Fighting the Good, Long Fight

The war on cancer is 45 years old. And while there have been some significant advances since passage of the National Cancer Act in 1971, the conflict has spread out along many fronts.

With the realization now that there are more than 200 types and subtypes of cancer, the battle plan has evolved from a one-size-fits-all strategy to a data-driven, more personalized approach, which means the army of researchers and clinicians devoted to fighting cancer also has evolved.

“We’re seeing the emergence of the new cancer biology,” says John McDonald, director of the Integrated Cancer Research Center (ICRC) at the Georgia Institute of Technology. “It’s actually being driven now by technologies and expertise that lie outside the traditional framework of cancer biology. That’s why I think you’re probably going to see major breakthroughs in cancer research coming out of places like Georgia Tech and M.I.T., as opposed to traditional medical schools.”

Advances in genomics and high throughput sequencing have generated massive amounts of data, “and it’s opened up the field to people that were not trained as cancer biologists, but have the necessary skillsets for the analysis of all this new, big data,” says McDonald, a faculty researcher with the Petit Institute for Bioengineering and Bioscience and professor in the School of Biological Sciences, who has definitely seen his share of breakthroughs in his own recent research focused on ovarian cancer.

The cancer biology that McDonald knew when he was a college student has moved from an era of specialization into an era of multidisciplinary research, in which researchers from a wide range of areas now work together on common projects.

“Twenty five years ago, these people probably wouldn’t have spoken to each other because they didn’t have any common interests,” says McDonald. “I was like a kid in a candy store when we first came to Georgia Tech, and it still feels like that – the idea of being in a place where all of this expertise and creativity exist. Cancer research is not a one-person endeavor. It’s all about collaboration.”

And McDonald has plenty of collaborators within and beyond the ICRC, which occupies a busy space where molecular biology, computational science, engineering and nanotechnology converge. Together, these scientists and engineers are developing next generation cancer diagnostics and therapeutics.

Family Affair

Fatih Sarioglu trained as an electrical engineer in his native Turkey and later at Stanford University, developing particular expertise in microsystems and nanosystems, developing sensitive, small-scale devices to look at atoms. After earning his Ph.D., he says, “I wondered how I could use these skills to benefit humanity.”

Sarioglu, assistant professor in the School of Electrical and Computer Engineering and a Petit Institute faculty researcher, he spent three years as a post-doc at Massachusetts General Hospital and Harvard Medical School, learning about cancer. He found his opportunity, “to give biologists and biomedical scientists and clinicians capabilities they don’t have.”

There was a personal reason for Sarioglu’s interest in cancer, as well. The disease took the life of two grandparents. But he was particularly motivated when his mother-in-law was diagnosed, back in Turkey, with late-stage brain cancer.

“It was devastating. I knew life expectancy was about four or five months,” says Sarioglu. “But their diagnosis was based purely on the pathology, a biopsy slice.”

He asked a colleague at Mass General, David Lewis, one of the world’s top pathologists, for another opinion. Lewis’ conclusions were vastly different. The cancer was benign, operable, and Sagioglu’s mother-in-law is alive and well.

“It showed me that we still have to improve how we diagnose cancer,” says Sarioglu, whose lab develops microfluidic chips that can isolate tumor cells out of billions of other cells. At Mass General, he worked on a device that captures clumps of tumor cells before metastasis, preventing the spread of cancer.

He’s continued that work since arriving at Georgia Tech in 2014, developing microchip technology that analyzes cells accurately and at very high speeds. Essentially, it is a better way to find the needle in the haystack, a minimally invasive way to diagnose cancer, liquid biopsy.

“The possibilities are endless, really,” says Sarioglu, who counts McDonald and Fred Vannberg (an expert in DNA sequencing who specializes in the molecular analysis of cancer) among his research collaborators. “The technology is applicable to all types of cancer.”

Doing Better

The primary tumor is rarely the killer in cancer. Nine times out of 10, cancer kills because it spreads to other parts of the body. So when a patient gets a cancer diagnosis, one of his first questions is, “has it metastasized?”

“You can obviously appreciate the anxiety. The physician and patient wonder the same exact thing. That’s the first question,” says Stanislav Emelianov, professor in the Georgia Tech/Emory Wallace H. Coulter Department of Biomedical Engineering (BME), a Georgia Research Alliance Eminent Scholar and the Joseph M. Pettit Chair in School of Electrical and Computer Engineering.

“Then there are more questions. What is the prognosis, the treatment, how do I deal with this – a lot of questions that can be better answered if we know the answer to the first question,” says Emelianov, whose team designs ultrasound imaging devices and algorithms, and has embarked on a project supported by a grant from the Breast Cancer Research Foundation to use light and sound and a non-radioactive molecularly targeted contrast agent, to answer that anxious first question.

The traditional approach has been to inject radioactive material and tracking that, then biopsy, which involves incision of the skin to expose the lymph node and taking pieces out to look for cancer.

“It is accurate, but it is also invasive, complicated and uses radioactive material,” Emelianov says. “We can do better.”

Emelianov speculates that in the future, we may be able to “weaponize” these contrast agents to actually kill cancer cells. Meanwhile, his team also is using its advanced imaging technology in collaboration with colleagues at Emory University’s Winship Cancer Center, to diagnose thyroid cancer and differentiate between malignant and benign tumors.

Tech’s Cancer Army

There are more than 40 faculty researchers at Georgia Tech who are members of the ICRC. They come from 12 different departments or schools. And there are an additional 16 researchers from academic and medical institutions that are affiliate members. It’s a diverse intellectual force that is giving Georgia Tech its own identity in cancer research.

“We can be a major player in cancer,” says McDonald. “How many medical schools have this breadth of expertise?”

He’s talking about young researchers like Susan Thomas, awarded Georgia Tech’s first grant from Susan G. Komen (breast cancer research foundation), supporting her work in immunotherapy for breast cancer; and Manu Platt, whose lab developed a new technique to give patients and oncologists more personalized information for choosing breast cancer treatment options.

And he’s referring to computer scientists like Constantine Dovrolis, who has spent the last few years investigating a phenomenon called “the hourglass effect” that is present in both technological and natural systems. He’s adapting what he learned studying embryogenesis with Georgia Tech biologist (and Petit Institute researcher) Soojin Yi to his collaboration with McDonald in cancer research.

He’s also thinking of BME-based researchers James Dahlman and William Lam.

Dahlman, an assistant professor who came to Georgia Tech earlier this year, works on cancer in two ways. Focusing extensively on primary lung tumors as well as lung metastasis, his team works on delivering genetic drugs to tumors.

“We have changed their gene expression, and either slowed tumor growth or caused established tumors to recede,” says Dahlman, an expert in gene editing. “In some cases, we have delivered multiple therapeutic RNAs to tumors, so that tumor cells are hit with a genetic ‘one-two’ punch that affects multiple cancer causing genes.”

His lab also creates tools to understand how cancer genes cause tumor resistance, studying how combinations of genes influence tumor growth, “because cancer is such a complicated disease and the genetics of cancer are notoriously difficult to understand,” Dahlman says. “It’s driven by many genes working together at once.”

For Lam, the war on cancer is waged in a lab and on the front lines, in a clinical setting. In addition to being a biomedical engineer, he’s also a pediatric hematologist-oncologist who treats patients at Children’s Healthcare of Atlanta.

His Ph.D. was actually focused on the biophysics of childhood leukemia, and his research in this area has focused on a small percentage of patients who develop leukostasis (stroke-like symptoms and lung failure).

“We always thought it was due to the biophysical properties of leukemia cells, which become big and sticky and jam up the plumbing of our blood vessels in our brain and lungs, which happen to have the smallest blood vessels,” says Lam, who is collaborating with Todd Sulchek, associate professor in mechanical engineering and a Petit Institute researcher.

“We’re combining some of Todd’s microfluidic technologies and our microfluidic technologies, to develop more high throughput ways to address this issue,” says Lam.

He’s also collaborating with the lab of BME professor Krish Roy on developing a ‘lymphoma on the chip’ model, to study how new cell therapies can directly affect the killing of cancer cells, as a way to determine whether those therapies have what it takes to work in the patient.

It’s all part of the multidisciplinary, “basement to bench to bedside” approach that Lam’s lab, with its connections to Georgia Tech, Emory University and Children’s Healthcare, has become known for.

“Within our lab, we’re certainly interested in technology development,” Lam says. “But then, we’re also interested in the assessment of the technology and, ultimately, directly translating that to the patient. Our lab lives in that entire space.”

Energy

Energy is everywhere, all the time, impacting everything that everyone does. The forms it takes may change constantly, but there is just as much or just as little energy in our closed system universe today as there ever was.

Without energy, there is no life or death. Without energy, you are intangible, insubstantial, non-existent, and for a species like ours existence is typically preferable to the alternative, but in a certain sense, our existence is also unavoidable, because of energy.

We tame it and domesticate it, help energy change form, not unlike the first posturally challenged hominid that shambled back to his ancient campsite clutching a flaming branch, probably lit from a pile of sun-fired underbrush, or maybe lava from a volcanic eruption.

The branch has evolved and we've monetized manifest energy, but ultimately we can’t really control it because we depend on it more than it depends on us. So we might as well learn to get along with it.

Military/veterans healthcare experts front and center at Georgia Tech

I did not want to write this story, because I feel ill-equipped to write about war and its effects, even in the cold abstract. I've never covered a war as a correspondent, never been to war, haven't lost a family member or close friend in a war. But when I read casualty numbers and statistics it sometimes makes my stomach turn, because those figures represent flesh and blood and souls, people. I am ill equipped. But I do appreciate the people who take on the terrible burden of fighting a war, and I appreciate the work of the people putting this symposium together -- people I get to work with -- brilliant scientists whose research is improving the lives of service members and veterans who have been injured. So, here's the little story.


Some things about combat don’t change. Soldiers put themselves in harm’s way for love of country. It’s part of the job description. On the other hand, some things do change, in substantial ways. For one thing, soldiers are surviving combat injuries in greater numbers than ever before.

According to the Philanthropy Roundtable publication, Serving Those Who Served, the U.S. Armed Forces’ wounded-to-fatality ratio has gone from 2:1 in World War II and 3:1 in the Vietnam War to 8:1 in the Iraq/Afghanistan war. The odds for a soldier’s survival have improved thanks largely to advances in emergency and in-theater medicine.

The inevitable result is that a large number of service members and veterans are living with debilitating injuries and disabilities. It’s a reality that emphasizes the importance of the research in regenerative medicine being done at the Georgia Institute of Technology, and makes this week’s Military and Veterans Healthcare Technologies Symposium particularly timely.

The symposium, sponsored by two Petit Institute research centers, the Center for Advanced Bioengineering for Soldier Survivability and the Regenerative Engineering and Medicine Center (REM), will provide an opportunity for investigators to see what their colleagues are doing in this broad area of military medicine. The plan is to bring together experts from Georgia Tech, Emory, and the University of Georgia, this Thursday, January 30^th (8:30 a.m. to 3 p.m.) in the Suddath Room (1128) at the Parker H. Petit Institute for Bioengineering and Bioscience.

Research in technologies from combat casualty care to veteran rehabilitation will be highlighted. So the focus will be on the kind of regenerative medicine that can restore functionality to injured limbs and tissues, and improve a soldier’s quality of life following a neuro and/or neuromuscular injury on the battlefield. Tech’s research strengths in this area lie in the treatment of osteoarthritis, musculoskeletal injuries, fibrosis or scarring, and traumatic brain injury (TBI) and motor control.

Closer to the battlefield are advances in hemotosis and bleeding detection, and infection and inflammation control, where Tech’s strengths lie in technologies that induce or enhance clot and scar formation, imaging, immunomodulation, and the treatment of wounds and infections, broadly speaking.

Bringing all of this research to light is an eclectic gathering of engineers and scientists, experts in their fields, including the symposium faculty advisor, Thomas Barker, and REM co-director, Johnna Temenoff, both from Georgia Tech. Also speaking with be: Andrés J. García, Robert Guldberg, Robert Kistenberg, Will LaPlaca, Krishnendu Roy and Lena Ting from Georgia Tech; Wilbur Lam, from Emory and Georgia Tech; Robert Taylor, from Emory; Nick Willett, from Emory and the Atlanta Veterans Administration; Steve Stice, from the University of Georgia; and Brian Pfister, who is with the U.S. Army Medical Research and Materiel Command.

 “We hope to get a feel for current Department of Defense priorities, initiatives and interests as well,” says symposium program manager Martha Willis, who also sees the event as an opportunity to build community, explore new research synergies, and begin developing multi-investigator grant applications.

“In addition to the presentations on the agenda, there is time for networking and discussions,” she says. “The hope is that new research collaborations will result, old ones will be reinforced, and investigators will have a chance to discuss future opportunities for funding their work.”

Molecular Artistry: Irving Geis shed light on an unseen world

The atrium of the Parker H. Petit Institute for Bioengineering and Bioscience was swarmed by hundreds of guests on Saturday, October 18, for the BUZZ on Biotechnology, an annual outreach event geared toward teenaged students, an interactive open house to inspire future scientists, and maybe generate a little interest in attending the Georgia Institute of Technology.

The kids took part in a bunch of hands-on experiments, many of which are designed to teach something about biology at the molecular level. They went from demonstration table to demonstration table, building edible cells out of candy or extracting DNA from peas, unaware that all around them, hanging on the atrium walls, are some of the most influential images ever made of molecular biology. This is the art of Irving Geis, whose 116th birthday also happened to be October 18, a former Georgia Tech student who did more for myoglobin’s street cred than anyone before him.

Geis, who died in 1997, was a pioneer whose seminal, oft-reproduced painting of a sperm whale myoglobin molecule for Scientific American in 1961 basically launched the field of molecular illustration, an artist whose complex and colorful depictions of an unseen living world have helped inspire and enlighten generations of students and scientists.

“We all knew about Irving Geis,” says Sheldon May, a biochemistry professor who helped start the Petit Institute and led the effort to bring Geis’s work to the atrium shortly after the building opened 15 years ago. “Anyone who taught biochemistry used his illustrations. He was an amazing artist, strongly influenced by Da Vinci, and he did it all in a time before computer graphics.”

Geis, born in New York City in 1908, moved to Anderson, South Carolina, as a kid. He thought he wanted to be an architect, so he attended Georgia Tech from 1925 to 1927 with that in mind.  He didn’t graduate from Tech, but his experience in Atlanta obviously left an impression, according to his daughter.

“My father couldn’t carry a tune and almost never sang, but he taught me the song, I’m a Ramblin’ Wreck from Georgia Tech, when I was six years old,” says Sandy Geis. “It was my favorite thing to sing. Can you imagine? A six-year-old kid singing, ‘a hell of an engineer’ at the top of her lungs.”

Geis may have enjoyed his time at Tech, but he just wasn’t bound to be an architect, and went on to earn a Bachelor of Fine Arts at the University of Pennsylvania (1929) and after earning a degree in design and painting from the University of South Carolina in 1933 he moved back to New York to work as a freelance illustrator. He did a lot of work for Fortune magazine, including a drawing of the circulatory system that marked his venture into scientific illustration. “He was very proud of that. It really jumpstarted his interest in biology,” Sandy Geis says.

During World War II, Geis worked as chief of the graphics section of the Office of Strategic Services (OSS, the predecessor of the CIA) and later as art director for the Office of War Information. Following the war and for the rest of his life he worked as a freelance artist, and from 1948 on he shaped the genre of scientific illustration. That was the year he started contributing to Scientific American, where he produced some of the most iconic images of scientific illustration, the most famous in 1961.

“The myoglobin painting was a landmark in his career, and in science. It was really the first illustration of the molecular world,” says Sandy Geis, whose father typically spent a few weeks on a project – learning the subject, talking with the scientist writing the article he was dressing up, and producing an illustration. But the myoglobin watercolor painting took six months, because it takes a while to break new ground.

“There was always a back and forth dialogue with the authors, the scientists,” Sandy Geis says. “Between his photographs, and sketches, and the constant dialogue, he was able to elucidate whatever they said. It was a complicated process, and my father was such a perfectionist.”

The myoglobin illustration accompanied the article by British biochemist John Kendrew, who described the structure of myoglobin, a protein found in muscle tissue, and recruited Geis to convert his physical models of myoglobin into a painting. It became the first molecule that most people ever actually saw.

“He was the preeminent molecular illustrator,” says May. “He used art to beautifully demonstrate the structure and function of molecules.”

The myoglobin painting increased demand in Geis’s talents. From 1963 until his death he illustrated a number of major books on biochemistry and molecular biology, including three that he co-authored with Richard Dickerson, the UCLA biochemistry professor, who had worked with Kendrew on solving the first high-resolution x-ray crystal structure of myoglobin in 1958.

“It was never clear whether Irv illustrated my books, or I wrote Irv’s captions,” Dickerson wrote in the journal Protein Science in 1997, following Geis’s death. “In the end, it didn’t matter; together we could do more than either could have done alone.”

According to Dickerson, his co-author’s genius wasn’t in depicting a protein exactly how it looked, but drawing it in a such a way that showed how the molecule worked, an artistic process that Geis called, ‘selective lying.’ Geis, wrote Dickerson, “was very taken with the importance of using art to put across scientific concepts.”

Geis also illustrated several editions of the Biochemistry, a nearly ubiquitous textbook that Georgia Tech scientists like May and Loren Williams are very familiar with.

“I’d loved his work for years, but at first, I didn’t know he went to Georgia Tech, until I found a copy of his obituary,” says Williams, a biochemist who discussed with May the idea of bringing Geis’s work to the Petit Institute building, which opened in 1999.

May reached out to Sandy Geis, “called her out of the blue,” he says. Around the same time, the Howard Hughes Medical Institute was working on acquiring the Geis archives, but May called first, “and one thing led to another. She was very happy that we were doing something to perpetuate her father’s contribution to science.”

Sandy Geis happily donated the illustrations that hang on the atrium walls, three floors up. She hopes his work will continue to inspire scientists, as it has for generations.

“I’m glad that his work is displayed at Georgia Tech,” she says. “Because his passion was to teach, really, to influence as many scientists and students of science through the generations. And that’s what he did. Two Nobel Prize winners told me personally that the books by Dickerson and Geis were a big influence for them.”

Shortly after Georgia Tech acquired the artwork in 2000, the Howard Hughes Medical Institute purchased the Geis Archives, which includes art as well as correspondence and private journals. But the dozen Geis pieces in the atrium are rare treasures (even without the 1961 myoglobin piece) that helped have given the Petit building a sense of colorful equilibrium. The molecular art serves as a fitting offset to the massive Cell Wall, the nine-piece, 12 foot by 24 foot painting by artist Karen Stoutsenberger Ku (typically is one of the first things anyone notices when they enter the Petit Institute atrium).

“When we moved into the building, the Cell Wall was all there,” May says. “But we, the biochemists, were thinking, ‘what can we do from an artistic point of view?’ The engineers at the time were all cellular oriented, and we were very molecular oriented. We wondered what we could do from a visual point of view to play up the fact that this institute brings together the molecular and the cellular, the science and the engineering. And we remembered those illustrations from the Biochemistry textbook. Of course! Irving Geis!”

In his lifetime, Geis evolved to the point where, especially in his later years, he was an occasional scientific lecturer. It was easy for the casual student of the visual arts to confuse him as some kind of molecular scientist.

“My father understood the science, and he understood scientists,” Sandy Geis says. “He could speak their language – he was an interpreter of their language. But first and foremost, he was always an artist.”

Something Stupid About Being Stupid

Here in the 21st century social media culture, where everyone has their own personal sounding board (you know, like this blog), where empathy has given way to self-absorption, where conscience has given way to trendiness, where the fervent desperation for immediate and constant attention is worn on our cyber sleeves (i.e., "status updates"), leading to an overabundance of pixelated crazy (and occasionally useful and interesting -- you know, like this blog) shit floating all around us, it is nice to know that it is OK to be stupid ... as long as we are productively stupid. That's the essence of a 2008 essay by Martin Schwartz in the Journal of Cell Science.

"Productive stupidity means being ignorant by choice," writes Schwartz (a former University of Virginia professor who is now at Yale) in his essay, entitled The importance of stupidity in scientific research, which I found hanging on the office door of the eminently cool Tom Barker (and here: http://jcs.biologists.org/content/121/11/1771.full), a professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech.

"In science," Barker told me, "if you know all of the answers already then you're in the wrong place." But his contention and Schwartz's welcome message apply to almost any field involving research and researchers, like writing, and especially journalism.

I've always loved research, so I've got lots of experience with stupidity, as Schwartz defines it. And since I don't embarrass easily, I've not been particularly shy about letting the countless sources I've bothered know just how stupid I am (a trait that I share with many journalists). A question I've gotten a million times from sources is, "what's your story about?" My typical stock answer: "I don't know. Haven't written it yet." Usually followed by: "I'll know more after talking with you. That's why I'm talking with you."

I might have some ideas, an angle I'd like to pursue, and specific questions that need answers. But if I'm just seeking answers to support my preconceived notions, then I'm not really doing research -- I'm looking to justify my point of view, which is limited by my preconceived notions. I'm not talking about being objective (a bullshit unattainable dream, considering we're humans). I'm talking about honest discovery. Self-gratifying justification is not the same as discovery, which is a place I can't arrive at unless I begin with stupidity (a condition which comes surprisingly easy to me).

But for some researchers with untamed egos -- scientists, journalists, whoever -- this place of ignorance is repugnant, hellish, embarrassing proof that their shit does not, in fact, smell like blueberry muffins. To them I say, get over it. You were born stupid. We all were, even Einstein. Of course, this truth can be really difficult for smart people who can't remember ever being stupid, who are accustomed to knowing a lot of stuff, and getting a lot of answers right.

"No doubt, reasonable levels of confidence and emotional resilience help," writes Schwartz, who believes that education (science education in particular, but to my mind, any education, institutional or otherwise), can do more to ease the transition from learning the obvious, or knowing the known, to making our own discoveries. "The more comfortable we become with being stupid, the deeper we will wade into the unknown and the more likely we are to make big discoveries."

Now that's something that I can wrap my stupid head around.

(En)lighten up: The biology of depression

The sad thing about depression (besides the fact that is is depressing), is most people (even people with clinical depression) don't give a damn about this particular disease, until someone like Robin Williams takes the fast and horrible way out. 

We will mourn the loss of an influential person, a great artist like Williams, and then tune into our next flavor of the day, and the hands of time keep spinning while the list of quiet casualties (i.e., the not famous, living their lives of quiet desperation - thank you, Mr. Thoreau) keeps rising. And by casualties, I don't necessarily mean suicides. For people who have struggled with a major bout of depression, it can be a pretty serious wound by itself, with plenty of side effects. 

Taking the "lighten the hell up" approach doesn't usually work. But this isn't about eliciting cheap and temporary sympathy for these folks (most of whom lead the most ordinary of lives, content the great majority of the time). It's about awareness, and understanding a widespread issue (and maybe supporting whatever measures and efforts there are to reduce the bad shit). 

Since the news broke about Williams' suicide, the responses have run the gamut from one extreme to another, from criticism that he took the coward's way out, to the deepest sympathy. Personally, having faced the D-demon myself, I fall into the latter category. I certainly can't empathize with a person who was as globally beloved as Robin Williams, but can definitely understand the problem of facing the dark defenseless and hopeless. 

Depression is a complex thing. It isn't a case of the blues, not just that. Nor is it exactly like addiction, as some cyber-therapists have alleged -- admit you have a problem and deal with it, damn it ... go to a 12-step program! The thing is, as with most disease, of course you have to admit a problem and deal with it, otherwise, the disease generally wins. Like with cancer or diabetes or so many other things. 

With that in mind -- the squishy nexus of biology and depression -- here's a link that might help you better understand the biology behind depression: http://well.wvu.edu/articles/the_biology_of_depression

There's also this: http://www.allaboutdepression.com/cau_02.html

This also is really interesting: http://www.yalescientific.org/2011/02/uncovering-the-biology-of-depression/


Some of what we know is, at least 15 million adults in the U.S. suffer from a major depressive disorder in a given year; people with depression are four times as likely to develop a heart attack than those without a history of the illness (and after a heart attack, they are at a significantly increased risk of death or second heart attack); there is a high prevalence of depression that co-occurs with other illnesses (cancer, AIDS, Parkinson's); major depressive disorder is the leading cause of disability in the U.S. for ages 15-44 (and the leading cause of disability worldwide among persons five and older -- FIVE!!??); depression ranks among the top three workplace issues, following only family crisis and stress (which often lead to depression ... such a vicious cycle); its annual toll on U.S. businesses amounts to about $70 billion in medical expenditures, lost productivity and other costs; oh, and there are more than 30,000 suicides in the U.S. each year, at least two thirds of them caused by major depression (Robin Williams, hello!). 

The good news is, about 80 percent of those treated for depression show an improvement in their symptoms generally within four to six weeks of beginning medication, psychotherapy, attending support groups or a combination of these; but here's the thing: Despite its high treatment success rate, nearly two out of three people suffering with depression do not actively seek nor receive proper treatment and an estimated 50% of unsuccessful treatment, or non-treatment for depression is due to medical non-compliance (including financial factors). 

Meanwhile, smart people are working on the problem. Here's something about research that Georgia Tech is involved in:  http://news.emory.edu/stories/2014/04/precise_brain_mapping_improves_response_to_dbs/


The bottom line is, most folks haven't read this far because, quite honestly, depression isn't sexy (as opposed to liver disease and ribosomes and molecular biology and the other sexy stuff you're used to reading on this blog). Most folks just don't care, and they won't, until someone like Robin Williams takes himself out (to wit, this blog entry), and even then, most folks  are typically wired to a 24-hour news cycle, in which today's celebrity suicide gives way to tomorrow's new shiny thing. 

Good luck out there, be kind to each other. The world will keep spinning either way, at least for another four billion years or so. How it spins and how nice the ride is for the humans tethered to the big blue ball depends on the lot of us.


P.S. Here's a blog post by yours truly, of a more personal (and hopefully helpful) nature: http://fourcrickets.wordpress.com/2014/08/13/this-one-got-to-me/

Holy Grail: Getting closer to an HIV cure

This is the one. This is the project that Phil Santangelo will be talking about when he’s 80 and retired and rocking on the front porch, in some distant future – a promising, healthier future for mankind because, well, this is the one.

Santangelo, associate professor in the Wallace H. Coulter Department of Biomedical Engineering at the Georgia Institute of Technology, is helping lead a research team that was recently awarded a $5.5 million grant from the NIH/NIAID (National Institute of Allergy and Infectious Diseases) for their role in a national, multipronged effort to once and for all cure HIV/AIDS.

“This is like the Holy Grail for a molecular imaging person who’s interested in infectious disease. From my point of view, this is it, this is huge,” says Santangelo, who is partnering with Emory’s Francois Villinger as principal investigators on the research, supported by the aforementioned R01 (which is the original and historically oldest grant mechanism used by the National Institutes of Health, or NIH).

The prospect of eliminating HIV from infected patients may be achievable with novel anti-retroviral therapies, but it would require new tools with greater sensitivity than what is now available. So the research aims to create and improve imaging technology to better monitor HIV reservoirs, the thought being that if you attack these elusive reservoirs, you can stop HIV. Santangelo says a finish line is in sight. Almost.

Here's the dilemma. A person who's infected with the HIV virus is treated with anti-retroviral drugs. They appear to work. Within a month, the virus is undetectable in the blood stream. It's been suppressed. But if you take the patient off the drugs, the virus comes back. It rebounds. "The drugs work but they are not sufficient to clear the virus. And really, we don't know why that is yet," Santangelo says. "Where is the virus? Where are the active reservoirs during suppression?"

The prospect of eliminating HIV from infected patients could be close at hand, but such a lofty goal will require new tools with greater sensitivity than currently available to monitor the progress of novel anti-retroviral therapies – not only in blood but also in organs that harbor such reservoirs and sites of residual viral replication in vivo.

“We’re not necessarily in this project, quote, creating the cure. But we’re creating a tool that’s going to give us a lot more information about how you might go about doing that,” Santangelo says. “Otherwise, it’s a shot in the dark, you’re just trying different approaches.  It’s trial and error. In the drug development world, trial and error is useful, but not ideal, and certainly not efficient”

This research and resulting improvements in imaging technology, he says, will eventually give drug developers more information than they’ve had before, about how drugs are affecting very specific parts of the body.

“It’s about giving them much more powerful information about what’s happening, as opposed to downstream information,” says Santangelo, whose research areas include molecular imaging, nano-biophotonics, and optical microscopy. The long-term aim is to cure HIV, he adds, “and we’re working on a tool to help facilitate that.”

And that, he adds, is the reason the research got its funding – the NIH wants this tool in its toolbox. The grant covers five years, but it’s been a seven-year journey to this point. It began with a discussion between Santangelo and Emory professor Eric Hunter, whose research is focused on the molecular biology of HIV and other retroviruses.

“We were sitting around a table and Eric basically said, ‘one thing we’d like to know is, where is the virus? Is there a way to image this?’ I said, ‘I have no idea, but let’s see if we can figure that out.’ So I went back to the drawing board and thought about ways to approach the problem,” Santangelo says. “But that’s how it started – a group of people sitting around the table, asking, ‘how do we address this?’ and me being crazy enough to say, ‘I’ll try this,’ because I don’t say no to anything.”

Hunter introduced Santangelo to researcher/pathologist Villinger. They went after and received a $30,000 boost from the Woodruff Foundation, then got $100,000 from the Georgia Research Alliance, “and these were so important in pushing the momentum forward,” Santangelo says.

Then they received $450,000 from the NIH in the form of an Exploratory/Developmental Research Grant Award (R21) and now, $5.5 million, to support the work of an all-star team of researchers, including (among others) principal investigators Santangelo and Villinger, as well as Ray Schinazi, who directs the Laboratory of Biochemical Pharmacology at Emory, who is a co-investigator.

The overall goal, according to Santangelo, is to create or improve an imaging tool that will determine how the virus is being affected by a new drug strategy, and also to help promote new drugs that Schinazi is working on – “to clear HIV, and also to make current drugs more effective,” says Santangelo, who believes that by enhancing current imaging technology, particularly CT (computed tomography, or CAT scanning) and PET (positron emission tomography), he can track the reservoirs, including active viral reservoirs.

“If you can figure out where the reservoirs are, if you can figure out how long they are being affected by the drugs, and how the drugs are actually changing the reservoirs, we might be able to clear them,” says Santangelo, who looks like a kid contemplating a super toy that hasn’t been invented yet. “And if you can clear these reservoirs, you could cure AIDS, and if you can cure AIDS, well, that would be pretty awesome.”