Advancing the Science

Mayo Clinic Medical Science Blog – an eclectic collection of research- and research education-related stories: feature stories, mini news bites, learning opportunities, profiles and more from Mayo Clinic.

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4 days ago · Two minutes to win it

Alligator Tank award presented to winners: a copper coin in a 3-D printed holder.

Nine teams of Mayo Clinic employees pitched their ideas for health care innovations at the second annual Alligator Tank competition at the Mayo Clinic Florida campus on November 14, 2018.  Each team was given 120 seconds to explain their solution to a problem in the medical field before a live audience and a panel of expert judges — or “alligators.”

The evening event was moderated by Charles Bruce, M.D., chief innovation officer for Mayo Clinic’s Florida campus and medical director for the campus Life Sciences Incubator, who emphasized the criteria by which the judges would evaluate pitches. Teams had to answer the following questions:

  • What is the problem?
  • What is the solution?
  • Why you?
  • Why now?
  • What is the business case?

The top three pitches advance to the next level of the competition, Walleye Tank, on Mayo’s Rochester campus December 7.

 

Mayo Clinic staff sat in the audience at Alligator Tank to cheer on their colleagues.

Inspiring the next generation of life science entrepreneurs

The Alligator Tank is presented by the Mayo Clinic Office of Entrepreneurship and is designed to promote the entrepreneurial community at Mayo. “The goal is to inspire innovation across all disciplines on campus, whether you are a researcher, a clinician, or an allied health employee,” says Maarten Rotman, Ph.D., Mayo Clinic Office of Entrepreneurship. “We’ve seen great collaboration among different groups of employees. It’s about bringing together the best minds to solve problems for patients and medical staff.”

 

Nine teams jumped into the Alligator Tank, three emerged victorious

The nine teams and their projects included:

  1. Forecast Deep Learning – A next generation of continuous glucose monitoring for Type 1 diabetes that employs deep learning to glean information about a patient’s metabolic nature and generates a predictive and preventative model of care. Adip Bhargav; Arjun Sadanand; Alex Choi; Cesar Garcia
  2. Debriefing…there’s an app for that – An app that can be loaded with scenarios from the simulation center and allows faculty to click on a corresponding action as the scenario unfolds, making use of time in the center more efficient. Heidi Felix, DHSc, MPAS; Kristin Rosenbush; Nell Robinson
  3. WINNER – Novel MRI Coil– A novel MRI coil that improves image quality and enables advanced MRI techniques.  Chen Lin, Ph.D.; Erik Middlebrooks, M.D.; Prasanna Vibhute, M.D.;Vivek Gupta, M.D.
  4. Kalita Cord Keeper– A device that clamps to the underside of a surgical stand with cord channels that allows medical personnel to neatly store cords and tubes without tangling during surgery.  Lori Kalita and Timothy Harshman
  5. Brazen – A novel approach of diagnosing sports-related concussions using unique algorithms to test a player’s eye movements and determine abnormal brain activity after a head injury. Jason Siegel, M.D.; Jeff Prussack; Xuewei Wang, Ph.D.
  6. Total Pocket – A device used in surgical cases that eliminates the need for adhesive to keep storage pockets in place on surgical drapes.  Timothy Harshman
  7. WINNER – Adjustable Fracture Nail  – A nail used in orthopedic surgery for tibia fractures that allows for guided adjustment for each patient, resulting in better long-term outcomes. Christine Mehner, M.D., and Marion (Toni) Turnbull, Ph.D.
  8. WINNER – QT Grid – A ring-shaped device that allows for 360 degree recording of cortical electrical activity in the brain during surgery with simultaneous surgical resection, for patients with epilepsy. Karim ReFaey, M.B., B.Ch.; Jake McKay, M.D.; William Tatum, D.O.; Alfredo Quinones-Hinojosa, M.D.
  9. Intra-earplug MR Microphone – A small microphone embedded inside protective headphones or ear plugs worn by patients during an MRI procedure, which continuously monitors the sound pressure level of their ears and triggers a warning when levels exceed safe margins. Chen Lin, Ph.D.; Prasanna Vibhute, M.D.; Robert Pooley, Ph.D.

The teams had only two minutes to pitch their biomedical solutions to the panel of judges, which included: Magdalena Cichon, Ph.D., Mayo Clinic Ventures; Vic Nole, director, Life Sciences Incubator on Mayo’s Florida campus; Michelle Freeman, M.D., assistant professor of medicine, Critical Care; and K.L. Venkatachalam, M.D., associate professor of medicine, Cardiovascular Diseases. The judges left the room to deliberate and make their final picks. They returned ten minutes later, when Dr. Bruce announced the top three pitches.

The three winning teams: QT Grid (left), Adjustable Fracture Nail (center), and Novel MRI Coil (right), posing with Amanda Andrews and Maarten Rotman, Ph.D.

 

What it takes to survive the Alligator Tank

“Alligators”

The judges knew what they were looking for in the winning teams. “I was guided by how much of an impact the proposal could make on patient care,” says Cichon. “I am always looking for significance of the problem and novelty of the solution,” says Nole.

“The Alligator Tank provides an opportunity for any of our employees to express their creativity in advancing health care,” says Tushar Patel, M.B., Ch.B., dean for research on Mayo Clinic’s Florida campus. “We are seeking to promote an entrepreneurial community and spirit of invention on our campus, as part of our long-term goal of establishing Northeast Florida as a biotechnology hub, with a health care focus anchored by Mayo Clinic.”

Each of the winning teams received an American Wildlife Series copper coin featuring an alligator, presented in a holder printed on a 3D printer from research facilities on Mayo’s Florida’s campus. They also received $1,500 in travel money to Mayo’s Rochester campus for the Walleye Tank pitch competition. Teams with winning proposals at that event compete for recognition and seed funding to continue advancement of their innovations.

Wed, May 30 6:00am · Florida symposium on Alzheimer's disease features Mayo Clinic researchers and state-based research findings

June is national Alzheimer’s and Brain Health Awareness Month—and in Florida—research investigators from around the state will gather in Orlando to highlight basic science advances for this devastating disease. The Florida Health Alzheimer’s Disease Awareness & Research Symposium, June 7-8, features presentations by several Mayo Clinic researchers from Florida and is hosted by the Florida Department of Health.

The event is free and open to the public, but registration is recommended.

Nilufer Ertekin-Taner, M.D., Ph.D., professor of neurology and neuroscience, leads the Neurogenetics Research Laboratory on Mayo Clinic’s Florida campus.

Nilufer Ertekin-Taner, M.D., Ph.D., professor of neurology and neuroscience, leads the Neurogenetics Research Laboratory on Mayo Clinic’s Florida campus. She will present Genetics of Alzheimer’s Disease: Gaps, Challenges and Opportunities at the event. Her lab focuses on uncovering the mechanisms that lead to Alzheimer’s and other neurodegenerative diseases through genetic discoveries.

Dr. Taner has received funding from the Florida Department of Health through the Ed and Ethel Moore Alzheimer’s Disease Research Program. The program supports research leading to prevention, diagnosis, treatments and cures. One area where Dr. Taner has focused her research is highlighted in a recent study on Alzheimer’s in African-Americans. Her research team found a new gene mutation that could be identified as risk factor for late-onset Alzheimer’s in this population.


Leonard Petrucelli, Ph.D., chair and Ralph B. and Ruth K. Abrams professor, Department of Neuroscience on Mayo’s Florida campus, will also present at the event.

Leonard Petrucelli, Ph.D., chair and Ralph B. and Ruth K. Abrams professor, Department of Neuroscience on Mayo’s Florida campus, will present Translation of Clinical Research at the symposium.  Dr. Petrucelli also serves on the Ed and Ethel Moore Alzheimer’s Disease Research Grant Advisory Board as assistant chair. His research team focuses on investigating the cellular mechanisms that cause neurodegeneration in diseases such as Alzheimer’s, frontotemporal dementia (FTD), and amyotrophic lateral sclerosis (ALS).  His team emphasizes translational research to identify and develop therapies for treatment and prevention. Dr. Petrucelli will also moderate a panel session, The Clinical Trial Experience, the Researcher and Participant Perspective.


Neill Graff-Radford, M.D., professor of neurology in the Department of Neurology on the Florida campus, will moderate a panel session during the event.

Neill Graff-Radford, M.D., professor of neurology in the Department of Neurology on the Florida campus, moderates a panel session, Living with Alzheimer’s Disease, at the symposium. Dr. Graff-Radford is a member of the Ed and Ethel Moore Alzheimer’s Disease Research Grant Advisory Board. His research focus areas include cognitively normal aging, normal pressure hydrocephalus, finding a blood test for Alzheimer’s disease, dementia in Caucasians versus African-Americans, and late-onset Alzheimer’s disease and frontotemporal dementia.


Francine Parfitt, C.C.R.C., is the Neuroscience Clinical Research Center’s operations manager.

A lunch and special topic presentation, Healthy Brain Awareness: Creating a Complimentary Lifestyle, will be given by Francine Parfitt, C.C.R.C., manager of operations, research, Neuroscience Clinical Research Center at Mayo’s Florida campus. She will also present an Information Session on Agitation and Dementia.


In addition to these Mayo experts, the symposium will cover a host of topics and showcase research findings of grantees of the Ed and Ethel Moore Alzheimer’s Disease Research Program from around the state of Florida. Program topics include:

  • New therapies for increasing quality of life for people living with Alzheimer’s
  • Clinical trials for people with Alzheimer’s disease and early findings
  • Basic science advances for understanding the disease
  • Discoveries identified through Florida’s research networks for preserving brain health and delaying the onset of Alzheimer’s disease
  • Studies that assist in determining disease conditions, targets for preventive healthcare and risk factors for disease

Learn more information about the symposium and research on Mayo Clinic’s Florida campus.

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Tue, Mar 20 12:00pm · Navigating the intricacies of aggressive cancers to address the unmet needs of patients

Deep inside a cancer biology research laboratory, amid countless vials, machines and experiments, recent genomic findings have pointed to a new potential route addressing some of the most aggressive cancers. Recently researchers on Mayo Clinic’s Florida campus zeroed in on a genetic pathway—SCD1—which they found operates in high gear in many potentially deadly tumors. Their plan now is to interrupt the SCD1 protein with a novel molecule they developed, which may interfere with cancerous cells while leaving normal cells alone.

Research from the lab of cancer biologist John Copland, Ph.D., identified that the SCD1 pathway is active in a myriad of aggressive cancers. His team found SCD1 proteins, enzymes produced by the gene, appear in abundance in several fast-growing tumors, though they aren’t prevalent in normal tissue. In fact, high levels of the SCD1 are associated with a poor prognosis in certain forms of breast, lung, colon and soft tissue cancers. The enzyme plays a key role in breaking down fats in tumor cells, in particular converting complex, saturated fats into simple, usable fats and fatty acids that tumors store for energy and growth. The conversion of fats is known to be essential for tumors to grow and thrive.

Dr. Copland’s team has taken the next step to translate the SCD1 discoveries into a potential treatment. He recently received funding from the Bankhead-Coley Cancer Research Program, as announced by the Florida Department of Health, to do just that. The next stage of research aims to interrupt the SCD1 pathway, essentially starving rapidly growing cancer cells.

Using state-of-the-art technology, his research team developed a novel SCD1 inhibitor, a molecule capable of interfering with the SCD1 enzyme to stop the conversion of fats by tumor cells. In laboratory tests, the molecule interfered with cancers of the breast, kidney, liver, bladder, prostate, lung, thyroid, pancreas, colon, ovaries, and with melanoma. Over the next three years, the team will study this compound and its ability to block tumor growth, particularly in aggressive breast and colon cancers and melanoma.

“In general, normal organs don’t express SCD1, the SCD1 inhibitor wouldn’t have toxicity to other tissues,” says Dr. Copland. “While clinical trials in humans could be several years away, we are working on this promising compound, which we hope ultimately could be taken in pill form.”

The studies will combine the compound with other drugs already approved by the Food and Drug Administration to identify optimal drug combinations that interfere with cancer growth. “The SCD1 pathway is turned on in many aggressive cancers, where the cells replicate rapidly. We hope that an inhibitor would be effective for a broad range of cancers,” Dr. Copland says. Discoveries made in the lab will serve as the catalyst for developing clinical trials, with the aim of bringing innovation to patient care, faster.

Oct 3, 2017 · Alzheimer’s Researcher Receives MERIT Award

Dr. Guojun Bu in his Florida laboratory.

Neuroscientist Guojun Bu, Ph.D., Mary Lowell Leary Professor of Medicine, on Mayo Clinic’s campus in Florida, has been selected to receive the prestigious Method to Extend Research in Time (MERIT) Award. Granted by the National Advisory Council on Aging, the award provides long-term research funding to outstanding principal investigators who have demonstrated success on projects supported by the National Institute on Aging (NIA). The NIA MERIT award is given to fewer than a handful of researchers annually and offers up to 10 years of NIH support.

“This is an honor that recognizes excellence in research and helps to ensure the continued success and productivity of his research program,” says Tushar Patel, M.B., Ch.B., dean for research on Mayo Clinic’s campus in Florida.

Dr. Bu’s lab has a two-decades-long track record teasing apart the neurobiology of Alzheimer’s disease.

Alzheimer’s medical illustration of amyloid plaques

His team has made headway understanding the mechanisms of the Alzheimer’s gene, APOE, and its high-risk variant, APOE4. In recent studies, Dr. Bu described the role of APOE4 in impaired insulin signaling in the brains of Alzheimer’s patients.

His team has also been focusing on understanding the cerebrovascular effects of Alzheimer’s, in particular determining how the disease reduces the brain’s ability to clear out deposits of the sticky protein known as amyloid peptide. His group recently identified “clean-up” cells in the healthy brain, responsible for removing toxic amyloid deposits, the main pathological component of Alzheimer’s brains. Funding from the MERIT Award will further his investigations of the brain’s natural clean-up mechanisms, as he focuses on the brain’s vasculature. Studies will investigate the cerebral blood vessels, which remove accumulating amyloid protein, as well as drainage pathways that run alongside the blood vessels, and will look at the role APOE plays in the effectiveness of these amyloid clearance systems.

“I’m grateful to have the opportunity to advance what we’ve begun as we look deeper into these mechanisms and collectively try to find a cure for Alzheimer’s disease,” Dr. Bu says. “And I’m also grateful the award provides lengthy protected time, where you don’t have to spend too much time writing grant applications and can focus on doing science.”

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Sep 6, 2017 · Access to clinical trials- focus of Florida policy forum

Health care organizations from around the state of Florida came together on Mayo Clinic’s Jacksonville campus Aug. 29 to raise awareness about clinical trials research taking place in the state. The Florida Policy Forum on Clinical Trials also focused on strategies for recruiting more diverse participants and the important role clinical trials play in providing improved treatment options for patients.

“It is crucial for patients to have access to high-quality, innovative clinical trials that may open doors to new treatments, and it is particularly important to ensure clinical trials are accessible to all, including minorities,” says Tushar Patel, M.B., Ch.B., dean for research at Mayo’s Florida campus. “The Office of Health Disparities Research at Mayo supports the recruitment of diverse populations into our research studies. We have also made dramatic improvements in how quickly we can activate a clinical trial so that patients have faster access to clinical trials and treatments that may benefit them.”

Dr. Patel opened the program in Kinne Auditorium with welcoming remarks to about 100 people in the audience, consisting of major cancer centers and health systems in Florida, state government and policy makers, patient advocacy organizations and consumers. Florida State Representative Jason Brodeur (House District 28), chair of the House Health Care Appropriations Subcommittee, served on one of the panels, explaining how the state of Florida funds clinical trials.

Panel discussions included a focus on the importance of clinical trials and how to close the disparity gap, as well as the future of cancer clinical trials. Asher A.Chanan-Khan, M.D., chair of Hematology/Oncology, and Sikander Ailawadhi, M.D., vice chair, clinical practice, Hematology/Oncology, represented Mayo on the panels. Dr. Ailawadhi emphasized that more can be done to provide patients the access they need to clinical trials. He told the audience that Mayo Clinic is working to develop clinical trial pathways for clinicians so that “clinicians can decide when patients walk in the door, what clinical trial they are eligible for. As long as patients get the right treatment at the right time, we can make a difference.” He stated that he believes clinical trials should become the standard for cancer care across the country. That comment earned him applause.

Dr. Chanan-Khan commented that “we’ve developed an extensive resource and infrastructure on campus for novel clinical trials” at Mayo Clinic. “We look at the science first and bring it to the patient.” He called for action in seeking legislative solutions to remove financial barriers so that every patient could have access to clinical trials.

The event was hosted by the American Cancer Society Cancer Action Network. Other participating health care organizations included Moffitt Cancer Center; UF Health Shands Hospital; Baptist MD Anderson Cancer Center; University of Miami Sylvester Comprehensive Cancer Center; 21st Century Oncology, UF Oncology and Infusion Center; and PhRMA.

Find out more about clinical trials on Mayo’s clinical trials website.

May 9, 2017 · Increasing the Odds

Increasing the Odds

Mayo Clinic performs more transplants than any other organization in the country. That experience allows Mayo Clinic scientist-physicians to study stem cells and personalize drugs to fight organ rejection and increase the number of viable lungs.

Immune-Building Stem Cell Research

In the 1970s, when Cesar A. Keller, M.D., started his career in pulmonology, lung transplantation was widely considered science fiction. Now, lung transplantation is a lifesaving option for thousands of people every year, but it’s not perfect, Dr. Keller says. For adults, the five-year survival rate is about 55 percent, according to 2008–2015 lung transplant data from the Department of Health and Human Services.

With the help of philanthropic support, Dr. Keller and colleagues in the Mayo Clinic Center for Regenerative Medicine are trying to solve the most lethal imperfection of lung transplantation, a syndrome called chronic organ rejection.

Moving From Rejection to Acceptance

Chronic rejection is considerably more common in lung transplantation than in other solid organ transplants. This is most likely due to environmental factors, which “the lungs are exposed to continuously, with every breath a patient takes,” Dr. Keller explains.

To solve that challenge, Dr. Keller and his colleagues are using tools that are today’s version of science fiction becoming science fact: stem cells and regenerative medicine.

Stem cells have the ability to repair damaged cells, transform into almost any cell the body needs and temper the immune system. So, Dr. Keller’s team launched an initial clinical study to evaluate safety and dose considerations of stem cell use in lung transplant patients who have chronic organ rejection. Researchers also gathered data on whether the treatment may have potential for improving lung function or slowing the progressive decline in function that occurs with chronic organ rejection.

The study used bone marrow-derived stem cells, which were infused through an IV and circulated to the lungs. The lungs “trap all of the stem cells,” Dr. Keller says. His team is preparing for a larger clinical study that will be based on the initial study results. “It took us seven years from our concept to delivering stem cells to the first patient,” he says. “It’s going to take at least another seven or eight years to see if this is successful.”

Developing Lung Restoration Capabilities

A rendering of the lung restoration center on the Mayo Clinic campus in Jacksonville, Florida.

This research and other activities in the Center for Regenerative Medicine will be extended by another new technology that is coming to the Florida campus. In 2016, Mayo Clinic and United Therapeutics broke ground on a lung restoration center that could more than double the number of donor lungs viable for transplantation in the United States. (Read news release).

United Therapeutics is working to improve donor lungs and make them suitable for transplantation using “ex vivo lung perfusion technology.” The technology stores lungs in a specialized chamber and treats them with solutions and gases that can reverse lung injury and remove excess fluids.

Dr. Keller says the technology, which preserves lungs when they are outside the body, can be used to research the benefits of delivering stem cells to lungs before they are transplanted into a person. That strategy may help reduce immune system responses after the lungs are transplanted. “It was literally all science fiction when I began,” Dr. Keller says. “It’s interesting to think about where the field was when I started and to see these concepts become things we can apply.”

Despite the use of immuno-suppressants, a person’s body at times can recognize the transplanted organ as a foreign object and attempt to protect itself by attacking the new organ. Even with immunosuppression medications, some transplant patients experience episodes of rejection.

There are two main types of rejection:

Chronic rejection occurs over
many years because a patient’s immune system never fully accepts
the transplanted organ and slowly damages it.

Acute rejection may occur from  the first week after the transplant to three months afterward.

An Individualized Strategy for Stopping Organ Rejection

The effectiveness of immunosuppressant drugs is governed by a number of factors, but a major contributor is an individual’s genome. The genes that make up each person’s genome direct how a drug is metabolized and how it stimulates the immune system to accept the transplant.

While these drugs help a transplanted organ continue to function, they tax the rest of the body. For transplant patients, it is essential to understand the appropriate regimen of anti-rejection medications.

Mayo Clinic’s Center for Individualized Medicine is collaborating with a molecular diagnostics company to monitor patients after an organ transplant and improve the efficacy of these drugs by tailoring the treatment to an individual’s genome through the TOGETHER trial.

The initial focus is on immunosuppressant therapies for 250 kidney transplant recipients.

“Genomic analysis of blood can reveal early signs of rejection in transplanted kidneys,” says principal researcher Mark D. Stegall, M.D., the James C. Masson Professor of Surgery. “The potential clinical utility is to be able to monitor for rejection more frequently than is possible with surveillance biopsies and to individualize immunosuppression in transplant recipients.”

Among this study cohort, kidney transplant patients will have genomic testing at five intervals throughout their first postoperative year. These data points may help transplant care teams fine-tune immunosuppression drug regimens and improve patient outcomes.

“The promise of individualized medicine is  that we can now use information found in a patient’s own genetic code to provide better,  more personalized answers about their medical  care. Through important efforts such as the TOGETHER trial, we can and will make that promise more of a reality for our transplant patients,” says Alexander S. Parker, Ph.D., the Cecilia and Dan Carmichael Family Associate Director for the Center for Individualized Medicine at Mayo Clinic in Jacksonville, Florida.

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This article was originally published in Mayo Clinic Magazine, Volume 1, 2017.

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