Research Round Up

Bohdan Pomahac

An Inside Look at Face Transplantation

In March 2011, a surgical team at BWH performed the first full face transplantation in the nation and went on to complete a total of three that year. Now, in the first research publication to evaluate full facial transplantation in the U.S., and largest series worldwide, the researchers describe details of patient preparation, novel design and execution of the operation as well as unique immunosuppression protocol allowing for lowest long-term maintenance drug regimen. They also share details of the early functional outcomes and demonstrate facial transplantation as a viable option in the treatment of severe facial deformities and injuries.

In an effort to advance the field of face transplantation, Bohdan Pomahac, MD, director of the Plastic Surgery Transplantation Program and BWH Burn Center, and colleagues document the novel processes involved in a successful face transplant program from screening candidates to the transplant procedure itself and the follow up management of the recipients.

Researchers describe the rigorous screening and consent process that each patient must pass, which includes evaluation by a team of physicians who determine whether the patient is physically and mentally prepared for the procedure through numerous clinical and psychological evaulations. Once a candidate is approved by the face transplant team and the Institutional Review Board at BWH, physicians work closely with the New England Organ Bank (NEOB) to identify the criteria for suitable donors and the process for obtaining consent for this unique transplantation.

This research is published in the Dec. 27, 2011, issue of the New England Journal of Medicine.

Omid Farokhzad and Zeyu Xiao

Getting Cancer Cells to Swallow Poison

Researchers in the BWH Laboratory of Nanomedicine and Biomaterials have created a drug delivery system that is able to effectively deliver a tremendous amount of chemotherapeutic drugs to prostate cancer cells. Omid Farokhzad, MD, of the Department of Anesthesiology Perioperative and Pain Medicine and Research, and his team developed a strategy that allowed them to select ligands (molecules that bind to the cell surface) that specifically target prostate cancer cells. In addition to binding to cancer cells, these specially selected ligands have the unique ability to distinguish between cancer and non-cancer cells and are designed to be swallowed by any desired types of cancer cells, even if their cancer markers are unknown. After selecting for these special ligands, the researchers then attached nanoparticles containing chemotherapy to them, which were then targeted and delivered to prostate cancer cells.

"Our strategy simplifies the development process of targeted nanoparticles and broadens their applications in cancer therapy," said lead author Zeyu Xiao, PhD.

The study is electronically published in the January 3, 2012, issue of ACS Nano.

Gary Hunninghake

Statin-Scarred Lungs

Use of cholesterol-lowering drugs called statins may be linked to interstitial lung disease (ILD), according to a new study. BWH researchers looked at the association between statin use and interstitial lung abnormalities (ILA) in 2,115 current and former smokers. Statin users had a 60 percent increase in the odds of having ILA compared to non-statin users. The link between statins and ILA was strongest in higher age groups and with statins readily dissolved in water, such as pravastatin. The researchers also found that statins aggravated bleomycin-induced lung fibrosis (scarred lung) in mice.

“Caution should be used when extrapolating these findings to the care of patients,” said Gary M. Hunninghake, MD, MPH, of the Division of Pulmonary and Critical Care. “Clinicians should be aware, though, that radiological evidence of ILD can develop in some patients treated with statins.”

The study is published in the Jan. 6, 2012, online issue of the American Journal of Respiratory and Critical Care Medicine.

Charles Lee

Zebrafish DNA: As Varied as Its Stripes

The tropical freshwater zebrafish, Danio rerio, has become a common animal model for scientists conducting research in various biomedical specialties, such as genetics. However, a new study is alerting researchers to variations in zebrafish DNA that could potentially affect studies intended for translation to human diseases.

A study led by Charles Lee, PhD, of the BWH Department of Pathology, identified 31,749 copy number variants (CNVs), which encompass 14.6 percent of the zebrafish reference genome. CNVs are genomic alterations resulting in gains or losses of DNA segments. The CNVs identified by Lee and his team represent 80 zebrafish genomes from three commonly used laboratory strains and one native population. According to the researchers, the extensive variation among zebrafish strains impact phenotype and how zebrafish are used in human disease studies. The study is published in the Jan. 10, 2012, issue of the Proceedings of the National Academy of Sciences (PNAS).

Charles Czeisler

Sleep Disorders Shown to Cause Poor Health in Police Officers

Sleep disorders affect 50 to 70 million Americans, and most go undiagnosed and untreated. Untreated sleep disorders have been associated with increased risk for injuries and accidents and are linked with additional physical and mental health issues. In a first of its kind study, researchers from BWH measured the impact of sleep disorders on police officers’ health, safety and performance. They found that sleep disorders among officers are common and are associated with poor safety and performance outcomes. Charles A. Czeisler, PhD, MD, chief of the Division of Sleep Medicine at BWH, was the senior author of the study.

Over a period of two years, researchers gathered data from 4,957 police officers in North America. Police officers were categorized into two groups: those who were screened on site at police facilities, and those who volunteered to participate virtually online.

The onsite survey, performed at the Philadelphia Police Department and the Massachusetts State Police Department, included screenings for sleep disorders as well as surveys about health and performance. The online survey involved a sample of municipal, state, county and other law enforcement officers from across North America and was used to compare data that was collected from the two intensively sampled onsite municipal and state police departments. Follow up surveys over a period of two years were also conducted.

The findings are published in the Dec. 21, 2011, issue of the Journal of the American Medical Association.