November 13, 2009
NIH Podcast Episode #0097
Balintfy: Welcome to the 97th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health—the nation's medical research agency. I'm your host Joe Balintfy, and coming up in this episode: a talking glossary explains genetic terms, and details and discussion regarding flu shots, including the H1N1 vaccine. But first news about new treatments for vision loss. That's next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
New Treatment Found to Reduce Vision Loss from Central Retinal Vein Occlusion
Balintfy: Scientists have identified the first long-term, effective treatment to improve vision and reduce vision loss associated with blockage of large and small veins in the eye – those blockages are called occlusions. Two studies were part of the Standard Care vs. Corticosteroid for Retinal Vein Occlusion or SCORE Study. The SCORE study is a clinical trial conducted at 84 sites and supported by the National Eye Institute. Anahita Hamidi reports on the SCORE study findings.
Hamidi: The second-most common cause of vision loss in this country results from a condition known as retinal vein occlusion, which is a blockage in the blood supply from the retina—the light-sensitive tissue in the back of the eye. The two main kinds of retinal vein occlusions affect different-sized blood vessels and are treated in different ways. A recent study, called the Standard Care vs. Corticosteroid for Retinal Vein Occlusion, or SCORE study evaluated methods of treatment.
Dr. Chew: The SCORE study really consists of two separate studies looking at two different aspects – but a similar disease in the same sort of spectrum – looking at retinal vein occlusions.
Hamidi: Dr. Emily Chew is Deputy Director of the Division of Epidemiology and Clinical Applications from the National Eye Institute. She explains that blood vessels in the eye come in two sizes.
Dr. Chew: One is sort of larger called the central retinal vein and the other is called the branch retinal vein, which are the smaller veins, smaller vessels in the eye.
Hamidi: Currently, no treatment exists for central retinal vein occlusion, a blockage of the major blood vessels. The SCORE Study was the first to compare the safety and effectiveness of an anti-inflammatory corticosteroid for central retinal vein occlusion.
Dr. Chew: The second study, the branch retinal vein occlusion, looked at the smaller vessels and because laser’s always been thought to be important and also proven to be useful so we had to really do a head-to-head comparison with lasers.
Hamidi: At one year, central retinal vein occlusion patients who received a corticosteroid medication were five times more likely than those who did not receive treatment to experience a substantial visual improvement. But Dr. Chew points out that doses of both one and four milligrams we given.
Dr. Chew: The side effects for the 4 milligram was much higher than for the 1 milligram. So for that reason, 1 milligram would be the preferred treatment because the number of people who improve vision was very similar which was close to almost 30% and it was almost a 5 times increase or odds of improving your vision if you were given a steroid injection.
Hamidi: In the branch retinal vein occlusion—small vein occlusion study—which compared the use of laser versus steroids, the results suggested that laser is likely to be the more favorable treatment option.
Dr. Chew: And in fact, laser was almost identical to the treatment with steroid—that the vision improvement was very similar. And with laser, there isn’t the side effect of the cataract formation and the increased pressure, so it makes it a more desirable treatment because of that. So if you’re going to test anything else you’re going to want to test it against laser — that’s really become the standard of care.
Hamidi: Dr. Chew explains that although laser treatment is as effective as steroids, without as many side effects, steroids should not be ruled out as a potential therapy for retinal vein occlusions.
Dr. Chew: We’re not saying don’t use the steroids because the steroid obviously was as effective as the laser. There may be times when the laser is exhausted and you can’t get any better and maybe that might be helpful.
Hamidi: She adds that these steroids are not the same steroids that the public generally thinks about.
Dr. Chew: This is different from the steroid that, you know, people hear about out in the public – ones you use to make your muscles big, so this is a little bit different.
Hamidi: Dr. Chew acknowledges that while there is still much left to learn and to complement the results of the SCORE study, that this is one step in the right direction. For more information regarding the SCORE study visit www.nei.nih.gov/score. This is Anahita Hamidi, National Institutes of Health, Bethesda, Maryland.
NHGRI Launches Improved Online Talking Glossary of Genetic Terms
Balintfy: The National Human Genome Research Institute has launched the next generation of its online Talking Glossary of Genetic Terms. The glossary provides students, teachers and the public a reliable online resource for more than 200 terms and basic concepts behind today's breakthroughs in genetics and genomics. The website genome.gov/glossary can help those who want to understand genetics and genomics, or a term like "allele."
Witherly: What we try to do is create a single place to go where professionals can help you figure that out in a normal way.
Balintfy: Jeff Witherly is a senior advisor at the National Human Genome Research Institute’s Education and Community Involvement Branch. He explains that a new on-line glossary defines 256 genetic terms.
Witherly: A lot of the terminology in genetics, which is now working its way into the medical field, is not only common in the doctor's office, it’s common in movie plots that we see, and we try to understand it, it's become part of the American conversation. Some of these terms, like, are double terms, genetic variation, or even mitochondria, or what is DNA, or more difficult terms that are becoming more and more common, like allele, those are all terms that are easy to find in this glossary.
Balintfy: Witherly says each term has a written definition, that a layperson can understand, plus an audio explanation by NIH experts.
Witherly: They say some of the most wonderful things about these terms, with the passion that they have for the field, and the general understanding that somebody out there needs this.
Balintfy: For example, allele is explained by Dr. Leslie Biesecher (BEE-secker) a Chief and Senior Investigator at NHGRI.
Biesecker: So an "allele" is the word that we use to describe the alternative form or versions of a gene. People inherit one allele for each autosomal gene from each parent, and we tend to lump the alleles into categories. Typically, we call them either normal or wild-type alleles, or abnormal, or mutant alleles.
Balintfy: Witherly continues that in addition to the written definitions and verbal explanations, each term has a space for an illustration or a 3-D animation.
Witherly: For a teacher or a student, the illustrations can be downloaded in PDFs or PowerPoints, it can also be used copyright-free.
Balintfy: The Talking Glossary of Genetic Terms and a "Test Your Gene Knowledge" quiz are available at www.genome.gov/glossary. Stay tuned - after this break, some details from Dr. Fauci on flu vaccines. We’ll be right back.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Dr. Anthony Fauci on Influenza Vaccines
Balintfy: Earlier this month, the National Institute of Allergy and Infectious Diseases announced that healthy pregnant women have a good immune response following just one dose of the 2009 H1N1 influenza vaccine. The initial results were from an ongoing clinical trial measuring the safety and effectiveness of the H1N1 vaccine. To get some details and perspective on flu shots in general, I talked to Dr. Anthony Fauci, director of NIAID. My first question, why are flu shots important?
Dr. Fauci: Well, flu shots are important because they are the most effective way to avoid infection of influenza, both seasonal influenza as well as H1N1. Whenever you have an influenza threat, historically these vaccines have been quite effective, particularly in young, healthy individuals and in children, so it is one of the major modalities of preventing the spread of the influenza virus.
Balintfy: Dr. Fauci, how many flu shots should most of us be getting this year, is it two?
Dr. Fauci: Indeed, the fact is that there are individuals for whom H1N1 is a high priority. Those individuals should be getting H1N1. There are also a large number of individuals who overlap with that group, who should also be getting the seasonal influenza vaccine. So, an individual who would fall into the categories of benefit should be getting two separate vaccines. One is a seasonal vaccine, it contains three components to it, and the other one is the new 2009 H1N1 vaccine. People in the risk categories, such as pregnant women, young children and people with underlying conditions, that would predispose them to the complication, should unquestionably get both of them.
Balintfy: And when should we get these shots?
Dr. Fauci: The National Institutes of Health has done a study about the administration, simultaneously or separated, of the seasonal influenza vaccine injection, versus the H1N1 vaccine injection. They can be given on the same visit, as long as the injectable one, and you can get it as soon as it is possibly available. It’s never too early, and it’s never too late, so when it’s available, you should do it. The one thing that you can’t take, simultaneously, is the FluMist. For example, you can’t do the FluMist of the seasonal flu with the FluMist of the H1N1. They have to be separated by 28 days. You can go into the office and get the FluMist of one and the injection of the other, but you can’t do two nasal sprays at the same time. You can do two injections at the same time.
Balintfy: So is it possible that I could get both flues this season?
Dr. Fauci: It’s entire possible that if you don’t get vaccinated against the seasonal flu and you get the H1N1, when the seasonal flu comes around you very well, may also get the seasonal flu. That’s the reason why we emphasize, there are two separate vaccines, and the people who fall into the groups for which it’s recommended should get both.
Balintfy: Are there other things about flu prevention we need to remember Dr. Fauci?
Dr. Fauci: Yeah, we need to remember that in addition to vaccine, which is the best way to prevent the spread of influenza, there are common sense, hygienic things that can be done, as well as public health principles. The hygienic things is, wash your hands, you should cover your cough with your, put your face into the inner part of your elbow, you should sneeze into a handkerchief and throw it away. If you’re sick and a child, you shouldn’t be sent to school, and you’re sick and an adult you should not go to work. Those are the kind of common sense things that not only protect you but protect society.
Balintfy: And Dr. Fauci one more question: Do you think research will ever lead to a cure for the flu?
Dr. Fauci: Well, we don’t think in terms of a cure, we think in terms of a preventive modality, a vaccine that we would refer to as a universal vaccine, namely a vaccine that would protect you, consistently against any type of flu, the drifting changes that we see from year to year, as well as the occasional, rare, just a few times a century, pandemic, which we’re unfortunately going through right now. We refer to that as a universal influenza vaccine, or one that crosses all of the variations of influenza, and you can get it once or maybe boost it every few years and be protect. That’s the real goal that we’re aiming at.
Balintfy: Thank you very much Dr. Anthony Fauci. For more information on the flu, seasonal and H1N1, plus vaccine details, visit www.flu.gov. And that’s it for this episode of NIH Research Radio. Please join us again on Friday, November 27 when our next edition will be available for download. I'm your host, Joe Balintfy. Thanks for listening.
NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.