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Virgin births on the rise

Tue, 21 May 2013 15:24:00 GMT

Medical Discovery News
By Drs. David Niesel and Norbert Herzog

What do the New Mexico whiptail lizard, the water flea, the marbled crayfish, the boa constrictor and the bonnethead shark have in common? All these animals can create offspring without a fertilized egg. This means a diverse group of animals can produce young by “virgin births,” without sexual contact. This is not a new concept but we are now recognizing the wide diversity of species capable of virgin births.

This nonsexual process of reproduction in animals is called parthenogenesis, from the Greek word for virgin birth. In the blockbuster movie “Jurassic Park” one of the precautions taken was that only female dinosaurs were produced by recombinant DNA methods, to prevent them from reproducing uncontrollably. But when paleontologist Alan Grant (played by actor Sam Neill) and the children escaped from a Tyrannosaurus rex, they saw hatched dinosaur eggs. This showed that the female dinosaurs in the park were reproducing by the process of parthenogenesis.

Basic biology teaches that the process of reproduction has a strict requirement: a sperm and an egg must unite to create a fertilized egg that will develop into an embryo. During this process, a re-assortment of the male and female chromosomes occurs, which are then reduced to the normal level. This process of chromosome reduction is meiosis. In parthenogenesis, because there is only the set of female chromosomes, meiosis does not occur. And since all the chromosomes come from the mother, all the offspring are females, identical clones of the mother.

Parthenogenesis is risky to a species because it does not allow for increasing genetic diversity, a hallmark of sexual reproduction. Without genetic diversity, mutations can be passed down to new generations, which can accumulate and have damaging effects on the species. One clever mechanism for parthenogenic organisms to achieve genetic diversity is used by bdelloid rotifers, microscopic freshwater animals. They have evolved the ability to “grab” DNA from their environment and incorporate it into their own genome, handing down this new genetic information to the next generation. This must be successful, since this species has not had a male member (or any sex) in at least 40 million years!

Over the past decade, several new animals were found to be capable of parthenogenic reproduction in captivity. For example, female Komodo dragons that had not been in the presence of a male produced offspring that were genetically identical to the mothers. In nature, these lizards were thought to reproduce only sexually, so this was a surprise. In addition, a bonnethead shark and a boa constrictor were also found to produce genetically identical female offspring without sexual contact.

In all these cases, scientists do not know what triggers this nonsexual mechanism of reproduction. It seems certain that the process can sustain the species when no males are available. In itself, this may represent an evolutionary adaptation to preserve a species.

Science faces a frontier in terms of understanding parthenogenesis in the animal world. Understanding the signals that trigger this process could help save endangered species on Earth. And the possibility that biomedical science could bring this ability to humans means that it could also be a future concern for medical ethics and society.

Medical Discovery News is a weekly radio and print broadcast highlighting medical and scientific breakthroughs hosted by professor emeritus, Norbert Herzog, and professor, David Niesel, biomedical scientists at the University of Texas Medical Branch at Galveston. Learn more at www.medicaldiscoverynews.com.

Inside UTMB

Tue, 21 May 2013 07:00:00 GMT

Memorial Day closures
UTMB schools, business areas, administrative offices and most clinics will close Monday, May 27, for Memorial Day. John Sealy Hospital and the Trauma Center will be open, along with pediatric urgent care clinics at 2027 61st St. in Galveston and 3023 Marina Bay Drive in League City. Also open will be UTMB’s new adult urgent care clinic in the Specialty Care Center at Victory Lakes. All three urgent care centers will open from noon to 8 p.m. For more information about UTMB clinic hours, services and locations, visit www.utmbhealth.com or call the UTMB Access Center at 409-772-2222.

Free screening mammograms
Each year, UTMB Health and The Ruth Kempner Endowment for Breast Cancer team up to provide free screening mammograms for uninsured women in the community through a mobile mammography van that goes to two area churches. Participants must pre-register and meet a number of criteria to qualify such as be a legal resident of Galveston County, between 40 and 64, uninsured and other requirements.

Screening will take place 8 a.m. to 3 p.m., Sunday, June 2, at the Greater Barbour’s Chapel Baptist Church, 7420 Highway 1765, Texas City (deadline for registration is May 26); and 8 a.m. to 3 p.m. on Sunday, June 9, at the St. Augustine Episcopal Church, 1410 4th St., Galveston (deadline for registration is June 2). Registration packets are available at the churches or the UTMB breast imaging department at the Specialty Care Center at Victory Lakes in League City or in Galveston. For more information regarding the program, call 832-505-1721.

Educator award
Dr. Karen Szauter recently was honored by the American Association of Medical Colleges with the Career Educator Award. The Career Educator Award, presented by AAMC’s Southern Group on Education Affairs, recognizes her lifetime achievement in medical education, including a record of scholarship, leadership, collaboration and professionalism. She is a professor in the department of internal medicine and is an inaugural member of UTMB’s Academy of Master Teachers and was inducted in 2008 into the University of Texas Academy of Health Science Educators. In addition, she received the UT System Board of Regents’ Outstanding Teaching Award in 2012.

Moody brain research prize
UTMB recently awarded the Robert L. Moody Prize for Brain Injury Research to Dr. Jennie Ponsford, professor of neuropsychology at Monash University and director of the Monash-Epworth Rehabilitation Research Centre at Epworth Hospital in Melbourne, Australia. Ponsford is a prolific author, teacher, researcher and activist in the field of traumatic brain injury. The award was presented at the 13th annual Galveston International Brain Injury Conference at Moody Gardens hosted by UTMB’s School of Health Professions and the Transitional Learning Center.

Research volunteers
Volunteers are needed for an asthma research study. Individuals may qualify for one of UTMB’s studies if they have a history of physician-diagnosed asthma and are 18 to 65 and a non-smoker for at least one year. For more information, contact Afifa Khalil in the clinical trials office at akhalil@utmb.edu or 409-747-1887.

UTMB research presented in Finland
UTMB’s Dr. Tasnee Chonmaitree was an invited speaker at the Frontiers of Science seminar series in Turku, Finland, designed to bring top scientists to present their recent achievements on various fields of biology, cell and molecular biology and biotechnology. Chonmaitree’s speech and grand rounds presentation addressed the new American Academy of Pediatrics Clinical Practice Guideline on acute otitis media, which she co-wrote.

Pain, pain, go away Gene therapy at center of UTMB effort to eliminate neuropathic pain

Mon, 20 May 2013 15:39:00 GMT

University of Texas Medical Branch at Galveston researchers have been awarded a five-year, $1.8 million grant by the National Institute of Neurological Disorders and Stroke to apply the techniques of gene therapy to the problem of neuropathic pain — that is, pain that arises from a malfunction in the nervous system.

Neuropathic pain is a daily reality for millions of Americans, manifesting itself in a variety of life-impairing ways. Someone suffering from neuropathic pain might feel intense discomfort in response to a light touch, for example, or suddenly feel as though he or she were freezing in response to a small decrease in temperature. Caused by either accidental or disease-induced nerve damage, this kind of pain has proven very difficult to treat.

“Patients in neuropathic pain are willing to do almost anything to get relief,” said Dr. Volker Neugebauer, the co-principal investigator on the grant. “They’re in torment, often in really desperate situations.”

To make matters worse, long-term neuropathic pain often causes depression, acting through emotional mechanisms in the brain meant to underscore the importance of pain signals. Depression further increases the perception of pain, creating a vicious cycle of increasing pain and depression. And while conventional pain medicines can block the pain signal, they are usually successful for only a limited time only; eventually the pain returns when the nervous system compensates for the blockade.

Neugebauer and his UTMB colleague and co-principal investigator Thomas Green believe that a better anti-neuropathic pain strategy is to target higher brain regions and prevent the abnormal generation of persistent emotions. They focus on the amygdala, a structure best known for its role in emotional responses, including anxiety and depression and — in Neugebauer’s previous work — for its connection to pain regulation. Neugebauer and Green hypothesize that stopping abnormal activity in the amygdala by a particular type of receptor for the neurotransmitter serotonin will enable the successful treatment of neuropathic pain.

Although increased serotonin activity in the brain is generally thought of as a good thing — it’s the mechanism used by many antidepressant drugs — activation of the serotonin 2C receptor in the amygdala can cause problems, according to Neugebauer. “In neuropathic pain we see that this receptor is activated on cells that regulate output from the amygdala to brain areas where responses to potentially harmful situations are generated,” Neugebauer said. “This activity should be turned off when such response is no longer needed or useful, but these serotonin 2C receptors continue to drive amygdala output, creating a chronic pain state.”

In experiments with laboratory rats in which neuropathic pain behavior has been induced by nerve damage, Neugebauer and Green plan to investigate the possibility of “re-normalizing” the amygdala by injecting it with specially designed viruses containing genetic material that blocks cells’ generation of serotonin 2C receptors.

“The viruses that we’re using are adeno-associated viruses, very common vectors that about 80 percent of the people in our society have been exposed to,” Green said. “We’ve modified them so that they can’t replicate, and inserted a gene that instructs the amygdala cells to make small pieces of RNA that interfere with the production of serotonin 2C receptors.”

According to Green, who has been working with similar gene-therapy techniques for more than 10 years, the viral injections produce permanent effects in the brain and no off-target effects. The researchers plan to test the rats’ response to the treatment with a variety of behavioral experiments that will examine both its effect on chronic pain behavior and behaviors associated with depression.

In addition to the behavioral investigation, the project will include electrophysiological studies of amygdala activity, in an effort to further define the “circuitry” of this key pain and emotion center. It will also examine the inconsistent results achieved when chronic pain is treated with selective serotonin reuptake inhibitor antidepressants, attempting to determine whether serotonin 2C receptor activity might be responsible.

“SSRIs increase serotonin, and most of the serotonin receptors produce good effects,” Neugebauer said. “But increasing serotonin also means you’re hitting the 2C receptor as well, perhaps mediating undesirable effects. We want to take that out and then see if increasing serotonin produces consistently good effects.”

Protect yourself, loved ones with flu shot

Mon, 20 May 2013 09:35:00 GMT

By Dr. Richard Rupp and Bridget Hawkins

Dear VaccineSmarts,

Last year, I got the flu shot and ended up getting sick. What gives?

Horatio from Dickinson

Dear Horatio,

We sometimes hear this from parents coming in for their children’s immunizations.

While we have sympathy for those who become ill after receiving their flu shot, we can assure you that the flu shot does not give you the flu.

That being said, there are a few reasons why people might be experiencing illness following their flu shot. They might have been sick before receiving the flu shot or they might be sick from a cold virus that has similar symptoms to the flu.

Sometimes people end up getting the flu despite receiving the flu shot and experience more mild symptoms (the vaccine is not 100 percent effective), or they might have contracted a strain of the flu that is not covered by that year’s flu shot.

Every year, the flu vaccine makers determine which strains of the flu virus will be circulating in the United States. Sometimes their predictions are incorrect and alternate strains spread instead, rendering that season’s flu vaccine ineffective for those particular strains.

But improvements in technology and methods used to predict the strains have made this less likely in recent years. New vaccines are being developed that target a part of the flu virus that is common in all of the known strains of the flu virus.

If they are safe and effective, it’s thought that these universal vaccines would replace the seasonal flu vaccines, reducing the amount of flu vaccines needed throughout a person’s lifetime.

Flu shots are recommended for anyone older than 6 months, but are especially important for people who have a higher risk of complications from the flu such as pregnant women, those with chronic illnesses or compromised immune systems and senior citizens.

If you fall into one of these groups, you should consult your physician before obtaining a flu vaccination.

Another option for families to consider is “cocooning,” which is when all of the family members get vaccinated to protect a vulnerable family member in the house — such as a grandparent or a child with leukemia — from being exposed to the flu.

Even if you are the type of person who never gets sick, you should think about getting immunized to protect not only you, but your loved ones as well.

Dr. Richard Rupp is a pediatrician and member of UTMB's Sealy Center for Vaccine Development. Dr. Bridget Hawkins, Ph.D., is the assistant director of the Sealy Center for Vaccine Development. This column is supported by a UTMB President's Cabinet Award to provide information about vaccines. Visit www.utmb.edu/scvd/vaccinesmarts for more information.

More than one third of Texas women still receive unnecessary breast biopsy surgery

Thu, 16 May 2013 16:36:00 GMT

Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. Since 2001, national expert panels have recommended that the first course of action for women with breast lumps or masses should be minimally invasive biopsy.

Minimally invasive biopsies are most commonly done under ultrasonographic or X-ray guidance, with either a fine needle or preferably a “core tissue extraction” needle. They do not require surgery or anesthesia and leave little to no scarring. Most importantly, a diagnosis of benign (non-cancerous) or malignant (cancerous) breast mass can be determined before any decisions about treatment are made.

UTMB Director of Breast Imaging Dr. Morton Leonard points to a suspicious mass in a breast mammogram image. Click here to download a high-resolution version of the photo.

In spite of these benefits, new research from the University of Texas Medical Branch published in the Journal of the American College of Surgeons shows that expensive, invasive surgical breast biopsies remained the first diagnostic step for 35 percent of women diagnosed with a breast mass between 2000 and 2008 in Texas. The investigators performed an exhaustive analysis of Texas Medicare data from 2000 to 2008, including more than 87,000 breast biopsies.

The traditional method of removing the mass through surgery to obtain a definitive diagnosis has a number of negative consequences. If the mass is benign, then the woman had surgery unnecessarily; in fact, only 40 percent of the women studied ended up having breast malignancies. Simply put, thousands of women throughout Texas underwent surgery just to find out they did not have cancer.

Jennifer Thomas, UTMB mammographer, shows the core tissue extraction needle used for minimally invasive breast biopsies. Click here to download a high-resolution version of the photo.

On the other hand, if the mass is malignant, more surgery will probably be required to remove more tissue, so the patient will end up having to have multiple surgeries instead of only one. Surgery is far more expensive than needle biopsy, so for the Medicare patients in this study who underwent biopsy surgery, the government had to pay a much steeper tab.

“There is no benefit to the patient in having an expensive, invasive surgical procedure instead of a needle biopsy,” said senior author Dr. Taylor Riall, UTMB associate professor of surgery and a lead investigator for the study. “We need to get the word out to women across the state that surgery is not the procedure of choice for definitive diagnosis of a breast mass.”

The American Society of Breast Surgeons, the American College of Radiology and the National Cancer Center Network have all endorsed minimally invasive breast biopsy as providing results that are as accurate as surgical biopsies.

“At UTMB, minimally invasive biopsies are our diagnostic procedure of choice. We do them more than 98 percent of the time,” said Riall.

The National Cancer Center Network is trying to find out what barriers stand in the way of reaching a 90 percent rate of minimally invasive breast biopsies nationwide. The study is a step in providing crucial information that will help in the national effort.

This research, which was supported by the Comparative Effectiveness Research on Cancer in Texas research project, also examined the time trends, racial/ethnic variation and geographic variation in the use of biopsy techniques. It is the most detailed study of breast biopsy patterns undertaken in the United States and was funded by the National Institutes of Health and the Cancer Prevention Research Institute of Texas.

Co-authors are Christopher Zimmermann, Kristin Sheffield, Dr. Casey Duncan, Yimei Han, Catherine Cooksley and Dr. Courtney Townsend.

What you can do now to help prevent age-related muscle loss

Wed, 15 May 2013 14:58:00 GMT

UTMB’s Douglas Paddon-Jones and Dr. Elena Volpi weigh in on how best to prevent age-related muscle loss. Paddon-Jones advises doing resistance training: “It’s massively important for building muscle — and preventing it from vanishing in the first place.” If you’re deficient in vitamin D (your doctor can do a simple blood test) consider upping your daily intake with a supplement, suggests Volpi.

The surprising connection between your sinuses and stroke

Wed, 15 May 2013 14:55:00 GMT

Many of us already know that sinus conditions can trigger headaches and congestion, but a new study from Taipei Medical University says the inflammation that causes the pain and pressure of a sinus infection also increases the odds of suffering a stroke. UTMB’s Dr. Meera Gupta explains that sinus infections are most commonly caused by the same viruses associated with the common cold. When a virus sets up shop in your sinuses, it produces inflammation that causes the telltale pressure around the nose and eyes.

Can genetic testing determine your arthritis risk?

Wed, 15 May 2013 14:52:00 GMT

“Osteoarthritis has less of a genetic component than rheumatoid arthritis,” says UTMB’s Dr. Emilio Gonzalez. Experts say about 30 percent of the risk of OA is probably genetic. “But even if a [genetic] test revealed that you had an elevated risk, the advice wouldn’t differ from what we tell everyone, regardless of their family history or genes: Keep your weight in check, don’t smoke, and exercise regularly.”

Get in more fruits and veggies by juicing them

Wed, 15 May 2013 14:50:00 GMT

In this week’s column, UTMB’s Dr. Victor S. Sierpina writes about the benefits of juicing. “Drinking your fruits and veggies can easily get you on your way to meeting the minimal of servings we need daily. One good smoothie or juice can give up to 3-4 servings of plant-based antioxidants, fiber, vitamins, in a single easy to prepare, refreshing drink. All you need is a blender or juicer, some simple ingredients, and a little motivation.”

Tips for traveling in airplanes with kids

Wed, 15 May 2013 10:04:00 GMT

In this week’s Keeping Kids Healthy column by UTMB Drs. Sally Robinson and Keith Bly: The American Academy of Pediatrics has tips for traveling by air with children. “Talk to your children before coming to the airport about the security screening process. Let them know that their bags (backpack, dolls, etc.) will be put in the X-ray machine and will come out the other end and be returned to them.”