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Health Information Moving Medicine Forward

Advances in medicine can begin with a sudden insight or arise from years of meticulous research. At Rush University Medical Center, doctors and researchers take every opportunity to move medicine into the future, always with the aim of improving patient care.

The gates of knowledge
The road less traveled
Keeping people moving
Hitting a moving target 

The gates of knowledge

For years, researchers have been searching for a vital piece to the puzzle of how cells function in the body.

The puzzle involves the process for the opening and closing of ion channels — the pore-like pathways that allow the movement of ions across the membrane of the cell. Ions are electrically charged particles that control how cells work. The answer to this puzzle could lead to giant strides in understanding many diseases and their treatments. For example, cystic fibrosis, type 2 diabetes and heart disease involve malfunctions in ion channels.

A study at Rush may hold the missing piece — bubbles.

According to study author Bob Eisenberg, PhD, bubbles can form and break inside the tiny pathways. The ions are blocked by a bubble and are free to travel when the bubble breaks. This on-and-off mechanism lets the bubbles function as gates for ions.

The understanding of the link between ion channels and disease is relatively new. If this insight about bubbles as gates is confirmed, it could change the way researchers study many diseases and ultimately lead to new ways to manage or even cure them. To read more about Eisneberg's research, visit his laboratory homepage.

Bob Eisenberg, PhD, is chair of the Department of Molecular Biophysics and Physiology at Rush. He is a national leader in ion channel research.

The road less traveled

Huntington's disease involves problems with thinking, memory and personality, but jerky, involuntary movements called chorea are the hallmark symptom. It is rare enough to be classified as an "orphan disease," so few researchers focus on it. That's why, until recently, treatment for Huntington's disease has been woefully inadequate.

Now, however, a study at Rush has helped lead to the U.S. Food and Drug Administration's approval of a new drug called tetrabenazine — the first treatment for Huntington's disease to be approved in the United States.

Tetrabenazine treats chorea in Huntington's disease, and according to Kathleen Shannon, MD, a movement disorders specialist at Rush, virtually everyone with significant chorea responds to it.

"This drug decreases the chorea of Huntington's," Shannon says. "Patients see really substantial improvement."

Tetrabenazine isn't a cure for Huntington's disease, and it does have side effects. But it can significantly improve the quality of life for people with this condition.

Kathleen Shannon, MD, performs clinical research in Parkinson's disease, Huntington's disease and dystonia.

Keeping people moving

Thousands of people are walking — and running — today because surgeons have replaced their damaged joints. In fact, many advances in joint replacement surgery were pioneered by orthopedic surgeons at Rush. But researchers at Rush also look for ways to alleviate joint problems without surgery.

According to Joel Block, MD, a rheumatologist at Rush, changing the way people walk may help.

Block and others are studying biomechanical loading of the knee — the force exerted on this joint as you walk. Previous evidence suggested such loading can be reduced by altering the way the foot is positioned, and Block's group designed a shoe insert that does just that. The insert — which mimics barefoot walking — reduces the load on the knee by about 12 percent.

"For people in this study, their pain got substantially better and the progression of their condition was significantly reduced," Block says.

If this ongoing study confirms the benefits of relieving the biomechanical load on the knee, it could mean therapies such as shoe inserts could help some people delay joint replacement surgery.

Joel Block, MD, researches osteoarthritis and cartilage cell biology and has published numerous articles on these and other issues in rheumatology.

Hitting a moving target

Radiation therapy has helped thousands of people become cancer free. But it can cause side effects such as red, blistered skin; fatigue; nausea and vomiting.

Newer cancer treatments aim to lessen these problems by killing the cancer without harming normal cells. Rush is on the leading edge of these targeted treatments with technologies that do just that.

For example, a special computed tomography (CT) scanner uses 4-D to focus radiation at targets that dont stand still.

"With lung cancer, the tumor can move as the patient breathes," says Thomas Zusag, MD, a radiation oncologist at Rush. "We use the movement pattern to target the treatment."

Standard CT scanning works by taking multiple x-rays as it rotates around the patient. The 4-D CT has an additional sensor that reconstructs the movement of the tumor through the respiratory cycle. This creates a composite picture of the area the tumor occupies over time. Sophisticated treatment machines, such as Varian Trilogy and TomoTherapy, then use this information to direct radiation to the exact area, sparing surrounding tissue. Both of these treatment options are also available at Rush.

Precise treatments such as these spare normal tissue and reduce side effects, which is also the goal of targeted drug treatments — to kill the cancer without harming normal cells.

There are many kinds of targeted drug therapies, and researchers at Rush are working to find more. According to Stephanie Gregory, MD, hematologist and oncologist at Rush, Rush is participating in the development of a drug called an SYK inhibitor that works by preventing cancer cells from dividing, while sparing healthy cells. If approved, it will be an important tool for fighting cancer.

Stephanie Gregory, MD, specializes in blood cancers. She is involved in research on targeted therapies for cancer and is the medical director of the Section of Hematology at Rush.

Thomas Zusag, MD, researches precision radiation treatments and specializes in lung and gynecologic cancers.

Did you know?

Medicine isn't confined to hospitals. Rush reaches out to the community with a variety of health care programs for disadvantaged children and adults. Rush also sponsors after-school science clubs and helps build modern science labs in public elementary schools to encourage future researchers. It's all part of moving medicine forward.

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