October 2, 2008

Uterine Fibroids — i on NIH — episode #0014, segment 2

In this eye-to-eye interview, we turned to a researcher from NICHD. Dr. Alicia Armstrong is an expert on uterine fibroids, which are the most common, non-cancerous tumors in women of childbearing age.

Transcript

Welcome to “i on NIH”!

Featured in this month’s episode are segments about the renaming of the National Institute of Child Health and Human Development and a segment about uterine fibroids.

From the national institutes of health in Bethesda, Maryland – America's premiere medical research agency – this is “i on NIH”!

Covering health-research topics important to you and the nation, this public service vodcast is your information source from inside all 27 institutes and centers at NIH.

Half an hour, once a month, we'll show you the excitement of advances and the important information that comes from medical research.

And now, here's your host, Joe Balintfy.

Host: Welcome to the fourteenth edition of i on NIH! Thanks for tuning in. For this episode, we examine one of the 27 different institutes here at NIH, the Eunice Kennedy Shriver National Institute on Child Health and Human Development. The NICHD recently got that new name and we have a look at the celebration and reasoning behind it. We also look at just one of the illnesses NICHD researchers study: We’ll have an eye-to-eye interview about uterine firbroids. But first, we have our news update. Here’s Harrison Wein from the NIH news-desk. Harrison…

Harrison: Thank you, Joe. In this NIH Research Update, West Nile virus, drugs that boost exercise endurance—at least, in mice, and children’s physical activity levels move in the wrong direction.

Since West Nile virus first appeared in the US a decade ago, it’s become a seasonal epidemic, flaring up in the summer and continuing into fall. It’s spread by mosquitoes. In 2007, the virus caused over 3,400 reported infections nationwide, and nearly 100 deaths. Unfortunately, our understanding of the virus on a molecular level has been limited. The virus encodes only 10 proteins of its own, so it must use many human proteins for infection. In a new study, NIH-supported researchers used a technique called RNA interference to “silence” over 21,000 different genes in human cells in the laboratory. They infected the gene-silenced cells with West Nile virus. Then they looked for viruses in the cells to see which genes either helped or hindered infection. The researchers discovered over 300 human proteins involved in West Nile virus infection. That gives scientists a much better picture of how the virus works, and a lot of potential antiviral targets.

Scientists have long searched for drugs that mimic or enhance the effects of exercise. Four years ago, researchers at the Salk Institute found a genetic switch that regulates several genes in muscle cells. Mice with an overactive version of the genetic switch had nearly double the running endurance as normal mice. In their latest research, the scientists used drugs to activate the genetic switch. Mice took the drug and had a month of endurance training, running on a treadmill for about a half hour each day. The treated mice were able run up to 75% farther than mice that had only the exercise training. They also tested a drug that enhances another exercise-related molecule, and that’s where the real surprise came in. Four weeks of the treatment alone activated exercise-related genes and enhanced running endurance by 44% in sedentary mice. In fact, the drug allowed sedentary animals to run longer and farther than animals that had received weeks of exercise training. Of course, these drugs’ effects on human muscles and endurance are still untested. But the muscles of humans and mice use similar genetic pathways, so the researchers think their findings will eventually lead to improved therapies for people.

The 2005 Dietary Guidelines for Americans recommends that children and teens get at least 60 minutes of physical activity on most, if not all, days of the week. To see whether children are meeting these recommendations, an NIH-funded team looked at more than a thousand children from diverse backgrounds. The researchers recorded the activity of more than 800 9-year-olds for about a week. The kid’s activity levels were then measured again at ages 11, 12 and 15. At ages 9 and 11, more than 90% of the children met the recommended level of activity. By age 15, however, only 31% met the recommended level on weekdays, and only 17% met it on weekends. This research highlights the need for families, communities, schools, health care systems and governments to keep encouraging kids to get physical activity as they age.

Read about these and many other research studies in “NIH Research Matters.” Go to the NIH home page and look for the link on the right-hand side, under “In the News” that says, “eColumn: NIH Research Matters”

And in this month’s health newsletter, “NIH News in Health”… Read about staying up-to-date with your vaccines, a personalized supplement plan in your future and more in the August issue of NIH News in Health. You can find it at news-in-health-dot-nih-gov.

This is Harrison Wein at the NIH Science Desk.

Joe: Thanks Harrison. Congress recently renamed the NICHD in honor of Eunice Kennedy Shriver for her essential contribution to the institute's founding. “I on NIH” covered the ceremony.

VO: Established in 1963, the institute is now called the Eunice Kennedy Shriver National Institute of Child Health and Human Development. NIH Director, Dr. Elias Zerhouni summarized the importance of the renaming event.

Zerhouni: Today, we’re witnessing an event that is illustrative of a fundamental truth. And that is, history is made by a few leaders with a vision when it’s embraced by all of us as a mission. And I think today, we’re seeing the vision of a few leaders.

VO: Members of Congress, federal officials, as well as family and friends of Mrs. Shriver at the renaming event, included Senators Edward Kennedy and Orin Hatch, Congressman Steny Hoyer, and Governor Arnold Schwarzenegger. Dr. Duane Alexander is director of the newly renamed institute. He explains the significance of the day.

Alexander: Today, we have a dual celebration and commemoration. The 45th anniversary of the establishment by act of Congress of a new institute at the National Institutes of Health called the National Institute of Child Health and Human Development. And now the renaming of that institute, also by act of Congress. Both of these events focus on one extraordinary person, Eunice Kennedy Shriver.

Zerhouni: And I can say with absolute certainty that no other public figure has made a more significant contribution to improving the quality of life for people of all walks of life. For this, Mrs. Shriver, we thank you and we salute you.

VO: One family in particular shared its personal gratitude: Mrs. Jan Monaco and her four children, two of whom, she says, are here today because of the NICHD and research centers.

Monaco: These facilities exist, thanks to Mrs. Shriver, serve as a place for top scientists and physicians worldwide to collaborate with one another for the sole purpose of developing ways to improve children’s health. It is reassuring to know that our children receive not only quality care in the clinical setting from their physicians, but access through them to innovative research developments only a few floors away, referred to as a benched bedside approach. Mrs. Shriver, on behalf of my children, and others like them, I extend my heartfelt appreciation and gratitude to you.

VO: Another close, personal perspective was shared by Mrs. Shriver’s brother, Senator Edward Kennedy.

Kennedy: All of you who know Eunice understand she's not the kind of person who takes a no for an answer. In fact, she doesn't take the first hundred no’s for an answer either. She is very competitive, she's tenacious and she's unstoppable. I guess you could say that Eunice has a talent for getting her way. And lucky for all of us, her way is to make the world a better place for people with disabilities, and she's been doing that with incredible success for more than 60 years.

VO: Mrs. Shriver says much, but not all of her life has been spent working to make the world a better place for people with intellectual disability.

Shriver: But in a strange way, perhaps, my life is also about the adversity I encountered. I believe I am lucky that I experienced the sting of rejection. I’m sorry that I experienced the sting of rejection as a woman who was told that the real power was not for me. I am lucky that I saw my mother and my sister, Rosemary, be treated with the most unbearable rejection. Today, we stand in one of the great legacy, NICHD, which together with the university affiliated programs, and the President’s council, remains unmatched, advanced in American touched life.

Shriver: You may ask what good will come from this for yourselves or for your country. This is it. There is no joy like the joy of unleashing the human spirit. There is no laughter like the laughter of those who are happy with others. There is no purpose nobler than to build communities of acceptance for our very special friends in our community. This is our glory. This is the greatness of the United States of America. Please do not let it be trampled on. So, thank you for this great honor. Thank you for reinforcing for me the power of faith, of hope, of love. I have always believed these to be the most important gifts of our lives in each other.

VO: The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit www.nichd.nih.gov.

Host: In this eye-to-eye interview, we turned to a researcher from NICHD. Dr. Alicia Armstrong is an associate investigator and a staff clinician. She’s also an expert on uterine fibroids, which are the most common, non-cancerous tumors in women of childbearing age. So we started our discussion with her by asking, what exactly are uterine fibroids?

Armstrong: Uterine fibroids are an overgrowth of the muscle in the uterus. They’re benign, meaning non-cancerous, tumors.

VO: “Do fibroids cause symptoms?”

Armstrong: They can cause multiple symptoms. The most commons symptoms are bleeding and pelvic pain and pressure.

VO: “What causes uterine fibroids?”

Armstrong: We don’t know, which is why we’re interested in doing research into not only how to better treat fibroids, but what causes fibroids. It’s not something that’s related to behavior or environment. It appears to be genetic. And because it’s so common, there aren’t a number of effective things that can be done prophylacticly. With some illnesses, for instance with diabetes, by avoiding becoming obese you can lower your risk. With fibroids, because it is so common and because it tends to run in families, there aren’t a lot of things that you can do to avoid getting fibroids.

VO: “Are there certain women who are more likely to get uterine fibroids?”

Armstrong: Well, in terms of ethnic groups, African American women are more likely to get fibroids. The lifetime incidence for African American women is 80 percent. It’s 60 percent for Caucasian women, so a very common problem among all races. It also tends to run in families, in that if someone’s mother or sister had fibroids, they’re at greater risk.

VO: “What kinds of treatments are currently available for fibroids?”

Armstrong: Currently the only cure is surgical. That’s why we’re so excited about the research that we’re doing to look at a medication, an oral drug that can help shrink fibroids. And the surgeries that are offered for fibroids, there’s two. The only cure is hysterectomy, which means removing the entire uterus. Myomectomy, which is removing just the fibroids, is also a surgical treatment, but there’s a chance that the fibroids can grow back, so it’s not considered a cure.

VO: “What kind of research is being done for treating fibroids?”

Armstrong: We’re looking at a medication that in preliminary results has been shown to shrink the fibroids. It doesn’t make them completely go away, but it does shrink the fibroids. One of the other benefits is while women are on the study drug, their periods often become much lighter or even stop, which addresses one of the major side effects, one of the major problems with fibroids, which is heavy bleeding. Now, the medication affects a hormone progesterone, and that’s how it helps to shrink the fibroids, and there are very few in the way of side effects, and there haven’t been any long term serious complications that have been seen with the study drug or drugs that are similar to the drug that we’re using in this current investigation.

VO: “Who would qualify to be included in a study on fibroids?”

Armstrong: Well, women between the ages of 25 and 50 who are not yet menopausal, who haven’t yet gone through change of life, who have symptoms from fibroids. And as I mentioned, the most common symptoms are bleeding, pain and pressure. Most of the women that are in the study are local because it does require multiple study visits, so it’s primarily women in the Washington, D.C. and Virginia and Maryland areas that are enrolled.

VO: Thanks to Dr. Armstrong from NICHD. For more information about the study she mentions, visit fibroids.nichd.nih.gov or call 1-800-411-1222.

Host: And that's it for this episode of i on NIH – thanks for joining us! We're still fine tuning this video podcast, so please keep checking back for new material. And look for these and more segments from NIH on You Tube. For now, thanks again for watching and join us again next time. For I on NIH, I'm Joe Balintfy.