June 2016 Grand Rounds

Jun 14, 2016 at 10:31 am by steve


HIV Vaccine Should Adapt as Virus Mutates

Human immunodeficiency virus is a highly variable virus that adapts to a person’s immune response during the lifetime infection, and a study published in Nature Medicine shows that viral adaptation in HIV can predict a person’s current disease status, as well as the degree to which newly transmitted HIV-1 is adapted to their new host.

By using a novel method to measure the extent of adaptation of a virus to a person’s cellular immune response, the investigators were able to predict how rapidly the disease would progress in that person.

The cellular arm of the immune response, through CD8+ T-cells, eliminates HIV-infected cells. These T-cells are activated by pieces of the virus, peptide epitopes, presented on the human leukocyte antigen proteins on the surface of antigen-presenting cells. HLA is a cell surface protein that is one of the most polymorphic variable parts of the human genome, as unique as each person’s DNA.

Some spontaneous mutations in HIV change the epitopes, the antigens to which a T-cell binds, so that the HLA proteins no longer present them effectively, and no longer stimulate an immune response. This process of viral adaptation is constantly occurring, and some adaptations persist even after sequential transmissions to new individuals.

An international team, led by scientists from UAB, Microsoft Research, and Emory University, uses a model to quantify viral adaptation, showing that being infected by a virus highly adapted to their immune response is very detrimental to that individual.

“Individuals who were infected by a pre-adapted virus progressed three times faster to low CD4 counts and had much higher viral loads,” said Jonathan Carlson, PhD, senior researcher at Microsoft Research.

The researchers show that epitopes that are adapted are poorly recognized by the immune system when they are transmitted to individuals, and even when the adapted epitope is recognized, the immune response is much less effective at killing infected cells.

In this way, parts of the virus that would normally trigger an immune response are invisible to key components of the immune system, suggesting that universal holes exist in the immune response.

“If we can’t get functional responses to those adapted epitopes in the context of natural infection, it will be challenging to get responses induced by a vaccine,” said Eric Hunter, MD of Emory University.

An analysis of immune responses measured in the Step HIV vaccine trial showed that the more adapted the vaccine candidate, the poorer the response.

“As vaccines are developed for prevention of HIV, it is important to think about how we are designing it,” said Paul Goepfert, MD, director of UAB’s Alabama Vaccine Research Clinic. “To get the immune system to respond to the vaccine, you have to think about its response to the adapted form of HIV, and focus on those parts of the virus that are most difficult to undergo adaptation.

“The ideal vaccine would produce antibodies and cell-mediated responses. We haven’t optimized vaccines to be nonadapted to see if they would improve efficacy.”

While the number of infections seen within the United States has decreased over the past 10 years, there are still more than 50,000 new infections each year. Effective therapy to treat HIV has been available for almost 20 years, but developing better prevention methods is essential in decreasing or ending the number of cases of infection.

 

BioAlabama Meets Alabama 4th in US for Biotech R&D

Recently, more than 100 biotech CEOs, university leaders, researchers, entrepreneurs and investors convened in Birmingham for the 2016 BioAlabama Annual Meeting to identify opportunities for innovation and economic development stemming from the state’s growing biotechnology industry.

Strategies to develop innovative ideas and research—and transition those ideas into successful, job-creating companies—was the topic of two featured panel discussions and a keynote presentation from Rafael Andino, Vice President of Clearside Biomedical, a Georgia-based biopharmaceutical company that recently began the registration process for its Initial Public Offering.

This year, BioAlabama presented the inaugural Element Award, recognizing an individual’s ongoing efforts to help build the biotechnology and life science industries in Alabama, to Jim Hudson, co-founder of the HudsonAlpha Institute for Biotechnology in Huntsville.

The Alabama life sciences industry continues to flourish and be recognized globally for meaningful contributions to health and to agriculture. The latest Alabama Life Sciences Report indicates the life sciences industry in Alabama has experienced strong annual growth of 7.9 percent, ranking Alabama fourth in the country for growth in biotechnology research and development. This emerging economic engine can be seen in the more than 660 life science entities and their more than 13,000 employees in the state.

 

BioDynami Joins HudsonAlpha Campus

BioDynami, a biotechnology company established in 2015, announced that it has opened an office at the HudsonAlpha Institute for Biotechnology. BioDynami provides solutions for life science research and development, including reagents and services for next generation sequencing (NGS) library preparation and molecular cloning.

Cofounder and CEO Lisa Chen, MBA, is excited about the company’s relocation. “Given HudsonAlpha’s rapid growth, there are tremendous opportunities to collaborate with local biotechnology companies,” Chen said. “Huntsville’s sky is unlimited.”

One of BioDynami’s products is the NGS DNA Library Prep Kit. The kit is the fastest on the market so far. DNA libraries created with this kit will be ready in less than one hour, with only seven minutes of hands-on time, while similar kits from other companies take hours to get a library ready. The high library conversion efficiency makes it the best choice for researchers.

BioDynami is expanding its technology to other applications, such as low input DNA library preparation, cfDNA library preparation and library preparation directly using intact genomic DNA. BioDynami also provides reagents for DNA cloning and PCR cloning.

 

Brookwood Baptist Medical Center Earns National Accreditation for Bariatric Center

Brookwood Baptist Medical Center recently earned national accreditation as a comprehensive bariatric center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) – a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

The certification verifies that patients seeking surgical treatment for severe obesity and its related conditions will receive an extraordinary quality of care that meets the highest standards for patient safety. Only four centers in Central Alabama have earned the prestigious accreditation, two of which are Brookwood Baptist Health locations – Brookwood Baptist Medical Center and Princeton Baptist Medical Center.

“This accreditation is a testament to the commitment our staff has to offering our patients a multidisciplinary approach that includes preoperative and postoperative care personalized to each patient. It truly makes an impact on their long-term success,” Dr. Cameron Askew, Metabolic and Bariatric Surgery Director at Brookwood Baptist Medical Center said.

To earn the MBSAQIP designation, the hospital underwent an extensive site visit to measure essential criteria for staffing, training and facility infrastructure and protocols for care – ensuring its ability to support patients with severe obesity. The center also participates in a national data registry that yields semiannual reports on the quality of its processes and outcomes, identifying opportunities for continuous quality improvement.

Jackson Thornton Technologies Manager Earns Designation

 Rick Thompson, with Jackson Thornton Technologies (JTT), has earned the Certified Information Systems Security Professional (CISSP) designation.

Thompson, JTT’s Technical Services Manager, has worked in the technology industry for over 12 years. He is a systems, network and security engineer with hands-on technical experience in both the public and private sectors and advises clients on all aspects of information privacy and security programs. To achieve the CISSP designation, Thompson met stringent requirements including professional experience and a deep understanding of and expertise in cybersecurity threats, technologies, standards, practices and regulations.

 

Alabama Listed as Third Best Place in U.S. to Practice Medicine

Alabama — specifically Birmingham — is the third-best place in America to practice medicine, according to Medscape, a division of the WedMD Health Professional Network.

Medscape analyzed cost-of-living data, average compensation, malpractice rates, affordable housing, state and local tax rates, and physician density as part of its decision-making process. A variety of quality-of-life measures were consulted, as were data on a community’s appeal for physicians at different stages of their careers.

The publication cites the presence of the UAB Health System as one major draw, along with good physician compensation, low cost of living and a low tax rate. A favorable malpractice environment is also listed as a benefit.

 

Top Scientist to Chair UAB Pathology

George Jabboure Netto, MD, an internationally recognized clinician-scientist, has been named chair of the Department of Pathology at the UAB School of Medicine.

Netto comes to UAB from the Johns Hopkins University School of Medicine, where he is the director of Surgical Pathology Molecular Diagnostics and professor of pathology, urology and oncology. He will join UAB on Oct. 1, 2016.

“I am thrilled to join the distinguished team of scientists and clinicians at a world-premier institution such as UAB,” Netto said.

UAB’s Department of Pathology is currently ranked 10th nationally among its peers in funding from the National Institutes of Health. The clinical service completes more than six million procedures each year.

Netto’s primary research interest has focused on the evaluation of molecular biomarkers to serve as potential markers of detection, prognosticators and therapeutic targets in the management of urologic cancers. He is also recognized for his expertise in molecular diagnostics of solid tumors.

Netto began his career at Damascus University in Syria, where he earned his medical degree before beginning a residency in anatomic and clinical pathology at Baylor University Medical Center. Following residency, he completed fellowships in surgical pathology at the Washington University School of Medicine and in urologic pathology at Memorial Sloan-Kettering Cancer Center.

He joined the faculty at Baylor in 1996 and served as director of the residency training program, director of tissue procurement and director of molecular pathology.

He joined the Johns Hopkins School of Medicine in 2005. While at Hopkins, he gained international experience as medical director of Amcare Labs International Inc., and as international medical director of the Johns Hopkins Clinica Las Condes and Clinica Las Condes Comprehensive Cancer Center in Santiago, Chile.

 

K. David Moore, MD Joins Andrews Sports Medicine

K. David Moore, MD has joined Andrews Sports Medicine and Orthopaedic Center.

Moore previously served as Director of the Center for Joint Replacement at UAB. He joined the faculty at UAB in 2001, after serving as Chief of Adult Reconstruction for the United States Air Force at Wilford Hall Medical Center in San Antonio, Texas.

“We are excited to welcome Dr. Moore to our practice,” said Dr. E. Lyle Cain, Jr., managing partner with Andrews Sports Medicine and Orthopaedic Center. “Dr. Moore’s depth of knowledge, expertise and research in joint replacement surgery is an asset to our practice.” 

Moore is currently one of only a handful of surgeons in the country using three-dimensional CT scans and computer-assisted manufacturing to create patient-matched implants for use in complex, total hip revision. His clinical interests include minimally invasive surgery, early intervention in the treatment of arthritis, image-assisted surgery, and alternative bearings in total joint arthroplasty.

“Andrews Sports Medicine has an international reputation for excellence. I have had the pleasure of knowing many of the surgeons at Andrews for years and I have entrusted them with the care of my family on several occasions,” Moore said.

Moore is a member of the American Association of Hip and Knee Surgeons and the American Academy of Orthopaedic Surgeons. He is a reviewer for the Journal of Bone and Joint Surgery, The Journal of Biomedical Research, Clinical Orthopaedics and Related Research, and The Journal of Arthroplasty.

 

Richard Donlan, MD Joins DCH Center for Occupational Health

Richard Donlan, MD has joined The DCH Center for Occupational Health.

Donlan graduated from the University of Florida College of Medicine with a fellowship in primary care sports medicine after completing a residency in physical medicine and rehabilitation at the University of Pittsburgh Medical Center. Donlan graduated from the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine and received his bachelor of science in biology from Loyola College in Baltimore.

He has served as an assistant team physician for the University of Florida, Santa Fe College and several high school football teams in Florida and Pennsylvania.

Donlan is board certified in physical medicine and rehabilitation and sports medicine. He is a member of the American Academy of Physical Medicine and Rehabilitation, the American College of Occupational and Environmental Medicine, the American College of Sports Medicine and the American Medical Society for Sports Medicine. He has co-authored multiple peer-reviewed publications and given presentations at national meetings.

 

UAB New REACT Center

UAB has added a unique new center designed to serve as a national resource for medical rehabilitation researchers. The REACT Center — Rehabilitation Research Resource to Enhance Clinical Trials — offers training, consultation, funding and additional tools to catalyze high-impact interdisciplinary clinical trials. The center is one of six similarly funded nationwide by the National Institutes of Health’s P2C grant program. REACT will also serve as the nation’s first coordinating center for the six centers, sponsored primarily by the NIH National Center for Medical Rehabilitation Research.

The $5.7 million, five-year REACT award commenced in October 2015, with the coordinating center, or MR3 Network — National Medical Rehabilitation Research Resource Network — launched in February 2016. Principle investigator Marcas Bamman, Ph.D., serves as director of REACT, as well as the MR3 Network Coordinating Center.

 

AQAF of Alabama, IQH of Mississippi form Strategic Alliance                                

Alabama Quality Assurance Foundation (AQAF), a Birmingham-based nonprofit organization dedicated to improving health in Alabama, is entering into a strategic alliance with Information & Quality Healthcare (IQH), based in Ridgeland, Mississippi.

AQAF and IQH will operate under a newly formed management company, Quality Partners Management Services, Inc.

AQAF has provided health care quality improvement and utilization review services in Alabama for more than 40 years. AQAF works with Alabama health care providers and health plans to ensure that patients receive safe, cost-effective and evidence-based care.

IQH, a Mississippi not-for-profit corporation, has worked to improve the health of patients through quality improvement and tobacco cessation services.

Under a contract with the Centers for Medicare & Medicaid Services, both AQAF and IQH are members of the atom Alliance, a Quality Innovation Network-Quality Improvement Organization that serves Alabama, Indiana, Kentucky, Mississippi, and Tennessee.

AQAF and IQH will continue to provide services to their clients in their respective states. Quality Partners Management Services, Inc., which will be based in Birmingham, will provide administrative support to both organizations.

 

ART Fertility of Alabama Celebrates 30th Anniversary

ART Fertility of Alabama, an award-winning fertility program with offices in Birmingham, Huntsville, Tuscaloosa, and Montgomery, is celebrating its 30th anniversary of helping couples have healthy babies. The ART Fertility Program is dedicated to provide each couple with personal care in a safe and cost-effective manner.

“The Art Fertility Program of Alabama has been providing families across the state with the top care to result in the highest possible pregnancy rate and minimize the occurrence of high-risk multiple pregnancies,” states Virginia Houserman, MD. “It has been a magical 30 years and we are excited to continue helping families across Alabama.”

The program is led by Dr. Kathryn Honea, Dr. Virginia Houserman, Dr. Cecil Long and Dr. Chris Allemand who are Board Certified specialists in Reproductive Endocrinology and Infertility. All are skilled in comprehensive infertility care and offer a complete range of infertility services.

 

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