Four Medical University of South Carolina (MUSC) faculty members, representing diverse disciplines, received Center for Global Health Faculty Pilot Grants of up to $20,000 for a 12-month period. These grants were offered through a competitive scoring process comparable to the National Institutes of Health (NIH) scientific peer review.
MUSC Center for Global Health awards seed funds every year to stimulate research in low and middle-income countries with the larger goal of enabling investigators to leverage preliminary findings and data to become the basis of a competitive extramural research grant application. The peer-review process yielded the following grant awardees for 2015.
Louis Guillette, PhD
Director, Marine Biomedicine & Environmental Sciences Center
SmartState Endowed Chair
Professor of Obstetrics and Gynecology
College of Medicine
“Lipidomic profile and contaminants associated with pansteatitis in South Africa”
Guillette has worked regularly in South Africa for the last three and a half years conducting and publishing research on the “impact of toxic chemicals, either singly or as complex mixtures with other stressors, on the health of individuals or ecosystems”. According to the World Health Organization (WHO), pollution or environmental factors are the root cause of death, disease and disability in the developing world, where it is estimated to cause 25 percent of death and disease globally. Guillette and his colleagues are concerned with the impacts to not only tropical fauna, but humans as well. Guillette’s project seeks to 1) determine the relationship between disease occurrence and exposure to toxicants in fish at different trophic levels; 2) determine the plasma lipid profiles of fish with varying states of pansteatitis; and, 3) compare lipid profiles in fish species at different trophic levels to determine similarities in fish from another experimental study.
Guillette and colleagues will examine an inflammation disease, called pansteatitis, occurring in wildlife that will include tilapia, sharp-tooth catfish, and Nile crocodiles. Guillette’s research will be the first to fully characterize the lipidome and lipid related pathways of health and diseased fish to provide insight into the causes, etiology and anthropogenic impact on the local environment and human health. Also contributing to this study are MUSC graduate studies students Theresa Cantu and Jacqueline Bangma—both received global health trainee travel grants from the MUSC Center for Global Health.
Guillette wrote that, “a wider study examining other wildlife and humans is essential,” pending determination of similar lipid signatures, “and would be the basis for a proposal to the National Institute of Environmental Health Sciences (NIEHS). The proposal would further characterize this disease as well as examine potential human health related effects at an epidemiological level.”
Azizul Haque, PhD
Associate Professor, Department of Microbiology and Immunology
College of Medicine
“Immune regulation by arsenic”
According to Haque, current estimates show that 100 million people are exposed to dangerous levels of arsenic in drinking water globally, mostly in Asia and parts of South America. Exposure has been linked to numerous neurological, cardiovascular, dermatological and respiratory issues. In this study, Haque and colleagues will test whether exposed patients in Bangladesh modulate immune responses through differential antigen processing and presentation. The researchers will also test whether patients exposed to arsenic have challenged immune responses through altered antigen processing, induction of autophagy, and exhaustion of T cell proliferation. Haque’s project is tailored to patients in Bangladesh because of the exposure rates: an estimated 46-57 million people are exposed to very high concentrations of arsenic, according to the World Health Organization (WHO). As a result of this study, Haque and colleagues will seek out therapies for patients acutely and chronically exposed to arsenic. Abigail Lauer, MS, research associate in the Department of Public Health Sciences, will serve as Co-Investigator on this project.
“The goal of this proposal is to investigate whether environmental arsenic exposure perturbs immune responses in humans,” wrote Haque. “It aims to examine and compare antigen processing and presentation by antigen presenting cells from patients exposed to arsenic versus healthy individuals; and to investigate whether arsenic exposure triggers differential induction of cytokines/growth factors, apoptosis/autophagy and immune dysfunction in the hosts.”
Mae Millicent Peterseim, MD
Associate Professor, Department of Ophthalmology
College of Medicine
“Genetic analysis of children and families with retinal dystrophy in Costa Rica”
One in 5,000 people globally are affected by retinal dystrophies which lead to blindness. Retinal dystrophies are well studied in the U.S., and genetic analyses of these patients are routine. Clinical treatment trials are promising and the Storm Eye Institute at MUSC is involved in this research. Peterseim found that children in Costa Rica lack the opportunity for genetic analysis and chose to focus her research efforts on a “population that has been considered valuable for locating susceptibility genes of complex disorders”. She knows full well the issues faced by patients in Costa Rica given she spent a year there on sabbatical.
By identifying new genes in the host population, new treatments can be developed for patients. Peterseim and her team will conduct clinical examinations and obtain blood samples and DNA from 50 patients in order to describe the phenotype and epidemiology of retinal dystrophy genes in Costa Rica. Appropriate treatments will be made available to patients who need them. Daynna Wolff, PhD, Director of Clinical Cytogenetics and Molecular Pathology and professor in the Department of Pathology and Laboratory Medicine, will work as co-investigator with Peterseim to identify genetic changes to treat patients with retinal dystrophies in Costa Rica.
Peterseim wrote, “Identification of genetic mutations allows further research into gene replacement, stem cells, and pharmacological intervention, which has been shown to rescue photoreceptors in animal models and improve vision in human clinical trials.”
Suparna Qanungo, PhD – Dual-PI
Research Assistant Professor, College of Nursing
Assistant Professor, College of Nursing
“Patient navigation to enhance palliative cancer care services in rural India”
The need for palliative care is growing—notably because of the increasing trends in chronic or non-communicable disease around the world. According to Qanungo and Cartmell’s project, 80 percent of patients who need palliative care live in low to middle resource countries. What’s worse is that only 10 percent of these patients have access to palliative care services. Patients with cardiovascular disease, cancer, diabetes and HIV need access to care to improve the quality of life not just for themselves, but their families. Qanungo and Cartmell, in concert with their team, seek to fill holes in research and care that only recently have been getting the attention it deserves. Tellingly, the World Health Organization (WHO) published the first Atlas of Palliative Care just last year.
The lack of evidence-based models for palliative care in low income countries have prompted Qanungo and Cartmell’s work to explore the feasibility of utilizing local patient navigators to deliver home-based palliative care services in a low resource setting in rural Kolkata India. The researchers will use a sequential mixed methods approach to conduct key informant interviews with center administrators, clinicians and patients to develop a palliative care navigation intervention protocol based upon the WHO’s Palliative Care Navigation Toolkit. They will also pilot test the intervention to ensure that it fits with the existing cancer center’s infrastructure and best meets patients’ needs in rural India. “This [project] will enable the patients to receive pain and symptom support in their homes without having to travel long distances to the clinic,” explained Qanungo.
To evaluate the program, researchers will conduct feasibility testing of the palliative care intervention protocol using a single arm trial design. Martina Mueller, PhD, MS, associate professor and Barbara Edlund, PhD, MS, professor, both in the College of Nursing, are a part of the research team and will work with the principal investigators on the project.
“We found that the biggest need for cancer patients in rural India was palliative care given that patients are diagnosed at later stages and there are so few providers for a huge number of patients,” said Cartmell. “Our goal is to expand the reach of services because only 2 to 3 percent of patients have access to palliative care in rural India.”
Image on the newsletter front page is Dr. Louis Guillette, MUSC PhD candidate Theresa Cantu and team collecting blood and urine samples from Nile crocodiles in South Africa.