School’s TMA/AMA chapter
named best in nation

UT Medical School students are again making national headlines – the UT Houston American Medical Association Chapter was named Chapter of the Year by the American Medical Association at its recent annual meeting in Chicago.

“This is an unbelievable honor, and we would like to thank our amazing past leaders, officers, and student members who have dedicated their time and effort to making our chapter the best in the nation,” said Brittny Burkhalter, president, UT-Houston AMA/TMA. “Although so many contributed to our chapter winning the award, I would like to congratulate our immediate past President, Spencer Pruitt. His hard work and dedication over the past year is what made this award possible.”

In addition to the group award, third-year medical student Pruitt, was named the new chair of AMA Region 3 and received the Leadership Excellence Award. Chirag Patel, M.D./Ph.D. student, received the J. James Rohack, MD, Chair’s Citation for Exemplary Service.

“I am so proud of these students’ incredible accomplishments,” said Dr. Judianne Kellaway, assistant dean for admissions. “They will be great physician leaders.”

Burkhalter, a second-year student, said she was surprised to hear the news of the chapter’s national win. “I am also very proud of Spencer Pruitt and Felicity Kelly because they actually took the time to apply for this award in the midst of studying for the USMLE Step 1,” she added.

The Medical School’s chapter of the AMA, comprised of more than 600 students, has the most representation of any chapter on committees, boards, and councils at the state and national level.

“Our organization has so many goals, which is amazing because there is room for so many students to become involved and truly make a difference. The current priority of the American Medical Association is the Cover the Uninsured Campaign,” Burkhalter said. “I am particularly proud of the Business in Medicine lecture series that began this year. Every school should have an optional course like this for their students because it is so very important to learn this aspect of our profession.”

-D. Brown

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Compound may treat acute diarrhea

In a development that may lessen the epidemic of diarrhea-related deaths among children in developing countries, scientists in the laboratory of Nobel Laureate Dr. Ferid Murad have discovered a novel compound that might lead to an inexpensive, easy-to-take treatment. The results of pre-clinical tests appear in the June 16 online edition of the journal Proceedings of the National Academy of Sciences of the United States of America.

The compound - a pyridopyrimidine derivative - targets acute secretory diarrhea caused by E. coli and other enterotoxigenic strains of bacteria, which produce toxins that stimulate the linings of the intestines, causing them to secrete excessive fluid, thereby producing diarrhea.

Diarrhea kills an estimated 1.6 to 2.5 million children every year, according to researchers quoted in the Bulletin of the World Health Organization. Enterotoxigenic strains of bacteria may account for a significant amount of these deaths, according to an article in Clinical Microbiology Reviews. Enterotoxigenic E. coli or ETEC is a leading cause of bacterial diarrhea.

During pre-clinical tests, the compound was associated with a significant reduction in intestinal fluid secretion in an animal model of bacterial diarrhea. It was also linked to reduced fluid buildup during laboratory tests on human colon cells. It caused significant decrease in fluid secretion without apparent toxicity.

This unique approach to the treatment of enterotoxigenic diarrhea works by interrupting the diarrhea-causing chain of events that occur when bacterial toxins enter the intestinal tract. The compound slows the transmission of information in the epithelial cells lining the intestines. Consequently, the molecular mediators regulating the secretion of salt and fluid in the gut do not get fully activated. ETEC comes from feces-contaminated food or water and also causes travelers’ diarrhea.

“This newly discovered compound decreases the formation of ever-present cellular messenger molecules, cyclic guanosine monophosphate and cyclic adenosine monophosphate, caused by various bacterial toxins and might prevent or attenuate the intestinal fluid secretion, diarrhea and dehydration,” said Murad, the senior author, director emeritus of the IMM, director of the IMM Center for Cell Signaling, Regental Professor and John S. Dunn Sr. Distinguished Chair in Physiology and Medicine. “While this research looks extremely promising as a preventive or therapeutic intervention in Third World diarrheal disease and travelers’ diarrhea, much work remains to be done to move into clinical trials and eventual therapeutic approval.”

In the event of an earthquake, typhoon or other catastrophe, this potential diarrhea treatment could be used to treat outbreaks of enterotoxigenic E. coli caused by contaminated food and water supplies, Murad said. The compound can be placed in a pill for adults and in a liquid for children.

Secretory diarrhea describes the condition when the small intestine, which is normally an absorptive organ, is stimulated to secrete salts and water into the intestinal lumen, often in massive quantities. The resulting diarrhea can lead to profound fluid loss, dehydration, shock and death.

There are many causes of secretory diarrhea. The most common, by far, is infestation of the small intestine by certain bacteria, such as cholera or certain strains of E. coli, following ingestion of contaminated water or food. These bacteria multiply in the intestinal tract and produce toxins that bring about elevations of a group of intracellular messengers, cyclic nucleotides, that stimulate intestinal cells to secrete salt and water.

To date, there is no effective way of treating these diarrheas directly. Treatment is indirect and aimed at preventing serious outcomes by minimizing fluid loss using intravenous or, more recently, oral rehydration.

“Dr. Murad and his coworkers have discovered a relatively simple compound that indirectly inhibits the ability of several bacterial toxins to elevate intracellular levels of cyclic nucleotides, and inhibits fluid secretion by animal small intestine exposed to these toxins,” said Dr. Stanley Schultz, professor, associate dean for Institutional Advancement and Fondren Chair in Cellular Signaling.

“These findings are a promising lead into what could prove to be a triumph of translational research of staggering importance,” Schultz said. “An inexpensive drug that could block the intestinal secretory pathway, with minimal side effects, would be a ‘magic bullet’ that would not only save millions of lives in many parts of the developing world but would also save the billions of dollars that are lost annually because of diarrhea throughout the world. It would truly be a treatment of diarrhea rather than a treatment of the consequences of diarrhea.” Schultz received the 2006 Prince Mahidol Award for Medicine for pioneering research that led to the development of oral rehydration therapy.

Other contributors to the study include: Dr. Scott Gilbertson, the Robert A. Welch Distinguished University Chair in Chemistry and the director of the Program in Chemical Biology in the Department of Pharmacology and Toxicology at UTMB, and UTMB colleague Maria E. Estrella Jimenez; and Dr. Cirle Warren, assistant professor of medicine at the University of Virginia School of Medicine, and Dr. Richard Guerrant, director of the Center for Global Health at the University of Virginia School of Medicine, Charlottesville.

An international patent application for the use of this compound to treat secretory diseases is pending.

-R. Cahill

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Memorial Hermann – TMC
CEO addresses Senate

Faculty Senate welcomed Juanita Romans, CEO of Memorial Hermann – Texas Medical Center, as its guest speaker June 19.

“We appreciate your willingness to speak with us,” said Senate Chair Dr. Jeffrey Actor to Romans. “Having Memorial Hermann leadership addressing our group is a first.”

Romans gave an overview of the history of the affiliation with Memorial Hermann and the Medical School, noting that the partnership began in 1968, before the Medical School opened. “We renewed our affiliation agreement in 2005 for 15 years,” she said.

She said that the best work is done when there is a clear goal established.

“I have never been so encouraged about our relationship as I am right now. This is the time for alignment – we are much stronger together than separate,” she said, adding that Memorial Hermann is the largest hospital system in Texas.

Senators had the opportunity to ask questions and touched on such topics as joint recruitments and joint branding and marketing. Romans said it is the intent of Memorial Hermann to recruit together, and she said the institution is working to do a better job co-branding.

Dean Giuseppe Colasurdo echoed Romans words regarding joint recruitment and said that the faculty will be very pleased with upcoming marketing initiatives. He also talked about investing in faculty and ensuring proper compensation for residents.

“The pay for our residents is not competitive with peer institutions, and we need to work with our partners on that. We have received $5 million from the state, which will fund 35 new residents at the Medical School,” he said.

He said that an upcoming fund raising campaign to be launched by incoming President Larry Kaiser will need to support faculty. “Our margin from the practice plan also will go to support faculty and our programs,” he said, adding that a special request from the Legislature will be specific funding to retain faculty.

A town hall meeting will be held in August to welcome President Kaiser and introduce him formally to the Medical School, Dean Colasurdo said.

The next Faculty Senate meeting will be held at 4:30 p.m. July 17, with guest speaker Bassel Choucair, director of Medical School Information Technology.

-D. Brown

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