By L. C. Leach III
If you could get a behind-the-scenes look at South Carolina’s major medical research facilities, you would enter a world of human clinical trials, experimental treatments for hundreds of medical illnesses, and molecular investigation into all forms of human cells.
And no matter which facility you explored, you would find teams of professionals in every discipline searching for breakthroughs and cures to help people lead longer and healthier lives.
“Never before has our medical knowledge expanded at such an explosive rate,” said Dr. Peter Edelstein, chief medical officer at Elsevier Clinical Solutions, a global health and science information leader. “Personalized medicine, genomics, and other fields of medical research are changing health and health care worldwide literally daily.”
Here is a glimpse into the ongoing medical research at five S.C. facilities:
Greenville Health System – CenteringPregnancy for better birth outcomes
While GHS is known for premier research in cancer prevention and treatment, Dr. Amy Crockett has expanded its expertise in the field of maternal-fetal medicine.
Crockett leads the South Carolina CenteringPregnancy Expansion Project, which seeks to decrease rates of pre-term births and racial disparity by expanding access to group prenatal care.
“Our state has incredibly high rates of pre-term births,” Crockett said. “More than 11 percent of women in S.C. deliver pre-term (before 37 weeks gestational age), and nearly 15 percent of African-American women give birth early.”
Since 2012, the CenteringPregnancy Expansion Project has provided training and start-up funding to 18 obstetric practices throughout South Carolina, including Parkridge OB/GYN in Columbia and North Central Family Medicine Center in Rock Hill.
To date, more than 3,200 women have participated in the CenteringPregnancy program, and the rate of pre-term birth for these women is just 8 percent – a 34 percent reduction.
Seeking to further improve these outcomes, Crockett partnered with Dr. Liwei Chen, assistant professor of public health sciences at Clemson University, to lead a five-year research study funded by the National Institutes of Health. Their focus will be on understanding the biologic mechanism by which CenteringPregnancy works to reduce pre-term births.
“I love delivering babies, but babies that are born too soon or too small can suffer life-long consequences – such as asthma and cerebral palsy, and also learning and behavioral problems that can cause problems in school,” Crockett said. “The results of CenteringPregnancy are impressive and the work we are doing is truly making a difference for South Carolina families.”
Gibbs Cancer Center & Research Institute – Colorectal Cancer
As part of Spartanburg Regional Health System, Gibbs Cancer Center & Research Institute has made many advances in both the treatment and early identification of colorectal cancer.
Recently, a team of researchers led by Gibbs president Dr. Timothy J. Yeatman sequenced a mutant cancer gene known as APC in nearly 500 colorectal cancer patients.
Their findings revealed a “prognostic effect” in this APC gene that could help physicians better predict long-term outcomes for colorectal cancer patients.
“We have made discoveries involving deep, next-generation DNA sequencing of large numbers of colon cancer tumors that would not have been possible five years ago,” Yeatman said. “And these discoveries were possible because we were able to sequence a lot of colon tumors and compare their mutations.”
A cancerous colon tumor may be caused by a number of gene mutations.
All genes have two copies, one from the mother and one from the father.
These pairs are classified by four variations: (1) both copies normal with no mutations; (2) one mutation present, one normal copy missing; (3) one mutation present, one normal copy present; (4) both copies mutated.
“And our next step is to try to identify clinical uses for the sequencing of the APC gene,” Yeatman said, “in the hopes of predicting drug responses and other applications.”
Medical University of South Carolina – Islet Cell Transplantation
Insulin shots could soon be a thing of the past for diabetes patients – thanks in part to an investigation of islet cell transplantation by researchers with the Medical University of South Carolina in Charleston.
Utilizing a five-year $1.68 million grant from the National Institutes of Health, a collaborative team led by Dr. Hongjun Wang of MUSC’s Department of Surgery is exploring better treatment for chronic pancreatitis through the study of the liver protein, alpha 1 antitrypsin, and islet cells.
Islets are tiny clusters of cells in the pancreas that produce insulin.
Wang’s team is studying how to increase the survival of islet grafts following autologous islet cell transplantation for chronic pancreatitis patients.
“One of the current treatments for pancreatitis is the surgical removal of the pancreas – but this surgery creates problems,” Wang said. “It removes all of the patient’s islet cells, which in turn removes the patient’s insulin, and then makes the patient diabetic – which then creates other lifelong complications.”
A normal pancreas gland secretes digestive enzymes and insulin into the blood.
In islet cell transplantation, the pancreas gland is taken to a laboratory after removal while the cells are still alive. The gland is then gently digested to break it into different cell types including islet cells.
The islet cells are collected and infused back into the patient to go to the liver in the hope that they will stay there and continue to secrete insulin.
“Imagine a day when people with chronic pancreatitis or type 1 diabetes no longer need insulin shots,” Wang said. “That’s the direction we’re heading.”
McLeod Health – Oncology Research Trials
For more than 30 years, McLeod Health in Florence has been a leader in oncology, the study of cancerous tumors.
McLeod currently has 40-50 patients in oncology trials involving breast, prostate, lung, colon and other forms of cancer. The hospital is also engaged in quality of life studies conducted by McLeod Cancer Research Nurses.
“Our current cancer research is moving toward tumor-led DNA analysis,” said Dr. Michael Pavy, who began the cancer research program at McLeod in the 1980s. “This analysis will allow researchers to learn how tumors affect the body’s tissue, and how they can urge the body to reject the tumor.”
Trials are supported through an association of 22 community oncologists, surgeons, radiation oncologists, and urologists in Tennessee, Georgia, Virginia, North Carolina and South Carolina.
In a 2008 article for Newsweek (“Rethinking the War on Cancer”), science writer Sharon Begley reported, “Since 1971, the federal government, private foundations and companies have spent roughly $200 billion on the quest for cures.”
But only in the last several years have researchers seen a significant drop in U.S. cancer death rates.
For example, based on findings of the National Cancer Institute in Rockville, Mary., the U.S. cancer death rate in 1982 was 208.3 persons per 100,000 – up from 195.4 per 100,000 in 1950.
In 2013, that rate dropped to an all-time low of 163 per 100,000.
“Progress in beating cancer in all forms has been very slow,” said Begley, now a senior science writer at STAT, the life sciences publication of the Boston Globe. “And much of the decrease we are now seeing in U.S. cancer death rates reflects the continued decline in smoking as well as cleaner air and water.”
But through all efforts, in both clinical trials and in individuals wanting better personal health, Pavy and other McLeod researchers look to a day when they can say we are done.
“We’ve made some big strides,” he said. “But the future of cancer diagnosis and treatment will be a hundred times more innovative as we continue to conduct research.”