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Why Don’t Patients Listen to their Doctors?

Author: Arnie Phifer

A new Notre Dame research program looks for solutions to the problem of medical nonadherence

As part of the launch of a new research program in Health-Related Behavioral Sciences, the University of Notre Dame’s Advanced Diagnostics & Therapeutics initiative has made its first award to support an investigation of why patients with Type 2 diabetes don’t always follow their prescribed medical regimens.

Doctor Patient

The study, led by Guangjian Zhang, Associate Professor of Psychology, will collect pilot data on adherence to recommendations from physicians—regarding medication, diet, physical activities, sleep, and self-administered blood tests—in forty Type 2 diabetes patients and develop statistical methods to analyze the intensive longitudinal data that are produced.

“Our long term goal is to contribute to the understanding, prevention, and treatment of lifestyle-related chronic diseases,” said Zhang, “and diabetes is an important place to start.”

The World Health Organization estimates that there are 422 million people in the world living with diabetes, and work by other researchers suggest that only 7.3% of diabetes patients fully meet all three goals of controlling blood sugar, blood pressure, and blood lipid levels. Read More

Turning Ideas into Reality for Colon Cancer Research

Author: Jenna Bilinski

In July, 2014, Mike Patterson received some news that changed his life forever. He was diagnosed with stage four colon and liver cancer.

“They didn’t give me a lot of hope,” recalled Patterson.

Like many patients after receiving such a diagnosis, Mike asked for a second opinion. However, he was given the same grim verdict and began looking at treatment options. With very little time and few options, it was decided that chemotherapy was the best route. After several months of treatment, and no progress, Mike’s team of doctors decided to schedule his surgery on December 12, 2014. A date that now holds great significance to Mike.

This date was picked by his surgeons and happens to be the feast day of Our Lady of Guadalupe, which celebrates a religious apparition of the Virgin Mary.

While Mike was going through chemotherapy treatments, he was paid a visit by his friend, Brother Mauricio. Brother Mauricio traveled to the United States from Mexico and brought with him the shroud of Our Lady of Guadalupe. With the shroud, he prayed with Mike to defeat this monstrous disease. 

(Left to right) Dr. Amanda Hummon, Dr. Sharon Stack, and Mrs. and Mr. Mike Patterson

Mike recovered from his surgery with no complications. A couple weeks after surgery, Mike visited his oncologist for a post-operation check-up. He showed no signs of either cancer. Mike said, “They couldn’t give a medical explanation for what happened or how it happened … I instantly went from hopelessness to complete gratitude.” Ever since, Mike has been determined to do all he can with the resources he has, to help eradicate this disease.

During the Fall of 2015, Mike learned about the cancer research being conducted at the University of Notre Dame’s Harper Cancer Research Institute. Here he was introduced to the work of Dr. Amanda Hummon, Associate Professor of Chemistry and Biochemistry at Notre Dame and exceptional colon cancer researcher at the Harper Cancer Research Institute. Read More

Eli Lilly Faculty Fellowship Provides Drug Discovery Experience

Author: Brandi Klingerman

Notre Dame Researcher Developing Medication Delivery System to Combat Diabetes

Haifeng Gao 2

Diabetes is a metabolic disease in which the body has an inability to produce enough insulin. In the United States alone, it is estimated that the illness affects nearly 30 million diagnosed and undiagnosed people, and treatment often includes patients using an intravenous or IV method to get insulin into their system. This uncomfortable and inconvenient form of treatment can require anywhere from two to four injections a day, but a Notre Dame researcher is working to combat this problem with a less frequent, oral delivery system.

Haifeng Gao, an assistant professor of chemistry and biochemistry as well as an affiliated member of ND Energy and NDnano, is working at the newly opened McCourtney Hall to engineer soft nanomaterials and develop a polymer, or substance that has a molecular structure consisting of mostly large numbers of similar units bonded together, that could potentially carry insulin throughout the body. For the polymer to work, it would need to survive the harsh environment of the stomach, control the encapsulation of the insulin, and program the release of medication in a way that is as effective as current treatment methods. To do all of these things, Gao’s goal is to develop a unimolecular polymer carrier with multiple domains and functional groups, which utilizes several components that can work synergistically. Read More

Illuminating Ovarian Cancer Surgery

Author: Angela Cavalieri

One in 77 women will develop ovarian cancer in her lifetime.  Because ovarian cancer has no defined symptoms, most women will be diagnosed at a late stage of the disease where metastatic lesions are found dispersed throughout the abdomen.  Ovarian cancer is currently the fifth most common cause of cancer-related deaths in women. With new technology being developed at the Harper Cancer Research Institute, the ovarian cancer surgery success rate may ultimately improve significantly.

Ovarian cancer distinctly spreads in the abdomen generating many sites of cancer along the peritoneum, the tissue lining the abdominal cavity. The most common treatment of ovarian cancer includes a debulking surgery, or the removal of cancerous lesions from the abdominal/peritoneal cavity. Currently, ovarian cancer surgeries are considered a ‘success’ with the removal of all tumors 1cm or larger. However, with research being developed at the Harper Cancer Research Institute, this goal could soon become the removal of tumors as small as 1mm.

The major challenge lies in distinguishing the healthy cells from the cancerous cells. Anatomy text books are often color-coded and thus the identification of the body parts is simplified. However, in reality the tissue structure within the human body actually appears as a blend of pinks varying to reddish in color and is very difficult to decipher. There may be little to no visible distinction between healthy tissue and cancer cells or even nerves.

Enter a multi-colored, fluorescent signaling, targeted molecule tagging system. Bradley Smith, a principal Investigator at the Harper Cancer Research Institute, Director of the Notre Dame Integrated  Imaging Facility (NDIIF), and Emil T. Hofman Professor of Chemistry at the University of Notre Dame, has developed targeted, or “smart,” molecules that seek out and bind to specified cells. These molecules attach to the cancer cells and emit a fluorescent signal when viewed through a fluorescent camera and glow in a specified color. 

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New Discovery Paves Way for Pancreatic Cancer Treatment

Author: Jessica Sieff

Reginald Hill

Pancreatic cancer, the third leading cause of cancer-related deaths, is projected to be the second by the year 2030, according to a study in the journal of Cancer Research. The five-year survival rate is only 8 percent, making it the only major cancer with a survival rate in the single digits. Despite rising mortality rates, pancreatic cancer is under-researched and underfunded, and there are few Food and Drug Administration-approved treatments to combat the disease.

With the current pipeline for drug discovery taking 10 to 15 years from the laboratory to use, and an estimated 41,780 who will die from the disease this year alone, time is of the essence.

Now, patients suffering from pancreatic cancer may soon face better treatment options due to the latest discovery by Dr. Reginald Hill, Archibald Assistant Professor of Cancer Biology at the University of Notre Dame and researcher at the Harper Cancer Research Institute. Hill’s research focuses on drugs that are already approved by the FDA to find out why those drugs are not working in patients with pancreatic cancer.

“The bulk of a pancreatic cancer tumor is made of approximately 10 percent cancer cells and 90 percent supporting cells. Somehow, the supporting cells have figured out how to survive the chemotherapy,” Hill said. “Microscopic vesicles called exosomes, bubbles with genetic material released by cells during chemotherapy exposure, are released from supporting cells, educating the cancer cells on how to survive, resulting in a tumor becoming chemoresistant.”

Previous research has revealed that the majority of pancreatic cancer cases are resistant to chemotherapy and unresponsive to drug treatments found to be effective in other types of cancer.

Most new research has focused on destroying supportive cells. However, those studies concluded that when the supportive cells were attacked, patients actually developed more advanced cancer. “It was like poking holes into the area around the cancer cells and allowing it to spread,” he said.

Hill focused on blocking the release of exosomes, preventing the relay of information from supporting cells to cancer cells — which increased the efficacy of chemotherapy. This recently published study suggests that using an exosome blocker, which is nontoxic, in combination with standard-of-care chemotherapy will those with pancreatic and many other cancers as well. Read More

Before a cure, a crusade to stop lung cancer from spreading

Author: Jessica Sieff

Robert Stahelin

The American Cancer Society has reported that lung cancer, which kills more Americans than any other type of cancer, is expected result in an estimated 158,080 deaths in 2016.

Although drugs are currently available to fight lung cancer, drug discovery challenges persist because treatment options are limited. Not only is lung cancer often drug resistant, but radiation treatment and surgery can be quite difficult depending on the location of the tumor(s) within the lungs.

Robert Stahelin, adjunct associate professor of chemistry and biochemistry at the University of Notre Dame, is working to better understand lung cancer at a cellular level and is investigating drugs that could inhibit lung cancer growth and prevent it from spreading.

“I’m looking at signals within the lung cancer cells that cause them to grow quickly, move and divide,” he said. “With cancers, a primary tumor may metastasize and attack another organ in the body. Lung cancer often metastasizes — or spreads — to other organs such as the liver. Once the liver is infected, the cancer causes increased health problems and patients are more likely to succumb to the disease.”

Stahelin’s laboratory aims to advance understanding of how the mechanisms of lipid signaling are controlled in lung and other types of cancers. Membranes, composed mainly of lipids, hold the keys to cell division, growth and metabolism necessary for cancer cell growth and metastasis.

That understanding could ultimately help to determine the causes of lung cancer and identify viable targets, lipids or proteins for drug development and treatment.

Contact: Robert Stahelin, 574-631-5054, rstaheli@nd.edu

Originally published by Jessica Sieff at news.nd.edu on November 11, 2016. Read More

Notre Dame Researchers Receive CTSI Pilot Research Grants

Author: Brandi Klingerman

Indiana CTSI grants encourage use of core facilities throughout the State

The Indiana Clinical and Translational Sciences Institute (CTSI) announced that University of Notre Dame researchers have been awarded grants through the CTSI Pilot Funding program. The program is intended to promote the use of technologies and expertise available through CTSI Core Facilities, which are available at the partner institutions. 

Melancon2Bruce Melancon

In describing the awards, Bruce Melancon, CTSI Notre Dame site navigator and research assistant professor of chemistry and biochemistry, said, “The CTSI Pilot Funding program encourages faculty to utilize resources that they may not have considered. This provides an opportunity for CTSI-funded researchers to innovate and move their research to the next stage of the translational pathway.”

The goal of the grant is to award proposals that demonstrate outstanding scientific merit and that can also be linked to generating extramural funding or novel intellectual property through the use of Indiana CTSI designated core facilities.

Among the awarded grants:

Athanasia PanopoulosAthanasia Panopoulos

Athanasia Panopoulos, Elizabeth and Michael Gallagher Assistant Professor of Biological Sciences and affiliated member of the Harper Cancer Research Institute (HCRI), will conduct research for her project on “Molecular Profiling of Hematopoietic Progenitor/Stem Cell Populations.”

Kevin T. Vaughan, associate professor of biological sciences and HCRI affiliate, will work on his project about identifying new drug treatments for neurodegenerative diseases. Read More