pathways are, so that we can better prevent these debilitating disorders.

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Cathy Bradley says that by virtue of her departments location on the MCV Campus, it is positioned for

Answering todays healthcare questions

by M. Grace Maselli midst the swirl of rhetoric and controversy in the nation leading up to the Obama Administrations federal healthcare reforms this year, the Department of Healthcare Policy and Research on the MCV Campus set a course for finding solutions to some of those contentious issues. The vision for the year-old department, headed by founding chair and health economist Cathy J. Bradley, Ph.D., is to service not only the university but, ultimately, patients around the globe. By applying rigorous medical research standards to judge overall effectiveness, the department aims to identify outstanding healthcare policies and practices that can be translated into improved health for even some of the most intractable medical conditions. Established in May 2009, the department recently signed five new faculty members with recruitment efforts underway to fill two more faculty positions. I counsel each of my faculty members that were here to inform policies and practices to support people. And to provide information that is relevant to their health, their livelihoods, and to the nation as a whole when we think about public health policy and how to move forward, says Bradley whose own research is funded by several National Institutes of Health grants. For decades the MCV Campus has delivered health

services for low-income, uninsured patients with chronic and acute illnesses. Known as a safety net provider, the academic medical center receives funds from multiple sources to administer health services to an at-risk population. By virtue of being situated on the MCV Campus, the Department of Healthcare Policy and Research is uniquely positioned to study models of healthcare delivery at a health system that is experienced in meeting the needs of a diverse population, Bradley says. As health economists, Bradley and her team believe research priorities should be placed on maximizing positive health outcomes. But in a struggling economy facing intense pressure from rising healthcare costs, we need to look at where we get the best use of our dollars, by evaluating healthcare treatment options in the context of cost, Bradley says, adding that the new healthcare reforms bring to her department a terrific opportunity to provide evidence-based answers to some burning questions we have about an uninsured population with chronic illness.

A CASE IN POINT
Grants totaling more than $3 million

from the National Cancer Institute support studies led by by Cathy J. Bradley, Ph.D., in the field of cancer outcomes and survivorship. Bradley explains, I examine what it costs the nation as a whole when people are diagnosed and treated for cancer. She is currently directing a five-year study looking at 625 women in Virginia with breast cancer. To learn whether the source of health insurance dictates a womans healthcare choices, Bradley and her team are collecting data from urban and rural hospitals on women with different sources of employer-based health insurance: married women with their own health insurance; married women under their spouses policies; and single women with health insurance in their own names. What we quickly discovered is that if a

persons health insurance is tied to employment, that person is unlikely to leave her job, Bradley says. Data collection gets into the depths of womens experiences. Under consideration are things like cancer treatment types, numbers of missed appointments and reschedulings. Questions are asked of study participants such as, Did you quit your job when you found out you had cancer? What did your employer do to help you? Were you able to continue health insurance coverage? We want to understand more about the kinds of incentives created by an employerbased system of insurance for ill employees and employers, she says. An understanding of choices and their consequences could then be translated to information that could help employees and employers opt for solutions

that lessen the trade-offs that are common today. Already her research techniques are influencing others in the field. A visiting scholar from Irelands National Cancer Registry recently spent a month in Richmond to replicate one of her cancer studies. Bradleys hope for her own research is that it will influence public health policy so the decisions people have to make about health versus employment, for example, arent so stark.

RESEARCH NOTES
FIGHTING ANAPHYLAXIS Carole A. Oskeritzian, Ph.D., assistant professor of biochemistry and molecular biology When the bodys mast cells come in contact with allergy-causing agents, they release substances that trigger the bodys allergic response, leading to conditions like asthma and hives. Those substances include sphingosine-1-phosphate (S1P). Oskeritzian discovered that S1P further stimulates mast cells and exacerbates severe allergic reactions in mice. But blocking S1Ps access to its S1P2 receptor stifled the mast cells potential to become hyperactive. Because there is no cure for allergies, we need to think about new targets, new ideas and new strategies to help design a cure, prevent them and keep them under control, and interfering with the interaction of S1P with its S1P2 receptor might be a way to achieve this goal, Oskeritzian said. In fact, this approach could be a new therapeutic strategy to control not only acute life threatening exacerbations of anaphylactic shock, but also other inflammatory diseases where mast cell activation has been identified as a critical trigger and promoter, such as rheumatoid arthritis and atherosclerosis. Read more in the March 15 issue of the Journal of Experimental Medicine. The research was supported by grants from the National Institutes of Health. MOLECULAR PLAYER INVOLVED WITH BLADDER INFLAMMATION Liya Qiao, Ph.D., assistant professor of physiology and biophysics More than 4 million Americans suffer with a painful syndrome known as cystitis, which is characterized by frequent and urgent urination. Patients with cystitis demonstrate inflamed and enlarged urinary bladder. Qiao and her research team have discovered that NGF, a protein responsible for nerve growth, could also be responsible for the bladder enlargement that occurs with the disorder. According to their research, NGF is produced by the damaged bladder lining and acts on either the sensory nerve terminals or the bladder muscle cells in the bladder wall. Elevated NGF levels, in turn, stimulate the bladder muscle cells to generate more collagen, which then causes the thickness of the bladder wall to increase. Since its discovery in the 1950s, NGF has shown promise for diseases as diverse as Alzheimers disease, osteoarthritis and chronic lower back pain. Read more in the February 2010 issue of the Journal of Biological Chemistry. The work was supported in part by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. GENE LINKED TO AGGRESSIVE PROGRESSION OF LIVER CANCER Devanand Sarkar, Ph.D., MBBS, assistant professor of human and molecular genetics and a Harrison Endowed Scholar in Cancer Research at the VCU Massey Cancer Center Researchers have been studying the role of LSF for more than 25 years in fields outside of cancer, but our work is the first demonstration that LSF plays an important role in liver cancer, said Sarkar. Levels of the tumor-promoting genes expression are significantly higher in more than 90 percent of patients with liver cancer compared to their healthy counterparts. Because LSF is increased in such a high percentage of patients, it could be a potential target for therapeutic intervention, he said. Sarkars team found that LSF plays an important role in both the development and progression of liver cancer and that inhibiting LSF can reverse the aggressive properties of human liver cancer cells. Read more in the May 4 issue of the journal Proceedings of the National Academy of Sciences. The work was supported in part by grants from the Goldhirsh Foundation, the Dana Foundation, the National Institutes of Health, the Samuel Waxman Cancer Research Foundation, National Institute of Environmental Health and the Liver Tissue Cell Distribution System. NICOTINE NO MATCH FOR SNAIL TOXIN Darlene Brunzell, Ph.D., assistant professor of pharmacology and toxicology When a smoker takes a puff from a cigarette, the inhaled nicotine acts on nicotinic receptors in an area of the brain associated with control of motivation and reward. Activation of these receptors results in the release of neurotransmitters such as dopamine and makes the brain think it wants more nicotine. Together with colleagues from VCU and the University of Utah, Brunzell has discovered that a peptide known as alpha conotoxin MII may reduce motivation to use nicotine in rats by blocking the action of these nicotine receptors. MII is found in nature as part of the cocktail of toxins that the sea-dwelling Magician cone snail uses to paralyze its prey. Most tobacco cessation therapies hit a wide array of nicotinic receptors that regulate cognition and emotion in addition to their control of tobacco use, explained Brunzell. MII-sensitive receptors represent a much smaller pool. If our studies in rats hold true in humans, blocking these receptors may be sufficient to curb tobacco use without producing undesirable side-effects. Read more in the February 2010 issue of the international journal Neuropsychopharmacology, a journal of the Nature Publishing Group. The study was supported by grants from the National Institutes of Health. RESEARCH ADVANCE COULD LEAD TO LONG-LASTING EMPHYSEMA TREATMENT Frank Guarnieri, Ph.D., adjunct professor of physiology and biophysics Smoking cessation remains the only known effective emphysema treatment. The disease has seen no significant treatment advance despite decades of research in part because the lungs are designed to quickly transport the drugs out of the lung tissue and into the bloodstream. Guarnieris lab has developed a targeted, long-lasting emphysema treatment that dramatically enhances the length of time that the drugs remain in the lungs to work more effectively. The team achieved this by successfully connecting a human neutrophil elastase (HNE) inhibitor to a larger peptide that is naturally present in the lungs mucous lining. As a result, patient dosing and compliance would be made easier and by confining the treatment to the lungs, known side effects are substantially reduced or eliminated, said Guarnieri. The breakthrough technique, developed during experiments on mice, may lead to better treatment options for human patients with emphysema. The study was one of five in the June 8 issue of the Proceedings of the National Academy of Sciences highlighted for their importance by the journals editors. A NEW TARGET FOR SOLID-TUMOR CANCERS William A. Barton, Ph.D., assistant professor of biochemistry and molecular biology In the process known as angiogenesis, tumor cells recruit new blood vessels that both feed the tumor with nutrients and provide a conduit for the cancer cells to spread throughout the body. Researchers have traditionally looked to the proteins involved in angiogenesis as attractive therapeutic targets, but a new discovery instead points to a receptor long known to be involved in the process but, until now, overlooked. Our study suggests that an alternate therapeutic target may be more viable than those tested in the past, said Barton of the findings that could lead to improved drug treatments for solid-tumor cancers. Together with colleagues from VCU and Memorial Sloan-Kettering Cancer Center, Barton reported a new role for the Tie1 receptor. It interacts with and inhibits another essential protein, known as Tie2, that is also involved in angiogenesis. Read more in the March 2010 issue of the journal Molecular Cell. The research was supported by grants from the National Cancer Institute, the National Heart, Lung and Blood Institute and the VCU Massey Cancer Center.

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SOCIOECONOMIC STRESSES COULD LOWER LIFE EXPECTANCY Steven H. Woolf, M.D., M.P.H., professor of family medicine and director of the VCU Center on Human Needs People who live in areas with lower household incomes are much more likely to die because of their personal and household characteristics and their community surroundings. These findings are especially timely during the current recession. Policymakers typically think of the economy, jobs and education as separate issues from healthcare reform, but theyre deeply connected, Woolf said. Social policy is health policy, probably saving more lives than anything done in health care. He points out that the findings are not tied to how much money people make. Rather, Areas with high household incomes also tend to have better schools, a different racial and social mix and healthier community conditions. Analyzing census data and vital statistics from Virginia counties and cities over a 16-year span, Woolf demonstrated that one out of four deaths would have been averted if the mortality rates of Virginias five most affluent counties and cities had existed statewide. In some of the most disadvantaged areas of the state, nearly half of the deaths would have been averted. Read more in the April 2010 issue of the American Journal of Public Health. This study was funded by the Robert Wood Johnson Foundation. LINKING CHOLESTEROL TO INSULIN SENSITIVITY Shobha Ghosh, Ph.D., professor of internal medicine Although diabetes and heart disease often co-exist, current management of diabetes does not necessarily include cholesterol control, Ghosh said. Her latest study provides the first evidence that eliminating cholesterol from the body reduces systemic as well as fat tissue inflammation and represents a new strategy to prevent inflammationlinked diseases such as diabetes. A key enzyme called CEH increases the removal of cholesterol from the body and as a result, reduces inflammation of fat tissue. In studies with mice, when CEH levels were increased by introduction of the human gene, the animals had improved insulin sensitivity that corresponds with a decrease in the development of diet-induced diabetes. This improvement was observed despite a comparable high-fat high-cholesterol or Western diet-induced weight gain indicating that enhancing cholesterol removal from the body can prevent diabetes irrespective of diet-induced obesity. This study underscores the importance of maintaining cholesterol balance, not only for preventing heart disease but also for reducing diabetes. Read more in the April 2010 issue of the Journal of Biological Chemistry. The work was supported by grants from the National Heart, Lung and Blood Institute and the American Diabetes Association. SUPPORT FOR CANCER PATIENTS Levent Dumenci, Ph.D., associate professor of social and behavioral health and founding director of the Behavioral Measurement Core Facility at the VCU Massey Cancer Center Recent research shows that individuals with low health literacy are more likely to have limited knowledge about cancer screening, and it is a contributing factor to insufficient utilization of preventive health services, said Dumenci. In response, he will develop the first health literacy measure designed specifically for cancer patients. The project will identify cancer patients who need help and extra support to handle the complexities of their medical care at the time of diagnosis and better assist them as they go through treatment. The research is supported by a National Cancer Institute grant totaling nearly $3 million.

MASS SPECTROMETRY TO ANALYZE PROTEIN DAMAGE RESULTING FROM OXIDATIVE STRESS Jill Bettinger, Ph.D., assistant professor of pharmacology and toxicology, and Michael Grotewiel, Ph.D., associate professor of human and molecular genetics The process of aging as well as many diseases can lead to damage from molecules known as free radicals. When the body produces more of these free radicals than it can effectively neutralize, an imbalance occurs that has been termed oxidative stress. Bettinger and Grotewiel will collaborate with Scott Gronert, Ph.D., chair of chemistry on VCU's Monroe Park Campus, to analyze the protein damage that results from oxidative stress caused by environmental factors, aging and genetic effects. The team will develop methods for monitoring the damage, which could have applications for surveying environmental hazards or developing drugs to combat diseases involving oxidative stress. Recent advances in mass spectrometry will allow them to examine the damage in more detail than was possible in the past and potentially find molecular damage patterns that could act as "fingerprints" of the disease process. Using animal models to probe where and how the damage occurs, the team will look for links between the types of damage and the nature of the disease or aging process. The research is supported by a four-year, $980,000 grant from the National Institute on Aging.

YO U N G IN V E S T IG AT O R
M.D./Ph.D. Candidate Presents Research
by Isshin Teshima

in Japan

David Gibbs research beg an as an attempt to understa nd allergies and ended up explaining a key element of cancer. An M.D./Ph.D. candidate in the School of Medicine , Gibbs research focuses on the enz yme ADAM10, which has several different roles, including reg ulating the formation of antibodies that promote alle rgic reactions. At the microscopic level, dif ferent elements can often be responsible for several differ ent functions, said Gibb. In Gibbs case, ADAM10 also was responsible for the con trol of the differentiation of hem atopoietic stem cells the precursor to white and red blood cells. Gibbs research concluded that too little ADAM10 in tests meant that these stem cells would not develo p into important antibodyproducing cells, resulting in a highly weakened immu ne system. Too much of the gene and the cells would develop into myelo id cells, influential in the dev elopment of cancer. Researchers have labeled this enzyme as a target in can cer therapy, and many have been interested in blo cking ADAM10, said Gi bb. They will have to be aware of some of the conseq uences of those actions wh ich may or may not be beneficial. His findings were publishe d in a paper in the March 2010 issue of the Journal of Experimental Medicine. An d in August, Gibb presented his findings at two conferences in Japan, includ ing the 14th International Congress on Immunology. Gibbs academic adviser, Da niel Conrad, Ph.D., profes sor of microbiology and immunology, says that D avid has demonstrated the ability to both do his own studies and make collabora tive contacts with other lab oratories, here in the United States as well as in other countries. In addition to being invited to present his research, Gi bb was also awarded a travel grant. Travel award s and speaking invitations mostly go to postdoctoral or junior faculty candidate s, said Conrad. It is a me asure of the importance of the studies that has resulted in both the travel awards as well as the invitations to present.

Anything is Possible
had a lot to do on Fathers Day 1984. Spending time with his father was top on the list. Having just returned home to Creston, Iowa, from his freshman year at the University of Iowa, he also wanted to catch up with his family. He had also planned a date. There was a lot to do and he was in a hurry to do it all. It had been raining a lot that May and early June and finally it was starting to get nice, he remembers. I had just started dating a girl who I knew from high school, but Id never been out to her house. I was low on gas and running late. Along the way to see her, on unfamiliar roads, he and his Triumph sports car slid across a bridge and fishtailed. Perhaps into a culvert. He doesnt know. The last thing I remember was seeing trees coming at me, he says. I woke up outside my car and I knew immediately something was terribly wrong. I felt like I had a sledgehammer in my chest and my legs were floating behind me. He usually wore his seatbelt, but didnt that day. Paralyzed from the chest down, Goetz spent five months in a rehab hospital in Des Moines followed by a month at Craig Hospital in Denver, Colorado. It was an opportunity for me to do some different things, to try walking with different braces and be exposed to some different sports and things like that. There were a lot of young people out there. Goetz, a former high school wrestler and cross-country runner, isnt a candidate to walk with braces because of the extent of his paraplegia. Its not practical. I did it more for exercise. I got really strong trying! He stays physically fit through recreational hand cycling and is now looking for less

by NAN JOHNSON

LANCE GOETZ

traveled roads to cycle in his new neighborhood in Richmonds Woodlake community. One day, he says, he and his 6-year-old twin boys will cycle together. Goetz and his family relocated to Richmond over the summer from Dallas, Texas where he was a staff physician specializing in spinal cord injuries at the Dallas VA Medical Center and an associate professor in the department of physical medicine and rehabilitation at the University of Texas - Southwestern Medical Center. He came to Richmond to join David Gater, M.D., chief of the spinal cord injury service at the McGuire VA Medical Center, and to continue his research in return to work issues for those with spinal cord injuries. He also joined the medical schools faculty as associate professor in the department of physical medicine and rehabilitation.
Ive always been interested in doing research and I love taking care of veterans. My experience in rehabilitation led me to want to go into physical medicine and rehabilitation, Goetz says.

People with spinal cord injuries face a lot of ongoing challenges that result in complications, he explains. Urinary tract infections and pressure ulcers are the number one reasons for hospital admissions [among persons with spinal cord injury]. He also was involved with a national research project that studied anabolic steroid therapy to promote the healing of pressure ulcers in persons with spinal cord injury. Now at the McGuire VA Medical Center, he hopes to enroll patients in new urinary tract studies. His research involvement also includes a special kind of vocational rehabilitation called supported employment, which is individualized, personcentered research based on an individuals interests, not on vocational inventory. Its place and train as opposed to train and place, he says. That busy day back in 1984 changed Lance Goetz's life. But he considers himself lucky. His patients are lucky, too. They can see, through his example, that though their lives have changed, anything is possible.

LANCE GOETZ, M.D. IS A NEW RECRUIT TO THE DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION. HE AND HIS TWIN 6-YEAR-OLD SONS ENJOY EXPLORING THEIR NEW HOME IN RICHMOND.

DEANS DISCOVERY REPORT | Volume 9, Number 2 The Deans Discovery Report is published twice a year by Virginia Commonwealth Universitys School of Medicine on the Medical College of Virginia Campus. Reader comments and suggestions are welcome; please call (800) 332-8813 or (804) 828-4800, e-mail MedAlum@vcu.edu or write to P.O. Box 980022, Richmond, VA 23298-0022. The Dean's Discovery Initiative provides an opportunity for donors to transform the research environment in the School of Medicine. Through philanthropy, alumni and friends can support the school's research endeavor in ways that traditional funding sources do not. Dean: Jerome F. Strauss III, M.D., Ph.D. Produced by the School of Medicines Alumni and Development Office: Associate Dean for Development, Tom Holland; Editor, Erin Lucero. Contributing Writers: Nan Johnson, A.J. Hostetler and M. Grace Maselli Photographers: Allen Jones, Tom Kojcsich and VCU Creative Services Illustration: Damian Williamson Graphic Design: Zeigler|Dacus Virginia Commonwealth University, 2010.

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