University of Louisville neurologist and researcher Robert P. Friedland, M.D., a professor in the Department of Neurology, will teach and conduct research in Japan during a one-year sabbatical beginning May 1. Friedland will conduct research on neurodegenerative diseases at the Kyoto Prefectural University of Medicine (KPUM). The work is funded by a long-term Invitational Fellowship for Research in Japan from the Japan Society for the Promotion of Science (JSPS) which was awarded through a competitive selection process.

Friedland has studied Alzheimer’s disease, dementia and related conditions for more than 30 years. His previous work has uncovered the role of amyloid proteins made by intestinal and oral bacteria in neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease), Alzheimer’s disease and Parkinson’s disease. Previously, Friedland worked with researchers at the National Cerebral and Cardiovascular Center in Osaka to reveal the important influence of oral bacteria on the development of hemorrhagic stroke.

In Kyoto, Friedland will further investigate the influence of the microbiota on neurodegenerative disease models in fruit flies. He plans tests to determine the influence of functional bacterial amyloid proteins on the aggregation of brain proteins, a key element of neurodegenerative diseases. Friedland will collaborate in this research with Toshiki Mizuno, Ph.D., of the KPUM Division of Neurology and Gerontology, one of several Japanese researchers with whom Friedland has worked for several decades.

He also will conduct research with collaborators at the Kyoto Institute of Technology.

“I am excited to have the opportunity to collaborate further with my Japanese colleagues and to conduct this research in Kyoto,” Friedland said.

JSPS awards fellowships to select international researchers to conduct collaborative work with researchers in Japan. Long-term fellowships for 2020 have been awarded in agriculture, engineering, chemistry, math, humanities and medicine. Friedland received one of four fellowships in the field of medicine.

After his year in Kyoto, Friedland will continue his research and clinical work at UofL, where his collaborators in the lab of Levi Beverly, Ph.D., currently are finishing data analysis on a study of the influence of bacterial amyloid on ALS in mice.

Faculty from the Department of Pharmacology and Toxicology were honored at the inaugural School of Medicine Celebration of Faculty Excellence on February 18.

• Dr. La Creis Kidd received the multicultural teaching award. 
• Dr. Scott Whittemore received the Outstanding Scholarship, Research and Creative Activity Award for Career Achievement.
• Dr. Christopher States was nominated for Outstanding Scholarship, Research and Creative Activity Award in the basic and applied sciences.

Flavors and aromas are the key to great beer. Kristy Holsopple and Sam Gambill have developed some uniquely flavored beers for their microbrewery, Holsopple Brewing, including brews flavored with blueberry, toasted hemp seeds and cinnamon, to name just a few.

Holsopple, a microbiologist, and Gambill met at a brewery and each have 15 years in the alcohol manufacturing industry. Now married with two young boys, they share their brewing talents with customers at the brewery. At the next Beer with a Scientist, Holsopple and Gambill will discuss beer sensory terms and how raw materials and yeast create beer aromas and flavor.

The talk begins at 7 p.m. on Wednesday, Feb. 26 at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer or other items is not required but is encouraged. Organizers encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. At these events, the public is invited to enjoy exactly what the title promises:  beer and science.

A new collaboration with Pfizer Inc. will enable the University of Louisville’s Division of Infectious Diseases to play a significant role in epidemiological research related to vaccine-preventable diseases affecting adults, including the elderly.

UofL has been designated the first Center of Excellence by Pfizer Vaccines.

“UofL’s Division of Infectious Diseases has a rich history of collaboration with Pfizer through the successful implementation of numerous clinical epidemiological research studies. We are excited to formalize a long-term collaboration that builds on these past successes,” said Julio Ramirez, M.D., chief of the Division of Infectious Diseases at the University of Louisville.

The Center of Excellence, directed by Ramirez, is a collaboration between the university and the pharmaceutical corporation aimed at determining the human health burden of important infectious diseases and potential vaccine effectiveness. The data will provide robust evidence to national health officials and independent policy makers who develop recommendations for the use of vaccines in immunization programs worldwide. Studies will take place in hospitals, long-term care facilities and the community.

UofL is the first Center of Excellence selected by Pfizer Vaccines Medical Development and Scientific/Clinical Affairs to be part of an international network of epidemiological research organizations. This designation is for a period of three years with an option for renewal. Pfizer selected UofL because of the university’s exceptional capabilities for conducting population-based surveillance and clinical research that engages multiple health care facilities, health care personnel, industry and communities-at-large.

“Pfizer has had an outstanding working relationship with the University of Louisville for more than 10 years,” said Luis Jodar, Ph.D., chief medical and scientific affairs officer, Pfizer Vaccines. “The quality of disease burden evidence varies widely worldwide. Deriving accurate and credible population-based incidence estimates require comprehensive surveillance to identify cases of diseases within a well-defined and well-characterized geographic area. Thanks to UofL’s excellent network of research partners, the population available for research studies in Louisville can provide the data to derive estimates of disease burden that can be generalized nationally.”

The demographics of Jefferson County, Kentucky, are similar to the United States in general, including racial and ethnic make-up, socioeconomic status, and the proportion of rural and urban populations.

The research studies conducted as part of the center may lead to economic growth and development for the city of Louisville and the Kentuckiana region, including jobs and educational opportunities in the health care industry.

“This collaboration will provide increased visibility for the university on a global scale, making UofL attractive for high-caliber researchers and research grants,” said Neeli Bendapudi, Ph.D., president of UofL. ”It also presents an exceptional opportunity for our researchers to improve the human condition by helping to reduce the burden of infectious diseases worldwide by generating data that will inform governments and health care policymakers.”

Pfizer studies anticipated for UofL include population-based surveillance of infectious diseases including Streptococcus pneumoniae, a bacteria which causes pneumonia and other infections, Clostridioides difficile, a bacteria that causes severe diarrhea and colitis, and respiratory syncytial virus (RSV), a common virus associated with mild cold-like symptoms but can cause severe infection in some people, including older adults. Visit CERIDLouisville.org/research for additional information on these diseases and two Center of Excellence studies already underway at UofL:

• The City of Louisville Diarrhea (CLOUD) study launched in September 2019. Pfizer will be providing up to $6.5 million in funding for a one-year study of the incidence of diarrhea among Louisville-area residents.
• The Louisville Pneumonia study is up to $4.5 million in funding provided by Pfizer for a one-year study of the incidence of pneumonia among adults in Louisville that launched in November 2019.

Watch a video here

Technologies in development by researchers at the University of Louisville are aimed at ensuring astronauts on long-range space missions have access to medical care. A UofL research team recently tested rehydrating dried red blood cells in a weightless environment. The UofL group completed more than 50 weightless cycles during two flights to test rehydrating the blood and the use of 3D-printed surgical instruments aboard a ZERO-G aircraft.

ZERO-G is a privately owned company that uses a modified Boeing 727 jet to create a weightless environment using parabolic flight patterns. The experiments, sponsored by NASA, are designed to ensure that crews have access to proper medical treatment during long-range exploration space flights, such as to Mars.

Michael Menze, Ph.D., associate professor of biology, and Jonathan Kopechek, Ph.D., assistant professor of bioengineering at UofL, lead a team that has developed several methods for drying blood to enable it to be stored for long periods of time without refrigeration. The dried blood then can be rehydrated using sterile water when it is needed. Current methods for storing blood require constant refrigeration and the blood can only be stored for six weeks, which would not be sufficient for crews on years-long space missions.

“If cosmic radiation reduces red blood cell count, for example, you are not going to have a donor and a recipient [with a four-person flight crew], you are going to have four people needing blood and there is no good way to store it during a long space trip of months or years,” said Brett Janis, a graduate research assistant who also is involved in the project. “So being able to store it in a dried state and then confidently rehydrate it is critical.”

The dried blood is typically rehydrated by adding water and inverting the container, Menze said. This method relies on normal gravity, however, so the researchers devised other methods for potential use in space. [See a video about the project HERE.]

To develop testing procedures, Menze worked with George Pantalos, Ph.D., professor in the Department of Cardiovascular and Thoracic Surgery. Pantalos tested medical equipment in a weightless environment in the past and customized a glovebox enclosure he developed for his research for these experiments.

“If you are in reduced gravity or zero gravity, will the red blood cells rehydrate correctly and will they function like normal red blood cells, transporting oxygen to the tissues of the body,” Pantalos said.

Pantalos, Menze and Janis, along with other researchers and five students, designed and prepared the tests to rehydrate the blood cells and traveled to Florida with the glovebox and equipment in November 2019 to conduct the experiments aboard the ZERO-G aircraft. During the tests, the team assembled a bag with the powdered blood cells, a syringe and sterilized water in the glovebox. There they tested multiple techniques to rehydrate the cells during the weightless phases of flight.

“We tested two different ways of assisting in the mixing of liquid and powdered red blood cells,” Menze said. “We used pliable plastic bags instead of hard-plastic containers for the mixing. The water was added to the bag from an attached syringe and the liquid and powder were mixed by ‘massaging’ the bag or by using a second attached syringe and moving the liquid in and out of the bag. The ‘massage’ methods seem to work a bit better.”

Pantalos said the glove box and planned experiment techniques worked well, allowing the scientists and students to complete all the planned tests on the blood cells, which had been dehydrated using two different methods -- spray-dried and freeze-dried -- in 5 milliliter and 10 milliliter volumes. After the aircraft landed, the rehydrated samples were analyzed by a ground crew for evaluation to see if they are suitable for infusion into a patient.

“We found that the oxygen-carrying capacity of the blood was comparable to what we find when we are rehydrating our blood at one-earth gravity,” Menze said. “I was really excited.”

During the flight, Pantalos also tested the use of 3D-printed instruments to simulate basic surgical tasks such as incision and retraction. By 3-D printing tools and instruments they need aboard the spacecraft, it is possible for the crew to take basic materials and create specific pieces according to needs that arise during the mission rather than trying to anticipate all potential medical needs in advance.

The NASA Flight Opportunities Program, which supports projects for developing technology appropriate for use in space flight, funded the preparation testing and the flights. The UofL team now is preparing for their next flight campaign, planned for later this year, to test rehydration processes for cells dehydrated using different methods and rehydrating up to 350 milliliters of blood, which would be needed in an actual transfusion therapy situation.

You may have heard about breakthroughs in medical research such as CRISPR, a technology that allows scientists to edit genes, or the microbiota, the bugs that live in and on us and are getting the credit and blame for any number of health conditions. But how can non-scientists understand these subjects and their effects on health and health care?

University of Louisville researcher Levi Beverly, Ph.D., is here to help.

At the next Beer with a Scientist, Beverly, associate professor in the Department of Medicine, will explain these and other recent developments in biomedical research for people without a degree in science.

“We will talk about CRISPR, microbiota and other topics, but we also are asking the audience what they want to learn about,” Beverly said. “People are invited to bring an article or headline they have seen that needs more explanation or to post questions or topics on our Facebook page, Louisville Underground Science.”

Beverly’s talk begins at 7 p.m. on Wednesday, Jan. 22 at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer or other items is not required but is encouraged. Organizers encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. At these events, the public is invited to enjoy exactly what the title promises:  beer and science.

UofL was well represented at the AASLD (American Association for the Study of Liver Diseases) annual Liver Week, in Boston on November 13-17 2019.  We had more than 15 presentations, including several oral presentations on topics ranging from environmental liver injury to alcohol associated liver disease.  Dr. Craig McClain co-chaired the Alcohol SIG (Special Interest Group) meeting. 

https://www.aasld.org/event/liver-meeting

Dr. James Collins joined the faculty as tenure-track Assistant Professor of Microbiology and Immunology, starting January 1, 2020.  Dr. Collins’ research focuses on the factors that underlie the spread of of epidemic, hypervirulent Clostridium difficile.  His recent discovery of the link between dietary trehalose and C difficile virulence was recently published in Nature (https://www.ncbi.nlm.nih.gov/pubmed/29310122).  Welcome James!

Selected for her leadership in the area of geriatric education, Anna Faul, PhD, executive director, University of Louisville Trager Institute, has been elected to join the executive board of the National Association for Geriatric Education (N-AGE).

N-AGE is a non-profit membership organization representing geriatric education centers and other organizations that provide education and training to health professionals. The organization seeks to improve the quality of health care for older adults, including underserved and minority groups. N-AGE is a leading national voice for building a robust pipeline at every level of education to increase the size and skill set of students and professionals in the aging-related workforce.

“I am honored to be selected for this national leadership position. As a long-time educator in the field of gerontology, I am deeply passionate about increasing the workforce size and improving the skills of the aging-related workforce,” Faul said. “Workforce development is one of the UofL Trager Institute’s strategic initiatives and we have received several HRSA-funded grants to support this goal. I look forward to taking what we have learned from these programs to a national level.”

“We are thrilled that Dr. Faul has joined the N-AGE Board of Directors. She is an experienced leader in the field who brings a wealth of knowledge about aging services and geriatrics,” said Catherine P. Carrico, PhD, president of the N-AGE board.

As a new board member, Faul will serve as chair of the Education and Training Committee. In this role, she will further the committee’s goal of enhancing nationwide opportunities for the education of health care practitioners in geriatrics and gerontology. Specifically, Faul will work to increase the visibility of HRSA Geriatric Workforce Enhancement Programs and Geriatrics Academic Career Awards. This builds on her experience as principal investigator for both the UofL Trager Institute’s HRSA Geriatric Workforce Enhancement Program and HRSA Behavioral Health Workforce Enhancement Program. She also has served as mentor for Samantha Cotton, PhD, program manager at the UofL Trager Institute and 2019 Geriatrics Academic Career Award recipient.

Faul learned of her board selection during the 2019 Gerontological Society of America’s 2019 Annual Scientific Meeting in Austin, Texas. She begins her 3-year term on the N-AGE board in January 2020.

“I am grateful and excited to begin this new role on the National Association for Geriatric Education Board. This is an incredible opportunity to elevate the leadership of the UofL Trager Institute, and the University of Louisville in shaping the future of geriatric education in our country,” Faul said.

Rachel Safeek, a second-year medical student at the University of Louisville, is calling for medical schools to train future physicians in techniques to help prevent injuries and death caused by firearms. Her work has led to UofL being one of the first medical schools to incorporate this training for all students.

“About 40,000 Americans die and 85,000 others are injured each year from firearm-related causes, and the incidence of firearm-related morbidity and mortality has increased over the past decade,” Safeek said. “This is a very important public health issue. My classmates, colleagues and I believe that physicians have a role in counseling patients related to their health and we have an opportunity through those interactions to help reduce the number of firearm-related deaths and injuries.”

In September, Safeek and her colleagues wrote and presented a resolution that was adopted by the Kentucky Medical Association (KMA) to support training in Kentucky’s medical schools to reduce firearm-related morbidity and mortality in their curriculum. She presented a similar resolution at the American Medical Association conference in November, which was adopted by the American Medical Association Medical Student Section.

The resolution calls for all future physicians to have training to counsel patients in safe firearm use and storage, to know how to screen patients for suicide risk and to learn trauma-related first response techniques.

At UofL, Safeek presented a curriculum plan she coauthored with faculty members Suzanne McGee, M.D., and Charles Kodner, M.D., and Susan Sawning, M.S.S.W., to the School of Medicine’s Educational Program Committee, which voted to include it in the school’s curriculum beginning with the 2020-2021 academic year.

To jump-start the training effort, Safeek and other students and faculty have partnered with Whitney/Strong to organize a week-long series of optional events to educate UofL medical students, faculty and residents on firearm violence prevention, scheduled for February.

“Our hope is that more medical schools will incorporate this type of training into their programs and doctors will be able to help make a difference in this health crisis,” Safeek said.

For Priya Chandan, M.D., M.P.H., creating an inclusive world for individuals with intellectual disability is a life mission. Inspired by her older brother who has Down syndrome, Chandan is leading efforts to ensure all health care professionals are trained to treat adults with intellectual disabilities.

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has presented Chandan the Distinguished Public Service Award at the organization’s annual assembly in San Antonio, Texas. Chandan, assistant professor in the University of Louisville’s Division of Physical Medicine and Rehabilitation (PM&R) and the Department of Health Promotion and Behavioral Sciences, was selected thanks to her efforts at ensuring inclusive health through innovations in medical education and her work with Special Olympics.

In a ceremony last month, Chandan received the award, established to honor individuals who, in the course of public service activities, have significantly contributed to the growth and development of services that directly impact the specialty of PM&R. Previous winners of the award include Michelle Obama, Judith E. Heumann, an international disability rights activist, and numerous members of Congress.

Chandan is committed to inclusive health, the intentional inclusion of all people, including people with intellectual disabilities (ID), in mainstream health services, training programs, research, funding streams, policies and laws.

“Intentional inclusion of people with disabilities in the spaces physicians occupy — clinical, research and teaching environments — is critical for repairing trust with marginalized communities, including the 1 in 4 American adults with a disability,” Chandan said. “Historically, medicine has been part of the problem, which means we have a responsibility to be part of the solution moving forward by engaging in advocacy efforts together with the patients we serve.”

Chandan’s personal experience with her brother has given her a personal understanding of the need for physicians who can provide equitable care for people with ID. She led AAPM&R’s Inclusive Health Innovation grant from the Special Olympics, which involved policy, education and advocacy activities, including the creation of an AAPM&R Intellectual Disability Member Community.

“Dr. Chandan is taking her personal experience and has turned it into a passion that she uses every day in her career,” said Darryl Kaelin, M.D., chief of the UofL Division of Physical Medicine and Rehabilitation. “She is making better care for individuals with intellectual disability a local and national goal. She represents the University of Louisville well.”

Chandan directs the National Curriculum Initiative in Developmental Medicine, a partnership between Special Olympics International and the American Academy of Developmental Medicine and Dentistry to ensure future physicians receive training to care for individuals with ID across their lifespan. For this program, she oversees inclusive medical education efforts at 18 medical schools nationwide and led UofL’s participation in the program, partnering with Special Olympics Kentucky and Lee Specialty Clinic.

Chandan also received funding from WITH Foundation to further develop medical education in the form of a standardized patient experience for PM&R residents using actors from Down Syndrome of Louisville.

Chandan is involved in Special Olympics International's Inclusive Health movement, where she serves as a content expert for the Center for Inclusive Health, an online resource for health care providers and other audiences for ways to intentionally include people with intellectual disability in mainstream health care services, training programs and research. She also is a global clinical advisor for MedFest, the Special Olympics Healthy Athletes program that provides free pre-participation sports physical exams to athletes with ID. She has engaged residents and faculty in MedFest efforts in Virginia, North Carolina and Kentucky.

Chandan was a member of the 2018-19 cohort of the faculty leadership program at UofL, Leadership and Innovation in Academic Medicine (LIAM). As part of the year-long leadership curriculum, she and her group colleagues piloted interactive, online topic tournaments to increase active, self-directed learning opportunities in the medical school curriculum.

University of Louisville medical residents in collaboration with the UofL Office of Graduate Medical Education will make the holidays brighter for children in the community through their Toys for Tots toy drive. This is the fifth year 700 residents in 70-plus programs have made Toys for Tots the focus of their holiday service mission. This year the residents exceeded their goal of 1,000 toys. 

Ms. Stephanie Kittle, B.S. and Ms. Shelley Spalding, M.A., M.A.T. joined the Department on December 9 as our new Unit Business Manager and Graduate Program Coordinator, respectively.  Stephanie was the UBM at the Diabetes and Obesity Center in the School of Medicine previously.  Shelley was a student teacher at Bardstown High School prior to her current position.  Welcome Stephanie and Shelley!

It was another blockbuster performance for the University of Louisville Internal Medicine Residency Program as a long list of soon-to-be graduated residents learned their future destinations in the recent fellowship match.

Six of those will continue their education at UofL.

"This match outcome represents two and half years of careful preparation by our residents," Dr. Jennifer Koch, director of the Internal Medicine Residency Program said. "They have worked hard to develop excellent clinical skills and contribute to scholarly work in their respective fields. I am proud of each of them!"

Those from The University of Louisville who matched for 2020 include:

Children with spinal cord injuries have experienced remarkable results in recovery at the University of Louisville and Frazier Rehab Institute through locomotor training, a therapy designed to help them recover the ability to sit, stand and even walk. In locomotor training, the child is suspended over a treadmill and his or her feet are moved by trainers in a stepping motion. This taps into capability of the spinal cord to help the child regain movement and trunk control.

Andrea Behrman, Ph.D., of the UofL Department of Neurological Surgery and the Kentucky Spinal Cord Injury Research Center (KSCIRC), pioneered the use of locomotor training in children at UofL since 2012. Until now, however, Behrman’s team has used treadmills and harnesses designed for adults that have been adapted for children. The oversized equipment is cumbersome for children and working on cut-down adult-sized devices has resulted in unnecessary strain for the trainers and therapists who work with them.

So Behrman enlisted Tommy Roussel, Ph.D. of the Department of Bioengineering at UofL, to engineer a treadmill and harness system specifically for young children. Using engineering expertise, user feedback and a patent held by Susan Harkema, Ph.D., professor of neurosurgery and pioneer in spinal cord injury research in adults at UofL, a new treadmill was designed from the ground up just for children. [See video]

“It was kind of like putting a kid on an adult bicycle or watching kids play basketball with a ten-foot goal,” Roussel said. “So we have redesigned the system with the same operational capacity but with kids in mind.”

The new pediatric treadmill has multiple advantages for both children and trainers:

• Suspension tower is located behind the child on the treadmill so therapists can more easily and directly engage with the child
• Narrower tread, focusing the child’s steps and bringing trainers closer to the child’s legs and feet
• Trainers’ seats are more appropriately positioned closer to the child and are adjustable to accommodate trainers of different heights
• Treadmill tower swivels to allow the child to be hoisted from a wheelchair and onto the treadmill
• Smaller, more adaptable harness that is more comfortable and easier to adjust to the child’s changing capability

“The treadmill is a tool for us, but we want it to be a smart tool. By making it better, we are going to do our jobs better and the child is going to participate better,” Behrman said. “We changed it to make the child more accessible to the trainer with good body posture and position for all this repetitive activity.”

Thanks to funding and support from the Coulter Translational Partnership at UofL, the team was able to develop the initial prototype. Behrman and Roussel then collaborated with other specialized manufacturers, further refining the treadmill and harnesses. Once they had a customized treadmill, the team worked to commercialize the device and harness system to make it available to therapists in other centers.

“We starting thinking, ‘How can we make it better?’” Roussel said. “If we are going to move to manufacturing this, how can we make it more modular and with fewer parts that need to be assembled? That’s where the magic and the fun happened.”

The treadmill design was licensed to Power Neurorecovery and units are in place or on their way to facilities in Pittsburgh, Houston and New York, as well as in Louisville at Frazier Rehab Institute.

“In the last several years, we have been able to achieve things that have not historically happened in terms of rehabilitation outcomes for these children,” Behrman said. "Children once unable to sit on their own, for example, can now do so due to locomotor training. Such improvements open up other possibilities to play and engage, and help a child get back on the developmental track. This new treadmill system gives physical therapists and trainers a device that is state-of-the-art in design and utility and revolutionizes the way we deliver locomotor training specifically for children."

Oct. 28, 2019

Graduate students and postdocs from the Department of Pharmacology and Toxicology swept nearly all of the PhD and Postdoc presentation awards at the annual Ohio Valley Society of Toxicology meeting held on Friday, October 18 at Procter and Gamble, Inc. in Mason, Ohio.

Jamie Young received the first place award for her platform presentation.  Jamie is a PhD candidate in the laboratory of Professor Lu Cai.

Rachel Speer received the first place award for her poster presentation and third place in the Tox on Clock research presentation.  Rachel is a PhD candidate in the laboratory of Professor John Wise Sr.

Ana Cardoso received the first place award for her platform presentation.  Ana is a postdoctoral fellow in the laboratory of Professor Chris States.

Jennifer Toyoda received the first place award in the Tox on Clock research presentation.  Jennifer is a PhD student in the laboratory of Professor John Wise Sr.

Christine Kim received the second place award for her poster presentation. Christine is a PhD candidate in the laboratory of Professor Brian Ceresa.

Idoia Meaza received the third place award for her poster presentation.  Idoia is a PhD student in the laboratory of Professor John Wise Sr.

Cancer patients in Louisville, in Kentucky and throughout the region soon will have access to some of the most advanced immunotherapy treatments available. Louisville resident Thomas E. Dunbar has pledged $1 million to the University of Louisville to create a specialized center to provide chimeric antigen receptor positive T (CAR T) cell therapies to patients at the UofL James Graham Brown Cancer Center and other centers in Kentucky and the Midwest. The new program will be named the Dunbar CAR T-Cell Program.

“This gift will allow both kids and adults to be treated right here in Kentucky with the most innovative cell-based immunotherapy being developed,” said Jason Chesney, M.D., Ph.D., director of the UofL Brown Cancer Center.

See a video of the announcement here.

In CAR T-cell therapies, immune cells are extracted from the patient’s own blood and then are genetically modified to fight cancer. The modified cells are infused back into the patient where they fight the cancer and create long-term immunity to its recurrence. In addition to dramatic treatment results, CAR T-cell immunotherapy leads to fewer toxic side effects than traditional chemotherapy.

“Patients who have been treated with all the conventional therapies who then underwent treatment in clinical trials with CAR T cells had dramatic response rates. Eighty-three percent of kids in the original trial who had lethal, terminal B-cell acute lymphoblastic leukemia responded to this therapy,” Chesney said.

CAR T-cell therapy is FDA approved for treating patients who have B-cell acute lymphoblastic leukemia, who are mostly children, as well as adults who have an adult form of a B-cell (non-Hodgkin’s) lymphoma. This technology also is being tested for treatment of other cancers through clinical trials. Until now however, these treatments have been available primarily in larger coastal cities outside of the Midwestern United States.

“At the UofL Brown Cancer Center, we feel strongly that these advanced therapies should be available not just to people in New York or California or Texas, but to people in Kentucky, Indiana, Tennessee and Illinois. If you live in these areas, it is going to be very hard for you to be treated a thousand miles away with a therapy like this,” Chesney said. “And any patient with health assistance through Medicaid is likely to be covered only if the treatment is delivered within the state.”

The Dunbar CAR T-Cell Program will include laboratories for manufacturing the CAR T cells and will administer both FDA-approved and clinical-trial therapies to adult and pediatric cancer patients. The program intends to expand clinical trials and clinical research using CAR T-cell therapy to treat additional cancer types in Louisville. The goal is for the facilities to be fully functional and receiving patients by Sept. 30, 2020.

Tom Dunbar’s son, Evan, lost his battle to cancer with neuroblastoma in 2001 at the age of 6. In 2009, Wally Dunbar, Tom Dunbar’s father, lost his battle with melanoma. This year, Tom’s physician wife, Stephanie Altobellis, M.D., helped identify his own cancer.

“Kentucky is at ground zero, with the nation’s highest rates of cancer diagnosis and death,” Tom Dunbar said. “It’s completely unacceptable. We have to lead the charge right here where the need is the greatest and we can do the most good. We need treatments that are not toxic. Watching our loved ones miserable with pain, often just from the treatments, and yet still die in front of us simply can’t be the best that we can do.”

How CAR T cells work

T cells are key immune cells in the body that attack cancer cells. CAR T cells are T cells that have been isolated from the patient’s blood and then genetically modified to more effectively destroy the cancer cells.

A non-infectious virus is used to insert genes into the T cells that express a receptor specific to proteins, or antigens, present on cells of the cancer to be treated. The armed, loaded T cell is drawn into close proximity to the cancer cell, and the new cell sends a signal for the T cell to kill the cancer cell.

“We add the receptor gene into the T cells, which makes them stick to the cancer cells like Velcro,” Chesney said. “In theory, all cancers have unique antigens on their surface that we can target with this approach. We are nudging the immune system on to really hit the target, in this case the cancer cells.”

The sophisticated technology requires the use of a specialized clean room for genetically manipulating the patients’ immune cells. The clean rooms, known as Good Manufacturing Practice (GMP) laboratories, require specialized documentation and equipment to protect the individuals working there and ensure a sterile and controlled environment for the cells.

The Dunbar CAR T-Cell Program will include two GMP laboratories, one for use in pediatric therapies to be named for Evan Dunbar and one for adult therapies to be named for Altobellis. These labs are intended to support not only clinical trials and patient treatment at the UofL Brown Cancer Center, but also in other health centers in Louisville, Lexington and elsewhere.

“Our goal for the Dunbar CAR T-Cell Program GMP labs is to be a hub manufacturing facility for CAR T cells, not just in Kentucky, not just in the region, but for the entire country,” Chesney said.

For Dunbar, the goal is to improve cancer treatment for patients.

“The burden is on each of us to create a better future for our children,” Dunbar said. “Working together, we can ensure Louisville is equipped to provide the durable cures, free of side-effects, that we desperately need.”

Hepatitis C virus (HCV) infection has skipped a generation and become a predominantly millennial disease, according to research by John Myers, Ph.D., UofL Professor of Pediatrics. 

Myers and his team screened 82,243 individuals for HCV infection in 2016-2018 in Norton Healthcare in order to assess trends in a large health care system in an area with a high prevalence of opioid use and HCV infection. The investigators defined millennials as individuals born between 1980 and 1995, and baby boomers were those born between 1945 and 1965.

Traditionally, baby boomers were the largest drivers of HCV, though millennials have been shown in previous research to be the fastest-growing population of those infected with the virus. However, those studies were performed at single institutions with small sample sizes.

Millennials who were HCV-positive increased by 53 percent over the study period while the population of HCV-positive individuals among baby boomers decreased by 32 percent.

“The opioid crisis has led to a drastic demographic shift, and currently the typical HCV-infected individual is a younger male. Without interventions, this trend will continue for upwards of seven years, plateauing near the demarcation of millennials and generation Z.” Myers said.

The data were presented Oct. 3 in Washington at IDWeek, the combined medical meeting of four adult and pediatric infectious disease societies. 

Dr. John Wise Sr., Professor of Pharmacology and Toxicology recently received the EMGS Education Award from the Environmental Mutagenesis and Genomics Society.  The award is bestowed in recognition of sincere dedication to student and young investigator members of the Environmental Mutagenesis and Genomics Society.