Family teams with UK’s Dr. James Liau to raise awareness of cleft care

The 20-week ultrasound appointment allows expectant parents to get a sneak-peek of their baby growing inside the womb.

First-time parents Anna and Evan Ciannello went into their 20-week appointment expecting to see their baby’s physical features taking perfect form. Instead, the scan brought unwelcome news.

During the scan, the ultrasound technician noticed a separation of tissue at the baby’s upper lip. The visual was enough for doctors to diagnose the Ciannellos’ baby with a cleft lip and palate, which are birth defects of the lip and roof of the mouth that form early in infant development. Cleft lips and palates are the most common birth defects in the United States, occurring at a rate of about two in 1,000 births. More than 4,000 American babies are born with a cleft lip each year. In most cases, the defect is repaired early in a child’s life and they are able to live a normal and healthy life.

The diagnosis terrified Anna, who didn’t know where to turn for information about treatment and outcomes for babies with a cleft lip and palate. Because cleft lips are stigmatized in many cultures, including in American society, families remain silent about their child’s diagnosis, leaving other parents in the dark about how to respond to the diagnosis. The absence of a supportive local cleft care community was frightening for Anna.

“We were devastated when we learned the news,” she said of the diagnosis. “I went into panic mode; I thought I had done something wrong. I was very sad and overwhelmed.”

Looking for answers

Anna searched the internet for information about cleft lips and palates, which only intensified her uncertainty and fears. Through a husband’s friend, she connected with another mom in New Jersey whose child was born with a cleft lip and palate. This mom encouraged her to relocate to Philadelphia for corrective surgeries. Hoping to stay close to family in Kentucky, the couple started calling plastic surgeons at major pediatric centers around the region. Anna said every surgeon on the list referred her to Kentucky Children’s Hospital pediatric plastic craniofacial surgeon Dr. James Liau.

Liau is an outspoken advocate for families seeking cleft care in the region, as well as around the world. Liau met with the Ciannello family before the baby’s delivery to explain the initial diagnosis and options for treatment, assuring them that with early surgical intervention, he could make the cleft lip and palate virtually disappear.

“It was exactly what we needed to hear,” Anna said. “I started getting more confidence, and I felt good about the decision.”

Beginning Frankie’s journey

Francis, or “Frankie,” Ciannello was born in January 2016. On the night Frankie was born, Liau visited the family in their hospital room and conducted an assessment of Frankie’s cleft lip and palate. He believed Frankie’s case was manageable with a series of surgeries, and the first surgery to correct the cleft lip and repair his nose was scheduled for when Frankie was 6 months old. A second follow-up surgery to correct the palate was scheduled six months later. Frankie will have his next surgery when he is a little older so he gets a break for a few years.

Anna’s anxiety about her son’s appearance dissipated when she finally met him face-to-face. She realized Frankie’s appearance was not alarming or embarrassing, and his condition wasn’t a crisis, but an opportunity to challenge the ideal of “the perfect baby.” Frankie, an endearing and handsome baby, was perfect with his cleft lip.

When Anna took her baby to the thoroughbred sales at Fasig-Tipton, co-workers, clients and members of the equine community all embraced Frankie’s appearance. Frankie traveled with his parents to nine racetracks across the country before his first birthday, and Anna said no one ever stared or acted rude to her baby. Most people complimented his precious smile and happy demeanor. Everyone was drawn to him.

“They said he should be a little model,” she said. “I was so proud of how he looked.”

In fact, when Frankie was admitted for his first surgery in June 2016, Anna knew they would miss his distinctive lip and wide smile. The family had grown accustomed to the cleft lip; it was an important part of Frankie’s journey. Instead of shielding her son from the world, Anna decided to share Frankie’s story on social media in hopes of offering comfort and guidance for families processing the prenatal diagnosis cleft lip or palate. She posted photos of Frankie before and after his surgery and provided updates on his surgeries on a Facebook page. The outpouring of support was overwhelming. People called her and told her how they have loved following Frankie’s story and how it brings them to tears to see the photos and read about him.

“I just treated him like a normal baby,” Anna said. “I always wanted him to know I wasn’t embarrassed by him. I am so proud of him.”

Helping parents on their own journey

Anna now consults with parents who come to Liau with a prenatal cleft lip or palate diagnosis. She guides them through some of the complications related to the baby’s care, such as where to access special bottles for cleft babies, how to make adjustments for breastfeeding or what to expect after each surgery. Most importantly, she wants parents to feel confident and excited about the birth of a beautiful baby who might not conform to societal standards. She and Liau are working together to create a network of cleft care families to support one another in the local community and reduce the stigma of cleft palates.

“I see a baby with a cleft, and I have this instant love for them,” she said. “I have such a soft spot for these babies. They are so strong and have to go through so much at a young age.”

Recently, Anna saw a couple with a baby who had a cleft lip out in the community. She approached the couple to admire their baby, telling them their baby was very cute.

“They had so many questions for me. I remember the mother saying, ‘I think God sent you to us.’ It is an emotional thing, but I know what they are going through.”

In addition to supporting local families, the Ciannellos organized “Frankie’s Fund” to support Liau’s mission work abroad. Using his vacation time, Liau takes two mission trips a year to Ecuador and Guatemala to repair cleft palates and lips in third-world communities that lack medical resources. In September, Liau travels to Ecuador to volunteer as a surgeon for the Global Smiles medical mission. During these 10-day visits, hundreds of parents line up with children for evaluation, and surgeons accept about 40 of the most drastic cases for surgical repair. In the winter, Liau volunteers on a Children of the Americas mission trip, performing four to five surgeries a day on children in need of corrective surgery. Each trip, with the medical costs for the surgeries, adds up to about $75,000.

While a cleft diagnosis isn’t necessarily life threatening to a person in the United States, if left untreated the conditions can lead to life-long impediments for people in third-world countries. The stigma is more severe for someone living in Central America, and individuals with cleft palates are ostracized for the condition. Clefts also can cause speech defects, eating issues and severe infections that can lead to deafness. Liau believes he has an obligation to take his surgical skills to pockets of the world where surgical care is not easily accessible to children.

“We offer a lot of services to Kentucky, but in the same regard we have the ability to take it further to these other countries where they have no option,” Liau said. “There is no safety net for them.”

It’s more than medicine

The Ciannellos are grateful for the care they receive from Liau, who has become a friend and outreach partner in addition to being their son’s surgeon. “We can’t stress enough that not only is Dr. Liau an amazing surgeon, but he is also a wonderful person. He has such a kind and gentle way with children, and he always knows how to calm us nervous parents down during the entire process.”

Anna didn’t want to lose the image of how her baby looked with his cleft lip, so she has lots of photos as reminders. Another reminder is the subtle scar on Frankie’s upper lip, an edgy trademark that sets him apart from other toddlers.

“I always tell my husband, ‘Don’t you love how he’s a little different?’” Anna said of the scar.

Last year, Frankie’s Fund raised more than $15,000 to support Liau’s work in Ecuador. Click to give to Frankie’s Fund.

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Swallowing disorders are known as dysphagia. June is National Dysphagia Month, so it's the perfect time to discuss how dysphagia affects people every day.

Chronic difficulty swallowing can adversely affect quality of life

Debra Suiter, PhD, CCC-SLP, BCS-S

Debra Suiter, PhD, CCC-SLP, BCS-S

Written by Debra Suiter, director of the UK Voice & Swallow Clinic.

Most of us have experienced difficulty swallowing at some point. We might have coughed or choked on a piece of food or felt something “going down the wrong tube.” We might have experienced painful swallowing when we’ve had a cold or a sore throat and avoided certain foods or liquids that were more painful to swallow. Pills might have felt as if they got stuck when we tried to swallow them. In most instances, these encounters with swallowing difficulty are temporary and do not have lasting negative effects on our health or well-being. But for some individuals, difficulty swallowing is an ongoing issue that can have a significant impact on health and quality of life.

June is National Dysphagia Awareness Month

Swallowing disorders, known as dysphagia, can occur at any age. Dysphagia can result from a variety of causes, including neurologic diseases such as stroke or Parkinson’s disease; structural abnormalities, such as head and neck tumors or trauma to the head and neck; or pulmonary disease. Approximately one in 25 adults and nine in 1,000 children between the ages of 3 and 17 experience dysphagia each year. It is most common in older adults, although dysphagia is not a normal consequence of aging.

Dysphagia can have devastating consequences. If an individual coughs frequently when attempting to eat or drink, they may fail to eat or drink enough to meet their needs. Dysphagia can also result in pulmonary complications such as aspiration pneumonia. About one-third of individuals with dysphagia develop aspiration pneumonia, and 60,000 die each year from complications related to aspiration pneumonia, according to the Agency for Health Care Policy and Research (AHCPR).

Dysphagia can also impact quality of life. Eating and drinking are parts of our everyday lives. We celebrate birthdays or special occasions by eating cake; we go out to eat at our favorite restaurant with our friends or families. Someone who is experiencing dysphagia often cannot participate in these activities, and this can lead to social isolation, anxiety or depression.

Even if the individual is able to take some food or liquid by mouth, if they cough frequently or need to regurgitate food or liquid immediately after attempting to swallow them, they may become embarrassed to the point of avoiding situations where eating and drinking are involved. Many patients with dysphagia report avoiding certain activities, such as eating out in a restaurant, because they don’t want to embarrass themselves.

Seeking out specially trained providers

If you are experiencing any difficulty swallowing, please notify your doctor. He or she can then make a referral to a speech-language pathologist who can assess your swallowing and make recommendations for treatment if needed. Speech-language pathologists receive special training in assessing and treating swallowing disorders.

It is especially important to seek the services of a speech-language pathologist who has specialty certification (BCS-S) in swallowing and swallowing disorders. To find a specialist, search www.swallowingdisorders.org.


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Fireworks safety tips from UK HealthCare

Got fireworks? Keep your Fourth fun, safe with these tips

Thousands of children and adolescents in the United States are injured in firework-related accidents every year during fireworks season, which starts now and runs through the middle of July.

In fact, in 2015, more than 3,000 children and young adults under the age of 20 in the United States were taken to emergency rooms with injuries related to fireworks.

Before you and your family head outside to enjoy the Fourth of July and other summer festivities, check out our tips for staying safe around fireworks.

  • Leave it to the professionals. Instead of setting off fireworks at home, attend a public fireworks display. You’ll be out of harm’s way and still be able to enjoy the show.
  • If you are using fireworks at home, take precautions. Never let children play with or light fireworks, and always read all warning labels before use.
  • Do not wear loose clothing while using fireworks. And be sure to stand several feet away from lit fireworks.
  • Have an extinguisher nearby. A bucket of water, hose or fire extinguisher will work.
  • Don’t try to relight a firework that hasn’t worked properly. Instead, put it out with water and get rid of it.
  • Be careful with sparklers. Sparklers heat up to more than 1,000 degrees Fahrenheit and present a real health risk, especially for small children. Instead of sparklers, let your little ones use glow sticks – they’ll have fun and stay safe, too.
  • Be prepared for an emergency. Have a phone nearby in case you need to call 911, and teach children what to do if their clothing catches fire (stop, drop and roll). In the case of an eye injury, avoid touching or rubbing it, which can make the injury worse, and get help immediately.

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Dr. Rasesh Desai

Inspired by his sister, Rasesh Desai decided to become a doctor

Making the RoundsIn our latest Making the Rounds interview, we sat down with Dr. Rasesh Desai, an orthopaedic surgeon with UK Orthopaedic Surgery & Sports Medicine who works at The Medical Center at Bowling Green. Dr. Desai sees patients of all ages and specializes in joint replacement surgery, spine surgery and pediatric orthopaedic surgery. 

What kinds of patients do you see?

I see patients from all age groups – from newborns to adults. I’m in a unique position because of my variety of fellowship training. I’m fellowship-trained in spine surgery and joint replacement surgery, and it gives me an opportunity to see the patient as a whole person.

Sometimes a patient comes to your office with leg pain, hip pain or knee pain, and then you find out their actual problem is coming from the spine. Or sometimes it might be vice versa, where patients come in with back problems. But we find out the back problem is mainly the result of hip or knee arthritis.

Tell us about UK’s partnership with The Medical Center at Bowling Green

The UK orthopadic department has an agreement with The Medical Center at Bowling Green to provide orthopaedic service in this community. The main purpose of this affiliation is to provide the same level of care that you would get at a bigger hospital, right here in a smaller community.

What inspired you to get into medicine?

I saw my elder sister go into the medicine field, and it always inspired me to see her, how she treated her patients. You know, when you are a kid, when you are growing up, you go to the doctor when you are sick and they get you better and back to your life, and that always fascinated me.

During medical school, I worked with an orthopaedic surgeon. I saw the patients coming to the hospital with broken bones and severe pain, with arthritis, or not able to walk. And then getting them back on their feet was immensely satisfying, and that inspired me to become an orthopaedic surgeon.

What does your ideal weekend look like?

My ideal weekend is to be able to spend some time with my family and my 3-year-old son. Get him out to the park and play with him, because I don’t get much time to do that during the week. I also like to spend some time with friends and their families. Go out, watch a movie and maybe watch some sports on TV.

What’s your favorite movie?

I like all of the X-Men movies!


Check out our video interview with Dr. Desai, where he tells us more about working in Bowling Green and why teamwork makes a world of difference in patients’ recovery.


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Daniell Pruitt always wanted to ride a bike, but because of her spinal muscular atrophy, she never could. But UK HealthCare helped make her dream come true.

UK students make adapted bicycle a reality for disabled teenager

Danielle Pruitt is a pretty typical teenager. The chatty 13-year-old loves social media, hanging out with her friends and going to school (most days). Much to her parents’ chagrin, she often introduces herself with a drawn-out greeting of, “’Sup?”

Danielle cannot move her limbs or sit up. She has spinal muscular atrophy, a genetic disorder that affects the part of the nervous system responsible for controlling voluntary muscle movement. She is not able to do many things others take for granted. For the longest time one of those things was riding a bike.

Danielle’s mother, Beth, recounts previous attempts to give this experience to her daughter. She mentions a bike with a car-seat lying flat and attached to the handlebar. But this was not what Danielle was looking for, Beth said.

“There are so many things we want to do for her, and it’s frustrating to not be able to problem solve,” Beth Pruitt said. “She wanted a real bike.”

Promoting independence

In April 2016, Catherine Gohrband, a lecturer in the UK College of Health Sciences’ Division of Physical Therapy, helped a group of physical therapy students found a local chapter of AMBUCS, a national nonprofit organization that provides therapeutic tricycles to individuals unable to operate a traditional bike.

“There has been wonderful community and university support for both the chapter and the students involved with this project,” Gohrband says. “This organization has a mission to promote independence to persons with disabilities and provide children with disabilities the opportunity to pursue family recreation and leisure experiences through the use of these adapted bicycles.”

In August 2016, AMBUCS brought several bikes – called Amtrykes – to the Child Development Center of the Bluegrass for children to try out. Amtrykes can be adapted so that nearly every rider can be successful, no matter their physical condition. Danielle’s physical therapist Joanne Luciano, clinical director at On the Move Pediatric Therapy, recommended the event to the family, where Danielle rode an Amtryke for the first time. Her mother remembers the look on Danielle’s face. “It was phenomenal,” she said.

The family was not able to take a bike home that day, but they made an impression on Gohrband and her students.

Making dreams come true

Soon after the AMBUCS event, the CHS (College of Health Sciences) Staff Council was considering who might be the beneficiary of its annual Harvest Breakfast and Silent Auction.

“We wanted our fundraising efforts to go toward people and causes that were close to CHS,” Melissa Miller, CHS staff council chair, said. “After Catherine told us about Danielle, we made it our mission to get her a bike.”

Thanks to the hard work of Staff Council and the generosity of CHS faculty and staff, the silent auction was a success. The proceeds were enough to purchase not one, but two Amtryke bikes.

“We are all beyond thrilled that we got to make Danielle’s dream come true,” Miller said. “AMBUCS created an opportunity that we didn’t even know could exist for her, and it was a privilege to be part of it.”

To her parents’ delight, Danielle’s wish was granted. It takes her parents and therapist about 10 minutes to situate her comfortably on her bike, with various straps and harnesses meant to hold her securely and still allow for therapeutic movement.

“Can you take my picture on my bike like this?” Danielle asked, as she rolled her eyes toward the top of her head. “Because it shows my personality.”

Then Danielle speeds away, very much like a typical kid.

Flanked by her parents, Danielle Pruitt tries out her new Amtryke.

Flanked by her parents, Danielle Pruitt tries out her new Amtryke.


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As summer approaches and temperatures rise, it's important to learn how to recognize and treat different heat-related illnesses.

Learn how to recognize heat-related illness in yourself and others

Heat is one of the leading weather-related causes of death in the U.S., resulting in an average of over 600 fatalities annually. Heat-related illnesses account for an average of 2,800 hospitalizations nationwide each year.

Summer is here, and it’s important to keep in mind that your body’s ability to cool itself is challenged on very hot and humid days. When the body heats too rapidly to cool itself properly – or when too much fluid or salt is lost through dehydration or sweating – body temperature rises. This can result in a heat-related illness or death if left untended.

Also know that age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use can play a role in whether a person can cool off enough in very hot weather.

To be safe and keep those around you safe on extremely hot and humid days, it is important to know the symptoms of excessive heat exposure and the appropriate responses.

Heat cramps

Heat cramps may be the first sign of heat-related illness and may lead to heat exhaustion or stroke.

Symptoms:

  • Painful muscle cramps and spasms usually in legs and abdomen.
  • Heavy sweating.

First aid:

  • Apply firm pressure on cramping muscles or gently massage to relieve spasm.
  • Give sips of water unless the person complains of nausea, then stop giving water.

Heat exhaustion

Symptoms:

  • Heavy sweating.
  • Weakness.
  • Cool, pale or clammy skin.
  • Fast, weak pulse.
  • Possible muscle cramps.
  • Dizziness.
  • Nausea or vomiting.
  • Fainting.

First aid:

  • Move person to a cooler environment.
  • Lay person down and loosen clothing.
  • Apply cool, wet cloths to as much of the body as possible.
  • Fan or move victim to an air conditioned room.
  • Offer sips of water.
  • If person vomits more than once, seek immediate medical attention.

Heat stroke

Symptoms:

  • Altered mental state.
  • One or more of the following symptoms: throbbing headache, confusion, nausea, dizziness or shallow breathing.
  • Body temperature above 103 degrees Fahrenheit.
  • Hot, red, dry or moist skin.
  • Rapid and strong pulse.
  • Fainting or loss of consciousness.

First aid:

  • Heat stroke is a severe medical emergency. Call 911 or get the victim to a hospital immediately. Delay can be fatal.
  • Move the victim to a cooler, preferably air-conditioned, environment.
  • Reduce body temperature with cool cloths or bath.
  • Use fan if heat index temperatures are below the high 90s. A fan can make you hotter at higher temperatures.
  • Do NOT give fluids. (It may lead to pulmonary edema.)

How to stay safe during hot weather

Everyone should take these steps to prevent heat-related illnesses, injuries and deaths:

  • Stay in an air-conditioned indoor location as much as possible.
  • Drink plenty of fluids even if you don’t feel thirsty.
  • Schedule outdoor activities carefully.
    • Wear loose, lightweight, light-colored clothing and sunscreen.
    • Pace yourself.
  • Take cool showers or baths to cool down.
  • Check on a friend or neighbor and have someone do the same for you.
  • Never leave children or pets in cars.
  • Check the local news for health and safety updates.

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coconut oil

Check out these healthy alternatives (really!) for coconut oil

If you’ve been cooking with coconut oil with the idea it’s healthy, you’re not the only one. Cooking blogs, specialty food stores and many health-conscious eaters have embraced coconut oil as a healthy alternative to other cooking fats, such as butter.

Unfortunately, that healthy reputation may have been too good to be true. According to a recent American Heart Association advisory, coconut oil is 82 percent saturated fat – the type of fat you want to avoid in large quantities. Studies show saturated fat can raise your LDL cholesterol, or “bad” cholesterol, as much as butter, beef fat or palm oil. Canola oil, on the other hand, has only 7 percent saturated fat, and might be a healthier option for cooking.

All fats and oils have varying levels of saturated, monounsaturated and polyunsaturated fat. Saturated fat raises LDL cholesterol, which can cause atherosclerosis, a condition marked by the hardening and clogging of arteries that can lead to heart attacks, strokes and other cardiovascular diseases.

Replacing saturated fat with the healthier monounsaturated and polyunsaturated fat in the diet lowers cardiovascular disease risk as much as cholesterol-lowering statin drugs, according to the advisory.

So, which oils should you be using in your kitchen? Here’s what the AHA recommends:

Healthier cooking oils

  • Canola oil
  • Corn oil
  • Soybean oil
  • Peanut oil
  • Safflower oil
  • Olive oil

Cooking oils and fats to avoid or limit

  • Butter
  • Lard
  • Beef tallow
  • Palm oil
  • Palm kernel oil
  • Coconut oil

The AHA recommends that saturated fat should make up less than 10 percent of daily calories for healthy Americans and no more than 6 percent for those who need lower cholesterol.


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hiatal hernias

Q&A with Dr. Jonathan Kiev: What to know about hiatal hernias

Dr. Jonathan Kiev

A hernia is a medical condition that occurs any time an internal organ or tissue bulges into an area where it shouldn’t be. Hernias don’t always cause noticeable symptoms, but they can cause serious problems if left untreated.

In honor of Hernia Awareness Month, we sat down with Dr. Jonathan Kiev, a new cardiothoracic surgeon at UK HealthCare, to discuss a specific type of hernia called a hiatal hernia.

What is a hiatal hernia?

A hiatal hernia occurs when a portion of the stomach sneaks out of the abdomen above the diaphragm. This occurs fairly frequently and can cause symptoms of pain, heartburn and bloating depending on the size and location of the hernia. Most patients have no symptoms at all, and the hiatal hernia is only discovered incidentally during another test or procedure.

Why do hiatal hernias occur?

Hernias occur because of a weakness in the tissue. This can be caused by aging or even trauma, which may have caused a disruption in the abdominal wall layers. Pregnancy and obesity are known to contribute to the development of hiatal hernias, as well.

Can patients do anything to treat their hernia?

Generally, the answer is no, unless there are symptoms or if the hernia is large enough to require surgery. Patients who have heartburn or gastroesophageal reflux disease, or GERD, are given medications once they are evaluated by their physician to be sure that there are no other more serious medical conditions.

When is surgery for hiatal hernia necessary?

If the symptoms are disabling, like the person is having difficulty swallowing or they’re having food get stuck after eating, then surgery is appropriate. If a patient is anemic – a condition where their blood doesn’t have enough healthy red blood cells – sometimes the hernia can be the cause of anemia, and this can be relieved with surgery, as well. Rarely, a large hernia can become trapped, and emergency surgery is necessary to relieve the constriction.

How is a hiatal hernia diagnosed?

Beyond a good health history and physical exam, a physician may order a swallowing test with dye or a CAT scan to see if the stomach is above the diaphragm. Specialized tests by a gastrointestinal doctor might include an endoscopy, which looks at the lining of the esophagus and stomach for evidence of acid that may cause irritation.

What can patients expect if they need surgery?

Surgery can be done through the abdomen or the chest. Thankfully, today’s techniques allow the procedure to be performed with tiny incisions in a couple of hours so recovery is quick and pain is minimal. Most patients go home in a day or two and recuperate over the next several weeks.

Most patients go home in a day or two and recuperate over the next several weeks. Surgeons that specialize in minimally invasive procedures and thoracic surgeons are experts in the repair of hiatal hernias. Your physician can refer you to a surgeon in your area.

Are dietary changes necessary after surgery?

Patients can still eat all the foods that they enjoy, although they may be encouraged to modify their intake and meal frequency.

Is a follow-up necessary after this surgery?

Surgeons like to follow their patients closely to be sure that these hernias don’t come back. We know that the larger hernias have a higher likelihood of recurrence, and special procedures are done to minimize this. Overall, the results of this surgery are excellent, and patients are very satisfied afterward.


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Research featuring UK scientists shows promise in treating cancer

A new study published in Nature Chemical Biology featuring UK research highlights a promising new way to address lung cancer and other deadly diseases.

Lung cancer accounts for 25 percent of cancer deaths in the U.S., and one out of every two patients diagnosed with lung cancer won’t survive more than one year. The problem is at its worst in Kentucky, where the state continues to lead the nation in lung cancer incidence and death.

The new research brings together scientists from the UK College of Pharmacy, Memorial Sloan Kettering Cancer Center and St. Jude Children’s Research Hospital and reveals a new way to treat lung cancer by blocking cancer-causing proteins on a cellular level. The study involves a compound developed by UK College of Pharmacy Dean Kip Guy’s lab.

The foundation for research

The groundwork for the study began more than 10 years ago when Dr. Bhuvanesh Singh, a physician-scientist at Memorial Sloan Kettering Cancer Center, identified that an increase of a protein called DCN1 led to more malignant lung cancers and shorter life spans for his patients. Of the patients he studied, those with high levels of DCN1 succumbed to the disease more quickly than those with normal levels.

Frustrated by their findings, Singh’s team set out to study the specifics of DCN1. While DCN1 is a normally occurring protein, his team found that too much of it leads directly to cancer formation. Simply put, a malignant tumor was formed when the amount of DCN1 in a cell was increased. Thus, patients with more DCN1 got sick more quickly and died faster than their counterparts.

Efforts in Brenda Schulman’s lab at St. Jude, led by biochemist Daniel Scott, established how DCN1 interacts with other proteins and controls cellular processes. Their key discovery used X-ray crystallography to show that a small modification of the partner protein to DCN1, known as UBE2M, was required for DCN1 to work. This common modification, N-terminal acetylation, had not previously been shown to be critical to controlling activity of this specific protein. Recognizing the potential for targeting this modification, Shulman reached out to form a collaboration between the three laboratories.

Their goal: to develop a way to stop DCN1 from killing patients.

‘Jamming the lock’

Understanding the behavior and function of DCN1 was far more ambitious than running simple tests. It was a significant step forward in understanding how proteins within a cell work.

Building upon the science from Shulman’s team, Jared Hammill from Guy’s lab and Danny Scott from Schulman’s lab worked to stop the interactions of DCN1 altogether. If DCN1’s activity depended on this interaction, then it stood to reason they could create a compound to intervene and stop the interaction from happening.

Guy describes the interaction as a “lock and key model.” Scientists have a blank key – which is UBE2M – and a lock, which is DCN1. The key wants to fit into the lock, so it’s modified until it fits. This modification process is N-terminal acetylation.

“What’s the significance?” Guy said. “Well, we’re the first people to show that protein interaction controlled by N-terminal acetylation can be blocked. We’re essentially jamming the lock with a compound so the key won’t fit.”

The items jamming that lock are a series of small molecules created in the lab. When the molecules were tested directly in cancer cells, they worked. They effectively blocked DCN1 from binding to UB2EM. After decades of collaborative research, there was finally a barrier between lock and key.

What it means for patients

The impact of these findings for healthcare and lung cancer patients specifically could be profound.

“We are excited about the implications of this research, which offer us a meaningful solution for addressing diseases like cancer, neurodegenerative disorders and infection,” Shulman said. “It’s exciting to collaborate with so many complementary groups of expertise and to watch how Dr. Scott and Dr. Hammill led the team. This research opens many new doors for us.”

The collaboration between these three labs could mean relief to many of those suffering from a variety of diseases.

“To have spent decades on this research and have such promising results is truly exhilarating,” Singh said. “At the end of the day, what matters most is improving health outcomes for our patients. This work represents a very important step towards developing a new approach to treat the most difficult of cancers and hopefully increase cure rates.”

This research was funded in part by National Institutes of Health, the Howard Hughes Medical Institute and American Lebanese Syrian Associated Charities.


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exercise memory

Could exercise help ward off dementia? UK study aims to find out.

Allison Caban-Holt

Allison Caban-Holt

Written by Allison Caban-Holt, PhD, of the UK Sanders-Brown Center on Aging

Experts at the World Health Organization say that a sedentary lifestyle is one of the leading risk factors for death worldwide. We all know that being active can reduce our risk for diabetes, heart disease or even stress. But might it also help ward off dementia?

Recently, researchers have been studying the relationship between exercise and cognitive performance, bringing hopeful news about the benefits that exercise can provide patients who have degenerative brain diseases and cognitive impairment caused by Alzheimer’s disease.

The UK Sanders-Brown Center on Aging is one of 15 centers pairing with YMCAs across the country for a study called “Exercise in Adults with Mild Memory Problems,” or EXERT. EXERT will explore whether physical exercises such as stretching, balance and range of motion versus moderate-to-high intensity aerobic exercise can slow the progression of early Alzheimer’s disease memory problems (known as “mild cognitive impairment”) in older adults.

Participants will receive a free 18-month membership to a participating YMCA, a free personal trainer for 12 months, a personalized exercise program, medical evaluations and the opportunity to relax, meet new people and have fun.

To be part of this trial, participants must be between 65 and 89 years of age, experiencing mild memory problems, and able to exercise four times a week at the Lexington High Street YMCA for 18 months. Other criteria for the study include general good health, no recent history of regular exercise and not currently on insulin.

For more information about participating, please contact Molly Harper, EXERT study coordinator, at molly.harper@uky.edu or 859-323-2978, or visit the National Institutes of Aging website.

You or someone you know might be able to help prove the idea that “what’s good for the heart is good for the brain.”


Next steps:

  • Sanders-Brown recently teamed up with The Balm in Gilead to raise awareness about memory-related disorders in the African-American community. Learn more about the partnership.
  • Alzheimer’s disease usually affects people who are 65 or older. If there’s a senior in your life, be aware of these signs and symptoms of the disease.