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Unraveling the connection between insulin, PCOS and infertility

Virginia Commonwealth University researchers are on the forefront of studying the connection between insulin resistance and Polycystic Ovary Syndrome, or PCOS.

Insulin resistance is a condition in which the body produces insulin, a hormone made by the pancreas, but the muscle, fat and liver cells do not respond to insulin properly. Insulin helps to lower blood sugars (glucose) in the body after a meal. When the cells fail to respond adequately to circulating insulin, glucose levels rise, and the body needs to produce an increased amount of insulin to maintain the blood glucose in the normal range. Therefore, people with insulin resistance have elevated circulating levels of insulin. If the pancreas cannot keep up with the increased demand for insulin, type 2 diabetes can develop with high levels of both glucose and insulin circulating in the blood at the same time. Insulin resistance is also associated with an increased risk for developing heart disease.

Polycystic Ovary Syndrome causes hormonal imbalances leading to irregular menstrual cycles, excess facial and body hair, weight gain and adult acne. Women with PCOS also have insulin resistance and are at high risk for developing type 2 “We’re one of the top institutions worldwide looking at the connection between PCOS and insulin resistance,” said John Nestler, M.D., the William Branch Porter Professor and chair of the Department of Internal Medicine at the VCU School of Medicine. “Our ongoing research is investigating the influence of insulin on fertility.”

In the 1980s, Nestler was among the first scientists in the world to suggest that insulin was an important reproductive hormone. His pioneering work to induce ovulation through the use of such insulin-sensitizing drugs as metformin has led to the common use of metformin to treat infertility in women with PCOS.

“We know metformin can be an effective fertility treatment for most women with PCOS. However, we have found that some women don’t respond to metformin, and we want to know why. We think it may be related to individual genetic differences and gene variation in enzymes affected by metformin. This variation in specific genes may explain why metformin is not an effective treatment for some women,” said Nestler.

Nestler and his research team are currently focusing on pharmacogenomics, which is the study of how the actions of and reactions to drugs vary with individuals. The implication of this research is that based on the genetic profile of a patient, a physician may be able to discern whether the patient should be on metformin or not and would be able to apply therapy for PCOS more effectively.

This research is funded through a U54 grant from the National Institutes of Health. The center grant includes three main projects studying PCOS, including the work by Nestler and his team. For more information about PCOS research at VCU, visit www.vcu.edu/pcos.

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

 

 

Fertility problems connected to successful cancer treatments

By Jody Taylor

For some cancer survivors, the price of successful treatment is living with issues that arose from the treatment of their illness.

Dr. Elizabeth McGee’s research on graft-versus-host disease focuses on the consequences of bone-marrow or stem-cell transplantation on women’s hormonal health.

Her training in reproductive endocrinology and infertility included a postdoctoral fellowship in the Reproductive Scientist Development Program at Stanford University Medical Center. There, she began to study the development and regeneration of the ovarian follicle, which remains at the center of her research.  (http://edrv.endojournals.org/content/21/2/200.full)

An ovarian follicle contains a single egg, and is the basic element of the female reproductive system. Part of Dr. McGee’s research on ovarian follicles studied the effect of gonadotropins, which are protein hormones that can act as follicle stimulators.

And that formed a rather unlikely connection to problems she began seeing in patients who had undergone cancer treatment. The patients were suffering from fertility problems that were connected to graft-versus-host disease.

“I started learning about vaginal graft-versus-host disease because of the women who were being sent to me,” said Dr. McGee, an associate professor of obstetrics and gynecology at the VCU School of Medicine. Methods used to treat cancer were successfully fighting the disease, but those same methods were spawning other problems in patients.

In her research on what makes a healthy follicle and a healthy egg, she was able to draw parallels with hormones and female sexual tissue. Tissue is at the heart of graft-versus-host disease because it stems from receiving any kind of cells from someone else. Those cells contain different proteins which the host immune system hasn’t seen.

That can manifest itself in joint and muscle problems, eye problems and autoimmune diseases such as rheumatoid arthritis and lupus. It can also affect the reproductive system, but McGee noted, the problems were only beginning to be traced back to graft-versus-host disease. Some women were experiencing daily pain and discomfort, and it in its most severe form, the disease produced scaring that could close the vagina.

The commonality?

“This is all dealing with hormones and growth factors and female tissue,” Dr. McGee said.

“These women are having problems and truly suffering,” she said. “The quality of their life is truly diminished – and the quality of their partners’ lives, as well. That’s a big motivating factor, to find ways to keep this from happening or to treat it – to use what I’ve learned in science to help.”

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

Public health professor explores mind-body connections

By Jody Taylor

As Briana Mezuk, Ph.D., developed her research profile, she encountered a classic “which came first question” – Do the elderly sometimes become depressed because they suffer from old-age illnesses? Or does depression exacerbate the illnesses?

Mezuk, an assistant professor in the Department of Epidemiology and Community Health, focuses her attention on the relationship between mental and physical health. This relationship has an inescapable implication for women, who are two times more likely to develop depression. And according to the National Osteoporosis Foundation, women are 80 percent more likely to develop osteoporosis, a low bone-density condition.

“We need a more holistic view of how psychiatric conditions relate to health,” Mezuk says.

Her current research, based on a grant from the National Institute of Mental Health, examines depression and Type 2 diabetes.  It suggests that a relationship between late-life depression and vascular diseases such as diabetes may exist.

“A history of mental health seems to be a stronger predictor of diabetes than the reverse,” she says. “The disease likely doesn’t trigger depression.”

The study uses twin samples to test competing ideas. For example, a common element like stress could immune systems?

The study follows a pattern that Mezuk established in earlier research, which focused on depression and the onset of frailty in older adults. This study, which was recently completed as a part of the VCU Building Interdisciplinary Research Careers in Women’s Health, also found that symptoms can overlap.

“It’s sort of a tomato or tomatoe question,” she says. “Geriatric folks call it frailty. Psychologists call it depression. Losing the quality of life, which frailty would go along with, is a predictor of depression.”

The research grew out of Mezuk’s interest in the links between osteoporosis and depression. The biological reasons for depression, she found, also hurt bones. Often people who are depressed don’t exercise and they suffer from a loss of appetite.

Operating under the assumption that people become depressed because they are sick may be faulty reasoning, Mezuk says. There may be many factors that drive old-age illnesses, including the consequences of behavior that took place years before – including undiagnosed and untreated depression.

“I’m trying to understand these processes,” she says. “What consequences do they have over the life course? How do mental and physical health connect?”

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.


 

Wilson studies links to family history and breast cancer screening, prevention choices

By Jody Taylor

Does having breast cancer in the family motivate family members to be more adherent to screening and health behavior recommendations than individuals without such a family history?

Sometimes, as Dr. Diane Baer Wilson, Ed.D., M.S., R.D., found, the answer is “yes.” And “no.”

Using data collected from a study of daughters whose mothers had breast cancer, the associate professor in the VCU Department of General Internal Medicine and Massey Cancer Center, examined mammography screening practices and health behaviors including fruit/vegetable intake, exercise, alcohol intake, smoking and BMI (body mass intake) in daughters and compared the same measures with women in the general population.

The findings: Daughters (> 40 years old) of moms with breast cancer were significantly more likely than women in the general population to have “ever” had, and more recently have had, a mammogram.

“However, when we look at other health behaviors, there was no difference between groups for body mass index (BMI), exercise, smoking and alcohol consumption,” she said.

In fact, she said, the daughters were found to consume significantly fewer fruits and vegetables  — one of the staples of a good diet — than the general population.

“The results were interesting in that the daughters were more likely than the general population to have received a recent mammogram, indicating the importance of breast cancer screening. However, having a family history of cancer did not seem to motivate daughters related to adherence to health behaviors and BMI recommendations to any greater degree than women in the general population.”

Wilson’s research concentrates on the role of diet and exercise in cancer risk reduction. It isn’t surprising that those who are more physically active get fewer cancers. But if there is already a cancer diagnosis in your family, will you change your behaviors to lessen your risk?

“Scientists estimate that two-thirds of all cancers could be prevented” simply by not smoking, controlling alcohol consumption, eating in a more healthy way and introducing exercise into a sedentary lifestyle, she said.

That can be as simple as taking a walk.

Earlier, Wilson developed and tested a low-impact exercise program, “Walking Counts!” for African American breast cancer survivors, a population who have higher breast-cancer mortality rate than their white counterparts.

Each participant received a walking calendar and a pedometer, with a goal to work up to walking 10,000 steps a day. Participants could walk alone or form walking groups to support the formation of a healthy habit. Researchers found that simply wearing the pedometer encouraged participants to walk more.

“If adults start doing this, they’ll be great role models for their kids. As their children get older, they tend to mimic the patterns seen in their own household,” Wilson said. “Walking for exercise has been shown to reduce risk of several chronic diseases. This is really the good news.”

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

Complexities of PTSD rooted in neurobiological, genetic and gender causes

Odds are that up to half the U.S. population could be exposed to a traumatic event such as a sexual assault, car accident, a natural disaster or military exposure. This experience, for a certain number of people, results in post-traumatic stress disorder, or PTSD, according to Ananda B. Amstadter, Ph.D., assistant professor of psychiatry at the Virginia Commonwealth University School of Medicine and the Virginia Institute for Psychiatric and Behavioral Genetics.

Her work adds to the growing base of knowledge of the neurobiological and genetic bases of behavior that put mental illness on par with physical illness. Additionally, research is opening doors to explore novel and effective treatments for mental disorders.

Amstadter is an active researcher in the area of traumatic stress. She looks at genetic predictors of traumatic stress-related conditions and gene-by-environment interactions. She said the anxiety disorder is relatively common and can affect anybody in the population, from young children to older adults. Individuals who experience PTSD generally have a cluster of symptoms including re-experiencing the event, avoiding anything or anyone that is related to or reminds them of the event, feeling emotionally numb following a traumatic event and hyper-vigilance, or being extra alert to any signs of threat.

“PTSD affects approximately 8 percent of the population, but varies depending on the type of trauma a person experiences. For example, events such as physical assault or sexual assault tend to be linked to a higher rate of PTSD than the rates for a motor vehicle accident or a natural disaster,” explained Amstadter.

The treatment of PTSD can involve a variety of psychosocial treatments, including cognitive behavioral therapy, or CBT. This form of therapy does not involve the use of medications. Generally during a CBT counseling session, a therapist will work with an individual to approach the traumatic or feared event and talk about what happened. The therapist can lead the individual to re-experience the traumatic episode in a way that will help them move past the fear to which they have become accustomed.

“One of the hallmark symptoms of PTSD is avoidance. Often times, affected individuals will avoid thinking and talking about the event. They may also likely avoid anything that reminds them of the event,” said Amstadter.

“Unfortunately, this continued avoidance actually doesn’t lead to a natural habituation or a natural getting used to or accepting what happened,” said Amstadter.

Through her research, Amstadter is examining the environmental factors, as well as the biologic and genetic factors, to help understand the post-trauma trajectory of symptoms. For example, her research hopes to help better predict the factors that differentiate individuals who either do not develop symptoms or who experience a naturalistic recovery, from those who develop long-lasting symptoms of a mental health disorder, such as PTSD.

“On the biologic end, we know that about 33 percent of the risk for PTSD is due to genetic factors. We don’t know specifically which genes put people at risk for PTSD and that is what our research is trying to uncover,” said Amstadter.

“If we can determine which genes are involved and understand the effects of a particular variant we may be able to identify people that may need help in the aftermath of a traumatic event,” she said.

Through support from a National Institutes of Health grant, Amstadter and her team are examining the effects of combat history and PTSD status on stress reactivity and subsequent drinking behavior in emerging adults, as well as the role of genetic variants that may play a role in stress-related drinking. Through another NIH grant she is examining the genetic substrates of PTSD in a large epidemiologic study of disaster-exposed youths.

Through her work, she hopes to help to develop an upfront treatment that may prevent PTSD and associated disorders or reduce the suffering of those who encounter it.

In other work, Amstadter is a co-investigator on a research project to develop and determine the effectiveness of a web-based intervention for children and families affected by a disaster.

This article is adapted from 2010 and 2011 VCU University Public Affairs reports on Amstadter’s research.

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.


Breast cancer expert divides time between labs and operating rooms

By Jody Taylor

Initially, Dr. Kazuaki Takabe, M.D. and Ph.D, did’t t see himself as a researcher. As a student at Niigata University School of Medicine in Japan, surgery was his passion and molecular biology was only a means to that end.

But he soon found that breast cancer posed more questions than surgery alone could answer. The statistical reality that 1 in 8 U.S. women will develop breast cancer in her lifetime became a powerful motivator to discover why cancer spreads.

“If you want to save women’s lives, that’s the most effective way,” says Takabe, now an assistant professor of surgical oncology at Virginia Commonwealth University.

Takabe travels between the worlds of surgery and research, dividing his time between the operating room and the lab, where he is investigating the role of Sphingosine-1 phosphate (S1P) in cancer progression. His hope – to connect research to patient care.

“Cancer is scary because it spreads,” Takabe says. “If we can figure out how breast cancer does that, we can be hopeful to prevent it.”

Takabe’s study of S1P began with grants from the National Institutes of Health and the Susan G. Komen for the Cure Foundation. Those grants have been extended, so the work that began four years ago can continue through 2017. It all began as a scholarship project of VCU’s Building Interdisciplinary Research Careers in Women’s Health, which Takabe credits for launching his research career.

His  research focuses on hypothesis that S1P, a lipid mediator — plays a critical role in the spread of breast cancer. It’s important to note that it’s a  lipid and not a protein, Takabe says, because the role of lipids in cancer is vastly understudied to date compared to proteins.

Takabe says S1P plays a role in the development of new blood and lymphatic vessels in response to cancer progression. This could provide tubes through which breast cancer can spread to the lymph nodes and beyond.

“That’s the science part of it,” Takabe said. “But we want the science to be useful. What we’re talking about is how a lump can spread. And, more importantly, how can we stop it?”

To that end, the research team, which includes Department of Biochemistry and Molecular Biology chair Sarah Spiegel, Ph.D., and Harry Bear, M.D., Ph.D., the chairman of the Division of Surgical Oncology, is examining an existing drug that could have implications for breast-cancer treatment.

The drug, which is called FTY720, has been approved by the Food and Drug Administration to treat multiple sclerosis. The VCU team wants to see whether the same drug, which targets S1P signaling, could also be effective in treating cancer, including breast cancer.

Studies of the effects of FTY720 on mice with breast or colon cancer have shown very promising results to slow down its progression. Takabe and his group are investigating the ideal condition to use this drug on patients through the start of a clinical trial.

A reluctant student of molecular biology two decades ago, Takabe now serves as an affiliate faculty member in the Department of Biochemistry and Molecular Biology. He sees his dual medical roles as a way to connect the dots.

“I am a surgeon who is doing research,” he says.

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

 

Gates Foundation supports HIV researchers

VCU is a Grand Challenges Explorations winner, an initiative funded by the Bill & Melinda Gates Foundation.

With the $100,000 grant, researchers from the VCU Institute for Women’s HealthVCU schools of MedicineNursing, and World Studies in the VCU College of Humanities and Sciences, will work with community partners in Ségou, Mali, to pursue an innovative global health and development research project, titled “Reducing Harmful Inflammation and Attenuating Immune System Deterioration in HIV-Infected Malian Women.”

“This award will help us determine how certain beneficial intestinal bacteria in HIV-infected women in Africa relate to immune system function,” said principal investigator Daniel Nixon, D.O., Ph.D., director of the VCU HIV Center and associate professor in the Department of Internal Medicine. Patricia Cummins, Ph.D., professor of French in the VCU School of World Studies, and Saba Masho, M.D., associate professor of epidemiology and community health in the VCU School of Medicine, serve as co-principal investigators of the study.

More from VCU Across the Spectrum

Community-based research reduces poor birth outcomes

By Jody Taylor

Saba Masho, M.D., associate professor of Epidemiology and Community Health and Obstetrics and Gynecology, says it is all about the communities we serve. Her work with Richmond Healthy Start is centered upon a goal of reducing poor birth outcomes, including low birth weight and premature delivery, among African-American women.

Masho has worked on the Richmond Healthy Start initiative since 2003. Healthy Start is a federally funded program designed to provide care to low-income pregnant women. The services include screening, referral and comprehensive case management that encompass home visitation programs. She first became involved in the Healthy Start program as a graduate student at the University of California at Berkeley.

The Oakland Healthy Start project allowed her to understand issues surrounding racial disparities in perinatal health. Additionally, it provided her the opportunity to witness the complexity of this important public health problem. She learned that there are so many unanswered questions, which led her to focus her research in maternal and child health. She says one of the most important problems faced by public health professionals is the lack of evidence-based practices to guide interventions.

The project allowed her to work with stakeholders, including patients, providers and researchers. Most importantly, she says, the project allowed her to work with underserved communities who are in need of services. It is clear Masho enjoys working with the community.

“I wanted to be involved in community-based work – that has been my passion for a very long time,” she said. “I wanted to work with mothers and children. Clearly, they are vulnerable, underserved and voiceless, and I have always wanted to be a part of the solution and engage in the area of health service research, policy evaluation.”

Moving to Richmond provided her with the opportunity to work with the Richmond Healthy Start initiative. “After completing my doctoral work, it made it very natural to continue with initiative in Richmond,” she said. “The project opened doors to work with communities.”

Her research questions revolve around relevant areas identified by community partners, including patients and providers. She believes that communities and providers are in need of evidence-based practices to inform effective interventions.

“For instance, there once was a recommendation that women should gain as much weight as possible to reduce poor birth outcome,” said  Masho. “This was regardless of the women’s prepregnancy weight. It is only recently that we have learned that the weight gain should depend on the prepregnancy weight of the mother.”

In general, infant mortality and perinatal disparities are complex issues that require the collaboration of multidisciplinary sectors.

“The whole idea is to bring different partners together,” she said. “This is not something one particular agency could address. It is really a collective approach. To successfully improve outcomes, it is imperative that we engage the community.”

About VCU and the VCU Medical Center 

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

 

 

Antidepressant can treat major depression tied to perimenopause and menopause

An antidepressant can alleviate symptoms of major depression in women experiencing or about to experience menopause, according to a study led by a Virginia Commonwealth University researcher.

The research compared the effectiveness and safety of the antidepressant desvenlafaxine, known as Pristiq, to a placebo in a double-blind trial led by Susan G. Kornstein, M.D., a professor of psychiatry and obstetrics/gynecology in the VCU School of Medicine. It was published in the Journal of Clinical Psychiatry.

In the United States, depression is approximately twice as common in women as in men. More than 20 percent of women will experience depression in the course of their lifetime, and depression seems to be influenced by reproductive events, such as the menstrual cycle, the postpartum period and menopause.

Research, including earlier work by Kornstein, has shown that women may respond to antidepressants differently from men and may also respond to medication differently at different times in their lives, she said.

“It’s really an assumption to say that because an antidepressant works for depression in general that it works for depression related to reproductive events,” she said. “This is the first large study testing the effectiveness of an antidepressant specifically in peri- and postmenopausal women with depression.”

Kornstein is an internationally recognized researcher in women’s mental health and depression at VCU who studies how depression affects women across their life span and the influence of the menstrual cycle and menopausal status on depression and its treatment.

Some women report mood swings, irritability, anxiety and depression in the years leading up to menopause, called the perimenopause. The reason for these emotional problems isn’t  known, but the drop in estrogen levels that typically occurs during perimenopause and menopause may affect mood. The transition to menopause has been shown to be a high-risk period for major depression, in women both with and without a past history of depression.

Kornstein and colleagues evaluated Pristiq’s ability to alleviate major depression among women experiencing or about to experience menopause. The study enrolled 387 women who were peri-or postmenopausal and were diagnosed with major depression at 37 outpatient sites across the country. The women were randomly assigned to take either 100 mg or 200 mg daily of Pristiq or placebo for eight weeks.

The study found that women who took Pristiq showed significant improvement as measured by the 17-item Hamilton Depression Rating Scale and other psychological tests. The response rates were 58.6 percent for those taking Prstiq, compared to 38.2 percent for those on placebo. The drug was effective among the subgroups of perimenopausal women as well as those who were postmenopausal.

At the time the study started, the federal Food and Drug Administration had not yet approved Pristiq, which patients now typically take in 50 mg daily doses to treat depression. Kornstein said she is about to start recruiting patients for a new, similar study using the 50 mg daily dose.

Pristiq works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance. It is manufactured by Pfizer and was approved in 2008 to treat depression among adults. Wyeth, now a subsidiary of Pfizer, financially supported the study.

Kornstein, a consultant for Pfizer, is co-founder and executive director of the VCU Mood Disorders Institute and of the VCU Institute for Women’s Health, a groundbreaking center for treatment, research, education, and community outreach. She is also medical director of the VCU Clinical Trials Office. Her co-authors from Pfizer were Qin Jiang; Sujana Reddy, M.D.; Jeff J. Musgnung; and Christine J. Guico-Pabia, M.D., MBA, MPH.

About VCU and the VCU Medical Center

A version of this news article by Sathya Achia Abraham and the VCU Office of Public Affairs was published in August 2011. Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

 

VCU researchers study factors in preterm births

Several VCU investigators are focusing research efforts on health disparities among racial and ethnic populations, specifically looking at preterm births. Despite improvements to the nation’s general health, African-American women experience adverse pregnancy outcomes much more frequently than whites, resulting in infant death rates that are more than twice those of the white population.

Examining a variety of factors, including genetic and environmental, the research is funded through a P60 grant from the National Institute on Minority Health and Health Disparities.

“We have three main research themes: the identification of genetic factors that predict preterm births; the role of the vaginal microbiome in preterm birth; and the discovery of epigenetic and environmental factors that contribute to preterm birth,” said Jerome F. Strauss III, M.D., Ph.D., dean of the VCU School of Medicine, who is leading the research on maternal and fetal genomes.

Kimberly Jefferson, Ph.D., associate professor of microbiology and immunology, is leading the research on the role of infection within the vagina, and Timothy P. York, Ph.D., assistant professor of human and molecular genetics, is working on the epigenetic studies. The three themes are interrelated, according to Strauss, and the research teams are using a collaborative approach in studying this complex problem.

“This is the first major study to quantify the role of genetic factors and the environment in preterm birth in different populations. In addition, the vaginal microbiome is being comprehensively investigated so the role of specific microorganisms in preterm birth can be elucidated,” said Strauss.

A long-term aim is to determine how environmental factors, such as infection, interact with the genome to promote prematurity. The microbiome is a community of microorganisms, or microbes, inhabiting the human body. They inhabit almost every part of the human body, including on the skin, in the nose, mouth and gut, and in the urogenital area.  Sometimes they cause sickness, but most of the time the microorganisms live in harmony with their human hosts, even providing vital functions essential for human survival. Researchers at VCU are studying how microorganisms found in the vagina influence health and disease in women.

The research team at VCU has also identified a genetic variant that may account for the higher rates of premature delivery experienced by African-American women compared with European-American women. The findings may help physicians identify patients who might benefit from therapeutic interventions and preventative measures, including lifestyle change or medical therapy to reduce the risk of premature birth.

For more information about health disparity research, visit the VCU Center on Health Disparities website at www.healthdisparities.vcu.edu.

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.