July 15, 2011
NIH Podcast Episode #0138
Balintfy: Welcome to episode 138 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: we go in-depth first with a report on how a four-year-old is part of a study to fight diabetes; also how neurology researchers can use Google Maps to chart the brain; and what changes baby-boomers can expect now that they’re starting to turn 65. But first, this news update. Here’s Craig Fritz.
Fritz: NIH-funded researchers have slowed an immune system attack on the ovaries of mice. The mice developed a disorder resembling primary ovarian insufficiency, a menopause-like condition that affects women under the age of 40, sometimes years or even decades before normal menopause. Some cases of the condition appear to result from an autoimmune response — an immune system attack on the body’s own tissues. In the mouse study, the researchers nearly halted the immune assault. They believe they were able to do this by teaching the animals' immune systems to recognize that the ovarian protein is a part of the body’s own tissues. The study confirms that the protein is the main target of the autoimmune attack. The ovarian protein is found in the egg cell, and is essential for the egg cell to divide after fertilization. The study results may one day lead to a way to identify women with a high probability for developing primary ovarian insufficiency early, perhaps in time to explore fertility-sparing options such as frozen embryo storage, or freezing unfertilized eggs. Primary ovarian insufficiency affects about 1 percent of women under the age of 40 in the United States.
For this NIH news update – I’m Craig Fritz
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up, seeing brain scans in a new way – with Google Maps; we learn the term sandwich generation; and studying the mystery of diabetes with the help of volunteers. That’s next on NIH Research Radio.
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Study reaches recruitment target with help of young volunteer
Balintfy: News reports of the worsening obesity epidemic and its link to serious health conditions like diabetes are everywhere. But a growing number of people have a form of diabetes that is not connected to being overweight or eating too much sugar. This disease, known as type 1 diabetes, develops when the body’s immune system attacks the pancreas and destroys its ability to make insulin. No one knows what causes the immune response behind type 1 diabetes. But tens of thousands of volunteers including a four-year-old, are helping NIH-supported researchers shed new light on this perplexing disease. Rita Zeidner brings us the story.
Zeidner: Emily Gershbein barely winces when staffers at the Pacific Northwest Diabetes Research Institute in Seattle poke her four-year-old daughter Tilly with a needle to draw blood. Tilly doesn’t seem to mind, either. At the end of one recent visit, she scored a teddy bear. Another time she left with a new backpack. But Emily has her eye on a much bigger prize: an eventual vaccine or other preventive treatment for type 1 diabetes.
Gershbein: I was just looking for a chance to participate in something that might lead to a cure or a better treatment for diabetes and my sister has been diabetic since she was about eight years old. So, growing up with her, I knew what it was like for someone with diabetes. I thought it would be a great chance to maybe help in a small way.
Zeidner: Emily is among thousands of parents worldwide who enrolled a child in an NIH-supported study known as TEDDY, shorthand for The Environmental Determinants of Diabetes in the Young. As a participating parent, she brings Tilly to a special clinic for a few simple tests every few months. Emily regularly collects a stool sample from Tilly and submits it to researchers. And for several days a year, Emily meticulously records everything Tilly eats.
Emily is acutely aware of the challenges people with diabetes face. Her sister, now in her 40s, needs to constantly monitor her blood sugar by pricking her finger. If her sugar level gets out of whack, her life is at risk. The only way to stabilize glucose is with an insulin injection. It’s a temporary solution and far from satisfactory.
In light of her family history and the fact that Tilly tested positive for diabetes antibodies as a newborn, enrolling her in the study was a no-brainer for Emily. Emily Gershbein:
Gershbein: When her blood was tested at birth, it showed a slightly elevated risk. So I thought it would be a good idea for her to join in case it might benefit her. And I thought it would be a good for people with type 1 diabetes in general in case some of the research would help those people.
Zeidner: Type 1 diabetes develops when the body’s immune system destroys the pancreas, the only organ that produces the hormone insulin. Our bodies need insulin to properly process glucose, which gives the body energy.
People with type 1 diabetes, like those with its more familiar cousin, type 2 diabetes, are at increased risk of serious complications such as blindness, kidney disease, nerve damage and amputation.
But unlike type 2 diabetes, which often can be managed through regular exercise and a healthy diet, people with type 1 diabetes need insulin injections.
Around the world, NIH scientists are hoping to discover what causes type 1—what researchers like to call etiology. Dr. Judy Fradkin, director of diabetes research at NIH, says finding the root of the disease could be key to controlling it.
Fradkin: The purpose of the study to try to find environmental triggers of type 1 diabetes is to find something either that is protective, that we could give to somebody to protect them from developing the disease or to find something that causes the disease. Some of the kinds of things we think might be involved are viruses and some very specific gastrointestinal viruses.
We also are looking very closely at dietary factors that might influence the risk of type 1 diabetes. Already there are some studies ongoing looking at avoiding cow’s milk and using a preparation in which the milk proteins are broken down to see if that might prevent it. Other evidence suggests that early exposure to cereals might be important. But we really don’t know which dietary factors might be involved.
Zeidner: In another large international study called TrialNet, researchers also are looking to parents, children, brothers, sisters and even aunts, uncles and cousins of people with type 1 to solve the puzzle of how the disease develops and how to prevent it. This large, international network already has recruited more than 80,000 people to have their blood screened for type 1 diabetes antibodies. People who have the antibodies or develop diabetes may be offered experimental treatments that may slow or halt progression of the disease.
Fradkin: People who are at risk of the disease when they are followed before they get the disease and are diagnosed earlier often have better outcomes. So they are less likely to develop a potentially fatal condition known as diabetic ketoacidosis. Also, because they are put on treatment earlier, they often have better function of their insulin producing cells. Even though they require insulin they are easier to treat because their bodies can retain the ability to make even a little bit of insulin which can make a big difference.
Zeidner: Emily Gershbein’s decision to get Tilly screened for diabetes carried benefits she never anticipated. Tilly doesn’t have type 1 diabetes like her aunt. But tests she received as part of TEDDY revealed she has a related condition: celiac disease.
In celiac disease are unable to digest gluten, a protein in wheat and other grains. For someone with the condition, eating bread, cake or similar products most of us take for granted can cause painful indigestion and permanently damage the intestinal tract. The only way to prevent the disease from progressing is to avoid all gluten. And Emily Gershbein says she got a head start.
Gershbein: The benefit of finding out so early about the celiac is that she didn’t have these symptoms, so she wasn’t suffering. And she could begin treatment right away, the treatment being a change in diet. A gluten free diet. So she didn’t have any of the adverse affects coming from undiagnosed celiac, which can lead to malnutrition, stunted growth and other problems.
Zeidner: Getting healthy people to volunteer for a study that tells them they are or may become sick can be a hard sell. But Dr. Fradkin says it’s important to look at the bigger picture.
Fradkin: The people who participate in tests like TrialNet or TEDDY are really not only helping themselves and their own families, but potentially making a huge difference in the lives of everybody in this country and around the world who’s at risk of type 1 diabetes. Because if we can find a strategy to prevent or delay the onset, we can give children back many years of carefree childhood without all of the difficulties of pricking their fingers and adjusting their insulin.
Zeidner: Participating in TrialNet is free. To find out more about how you can sign-up and help researchers find a cure for type 1 diabetes, call 1-800-HALT-DM1, 1-800-HALT-DM1. THAT’S 1-800-425-8361. Or go online to www.diabetestrialnet.org. Find information about all government-supported clinical trials at www.clinicaltrials.gov. This is Rita Zeidner, National Institutes of Health, Bethesda, Maryland.
Researchers map, measure brain’s neural connections
Balintfy: We all know that expression: TMI or too much information. Well, neurologists and researchers studying the brain, now have a way to combat TMI. David Laidlaw, a professor of computer science and an NIH funded researcher at Brown University explains a new way neurologists can look at the brain.
Laidlaw: The premise of the research is that when you try to study something complex, it helps to look at it simply first to sort of understand it from a big picture and then to be able to move into more details and trying to understand the details as you become aware that they're important. So, if you tried to understand the entirety of the brain in, you know, one picture say, there'd just be too much, it would be overwhelming. And so there's a process of discovery that usually involves looking at simpler representations first or models of things that abstract away the complexity in order to find the important parts of the complexity.
Balintfy: The brain’s wiring, circuitry and processes are certainly complex. One analogy would be comparing a map of the brain, to a map of the United States.
Laidlaw: That's a great analogy, the road system of the United States. If you're going to go from Providence, Rhode Island to Washington D.C., you're going to want to get on 95, but you're going to do that on small streets at first and you'll be going into a level of detail to figure out those small streets. And then as you cruise down through Connecticut and New York and New Jersey and Delaware and Maryland, you don't really have to look, you can put that all in one picture and zoom back out and look at that.
The brain is organized in actually quite an analogous way. It has lots of big pathways, which go from one region of the brain to another, but then they branch out like the little roads and oftentimes, problems can show up at that detailed level or they can show up in the bigger roadways and looking at things at the right level helps to find them more quickly.
Balintfy: And what better way to navigate than Google Maps.
Laidlaw: One of the things that Radu Jianu, my PhD student, did was to recognize that Google Maps is a great familiar interface for navigating through a two-dimensional world like the roadways and the paths that we navigate through all the time on the surface of the earth. But any two-dimensional picture can be put into that. And if you have a really big picture like say you make a complicated two-dimensional visualization of the brain, then you can navigate around in that picture using the same interaction you're familiar with from Google Maps.
Jianu: So my lab was looking into creating visual tools for looking at brains.
Balintfy: That’s David Laidlaw’s PhD student, Radu Jianu.
Jianu: So we are using scans, brain scans, which yield sort of matrices and numbers and we convert that into paths in space, into 3D paths in space. And then we take those 3D paths in space and project them into 2D and then we show that in the Google Map.
Balintfy: Jianu and Laidlaw are computer scientists, not medical doctors, but have basically made a new tool for medical researchers to better see and understand the images they’re already getting.
Laidlaw: Oftentimes, when a neurologist or a brain scientist is studying something about a brain, there's something different about that brain and they're trying to find it. So it's sort of a needle in a haystack kind of process. It's a search process. And if they don't know where to look, then they kind of have to look everywhere.
What we're trying to do is provide something like a metal detector, if you will, something that finds needles or at least gives you an idea of where to look for needles as you're in amongst all the hay in a haystack. So we abstract away things to give you the organization of the brain so you can try to figure out where to go and how to search it efficiently or effectively to find the differences that you're looking for and see how they relate to the rest of the brain.
Balintfy: Medical imaging systems currently in use allow neurologists to see the brain in color and 3-D with remarkable detail. Jianu explains they’re taking the data that makes those images and allowing for easier ways to look at it.
Jianu: It helps in understanding a dataset faster because you can see the global picture, which you're familiar with and then you can drill down to discover what makes this particular dataset special, how it's different to other brains. And that can be identifying those small bits of information that makes one dataset different from another can be hard if you're shown the whole data at once. So I think this process of drilling in and out really helps in this discovery.
Balintfy: He adds that there is another way this Google Map aspect can help researchers: it’s web-based.
Jianu: And then other researchers would be able to easily access the dataset and see what it's all about. And that can shave off a lot of time of exploring other people's datasets and discovering the ones that are interesting to your research.
Balintfy: Brown University’s Laidlaw also sees his role in this research as a tool smith.
Laidlaw: One of the things I often get asked is as a computer scientist, how is this stuff that I'm doing computer science; and I think that one of the roles of computer science is to be tool smiths. So in a sense, we are fashioning the tools that other scientists can use and I think that's kind of an image that doesn’t get sort of portrayed very often. So it's kind of an interesting context for the work that some computer folks do.
Balintfy: And does PhD student Jianu think brain researchers that want to share their data and use Google Maps should contact him?
Jianu: Yes, they should.
Balintfy: Learn more about this NIH-funded research at the website, http://news.brown.edu. And thanks to the Brown University press office for helping with this story. Coming up: What we know about retirement, happiness and health. That’s next on NIH Research Radio.
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Changes with age
Balintfy: Welcome back to NIH Research Radio. Back in episode 136, we talked with Dr. Marie Bernard a deputy director at an NIH institute about the baby boom generation turning 65. Now we’re talking more with her about changes with age, in particular how in many respects, things get better. For example, recent research by NIH-funded scientists has shown that happiness and well-being increase after middle age. Dr. Bernard, what factors might affect that?
Bernard: Well, what we know is that happiness or well-being is dynamic throughout life, and it appears that after age 50 or so things get better. You have less in the way of stress and anxiety. You have less in the way of worry. So it's I guess a good thing to be a baby boomer.
Balintfy: A number of studies have found that people who are involved in hobbies, social and leisure pursuits, may be at lower risk for some health problems, and may even live longer. Is this kind of social connectedness linked to happiness or well-being?
Bernard: Our research suggests that social connectedness is very important in later life. We have some researchers who’ve demonstrated that the network of individuals that you interact with can make a different in truly happiness. If you're interacting with happy people, you're more likely to be happy. If you're interacting with people who don’t smoke or who are stopping smoking, you're more likely to do that. On the flipside, if you interact with a lot of people who are obese, you are more likely to be obese and you have to be careful about your friends. But those networks are very important. We have other research that suggests that people who are involved with organizations like clubs or who are regular attendees at church tend to have better health and greater longevity than others.
Balintfy: Dr. Bernard, how about wealth: is that connected to health?
Bernard: Wealth and health do appear to be related from the standpoint that if you are not healthy in those years just before retirement or shortly after retirement your wealth is likely to go down. If you look at a couple, the health of both of those individuals relates to their wealth. If one of them becomes quite ill, that can deplete one's resources. So it seems to have an impact.
Balintfy: Wealth and finances certainly are one of the factors that influence the decision to retire. Are we’re seeing some changes in retirement patters?
Bernard: We’re seeing all sorts of patterns with regards to retirement. The days when people would retire and that's it – they sat back in the rocking – are long gone. And we see some people who go from full-time work to part-time work and then to a traditional retirement. Some people go from full-time working one job to another career. Some people have been working full-time who go to full or part-time volunteer work which is as demanding as when they were in the work life, people following lots of different patterns and it seems to be correlated with people having better health and more vigor.
Balintfy: Another pattern, perhaps a challenge is this concept of the sandwich generation. Can you explain that Dr. Bernard?
Bernard: The sandwich generation is generally boomers again who have frail elderly parents as well as adult children. With the current cohort of older individuals living longer is very likely that someone who is born between 1946 and '64 has a parent who is in their 70s, 80s, maybe 90s who has frailty, that's frail physically or cognitively. They also may have still teenage children or adult children. Particularly they had an empty nest that got filled again with the economic downturn we've had recently. So those individuals who are between are considered the sandwich generation responsible for caring for both the older and the younger generation.
Balintfy: There are certainly many factors for older Americans and the baby boomers to consider. But do you also think there are more resources for them?
Bernard: I agree. I think that we know a lot more now than we did 50 years ago about what's needed to have a healthy lifestyle. And if people pay attention and take advantage of resource that are available at NIH in particular. There are lots of tips to help you to live as healthy life as possible.
Balintfy: Thank you again Dr. Marie Bernard. For those tips from NIH on healthy aging and topics for baby boomers, visit www.nia.nih.gov. And that’s it for this episode of NIH Research Radio. Please join us again on Friday, July 29 when our next edition will be available. If you have any questions or comments about this program, or have story suggestions for a future episode, please let me know. Best to reach me by email—my address is email@example.com. I'm your host, Joe Balintfy. Thanks for listening.
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