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Research Update

April 2018

Understanding the Connection between Obstructive Sleep Apnea and Cardiovascular Disease and Diabetes

Dr. Elisabet Børsheim is contributing her expertise in stable isotope tracer analysis to a study of a link between obstructive sleep apnea and cardiovascular disease.

Arkansas Children’s Nutrition Center and Arkansas Children’s Research Investigator Elisabet Børsheim, PhD, directs a research laboratory known for its work investigating physical activity, energetics, and metabolism. She recently began collaborating as a co-investigator with Dr. Jonathan Jun of Johns Hopkins, principal investigator on a study funded by the National Institutes of Health (R01HL135483) to better understand metabolism of obstructive sleep apnea (OSA) patients.

OSA is a common breathing disorder affecting 30% of adults and over 50% of obese persons. OSA occurs during sleep due to the reclined position and decreased airway muscle tone. To open the obstructed airway for improved breathing, the sympathetic nervous system, the body’s fight-or-flight response, activates causing the diaphragm and chest muscles work harder, and breathing starts again with a gasp, snort, or body jerk. Though OSA may result in a bad night’s sleep, it can reduce oxygen to vital organs and cause an irregular heart rhythm. It is a known risk factor for diabetes and cardiovascular disease and is implicated in other conditions such as hypertension and inflammation.

The prevailing theory about the link between OSA and cardiovascular disease is recurrent episodes of hypoxia and oxidative stress. However, an alternative theory is that the mechanism works through the sympathetic nervous system (SNS).

The mechanistic links between OSA and cardiometabolic concerns are undefined. The study designed by Dr. Jun aims to identify these links, which are crucial to developing clinical trials to better protect the health of OSA patients. If the driving force is the SNS, interventions to block its actions may prove beneficial in protection of development of cardiovascular disease. 

For this study, Dr. Børsheim will providing expertise in analyzing stable isotope (non-radioactive) tracers in plasma to determine the amount of tracers present. The data from Dr. Børsheim‘s laboratory will provide the study team with a precise description of the rate of fatty acid released and the rate of fatty acids used for energy.

“Though the study is in adults, not children,” noted Dr. Børsheim, “this study will provide valuable information that is relevant to children. Up to 10% of children may have OSA, and also in this group there is a link with obesity. This study will provide important knowledge about underlying mechanisms.”

In addition to this NIH-funded project, Dr. Børsheim’s research and laboratory receives additional NIH support through an R01 project for which she is a Co-Principal Investigator with ACNC Investigator Dr. Aline Andres (R01DK107516) and as Metabolism Core Director for the Center for Childhood Obesity Prevention (P20GM109096). As an investigator at the ACNC, Dr. Børsheim receives USDA-ARS funding for her research as well as for the Physical Activity Core. Dr. Robert Wolfe of the Department of Geriatrics and the Director of the Center for Translation Research in Aging and Longevity at UAMS, an internationally recognized leader in stable isotope technology in nutritional and metabolic research, is also a co-investigator on the project..

Taking the Field for Clinical Research

On Opening Night 2018, ACRI's Kimberly Voight (left) and Brandi Poe (right) shared information about participating in clinical research at Arkansas Children's. 

High-quality clinical research at ACRI increases our knowledge to improve the diagnosis, treatment, and prevention of pediatric diseases and disorders. Our pediatric clinical researchers conduct studies to answer specific questions about new biomedical and behavioral interventions, such as drugs, treatments, and devices, or new ways to use known interventions. Often known as clinical trials, these studies help researchers better understand these interventions to improve health care. An essential element of these studies is the participation of consenting patients and their families.

Many families already support clinical trials at ACRI, and to express the need for continued participation in this important work, ACRI has teamed up with the Arkansas Travelers baseball program for the seventh consecutive season. This year, Brandi Poe, Clinical Research Recruiting Coordinator, has scheduled 12 Travelers home games as promotional nights to encourage clinical trial participation. During those games along the concourse of Dickey-Stephens Park, Brandi and ACRI staff raise awareness of pediatric clinical research at Arkansas Children’s. They help interested families register for the clinical trials database and subscribe to ACRI’s text service. The families are eligible for ACRI promotional items and a gift card drawing.

This year’s efforts started on Opening Night 2018. In addition to the promotional booth, information on participating in clinical research at ACRI is in rotation on the LED screens on the outfield scoreboard and in the concourse concession stands. An advertisement for ACRI is also included in the “Discover Your Travs” bulletin given to all in attendance at games. Some of the promotional nights also coincide with heavily attended Travelers home games with promotional highlights such as kids running the bases, TV remote dig, and Independence Day fireworks.

Dr. Tamara Perry to Serve on NIH Study Section

Congratulations to Dr. Tamara Perry, Associate Professor, Allergy and Immunology, on accepting an invitation to join the Behavioral Medicine, Interventions and Outcomes Study Section, National Institutes of Health (NIH) Center for Scientific Review. Study section members are selected on the basis of their demonstrated competence and achievement in their scientific discipline as evidenced by the quality of research accomplishments, publications in scientific journals, and other significant scientific activities, achievements, and honors.

Dr. Perry’s research focuses on developing and implementing innovative programs to reduce asthma burden particularly among high risk and vulnerable populations. She is the principal investigator on an ACRI-funded project that delivers follow-up asthma care via telemedicine to children living in rural Arkansas communities. The study will compare health outcomes, clinic utilization rates, and patient satisfaction between patients receiving asthma care via telemedicine to those receiving in person visits. The project will inform future efforts to provide remote pediatric specialist-driven care for chronic health conditions.

Dr. Perry also is a co-investigator on a NIH-funded project (PI: Dr. Jill Halterman, University of Rochester; R01HL091835) that examines the impact of telemedicine follow up visits for inner-city children with asthma who are enrolled in a school-based asthma intervention. Participants in the study receive directly observed therapy at school plus telemedicine follow-up visits to help guide asthma medication management while allowing students to remain at school. Participants in the intervention arm will be compared to participants who receive traditional in person care from their regular provider.

Dr. Perry has recently published findings from her NIH-funded study (R01HL102388) that examined the impact of school-based asthma education via telemedicine. Although a difference in asthma symptoms between intervention and control subjects was not shown, participants who were in the intervention arm had evidence of improved medication adherence and reported that they took their medications as prescribed by their provider at a higher rate than those in the control group. Intervention participants also self-monitored their asthma symptoms at home more frequently than control participants. In addition, participants were very satisfied with the program and the majority of children completed all telemedicine visits as planned.

Dr. Perry has also published results of a clinical project examining the implementation of remote PFTs (pulmonary function tests) via telemedicine for pediatric asthma patients. She and her colleagues found that patients were able to successfully complete PFTs via remote access and telemedicine allowed patients to stay in their home communities and receive specialty asthma care. These findings suggest that telemedicine can significantly improve access to specialized pediatric care in rural communities which is particularly important in medically underserved regions.

Dr. Perry has served as an ad hoc reviewer for several study sections. The quality of her reviews were another factor in her invitation to serve as a permanent member of the Behavioral Medicine, Interventions and Outcomes Study Section. Dr. Perry’s four-year term to the study section will begin this summer.

Researcher Spotlight: Marie Schluterman Burdine, PhD

Dr. Marie Schluterman Burdine is an Assistant Professor of Surgery in the Division of Surgical Research at UAMS

How did you become involved in pediatric research?

As a research technician at UT Southwestern in Dallas, I worked with an investigator who focused on the genetics behind the development of congenital heart disease in pediatric patients. This inspired me to continue to work on diseases in children which typically lacks research and funding.

What types of sponsors (industry, federal, foundations, etc.) support your studies?

I am funded as a Junior Investigator at ACRI's Center for Translational Pediatric Research (P20GM121293).

What is your area of study?

Novel therapy for transplant immunosuppression therapy.

How is your research program innovative?

Novel approach to therapy solutions.

How has your work led to (or will lead to) changes in pediatric care?

It will lead to simplified treatment for pediatric patients who have received organ transplants.

Who do you collaborate with and what are the benefits of these collaborations?

Dr. Sarah Blossom, analysis of T cell differentiation techniques.

President's Choice Publications

The following articles were selected as this month's feature publications.

  • Joan M. Cranmer, Amy M. Scurlock, Rachel B. Hale, Wendy L. Ward, Parthak Prodhan, Judith L. Weber, Patrick H. Casey, Richard F. Jacobs.  An Adaptable Pediatrics Faculty Mentoring Model.  Pediatrics. 2018;141(5):e20173202.

  • Piccolo BD, Wankhade UD, Chintapalli SV, Bhattacharyya S, Chunqiao L, Shankar K. Dynamic assessment of microbial ecology (DAME): a web app for interactive analysis and visualization of microbial sequencing data. Bioinformatics. 2018 Mar 15;34(6):1050-1052.

Recent Grant Activity

Extramural Grant Awards

Principal Investigator

Agency

Project Title

Project Period

Total Funding

Elisabet Borsheim

NIH/Johns Hopkins University

Lipolysis during sleep and cardiometabolic consequences of sleep apnea

2/2018-1/2019

$35,063

Gregory Kearns

NIH/UAMS

TRI Sub Expanding Translational Research in Arkansas

9/2017-8/2018

$188,785

Intramural Grant Awards 

Principal Investigator

Agency

Project Title

Project Period

Total Funding

Marie Burdine

ACRI - Marion B. Lyon New Scientist Development Award

Inhibition of DNA-PK(cs) as Novel Immunosuppression Therapy for Pediatric Transplant Patients

4/2018-3/2020

$50,000

Grant Submissions

Principal Investigator

Agency

Project Title

Project Period

Total Funding

Eduardo Ochoa

AR Advocates for Children and Families/The Pew Charitable Trusts

Health Impact Project

3/2018-12/2020

$7,530

Gresham Richter

DOD/Vivonics

Non-contact Tissue Viability Assessment (NTVA)

6/2018-7/2020

$47,795

Umesh Wankhade

NIH/University of Utah

Biological signatures of blueberry derived microbial metabolites

12/2018-11/2022

$93,151

Ashley Acheson

NIH

Trauma intervention in children with family histories of substance use disorders

12/2018-11/2023

$3,795,645

Eduardo Ochoa

The Kresge Foundation/Boston Medical

Community collected Data to make the Case for Homes for Health / FY18 CHW

1/2018-12/2018

$12,854

Jason Farrar

COG Foundation

Discovery and Targeting of Epigenomic Alterations in Childhood AML

4/2018-3/2019

$100,000

Jason Farrar

Rally Foundation

Targeting Epigenomic Abnormalities in Pediatric Acute Myeloid Leukemia

7/2018-6/2020

$200,000

Jill Fussell

HRSA

DBP Leadership Education Training Program

7/2018-6/2023

$917,039

Laxmi Yeruva

NIH

miRNAs Induce Inflammation During Chlamydial Infection

12/2018-11/2023

$2,722,433

Thomas Abramo

NIH

Hemispheric rcSO2 readings enhance diagnostic seizure reliability, timeliness of anticonvulsants, and objective response measure in epileptic and developmentally-delayed patients: a proof of principle

12/2018-11/2021

$1,954,418

Wendy Nembhard

CDC

Arkansas Proposal to participate in the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS II) Component A

9/2018-8/2023

$4,575,282

Wendy Nembhard

CDC

Arkansas Proposal to participate in the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS II) Component B

9/2018-8/2023

$1,241,074

Clinical Trial Activity

Principal Investigator

Sponsor

Project Description

Project Period

Total Cost

Schmitz, Michael

Westward

Oral Morphine

3/18 -

$68,365

Berlinski, Ariel

Vertex

Tezacaftor- CF

4/18 -

$57,710

Romero, Jose

UAB

Asymptomatic CMV

4/18 -

$25,923

Neville, Kathleen

Amgen

Migrain

4/18 -

$329,562

Romero, Jose

Abbott

ALERERSV

2/18 -

$26,250

Scurlock, Amy

Aimmune

ARC011

2/18 -

$90,418

Courtney, Sherry

UAMS/ISPCTN

NOWS

2/18 - 6/18

$115,515

Elser/Neville

Impax

Zomigx

2/18 -

$60,210

James, Laura

Duke

SCOUT

12/17 - 5/18

$37,990

Berlinski, Ariel

Vertex

VX115-661

12/17 -

$74,092

Bonasso, Patrick

Internal

GASTROSCHISIS

1/18 - 12/18

$13,917

It All Begins with a Child: ACRI’s 2017 Annual Report

CLICK HERE To Download ACRI's 2017 Annual Report

In its 2017 annual report, It All Begins with a Child, ACRI reviews the successes of its diverse research expertise, ranging from basic science to clinical and community-based research. As ACRI envisions a future in which all children grow up to be happy and healthy, the work of its cross-disciplinary teams of physicians, biomedical scientists, and health care practitioners will continue until this vision becomes a reality. The report highlights ACRI’s culture of curiosity that inspires researchers to question, seek, and discover new and better ways to treat children.

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