UND BIOMEDICAL RESEARCHERS TRACK DOWN SOLUTIONS
The University of North Dakota School of Medicine & Health Sciences (SMHS) is home to research into, among other areas, Parkinson’s and other neurodegenerative diseases; in issues affecting Baby Boomers; and of cancers that commonly strike North Dakotans.
UND SMHS has been awarded $30 million over the last 10 years to advance investigations into diseases of the brain. Several other federal grants fund research in cancer, diabetes, eating disorders, alcoholism and many other diseases of both national interest and of special concern in North Dakota.
Several dozen researchers at SMHS work across this spectrum, tackling solutions, not just the causes, of such diseases. Scientists call it “translational research” and it means more therapies sooner reaching the bedside.
We focus in this article on the work of three people (in alphabetical order) at SMHS:
Donald Jurivich, DO (doctor of osteopathy), an expert on health challenges among older people.
Jau-Shin Lou, MD, PhD, MBA , Chair of neurology at both UND SMHS and at Sanford Health in Fargo and an expert in neurodegenerative diseases.
Gary Schwartz, PhD, PhD, (yes, he has two doctoral degrees) an epidemiologist and expert in the causes, triggers, history and distribution of various cancers.
Who is Donald Jurivich
Donald Jurivich, DO, is the founding Eva L. Gilbertson, MD, Distinguished Chair of Geriatrics at SMHS. He is a nationally known clinician. A Harvard University graduate, Jurivich focuses on chronic ailments of the aged, including Alzheimer’s disease.
All of his research is collaborative—he works with faculty and institutional leaders in the Department of Geriatrics, which develops and provides oversight of education, research, clinical care, training, and service programs. Jurivich works with clinical partners to educate and train current and future health professionals to serve an aging population.
Jurivich believes he and his research associates have found a clue to the mystery of Alzheimer ’s. This is important to North Dakota, which has an above-average life expectancy resulting in a greater proportion of senior citizens and elders, according to Joshua Wynne, MD, MBA, MPH, UND vice president for health affairs and dean of the UND School of Medicine and Health Sciences.
Jurivich’s most recent discovery appears to be a stress protein that is important in the regulation of amyloid—a starch-like protein naturally found in the body that sometimes gets processed the wrong way and accumulates. This aggregated form is thought to be toxic.
Jurivich studies the “master switch” of these stress proteins called HSF1 and notes that this is also thought to be a longevity factor that declines with age and even more so with Alzheimer’s.
Thus, he says, this new observation may be the first opportunity to explore a test for an individual’s risk for developing Alzheimer ’s, as well as determining effectiveness of treatments by monitoring HSF1 levels in white blood cells.
Because stress proteins resemble antibodies, vaccination against amyloid is considered another possible therapy for Alzheimer ’s. Recent research that targets people genetically destined to get Alzheimer ’s indicates this treatment may prevent the onset of familial/genetically inherited Alzheimer ’s before symptoms appear. Once diagnosed, Alzheimer ’s patients have an eight to 12 year life expectancy.
Dementia in general is a collection of different etiologies. Alzheimer ’s has a specific pathology, identified by plaques and tangles found in brain biopsies. The parts of the brain destroyed by disease varies with each patient. Short-term memory loss and spatial awareness issues are some of the challenges that patients and their families must deal with—when to pull a driver ’s license, take control of banking, make alternative living arrangements, and related life-altering decisions.
The good news, says Jurivich, is that simple things like adequate exercise and proper nutrition such as the Mediterranean diet may promote these longevity factors and strengthen our resiliency.
Who is Jau-Shin Lou, MD, PhD, MBA
A prominent neurologist, he’s founding chair of the Dr. Roger Gilbertson Endowed Chair of Neurology at the SMHS and chair of neurology at Sanford Health, Fargo. He’s a clinician with a growing practice at his Fargo-based neurology practice and an active researcher, delving into new and advanced therapies to treat Parkinson’s. He was voted one of U.S. News & World Report’s Best Doctors 2011–12. In addition to his clinical practice and research, Lou teaches medical students and post-MD residents.
In its declaration of Parkinson’s Awareness Day last spring, the N.D. Governor ’s office noted that Parkinson’s is the second most common neurodegenerative disease in the United States, affecting as many as 1.5 million people annually and rising. Parkinson’s, the 14th leading cause of death, costs the country $14 billion or more.
North Dakota is third in the nation for per capita incidence of Parkinson’s—making Jau-Shin Lou’s research program into the disease and effective treatments for it all the more compelling.
“We’re studying the use of transcranial direct current stimulation in patients with mild cognitive impairment to see if such treatment will improve cognitive function,” said Lou. He notes that this technology’s promise is that it can be used by patients themselves at home and it’s minimally invasive.
“It only takes a very small current to stimulate the brain, and the patient barely feels it,” Lou said. “Another important factor is that it’s not expensive—and it can easily be used at home.”
“For Parkinson’s and other neurodegenerative diseases, this research is leading us to a non-invasive, non-pharmacological way to manage and improve the function of our patients,” Lou said. “Not all treatments need medicine. Basically this technology is about improving a patient’s quality of life.”
“It’s not a magic bullet, but it’s promising,” Lou said.
Who is Gary Schwartz, PhD, PhD
Gary Schwartz, PhD, PhD, is professor and chair of the SMHS Department of Population Health. Schwartz does epidemiologic and translational studies of screening and therapeutic trials about Vitamin D and calcium in prostate and other cancers.
Schwartz, an epidemiologist who holds two PhD degrees, studies how the biology and natural history of cancers can be used to design better screening tests that can help in personalized medicine.
“Men with higher calcium levels in their blood are three times more likely to die of prostate cancer and women with higher calcium levels have a higher risk of diagnosis of and dying from ovarian cancer,” said Schwartz at a presentation for health care practitioners at Altru Health System in Grand Forks.
“During their lifetime, about one woman in 10 seeks surgical evaluation for a mass in her abdomen which may be ovarian cancer,” he said. “Most of these masses are not cancer, but the ones that are should be treated by a surgical specialist, since women with cancer who are treated by a surgical specialist have improved survival rates.”
Schwartz is especially interested in cancers of unknown cause that differentially affect North Dakotans.
For example, for reasons that are not understood, rates of chronic lymphocytic leukemia—the most common leukemia in the Western world—in North Dakota are among the highest in the nation.
One possible reason for the high rates here is that levels of residential radon—a natural gas produced by uranium in rocks and soils and a known cause of lung cancer—are high in North Dakota. Working to educate individuals about the potential health risks of radon and how to reduce them is one of Schwartz’s goals for the Department of Population Health.
This is just one example in which population health research at UND School of Medicine not only serves North Dakotans, Schwartz notes, but can improve health for individuals globally.
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