FYI from the NHLBI Index

September 2012: Vol. 13, Issue 2
Feature Articles

PIO Meeting Recap

The 13th annual NHLBI Public Interest Organization meeting was held Monday and Tuesday, June 11-12, 2012, in Bethesda, Maryland.

The keynote speaker Monday afternoon was Dr. Lawrence Tabak, Principal Deputy Director of the NIH. He gave an overview of the NIH mission, followed by information about the NIH budget. He noted that of the FY 2012 enacted budget of $30.9 billion, 83% (or $25.7 billion) went to fund extramural research programs. The combination of relatively flat budgets over recent years and inflation has left the NIH with about the same purchasing power as it had in 2002.

Dr. Tabak discussed the decrease in NIH grant application success rates: in 1978 about one-third of grant applications were funded, but in 2012 the success rate has only been 15 to 20%. He also discussed NIH efforts to increase diversity in the research workforce.

Dr. Gary Gibbons, the newly designated NHLBI Director (he subsequently assumed that position in mid August) addressed the PIO representatives. He said, "I feel some resonance with this group already. I'm not only a clinician-scientist, I'm a patient, the son of a patient, the brother of a patient, the father of a patient." He explained that his younger daughter was stricken with a neurological disorder in childhood, but thanks to research, she is now a junior in college and the diagnosis is a distant memory.

Tuesday’s full-day schedule started with remarks by Dr. Carl Roth, Acting Deputy Director, NHLBI. He added to Dr. Tabak’s earlier remarks about the overall NIH budget by discussing specific NHLBI concerns. He noted that during the budget doubling period of FY 1999 through FY 2003, using FY 1998 as the baseline, applications were funded up to the 32nd percentile, but that now they were only being funded to the 10th percentile, with funding extended up to the 20th percentile for Early Stage Investigators.

Dr. Roth also noted that the Institute will be required to increase funding of the Small Business Innovation Research (SBIR)/Small Business Technology Transfer (STTR) program over the next 6 years. The SBIR/STTR program accounted for 2.8% of the NHLBI’s FY 2011 budget and will be 3.5% of its budget in FY 2013. He also noted that if sequestration (across-the-board budget cuts mandated by the Budget Control Act of 2011) occurs, the NIH budget, and consequently the NHLBI budget, will decrease by about 8%.

Dr. Eric Green, Director of the National Human Genome Research Institute (NHGRI), discussed the Human Genome Project, which began in October 1990 and was completed in April 2003, and also described some of its key findings. He described the NHGRI strategic plan, developed in 2011, that emphasizes understanding the structure and biology of genomes and the biology of disease, advancing the science of medicine, and improving the effectiveness of healthcare.

In addition, Dr. Green noted efforts being made to lower the cost of genome sequencing to as little as $1,000 per genome, making it an affordable option to help clinicians make better diagnoses and determine best treatment.

Dr. Stanley Hazen, of the Cleveland Clinic Lerner Research Institute, gave a presentation about microbes inhabiting the intestinal tract - the “gut microbiome.” He discussed a study in which his group transferred the gut bacteria from either obese or lean mice into germ-free mice, which lack bacteria in the gut. The germ-free mice that received bacteria from obese mice became obese, whereas those receiving bacteria from lean mice remained lean, suggesting that the gut flora play an important role in obesity.

Dr. Hazen also described how gut bacteria produce metabolites that promote cardiovascular disease. His group found that people with high levels of one metabolite, trimethylamine N-oxide, had about a four-fold increase in risk for a major cardiovascular event (myocardial infarction, stroke) or death compared with people lacking the metabolite.

The final presentation was a panel discussion of obesity, moderated by Ms. Barbara Cady, President of Take Off Pounds Sensibly, Inc. (TOPS) and with participation by Dr. Diane Bild, NHLBI; Dr. Jim Kiley, Director, Division of Lung Diseases, NHLBI; Dr. Cay Loria, NHLBI; and Ms. Heather Kirkwood, Vice President and Outreach Coordinator, Hermansky-Pudlak Syndrome Network, Inc.

Dr. Bild discussed epidemiological studies on obesity, noting that in 1985, very few states in the United States had an obesity rate above 10% of the adult population, but now the rate is above 25% in most states, including about a dozen states that have an adult obesity rate above 30%.

Dr. Kiley discussed the data linking sleepiness and sleep apnea to obesity and cardiovascular disease (CVD) and the possibility that sleep may be an appropriate target for intervention to prevent obesity and CVD.

Dr. Loria discussed data indicating that there is no difference in weight loss results between people using low-fat versus low-carbohydrate diets; what really matters is the number of calories consumed.

Ms. Kirkwood discussed obesity-related difficulties confronting patients with chronic illness, such as taking medications that may promote weight gain. She noted how emotional issues and stress can prompt unhealthy eating habits.

Ms. Cady spoke about how TOPS seeks to work within an individual’s eating and exercise limitations to provide support in weight loss.

The final portion of the meeting was an opportunity for each PIO representative to meet the NHLBI staff member whose expertise is most relevant to the organization’s mission.

NHLBI-funded Investigators Receive Honors

Five NHLBI-funded investigators were among the ten recipients chosen by the Clinical Research Forum in its inaugural competition to recognize outstanding clinical research accomplishments in the United States. The Forum is a nonprofit organization founded in 1996 and dedicated to providing leadership in clinical research.

The NHLBI-supported awardees are Frank Accurso, M.D., University of Colorado, Aurora; Bonnie Ramsey, M.D., Seattle Children's Research Institute and University of Washington; Malcolm Brenner, M.D., Ph.D., Baylor College of Medicine, Houston; Stanley Hazen, M.D., Ph.D., Cleveland Clinic Lerner Research Institute; and Francis McCormack, M.D., University of Cincinnati.

Dr. Accurso and Dr. Ramsey were recognized for their clinical trials that assessed a new treatment called Ivacaftor (VX-770) for cystic fibrosis patients who have mutations in a gene called G551D. Ivacaftor was associated with improvement in lung function that began after 2 weeks of treatment and that was sustained throughout the 48-week study.

Dr. Brenner was honored for his work on improving bone marrow transplantation. His team created an enzyme "on/off switch" called iCasp9 to stop T cells in the immune system from attacking donor cells during the period immediately after transplants, when patients are most vulnerable. The iCasp9 cell-suicide system may improve the safety of cellular therapies and expand their clinical applications.

Dr. Hazen was recognized for identifying digestion byproducts in the gut that predict risk for cardiovascular disease (CVD), including hardening of the arteries. His team identified three metabolites of the dietary lipid phosphatidylcholine – choline, trimethylamine N-oxide, and betaine – and found that elevated levels predicted CVD risk in a group of more than 1,800 adults who were undergoing elective cardiac evaluations. This discovery provides opportunities for the development of new diagnostic tests and therapeutic approaches for atherosclerotic heart disease.

Dr. McCormack was recognized for testing a new treatment for the lung disease LAM (lymphangioleiomyomatosis) in women. He and his team found that sirolimus, which is typically used to prevent rejection after organ transplantation, stabilized lung function and was associated with a reduction in symptoms and improvement in quality of life. Sirolimus is the first drug to slow or halt the progression of LAM.

Modified 9/07/12
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Last Updated September 2012

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