REWIRING THE BODY RECONDITIONED LUNGS THE FUTURE OF HEALTH OUTLOOK.WUSTL.EDU SUMMER 2016 Healthy weight The science of countering childhood obesity outlook.wustl.edu Outlook 3 161741_OBC-OFC_CC15.indd 3 5/6/16 6:40 PM AUTHORHOUSE FROM ESPER DWAIN BY: ILLUSTRATED Easing kids’ fears Outlook Summer 2016 outlook.wustl.edu Mini Tandon, DO (left), assistant professor Published by Washington University School of Medicine, of child psychiatry, wrote a children’s book Office of Medical Public Affairs, Campus Box 8508, 4444 Forest Park Ave., St. Louis, MO 63108 ©2016 to help kids feel comfortable visiting mental PHONE (314 ) 286-0100 EMAIL [email protected] health experts. “Dr. Mini Mental Health Meets Willie Wannaknow” focuses on a boy MANAGING EDITOR DEB PARKER ASSISTANT EDITOR, DESIGNER ERIC YOUNG who is having problems at school because EDITORIAL/DESIGN SUPPORT GAIA REMEROWSKI, SARA MOSER of attention-deficit hyperactivity disorder EXECUTIVE EDITOR DONNA HEROUX and uncontrolled movements and sounds PHOTOGRAPHER ROBERT BOSTON (tics). Tandon, who provides readings at area CIRCULATION KATHI LAW elementary schools, plans to write other facebook.com/WUSTLmedicine.health books on conditions affecting children and @WUSTLmed adolescents — from autism to substance use. 161741_IFC-IBC_CC15.indd 1 5/6/16 6:37 PM JERRY NAUNHEIM Washington University School of Medicine OUTLOOK.WUSTL.EDU SUMMER 2016 18 Empowering families Enhancing the donor pool In a clinical trial, surgeons are evaluating 9 whether a sophisticated device can recondition subpar donor lungs, making them suitable for transplant. Restoring life and limbs Innovative nerve procedures are rerouting 12 the body’s “electrical wiring” and giving new hope to people with paralysis. Obesity in children Stemming the epidemic requires early 18 intervention and multipart programs that encompass the home, school and community environments. Taking the next step On Match Day 2016, 91 soon-to-be 12 Plastic surgeon Susan E. graduates of the School of Medicine learned BOSTON 24 Mackinnon, MD, at work where they will spend their residency. ROBERT COVER As a young child, Nancy Hulslander was nearing the obese level on 2 Pulse the growth chart for girls her age. Today, she is a 14-year-old freshman and competitive 26 Alumni & swimmer who maintains a healthy weight. Development Nancy and her family participated in a 26 Leading Together comprehensive study, headed by obesity expert Denise Wilfley, PhD, that emphasized the 30 Visionary gift importance of establishing routines and 33 Classnotes building a support network. See page 18. 30 New professorship supports vision research. PHOTO BY JERRY NAUNHEIM 161741_1-8_Pulse_CC15.indd 1 5/6/16 5:58 PM pulse YOUNG Wireless, dissolvable ERIC sensors can monitor brain Implants measure pressure, temperature before being absorbed into the body cientists at the School of Medicine risk of infection, chronic inflammation and “The devices commonly used today and engineers at the University of even erosion through the skin or the organ are based on technology from the 1980s,” SIllinois at Urbana-Champaign have in which it’s placed. Plus, using resorbable Murphy explained. They are large, unwieldy developed wireless brain sensors that devices negates the need for surgery to and require wires. But, he added, “There monitor intracranial pressure and temper- retrieve them, which lessens the risk of are ways to make them better.” ature and then are absorbed by the body, infection and further complications.” Murphy collaborated with the laboratory negating the need for surgery to remove Murphy is most interested in monitor- of John A. Rogers, PhD, a materials science the devices. The tiny implants could be ing pressure and temperature in the brains and engineering professor at the University used to monitor patients with traumatic of patients with traumatic brain injury. of Illinois, to build the sensors. The devices brain injuries and potentially record activ- About 50,000 people die of such injuries are made mainly of poly lactic-co-glycolic ity in organ systems throughout the body. annually in the U.S. Doctors must accu- acid (PLGA) and silicone, and they can “Electronic devices and their biomedi- rately monitor patients with such injuries transmit accurate readings on pressure, cal applications are advancing rapidly,” because an increase in pressure can lead to temperature and other information. said co-first author Rory K.J. Murphy, MD, further brain injury. Yet there is still no way The researchers used saline baths to a neurosurgery resident at the School of to reliably estimate pressure levels from show that the implants dissolve after a Medicine and Barnes-Jewish Hospital. brain scans or clinical features in patients. few days. Next, they showed the devices “But a major hurdle has been that dissolved in the brains of laboratory rats. implants placed in the body often trigger Unwieldy, wired devices “In terms of the major challenges an immune response, which can be prob- involving size and scale, we’ve already lematic for patients. The benefit of these used today are rooted in crossed some key bridges,” said co- new devices is that they dissolve over 1980s technology. The tiny senior author Wilson Z. Ray, MD, assistant time, so you don’t have something in the new dissolving sensors professor of neurological and orthopaedic body for a long time period, increasing the surgery, who along with Murphy, is update brain monitoring planning to test the technology in for the 21st century. patients with traumatic brain injuries. 2 Washington University School of Medicine Summer 2016 161741_1-8_Pulse_CC15.indd 2 5/12/16 4:41 PM Is atherosclerosis Alzheimer’s disease of blood vessels? YOUNG In atherosclerosis, plaque buildup within arteries ERIC impedes blood ow. Studying mice and tissue samples $60 MILLION The Elizabeth H. and James S. McDonnell III from patients’ arteries, School of Medicine researchers Genome Institute will receive $60 million from the National suggest this accumulation is driven, at least in part, Institutes of Health (NIH) to study the genetics of common by processes similar to the plaque formation in brain diseases, such as heart disease, diabetes, stroke, autism and diseases such as Alzheimer’s. epilepsy. The funding will support sequencing the DNA of 150,000 Amyloid beta and tau proteins are known to build to 200,000 individuals, including a significant percentage of African up in Alzheimer’s. is new research on atherosclerosis Americans and other diverse ethnic backgrounds. The goal is to shows a buildup of similar misshapen proteins inside cells. uncover how differences in DNA contribute to disease risk. Macrophage immune cells attempt to counteract the arterial plaque but become overwhelmed by the inamma- tory environment. e overwhelmed immune cells begin lling up with protein junk, interfering with their function. Benefits of a 5 percent weight loss Senior author Babak Razani, MD, PhD, and Ismail Sergin, PhD, rst A new School of Medicine study nds that for patients with SERGIN I. author and postdoc- obesity, losing small amounts of weight brings the greatest toral research fellow, health benets. and colleagues showed Researchers determined that even only 5 percent weight loss that the buildup inside lowered patients’ risk for diabetes and cardiovascular disease macrophages is due to and improved metabolic function in liver, fat and muscle tissue. problems with the cell’s Current obesity treatment recommends a 5 to 10 percent waste-disposal functions. weight loss, but losing 5 percent may be easier for patients, Mouse artery contains large plaque Normally, a protein said principal investigator Samuel Klein, MD, director of called p62 sequesters the Washington University’s Center for Human Nutrition. proteins and delivers them to cellular incinerators called e study randomly assigned 40 non-diabetic, obese lysosomes. During atherosclerosis, the researchers found individuals to maintain their weight or lose 5, 10, and then the lysosomes break down, and as they cease their waste 15 percent of that weight. disposal, p62 builds up. e researchers looked at To determine if excess p62 is damaging, the researchers body, organ and cell response asked whether atherosclerosis would become less severe if before and aer each person’s they got rid of it. Surprisingly, when p62 is missing and weight loss. no longer gathers waste, atherosclerosis in mice becomes Among the 19 volunteers even worse. who lost 5 percent of their “If p62 is missing, the proteins don’t aggregate,” Razani weight, insulin-secreting cell said. is is more damaging to the cell, as it leaves the function improved, as did THINKSTOCK waste behind rather than having it corralled into one large insulin sensitivity in fat, liver and muscle tissue. Body and “trash bin.” e study shows that as p62 gathers misfolded liver fat also decreased. proteins, it protects against atherosclerosis, even if the cell Losing above 5 percent, however, did not provide as many can’t actually dispose of the waste it gathers. e research- metabolic gains. “Muscle tissue responds to continued weight ers also found these protein aggregates and high amounts loss, but liver and adipose tissue have pretty much achieved of p62 in patient samples, suggesting these processes are their maximum benet at 5 percent weight loss,” said Klein. at work in people with atherosclerosis. Such evidence sug- Klein also wants to expand the research to patients with gests it would be better to focus on xing the cells’ system type 2 diabetes. for getting rid of the large protein aggregates, rather than on ways to stop the aggregates from forming. outlook.wustl.edu Outlook 3 161741_1-8_Pulse_CC15.indd 3 5/6/16 5:58 PM pulse THINKSTOCK Look for Poverty changes brain connectivity Many negative consequences are linked to growing up poor, and Washington University researchers have identi- ed one more: altered brain connectivity. NEW NAME The Department of Anatomy and Analyzing brain scans of 105 children ages 7 to 12, the Neurobiology is now the Department of Neuroscience.