Medication non-adherence remains a major challenge across nearly all diseases. To address complex medication regimens and combination therapies, researchers from Brigham and Women’s Hospital (BWH) have developed a “mini pill box” that can stay in the stomach for one week and provide a long-lasting dose of multiple medications.
In a study published online in Nature Communications in January, researchers from BWH, Massachusetts Institute of Technology and their collaborators describe success in delivering three anti-retrovirals for HIV in a pig model.
To address the challenge of accurately diagnosing chronic pancreatitis (CP), researchers at Brigham and Women’s Hospital (BWH) have introduced a novel prediction model that combines findings of endoscopic ultrasound (EUS) with pancreatitis-specific behavioral risk factors.
“We asked, can we come up with a more objective way to diagnose chronic pancreatitis?” says Linda Lee, MD, a gastroenterologist in the Division of Gastroenterology, Hepatology and Endoscopy at BWH. “If radiological findings are not obvious for chronic pancreatitis, how do we clinch the diagnosis?”
A mobile-based colonoscopy preparation guide at the Brigham and Women’s Hospital Endoscopy Center reduced inadequate prep quality from 11.5 percent to 3.8 percent in a three-month period.
When a patient arrives for their colonoscopy inadequately prepped, the procedure takes longer to perform, or must be canceled, which interrupts clinical workflow at significant cost.
Iverson MD, Frits M, von Heideken J, Weinblatt M, Shadick NA. Physical activity and correlates of physical activity participation over three years in adults with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2017;69(10):1535-1545. PMCID:PMC5436948
The Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study (BRASS) was founded 14 years ago by Drs. Nancy A. Shadick and Michael Weinblatt to study genetic and clinical predictors of disease activity, biomarkers of disease response, and the natural history of patients with rheumatoid arthritis (RA) treated in the biologic DMARD era. Over 1,400 patients with either new onset or established RA disease have been recruited from the practices of Brigham and Women’s Hospital rheumatologists. At annual visits, information is collected on multiple variables, including demographics, disease activity score (DAS), medication use, co-morbidities, and functional status. More than 1,200 clinical variables are collected at each six month timepoint, which allows for the generation of extensive phenotyping and clinical analyses.
Brigham and Women’s Hospital Division of Rheumatology, Immunology and Allergy
In 1977, Dr. Matthew Liang founded the clinical research group in rheumatology at Brigham and Women’s Hospital (BWH). The original funding for this group derived from the NIH Multipurpose Arthritis Center program. Dr. Lawren Daltroy, a behavioral scientist, joined Dr Liang in 1982, and they pursued several innovative behavioral trials focusing on lupus, back pain, and Lyme disease. The faculty grew during the 1980s and 1990s with the addition of Drs. Jeffrey Katz, Nancy Shadick, and Elizabeth Karlson.
Andrea L. Roberts, PhD, Susan Malspeis, MS, Laura D. Kubzansky, PhD, Candace H. Feldman, MD, Shun-Chiao Chang, ScD, Karestan C. Koenen, PhD, Karen H. Costenbader, MD, MPH Arthritis & Rheumatology, 2017;69(11):2162-2169.
Systemic lupus erythematosus (SLE) is an enigmatic inflammatory autoimmune disease. A widely-accepted etiologic model for SLE is that environmental exposures “trigger” the disease in genetically-predisposed individuals. The epidemiology of SLE – 80-90% of cases occur in women, and disease severity is much greater in African-American and non-white populations – points to the obvious role of genetics, and genome-wide association studies have identified many genetic factors associated with SLE susceptibility. Meanwhile, there is a growing list of exposures which have also been associated with SLE risk in epidemiologic studies, which include current cigarette smoking, crystalline silica, pesticides, and oral contraceptives and postmenopausal hormones among women. Models for how these and other environmental exposures may contribute to autoimmune disease pathogenesis include elevating concentrations of systemic inflammatory cytokines, increasing oxidative stress, and impairing T-cell function.
Cumulative Incidence Curves of the Composite Endpoint of MI or Stroke
Cardiovascular Risks of Probenecid Versus Allopurinol in Older Patients with Gout. Seoyoung C. Kim, Tuhina Neogi, Eun Ha Kang, Jun Liu, Rishi J. Desai, MaryAnn Zhang, Daniel H. Solomon. Journal of the American College of Cardiology Mar 2018, 71 (9) 994-1004; DOI: 10.1016/j.jacc.2017.12.052
Inflammation plays a critical role in the pathogenesis of both gout and cardiovascular disease (CVD). It is well known that patients with gout are at an increased risk of CVD, including myocardial infarction (MI), stroke, and heart failure (HF). While it remains controversial whether uric acid is causally linked to the development of CVD, beneficial effects have been reported for allopurinol, the most commonly used urate-lowering drug, on lowering blood pressure and improving endothelial function and metabolic profile. Probenecid is another, older drug used for gout. It works as a competitive inhibitor of the organic anion transporter, producing uricosuria, as well as an inhibitor of pannexin 1 channels, an ATP release channel involved in the assembly and activation of the inflammasome. The NLRP3 inflammasome plays a critical role in production of IL-1β, which drives the inflammatory cascade that results in acute gout. Thus, it is possible that probenecid may have positive effect in gout patients not only by lowering serum urate levels, but also by reducing production of IL-1β.
How do genetic variants disrupt brain cells and cause abnormal movements and memory loss? Can addressing these molecular glitches before disease advances lead to better outcomes?
The new Precision Neurology Program (PNP) at Brigham and Women’s Hospital (BWH) and Harvard Medical School addresses these key questions.
Researchers in the program, based in the BWH Department of Neurology, are drawing upon the full spectrum of basic research, clinical work, and discovery of targeted treatment for movement and memory disorders.
To speed innovation, a new NeuroTechnology Studio at Brigham and Women’s Hospital (BWH) now offers investigators access to advanced instrumentation, tools and expert support.
The goal of the NeuroTechnology Studio is to leverage advances in a range of technologies including microscopy, cell sorting and informatics to speed research and drive new understanding of brain function and of mechanisms underlying nervous system disorders. The Studio’s first two instruments for advanced imaging are installed and in use: a GE IN Cell Analyzer 2200 (a widefield high-content imaging system) and a Zeiss LSM880 + AiryScan confocal/super-resolution microscope.
Charles G. Jennings, PhD, has been appointed the executive director of the Ann Romney Center for Neurologic Diseases and the Program for Interdisciplinary Neuroscience at Brigham and Women’s Hospital (BWH).