Breakthrough Medicine 04
Any trauma, such as an electrical shock, that burns through a cell’s membrane will severely disrupt that cell’s contents. Raphael Lee, a plastic surgeon and bioengineer at the University of Chicago Hospitals, has found a way to mend that damage. Since 1990, when he watched his daughter use a plastic loop to blow bubbles, Lee and his team have worked on developing a synthetic polymer—called Poloxamer-188—that bonds with the surface of a cell and plugs any holes in its membrane. If injected early enough into a burn victim, it would hypothetically provide damaged cells the opportunity to rebuild themselves. The Food and Drug Administration has approved using P-188 for various purposes, and Lee has founded a company, Maroon Biotech, to explore how his discovery might help patients recover from spinal-cord injuries, heart attacks, and wounds from combat.
“At least half the germs that end up causing infections after surgery are already in a patient’s body when the patient arrives at the hospital,” says John Alverdy, a surgeon and critical-care specialist at the University of Chicago Hospitals. “We’ve found that the bacteria can sense on a very sophisticated level that something about you has changed [following surgery]. And some of those bacteria, though they have lived peacefully inside you, will turn mean.”
Though he recognizes that they are often necessary, Alverdy dislikes the standard antibiotic treatments—which he characterizes as “bombing our bodies”—because they encourage bacteria to mutate into forms resistant to antibiotics. As an alternative, he has developed a drinkable prophylactic that neutralizes the bacteria while a person is under surgical stress. A few hours later, when the body is out of the stress zone, the polymer leaves the body, and, as Alverdy puts it, “peace prevails in the land.”
Stem Cells and Autoimmune Diseases
For 15 years at Northwestern Memorial Hospital, Richard Burt, chief of its division of immunotherapy for autoimmune diseases, has battled lupus, multiple sclerosis, scleroderma, rheumatoid arthritis, and other diseases that turn a body’s defense mechanisms back on itself. Among other things, he pioneered the use of stem cells—from a patient, a donor, or umbilical cord blood (but not the federally prohibited embryonic stem cells)—as an agent to fight these illnesses.
“Your body is always trying to reset itself to fight a disease,” Burt says. “But sometimes if you have [an autoimmune disease], it’s using a police force that is corrupt. What we’re doing is bringing in a new class straight from the police academy to clean things up.” Stem-cell transplantation, which Burt has performed since 1997, is for patients “who have hit a brick wall,” he says. “The other therapies have all let them down and they need another option.”
Less than a year ago, Burt released a study showing that 50 percent of patients with life- or organ-threatening lupus who had had transplants of their own stem cells were disease-free at the five-year mark, and 84 percent of them were still alive.
Calming Children’s Fears
Working with Royal Philips Electronics, Advocate Lutheran General Hospital installed the first ambient radiology suite, which helps kids lie still during a CT scan—thus reducing the need for sedation. “There is an element of play that makes kids feel like it’s OK to be here,” says John Anastos, chief of Lutheran’s radiology department.
Reducing Incontinence Following Pregnancy
About 30 percent of women who deliver their babies vaginally lose, to some degree, their ability to control their bladders. “It’s a sisterhood of silence,” says Linda Brubaker, a urogynecologist at Loyola University Medical Center. “They have coping mechanisms and they adapt and they don’t tell anybody.” Until now, the most successful medications have produced unpleasant side effects, such as constipation.
Now Brubaker and three of her Loyola colleagues are conducting research with injections of Botox, the same drug used to smooth wrinkles. According to Brubaker, Botox (botulinum toxin) had been used for two decades to treat problems with skeletal muscles, the kind you control voluntarily. In 2003, members of her department tried Botox on the bladder’s smooth muscle for the first time. “I’ll be darned,” Brubaker says. “It worked.” At least seven medical centers in the United States are currently testing the procedure.
Anticipating Birth Defects
At Children’s Memorial Hospital, the three-year-old Institute for Fetal Health helps expectant parents plan for potential birth defects—such as cleft palate, clubfoot, and intestinal blockage—in their newborns. “It’s best to deal with the shock and worry beforehand, so [parents] can take control of the situation at birth and make better decisions,” says the institute’s clinical coordinator, Chris Talbott, an obstetrician.
Although babies are not delivered at Children’s, at least 1,500 expectant parents came for consultations in 2006, Talbott says. Prebirth consultation puts parents at ease, he says, and makes it possible to have the appropriate team ready when birth happens. Usually within three or four days of birth, the baby arrives at Children’s, and the assembled team goes to work. In the case of a cleft palate, that includes not only surgery (if that’s the chosen course), but helping the mother pump her breast milk and feed the baby through a specially designed nipple.