Five Years Before Brain Cancer Diagnosis, Changes Detectable in Blood

Newswise, July 11, 2017– Changes in immune activity appear to signal a growing brain tumor five years before symptoms arise, new research has found.

Interactions among proteins that relay information from one immune cell to another are weakened in the blood of brain cancer patients within five years before the cancer is diagnosed, said lead researcher Judith Schwartzbaum of The Ohio State University.

That information could one day lead to earlier diagnosis of brain cancer, said Schwartzbaum, an associate professor of epidemiology and member of Ohio State’s Comprehensive Cancer Center.

The study, published in the journal PLOS ONE, focused on gliomas, which make up about 80 percent of brain cancer diagnoses. Average survival time for the most common type of glioma is 14 months.

Symptoms vary and include headaches, memory loss, personality changes, blurred vision and difficulty speaking. On average, the cancer is diagnosed three months after the onset of symptoms and when tumors are typically advanced.

“It’s important to identify the early stages of tumor development if we hope to intervene more effectively,” Schwartzbaum said. “If you understand those early steps, maybe you can design treatments to block further tumor growth.”

While widespread blood testing of people without symptoms of this rare tumor would be impractical, this research could pave the way for techniques to identify brain cancer earlier and allow for more-effective treatment, Schwartzbaum said.

Schwartzbaum evaluated blood samples from 974 people, half of whom went on to receive a brain-cancer diagnosis in the years after their blood was drawn. The samples came from Norway’s Janus Serum Bank.

Because of previous research – including her own on the relationship between allergies and brain cancer – Schwartzbaum was interested in the role of cytokines, proteins that communicate with one another and with immune cells to spark immune responses. Schwartzbaum’s previous work found that allergies appeared to offer protection against brain cancer.

In this study, Schwartzbaum evaluated 277 cytokines in the blood samples and found less cytokine interaction in the blood of people who developed cancer.

“There was a clear weakening of those interactions in the group who developed brain cancer and it’s possible this plays a role in tumor growth and development,” Schwartzbaum said.

Cytokine activity in cancer is especially important to understand because it can play a good-guy role in terms of fighting tumor development, but it also can play a villain and support a tumor by suppressing the immune system, she said.

In addition to discovering the weakening of cytokine interactions in the blood of future cancer patients, the researchers found a handful of cytokines that appear to play an especially important role in glioma development.

The results of this study must be confirmed and further evaluated before it could translate to changes in the earlier diagnosis of brain cancer, but the discovery offers important insights, Schwartzbaum said.

“It’s possible this could also happen with other tumors – that this is a general sign of tumor development,” she said.

The research was supported by the National Cancer Institute.

Study Provides Guidelines on How to Prioritize Vaccination During Flu Season

Newswise, July 10, 2017 — After high-risk individuals, immunizing children and the elderly will have the greatest overall benefit when there are limited vaccine resources.

This could save both lives and money, according to a study published in PLOS Computational Biology by Nargesalsadat Dorratoltaj of the Virginia-Maryland College of Veterinary Medicine, in collaboration with colleagues at the Biocomplexity Institute of Virginia Tech.

When vaccine supplies are limited, public health officials are often required to prioritize which populations have the greatest need for immediate immunization. Official recommendations for how this assessment process should be carried out are often lacking or confusing.

To get a more realistic measure of how targeted vaccination efforts benefit society at large, the Virginia Tech research team developed a “synthetic population” that works, moves, and mixes with others much like a real community.

The extra level of detail in this simulation allowed researchers to capture an epidemic’s indirect or social effects, such as how one person’s vaccination may lower their family and co-workers’ risk of infection.

Previous studies have either focused on the individual benefits of vaccination or a single metric for measuring the financial and medical effectiveness of targeted vaccination. 

The new model revealed that the overall financial impact of vaccination is much greater than scientists had previously assumed.

“Depending upon the severity of influenza, the 'return on investment' can increase from three to seven times if we factor in how the immunity of vaccinated individuals indirectly benefits their contacts in the community by blocking the chain of transmission,” said study co-author Achla Marathe, a professor at the Biocomplexity Institute of Virginia Tech.

The researchers provide a framework that can be used to study different vaccine priority orders and different outcome metrics, such as the total number of infections, total dollars gained, and the risk of death among children or adults.

“Attack rates among the children are higher than among the adults and seniors during influenza outbreaks, due to their larger social contact network and homophilous interactions in school,” said senior author of the study, Kaja Abbas.

“Based on return on investment and higher attack rates among children, we recommend prioritizing children and seniors after high-risk subpopulations for influenza vaccination during times of limited vaccine supplies.”

Looking forward, the research team will apply this modeling framework to other urban and rural regions to inform policymakers how financial and medical benefits can be optimized through targeted vaccination strategies.

This story was adapted from a release that was originally written for and distributed by PLOS Computational Biology.

Brain Tumors: Still Devastating, but Treatment Has Come a Long Way

 Newswise, June 29, 2017-- – A brain tumor was the furthest thing from Kathy English’s mind that day in 2003 when she walked into a neurologist’s office. She’d had some uncontrolled sinus issues, so her doctors had ordered a variety of tests, including an MRI. When she arrived to get the MRI results, the neurologist said he had not yet had a chance to look at them himself. 

“He said we’d look at them together,” English recalled. “As he looked over the scan, he pointed out a small abnormality, a tumor which he described as a meningioma. Then he saw another one. And another. By this time, I was getting pretty worried. Ultimately, he found 12, and now I was really worried.”

A meningioma is a usually benign, slow-growing tumor. While referred to as a brain tumor, it actually does not grow from brain tissue but rather from the meninges, layers of tissue which cover the brain. Still, 12 meningiomas are not to be taken lightly.

The neurologist immediately referred English to neurosurgeon James Markert, M.D., an internationally renowned brain tumor expert at the University of Alabama at Birmingham.

Markert, who is professor and chair of the Department of Neurosurgery in the UAB School of Medicine, says meningiomas are relatively rare, but certainly not unheard of. He followed English for several years, and when one of the tumors began to grow, he surgically removed it, along with eight others that were easily accessible.

Two more were later eliminated through a gamma knife radiation procedure. Markert continues to monitor the others. Through it all, English never had any symptoms, other than a bucket-full of anxiety. 

“It was like knowing you have bugs on your head … ‘Get them off! Get them off!’” she said. “It’s so reassuring to know that I’m being treated and monitored by some of the top brain tumor people in the nation.”

Her experiences made English something of a brain tumor expert herself, certainly enough to realize something was not right when her husband, John, became dizzy and off-balance after bending over to unplug a computer cord.

He’d had a couple of bad headaches in the previous weeks, and that evening in the fall of 2016, there was something obviously wrong.

“We ruled out stroke pretty quickly, and our physician ordered an MRI,” English said. “The results came back — astrocytoma. A brain tumor. We were stunned.”

Two days later, John English was in Markert’s office, and in less than two weeks, had surgery to remove a Grade 2 tumor. His recovery has been robust, and he knows he is lucky.

“While we never anticipated having a second person in the family with a brain tumor, Kathy’s experiences made us proactive,” John said. “My prognosis is so much better due to the quick recognition of the tumor, and the quick response by UAB.”

The Englishes did not consider themselves prime candidates for brain tumors. Both are pescatarians (individuals who add fish to a vegetarian diet) who stay fit and keep a close eye on their health.  

“The scientific community still has much to learn in order to predict the onset of a brain tumor or who is at risk,” said Markert, who holds the James Garber Galbraith Endowed Chair of Neurosurgery at UAB and is a senior scientist in the Comprehensive Cancer Center.

“Some, called primary tumors, arise in the brain. Others are called metastatic tumors, which arise elsewhere in the body and migrate to the brain.”

The good news, Markert says, is that the landscape for brain tumor therapy is much better now than ever before.

“A diagnosis of a malignant brain tumor is still devastating, but we’ve come a long way,” he said. “The horizon is very bright for the development of even more impactful treatments in the very near future.”

Markert credits improved imaging with some of that optimism. Improvements in neuroimaging can now reveal much more information about the makeup of tumors.

“We used to classify tumors based simply on their microscopic appearance,” Markert said.

“We are now able to look at mutations within tumor cells, and we’ve found that certain sets of mutations are associated with different tumor types and subtypes. This really is precision medicine, as we can now tailor therapy based on our better understanding of the genetic signature of an individual tumor.”

A new oral chemotherapy agent called temozolomide is a good example. It is effective on some tumors, but others are resistant to the drug. Advances in genetic testing can predict which patients will respond best to the drug and which will not.

Another new agent, aminolevulinic acid, or 5-ALA, is used in a fluorescence imaging technique. The drug is absorbed into tumors and causes them to glow when viewed on an MRI. Surgeons can then better visualize the tumor, especially at its boundaries with healthy cells.

Those boundaries are usually indistinct, and the line between tumor and healthy tissue can be blurred. 5-ALA helps guide surgeons as they attempt to remove as much of a tumor as possible while leaving healthy tissue intact. 5-ALA is expected to be approved for use by the FDA in the near future.

New technology will soon be in place at UAB, such as intraoperative MRI scanning, where surgeons will have the ability to do real-time MRI scans in the operating room during surgery.

Another advance, also based on improved MRI use, will employ lasers surgically inserted into the tumor to precisely destroy tumor cells with heat energy.

Markert says proton therapy, an option over traditional radiation technology and coming to UAB in 2019, can be a valuable tool for pediatric tumors or tumors situated close to delicate structures such as the brain stem or optic nerve.

Another promising therapy has been under investigation in Markert’s lab for years. In 2001, Markert and his colleagues published initial results of a first-generation genetically engineered herpes virus as a therapy to destroy brain tumors.

A second generation virus, known as M032, is currently undergoing clinical trials. The virus infects tumor cells and replicates, while leaving healthy cells alone.

The act of viral replication in the tumor kills the infected tumor cells and causes the tumor cell to act as a factory to produce new viruses. As the tumor cell dies, progeny viruses are released from the cell.

These viruses infect other tumor cells in the vicinity and continue the process of tumor killing. The virus also causes the patient’s own immune system to attack the tumor.

“This process, especially combined with advances in immunotherapy, presents a very promising approach to treating tumors,” Markert said.

Markert explains that the body’s immune system is designed to patrol for foreign cells in the body, including mutated cancer cells. The immune system’s killer T cells have an off-switch, known as a checkpoint.

The checkpoint is usually turned off, keeping T cells from attacking healthy cells. It turns on — again, usually — in the presence of a foreign cell, prompting T cells to attack. But tumor cells are very good at fooling the checkpoint so it remains in the off position.

Drugs known as checkpoint inhibitors are under development which would turn the checkpoint on, stimulating the T cells to attack the tumor.

“One approach we are considering now is a combination of viral and immunotherapy,” Markert said.

“The viral therapy using our modified herpes virus should produce a vibrant immune response, followed by introduction of the checkpoint inhibitors, which would turn on the checkpoints and activate individual T cells.”

Markert is excited about the future of brain tumor research and treatment. As a leading academic medical center home of one of the nation’s Comprehensive Cancer Centers, and the state’s leader in personalized medicine, UAB is primed to be at the forefront of new discovery.

“We have a remarkable array of talent here, in radiation oncology, hematology/oncology, neurology, neurosurgery, and other fields,” he said. “We have an outstanding research enterprise in both adult and pediatric brain tumors. It’s an exciting time to be in this field.”

Brain cancer is not the most prevalent kind of cancer — breast and lung cancer top the list; but malignant brain tumors can be particularly devastating.

The National Cancer Institute predicts 33,800 new cases in 2017. The NCI also estimates that 16,700 Americans will die of brain cancer this year.

“We are turning a corner, but there are still too many people who die from brain tumors each year,” Markert said. “These patients and their families are very courageous people. We owe it to them to find better treatments.”

The Englishes had two firsthand experiences to convince them to continue to be proactive and involved in their health care.

“Pay attention to your body, and if something unusual happens, don’t blow it off,” John said. “Be aggressive in following up. We are two people who paid attention to our medical issues and, as a result, got the right care to provide us the best possible outcomes.”

Minimizing the Effects of Radiation Injury

New research conducted at the University of Kansas Medical Center could make treatment for gastrointestinal cancers safer—while also helping to mitigate the dangers of nuclear accidents and terrorist attacks

Newswise, June 29, 2017 — New research conducted at the University of Kansas Medical Center could make treatment for gastrointestinal cancers safer—while also helping to mitigate the dangers of nuclear accidents and terrorist attacks.

The research, led by Subhrajit Saha, Ph.D., assistant professor in the Department of Radiation Oncology at KU Medical Center, began more than five years ago when his team embarked on a quest to understand the biology behind radiation-induced gastrointestinal syndrome (RIGS)—a serious risk for people being treated for stomach, pancreatic, colorectal and other cancers in the abdominal area.

RIGS prevents the body from absorbing nutrients and often causes nausea, vomiting and diarrhea. RIGS occurs primarily when radiation treatment for these abdominal cancers destroys healthy tissue in the GI tract, especially the outer layer of the intestines, known as the epithelium. And when the epithelium is lost, bacteria can spill into the body and cause sepsis, which can kill a patient.

Because there is no drug treatment for RIGS, doctors must turn to radiation to treat their patients, which requires them to use extreme caution up to the point of compromising on the necessary treatment.

This is of specific concern to cancer patients as more than half of patients treated with abdominal radiotherapy are affected by RIGS.

"That's why when the colon is involved, doctors don't want to treat with radiation," said Saha. "And often they can't use aggressive doses of radiation even for other organs in the area because of the sensitivity of the epithelium. They have to be very, very careful."

RIGS also occurs when people are subjected to radiation through a nuclear accident or a nuclear attack.

 "This is hugely significant—the government has been investing in research for an effective countermeasure for terrorism involving radiation," says Saha. "The problem is, it's hard to treat someone post-radiation because the damage happens so fast, and the patient typical dies in seven to 10 days."

Macrophages, the Pac-Men for cellular debris, help intestinal stem cells regenerate

While Saha was still at the Albert Einstein College of Medicine in New York, his research team began with the knowledge that one reason RIGS is so hard to treat is that the abdominal area of the body has a high turnover of intestinal stem cells. Cells like these that divide quickly are especially susceptible to damage from radiation because their DNA gets more exposed.

To figure out how to get around that, the researchers needed to know more about the biology of the epithelium, specifically how intestinal stem cells (ISCs) renew and proliferate.

They published their first discovery six years ago, after they injected radiation-injured mice with stromal cells, a mixture of different cell types that make up connective tissue, and found that they stimulated intestinal stem cell regeneration and lessened the damage done by RIGS.

Now they knew that ISCs depend on the stromal niche to reproduce new cells, and of the different types of stromal cells, the macrophages were critical. Macrophages are white blood cells that eat up cellular debris, especially infected cells.

 "We knew that macrophages are the missionaries of the immune system," said Saha. "But we learned they also assist in organ growth, repair, and regeneration."

The question was how?

Solving the mystery of intestinal stem cell renewal

The first question for Saha, who had by then moved to KU Medical Center, was whether macrophages can help intestinal stem cells self-renew and multiply. The researchers had read studies showing that WNT proteins—a family of proteins that regulate the proliferation of cells, and related signaling—were very important for the intestinal stem cell renewal and proliferation. Moreover, they have found that macrophages also release these WNT proteins.

To learn more, the researchers set up a mouse model to halt the release of all 19 varieties of WNTs specifically produced by macrophages.

They found that mice without macrophage-derived WNT were much more sensitive to radiation and had more severe intestinal injury from radiation compared to mice who had not been treated.

"This told me that macrophage-derived WNT is important for intestinal resistance to radiation," said Saha.

For Saha, this discovery made for one of his best days in the lab, but it also was just the first finding. Additional studies showed that damage could be repaired in mice treated with macrophages capable of releasing WNT proteins. The intestinal epithelium was repaired, and the intestinal stem cells were also rescued.

Multiple subsequent studies have since reinforced their findings. They have confirmed that WNT release by macrophages is essential to the regeneration of intestinal stem cells and repair of epithelial tissue. Interestingly, in mice not exposed to radiation, WNTs don't seem critical to keeping the intestines healthy. But where there is a need for regeneration, they become critical.

"We were very much surprised," Saha said. "Macrophages are known for immune system surveillance, but now we know that they can get involved in organ repair."

It's all in the packaging

Working in collaboration with Andrew Godwin, Ph.D., deputy director of the University of Kansas Center Center, and his team, Saha's team also observed that macrophages release the WNTs via extracellular vesicles, tiny sacs of membrane released from the surface of cells. "That was not known," said Saha. "Now we know how WNTS are transported in the system."

Armed with this knowledge, researchers can begin to think about developing therapies using macrophage-derived WNT to allow doctors to treat gastrointestinal cancers more aggressively and lessen the damage done in the event of a nuclear mishap. Their study was published last year in Nature Communications.

Saha's team is currently working to develop small molecules that can modulate these macrophages to augment their role in regeneration. "We are confident that we can come up with an answer for the mitigation of acute radiation syndrome very soon," he said.

Good Nutrition, Physical Training and Mental Exercises Can Reverse Physical Frailty in the Elderly: NUS Study

Newswise, June 29, 2017 — Physical frailty is common among the elderly and is strongly associated with cognitive impairment, dementia and adverse health outcomes such as disability, hospitalisation, and mortality. A four-year study conducted by researchers from the National University of Singapore (NUS) showed that a combination of nutritional, physical and cognitive interventions can reverse physical frailty in elderly people.

Associate Professor Ng Tze Pin, who is from the Department of Psychological Medicine at the NUS Yong Loo Lin School of Medicine, and the leader of the research team, said that earlier research findings from the Singapore Longitudinal Ageing Studies (SLAS) by his team showed that physically frail elderly persons compared to their robust counterparts are eight times as likely to be cognitive impaired at the same time, and if they are not cognitively impaired, they are more than five times at risk of becoming cognitively impaired on follow up three years later.

“In addition, physically frail elderly persons are two to 10 times as likely to become functionally disabled on daily living activities, hospitalised and die earlier than their robust counterparts. When physical frailty and cognitive impairment are present together in the same individual, he or she is more than 20 times as likely to become disabled, hospitalised or die earlier. With such compelling evidence, if it is possible to reduce or even reverse physical frailty in the elderly, we could greatly improve their quality of life,” Assoc Prof Ng explained.

Assoc Prof Ng and his team conducted a four-year trial between 2010 and 2013, involving 250 community-living older persons in Singapore who were 65 years old and above and who showed signs of frailty.

“Our study shows that it is feasible to identify pre-frail and frail older persons in the community and primary care settings and provide them with lifestyle interventions to reverse frailty. We found that better nutrition, physical training and mental exercises can reverse frailty, enhance muscle strength and gait speed, reduce depressive symptoms and improve cognitive functioning. As such, these interventions can go a long way to reducing the high prevalence of physical disability, hospitalisation and mortality in an ageing society like Singapore,” Assoc Prof Ng added.

Fighting frailty in elderly people

Participants for the trial were recruited from October 2009 to August 2012 from various senior activity centres in Singapore. They were randomly allocated to receive lifestyle interventions in one of five groups for a period of six months. Three groups of participants were provided with either physical training, nutritional enhancement or cognitive training, while the fourth group received a combination of all three interventions. The last group was a control group which did not receive any intervention. The trial was conducted in collaboration with Khoo Teck Puat Hospital and St Luke’s Hospital.

Assessment of the participants’ frailty and other outcomes were made before the start of intervention. During the six-month trial, the participants’ progress were measured after three months and six months. A follow-up assessment was also conducted six months after the trial (i.e. 12 months after the start of intervention).

The NUS researchers found that the three types of intervention, as well as a combination of all three approaches, were able to reduce frailty and depressive symptoms, and improve cognitive functioning of the elderly.

Assoc Prof Ng noted, “The important message from our studies is that frailty is not an inevitable part of ageing. There is much that older people can do for themselves to avoid becoming frail and disabled, so it is vital that they pay attention to good quality diet and nutrition, engage in physical exercise, and participate in socially and cognitively stimulating activities.”

Intervention programmes to benefit the elderly

Following the encouraging findings from the trial, the research team is working with the Geriatric Education and Research Institute (GERI) and social service organisations to develop and implement pilot frailty screening and multi-domain lifestyle intervention community programmes. They hope that such programmes when successfully scaled up for mass intervention can help improve the physical, psychological and cognitive well-being of large numbers of senior citizens.

I Can Hear You Now: Clinic Provides Free Hearing AIDS for Low-Income Adults

U

University of Michigan Photo

How a new Ann Arbor program helps those with hearing loss — and provides a blueprint other academic medical centers may follow

New Ann Arbor program helps those with hearing loss — and provides a blueprint other academic medical centers may follow.

Newswise, June 29, 2017 — Low-income people dealing with hearing loss just got a little hope.

Doctors from Michigan Medicine’s Department of Otolaryngology — Head and Neck Surgery partnered with the Hope Clinic to create Hope for Hearing, a program that provides free hearing aids to uninsured adults.

The partnership between the free independent clinic and University of Michigan started in 2010 to provide Hope Clinic patients with access to specialty care.

“We saw there was a need for hearing aids,” says Aileen P. Wertz, M.D., a fifth-year resident in otolaryngology who also sees patients at the Hope Clinic. “Over half of the patients referred to us with ear complaints had hearing loss and could simply benefit from a hearing aid.”

After recognizing the need, Wertz and her colleagues looked to design a self-sufficient subspecialty program within the clinic that could act as a model for similar projects.

They began by soliciting hearing aid donations and a hearing aid verification system and securing a $5,000 grant for a computer enabled with audiological software and other equipment.

Primary care providers then referred adults with hearing complaints to the program.

Patients went through an initial assessment that included a formal audiogram and screening evaluation. If the audiometric test suggested a significant hearing loss and the otolaryngologist determined that a patient was medically cleared for hearing aids, the patient was referred to audiologists for hearing aid counseling and fitting.

In a study published in JAMA Otolaryngology—Head & Neck Surgery, Wertz and her colleagues examined the feasibility and outcomes of the program.

“During the study period — September 2013 through March 2016 — we garnered 84 hearing aids, and most of them were donated,” says Wertz. “Thirty-four patients were determined to be eligible for the free program and were offered hearing aid services. Of them, 20 patients (59 percent) have been fitted or are being fitted with free hearing aids.”

The cost of hearing aids

Most people who need hearing aids are surprised that neither Medicare nor most commercial insurance plans cover the cost. As a result, there is no price negotiation or consumer benefit.

Wertz says the average Hope for Hearing patient would pay about $2,260 to obtain equivalent equipment themselves or pay $1,210 for the most basic hearing aid available at U-M.

The only costs for Hope for Hearing patients are batteries for the hearing aid and transportation to and from their clinic visits.

What’s ahead

Deemed a success with room to grow, Wertz says the Hope for Hearing program is looking for ongoing funding to cover the costs of ear mold and hearing aid supplements.

Wertz attributes some of the success to date to the strong relationship between the Hope Clinic and U-M.

“This hearing aid program began with an established, successful academic center-community program partnership,” she says. “That was an important factor because enthusiastic audiologists and otolaryngologists were already invested and volunteering regularly at clinics.”

Wertz suggests that other institutions considering similar programs think about the target population’s cultural needs.

“Many patients in this program have required an interpreter to get through the audiologic evaluation and hearing aid fitting,” says Wertz. “Our program has been fortunate that a family member or friend with bilingual abilities has been able to serve as an interpreter for appointments.”

Stem Cell Treatment May Restore Vision to Patients with Damaged Corneas

Newswise, June 6, 2017 — Researchers working as part of the University of Georgia’s Regenerative Bioscience Center have developed a new way to identify and sort stem cells that may one day allow clinicians to restore vision to people with damaged corneas using the patient’s own eye tissue. They published their findings in Biophysical Journa

The cornea is a transparent layer of tissue covering the front of the eye, and its health is maintained by a group of cells called limbal stem cells. But when these cells are damaged by trauma or disease, the cornea loses its ability to self-repair.

“Damage to the limbus, which is where the clear part of the eye meets the white part of the eye, can cause the cornea to break down very rapidly,” said James Lauderdale, an associate professor of cellular biology in UGA’s Franklin College of Arts and Sciences and paper co-author.

“The only way to repair the cornea right now is do a limbal cell transplant from donated tissue.”

In their study, researchers used a new type of highly sensitive atomic force microscopy, or AFM, to analyze eye cell cultures. Created by Todd Sulchek, an associate professor of mechanical engineering at Georgia Tech, the technique allowed researchers to probe and exert force on individual cells to learn more about the cell’s overall health and its ability to turn into different types of mature cells.

They found that limbal stem cells were softer and more pliable than other cells, meaning they could use this simple measure as a rapid and cost-effective way to identify cells from a patient’s own tissue that are suitable for transplantation.

“Todd’s technology is unique in the tiniest and most sensitive detection to change,” said Lauderdale. “Just think about trying to gently dimple or prod the top of an individual cell without killing it; with conventional AFM it’s close to impossible.”

Building on their findings related to cell softness, the research team also developed a microfluidic cell sorting device capable of filtering out specific cells from a tissue sample.

With this device, the team can collect the patient’s own tissue, sort and culture the cells and then place them back into the patient all in one day, said Lauderdale. It can take weeks to perform this task using conventional methods.

The researchers are quick to caution that more tests must be done before this technique is used in human patients, but it may one day serve as a viable treatment for the more than 1 million Americans that lose their vision to damaged corneas every year.

The group first started this research with the hope of helping children with aniridia, an inherited malformation of the eye that leads to breakdown of the cornea at an early age.

Because aniridia affects only one in 60,000 children, few organizations are willing to commit the resources necessary to combat the disease, Lauderdale said.

“Our first goal in working with such a rare disease was to help this small population of children, because we feel a close connection to all of them,” says Lauderdale, who has worked with aniridia patients for many years.

“However, at the end of the day this technology could help hundreds of thousands of people, like the military who are also interested in corneal damage, common in desert conditions.”

Steven Stice, a Georgia Research Alliance Eminent Scholar, who plays an important role in fostering cross-interdisciplinary collaboration as director of the RBC, initially brought the researchers together and encouraged a seed grant application through the center for Regenerative Engineering and Medicine, or REM, a joint collaboration between Emory University, Georgia Tech and UGA. “A culture is developing around seed funding that is all about interdisciplinary collaboration, sharing of resources, and coming together to make things happen,” said Stice.

“Government funding agencies place a high premium on combining skills and disciplines. We can no longer afford to work in an isolated laboratory using a singular approach.”

The REM seed funding program is intended to stimulate new, unconventional collaborative research and requires equal partnership of faculty from two of the participating institutions.

“We tend to get siloed experimentally,” says Lauderdale. “To a biologist like me, all cells are very different and all atomic force microscopes are the same. To an engineer like Todd it’s just the opposite.”

The study, “Cellular Stiffness as a Novel Stemness Marker in the Corneal Limbus,” is available at http://www.cell.com/biophysj/fulltext/S0006-3495(16)30771-8.

Funding was provided by an NIH NIGMS Biotechnology Training Grant on Cell and Tissue Engineering, the Knights Templar Eye Foundation, the Center for Regenerative Engineering and Medicine, the Sharon Stewart Aniridia Research Trust and the NSF CMMI division.