Andrea Foulkes, associate professor of Biostatistics, recently received a five-year, $2 million grant from the National Institutes of Health to develop mathematical and statistical tools to improve prevention and treatment of cardiovascular disease and HIV/AIDS. Her work will organize genetic, immunologic and demographic data to examine how best to predict clinical outcomes such as heart disease.
As Foulkes explains, “There is more and more evidence now suggesting that a long-term viral infection can lead to a cascade of inflammatory responses associated with higher risk for cardiovascular disease. It also appears that complex diseases, particularly heart disease, are not caused by a single environmental exposure or agent, nor by a single genetic mutation, but by a constellation of these intersecting factors plus demographic factors such as race/ethnicity, gender and age.”
Discovering links among factors to identify potential patterns could improve clinical treatment options. “We’re looking for predictive markers, a cluster of characteristics that when they occur together warrant a closer look. The ultimate goal is to use all these factors to help clinicians decide on the best treatment strategy. We’re also trying to find ways to do this at lower cost,” says Foulkes.
Though the data are available now, clinicians and medical researchers are still working on how best to organize huge sets of information to identify a potential treatment breakthrough. “We’re at the stage of exploring the data, trying to develop tools that will allow us to find the meaningful points and patterns, particularly related to cardiovascular outcomes,” Foulkes notes.
The sheer amount of data available can seem overwhelming. Regional and national disease registries and research projects can collect literally hundreds of biomarkers, along with hundreds of thousands of bits of genetic information, for each patient. The work addresses a fact that medical researchers are now coming to realize that “you need a lot more patients than we expected because the effects of each factor individually are small. That’s just a phenomenon of statistics,” the biostatistician points out.
Though the power of huge numbers may allow Foulkes to discover a previously unsuspected cluster of factors that could provide an opening for new treatments, she will not use that alone, but will also look at existing data that have not yet been tapped fully. “We’re looking at this information in an entirely different way. It’s not just that the study is larger, we’re taking a different tack. We’re combining immunologic biomarkers, genetics, environment and other factors and asking how they may all work together.”
Increasingly, disease management and treatment is moving in the direction of personalized medicine, Foulkes says. “Physicians tend to administer treatments based on what is best for most people. We’re trying to assist medical practice in moving toward using a more individualized picture, which considers your specific internal characteristics. The hope is that these tools will ultimately allow us to get to that point.”
Foulkes’ studies are expected to yield models appropriate for generating hypotheses that would be tested later in clinical trials. She and colleagues also must take care to guard against a common pitfall when organizing vast data sets, that is, false positive associations. Therefore she will consider several methods to minimize error and test the robustness of observed associations.
Richard E. Peltier, assistant professor of Environmental Health Sciences, has been awarded nearly $750,000 from the National Institutes of Health (NIH) to investigate the effects of air pollutants on cardiovascular health. The funding is part of a Pathway to Independence Award (K99/R00) Peltier received while a postdoctoral fellow at New York University. The second phase, or R00 mechanism, takes effect following Peltier’s acceptance last fall of a tenure track faculty position with the UMass Amherst School of Public Health and Health Sciences.
The objective of the Pathway to Independence initiative is to assist junior investigators in transitioning to a stable independent research position with NIH or other independent research funding. The grant mechanism is highly competitive and the NIH distributes only a limited number of the K99/R00 awards each year.
Peltier, who is trained as an atmospheric chemist, will examine the relative toxicity of different air pollutants and their effects on cardiovascular health. Peltier’s investigation builds on his previous research findings on airborne particulate matter in New York City, which found unusually high concentrations of nickel, a toxic compound known to have deleterious health effects. The results were the first empirical evidence of this problem and eventually helped to lead to a ban in New York City on new residential boilers which use residual fuel oil that produce high nickel emission levels.
“We regulate based on total amount of particles, or how much total pollution is in a given volume of air,” says Peltier. “But in reality that volume of air can contain different kinds of pollutants and some are much more toxic than others.”
The relative toxicity of different pollutants, Peltier believes, is caused in part by the aging process. “The atmosphere constantly ages pollution – by the sun and different gases that are in the air – and this changes their chemistry. It changes very quickly. An hour later it’s very different than when it was first emitted. And I think that’s what leads to differences in toxicity.”
No one knows for sure why an aged particle may be more toxic than a “fresh” one. Peltier hypothesizes that it may be due to solubility. “Aged particles are usually more water soluble. When those particles get into our lungs, which are largely a water environment, they react differently than oily, non-soluble particles. Aged particles – that is to say, water soluble particles – will quickly dissolve in your lungs.”
In order to study this aging effect, Peltier will build a state-of-the-art photochemical aging chamber. Using a diesel generator, he’ll send exhaust into the aging chamber and change the chemistry of the particles through the use of ultraviolet lamps and the addition of gases commonly found in the atmosphere. His training in applied atmospheric chemistry makes his research approach unique because most investigations do not account for typical environmental processing of airborne contaminants and how this may affect human exposure and subsequent health outcomes.
With a number of promising grant proposals in the pipeline, Peltier plans to continue to expand his lab and build upon his current line of investigation. The results of Peltier’s research could ultimately inform policy decisions and environmental protection regulation that takes into account toxicity, and not just volume, of pollutants.
On January 20, 2011 a coalition of environmental health organizations including the UMass Amherst School of Public Health and Health Sciences announced that Springfield, Massachusetts has been named a Community Action for a Renewed Environment (CARE) community by the U.S. Environmental Protection Agency. The project will use EPA’s 10-step Road Map process as well as community strengths and resources to identify and prioritize local environmental risk data.
The Healthy Environment, Healthy Springfield (HEHS) Coalition is a broad-based partnership of members dedicated to reducing toxic pollutants and environmental risks in their local environment. HEHS lead organizers include Partners for a Healthier Community, the Pioneer Valley Asthma Coalition, Springfield Renaissance School and the Springfield mayor’s office and department of parks, buildings and recreation management, in addition to the School of Public Health and Health Sciences at UMass Amherst.
EPA has granted HEHS nearly $85,000 over two years for gathering information about environmental health risks in the city and identifying which ones are of most concern to residents. In addition to reducing risks of cancer and other serious health problems, broader benefits to the environment and the community can include more green space, reclaiming vacant lots for community gardens, increased recycling and renewable energy use, and greening industry.
Leading the two-part UMass Amherst effort for the CARE grant is Christine Rogers, assistant professor of Environmental Health Sciences. With Michael Muilenberg, a senior research fellow in public health, plus three public health students, she will gather data about a broad array of environmental health risks and contaminants in the Springfield area. These include air pollutants such as sulfur dioxide, nitrogen dioxide, carbon monoxide, ozone and particulates, plus water and soil pollutants such as arsenic. They will also document residential health risks such as lead paint, volatile organic compounds, tobacco smoke and allergens such as mold and cockroaches.
Rogers says, “Working closely with the EPA, we’ll gather data that have already been collected but have not been gathered in one place before, nor presented to the public in an accessible way. We’ll put it in an understandable format and help to present it to the community via neighborhood groups, public health agencies and other community groups. We’ll also be asking members of the Springfield community about their own concerns.”
Rogers and the UMass Amherst public health students also will be mentoring tenth-grade students at the Springfield Renaissance School who are studying environmental health in their biology classes. It’s hoped that mentoring by UMass Amherst public health students will pique the young peoples’ interest in taking leadership roles in environmental health risk assessment and community communication.
“When the community decides where it wants us to focus, that’s where we’ll put our efforts,” Rogers explains. “When it’s clear what priorities the community wants to examine, we’ll assist in applying for another grant to actually take steps to reduce exposure to those environmental health risks and hazards.”
The School of Public Health and Health Sciences is pleased to announce the first round of awardees of the Faculty Research Enhancement Grants. The grant funds, distributed in January 2011, totaled $45,497 and were awarded for the following proposals:
Sofiya Alhassan, assistant professor in the Department of Kinesiology, has been awarded a four-year, $448,782 K01 grant from the NIH National Institute of Diabetes and Digestive and Kidney Diseases.
The purpose of Dr. Alhassan’s project is to examine the effects of a culturally-appropriate Afro-centric dance program that engages both pre-adolescent African-American girls and their mothers on daughter’s physical activity and insulin levels.
The study will take place in the greater Springfield, Massachusetts area. Findings from this research may provide a viable option for increasing physical activity for African-American girls and their mothers, and thereby help to identify a strategy for reducing obesity and type 2 diabetes mellitus in African-American girls.
Earlier this year, Alhassan was awarded a two-year $174,972 grant from the Robert Wood Johnson Foundation as part of its Active Living Research Program.
The grant will fund a project to study how short bouts of structured physical activity during designated outdoor playtime impact physical activity and sedentary behavior during the school day. It will focus specifically on preschoolers of lower socio-economic status in the greater Springfield area.
The results of this project program will ultimately inform policy decisions regarding the design and implementation of physical activity programs in the preschool setting.
Susan Sturgeon, associate professor of Epidemiology, has recently been awarded a two-year, $165,000 grant from the American Institute for Cancer Research to conduct a study investigating the effect of pomegranate juice intake on the blood level of hormones known to be involved in the development of breast cancer. Results of experimental studies have shown that pomegranate juice reduces estrogen synthesis, as well as inhibiting cell proliferation, suggesting that pomegranate juice intake might reduce breast cancer risk. In the study, Sturgeon will work with Alayne Ronnenberg, assistant professor in the Department of Nutrition, and Elaine Puleo, Associate Dean for Research for the School of Public Health and Health Sciences, to evaluate differences in hormone levels in blood before and after a three-week intervention period. Differences in hormone biomarker levels in nipple aspirate fluid will also be explored. The study is important because pomegranate juice has often been touted as having beneficial health effects, despite limited information on such effects in humans.
The funding from American Institute for Cancer Research follows on the heels of two other recent grants Sturgeon has received to investigate links to breast cancer. In August 2010, the National Institutes of Health (NIH) awarded Sturgeon a two-year, nearly $200,000 grant. Sturgeon will collaborate with assistant professor Katherine Reeves and research associate professor Carol Bigelow to examine the possible link between light at night and an increased risk of breast cancer. One theory suggests that the hormone melatonin, which is produced at higher levels during periods of darkness, is somehow involved in the link. Results from a limited number of observational cohort studies that have examined the link between lower urinary levels of melatonin and increased risk of breast cancer have been inconsistent, prompting the need for additional studies. A nested case-control study will be conducted in which the urine of 284 invasive breast cancer and 568 control subjects in the Women’s Health Initiative Observational Study will be examined for levels of melatonin. This study is integral in clarifying the role of melatonin with relation to breast cancer and the development of new strategies to prevent the cancer.
In September, Baystate Rays of Hope – a division of Baystate Health Foundation Inc. – awarded Sturgeon funding to examine levels of patterns of methylation in white blood cell (WBC) DNA and breast epithelial cell DNA taken from the same individual. Methylation is a type of epigenetic change where a non-sequence modification of DNA is linked to the overall changes in gene expression. There is a likely link between methylation patterns in normal-appearing breast tissue and an increased risk of breast cancer. WBC DNA may carry epigenetic information that can be used to study an individual’s risk of cancer. The study will evaluate the extent of the correlation of methylation patterns in certain genes from these two types of tissues. The study results could be beneficial to the identification of individuals at high-risk of breast cancer as WBC DNA is more easily accessible.
Erin Snook, assistant professor of Kinesiology, received a one-year pilot grant from the Consortium of Multiple Sclerosis Centers to develop and test a new symptom questionnaire for multiple sclerosis (MS).
MS is a chronic disease of the central nervous system whereby a person's immune cells attack the myelin sheath that surrounds nerve axons. This destruction results in a wide variety of symptoms including balance and gait problems, cognitive impairment, sensory problems, fatigue, spasticity and muscle weakness.
Snook will be developing and testing an MS symptom questionnaire that assesses the severity, frequency and distressfulness of symptoms. Assessing multiple symptom characteristics simultaneously should lead to a more accurate measure of MS symptoms that can be used to track disease progression and the effectiveness of drugs and clinical interventions.