Research: Creating the health care of tomorrow
Emory’s investments in a strong research infrastructure over the past decade have continued to pay off. Even as the pool of available research dollars remained flat nationwide, the medical school’s funding from the National Institutes of Health continued to increase, with the school ranking 18th in 2006 among all medical schools in the country in total research grants awarded. Medical school faculty, including those at Yerkes National Primate Research Center, received 503 NIH grants, for a total of $188 million, more than triple the total from a decade ago when the school ranked 31st. These awards addressed some of the most scientifically exciting and challenging issues of our time.  
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  Nana GletsuDuring the past year



an Emory-designed AIDS vaccine moved forward in human clinical trials, and the Emory Vaccine Center joined forces with the leading genetic engineering and biotechnology center in India to create a new center to enhance vaccine development for HIV/AIDS and other infectious diseases, especially those that disproportionately affect the developing world.
 
         
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  Seasonal and avian flu
Building on decades of success in infectious disease and vaccine development, the medical school was awarded a $32.8 million contract in the past year to establish one of six NIH centers of excellence for influenza research and surveillance. Center leadership comes from the Department of Microbiology and Immunology, the Emory Vaccine Center, and the animal health vaccine development program at the University ofAvian flu virus Georgia. The Georgia Research Alliance added $2.5 million in recognition of this significant milestone in furthering Georgia as a national leader in vaccine and antiviral research and development.
Current research studies in the NIH-designated center include the following:
• how flu viruses mutate to infect different species,
• how vaccination affects human immune response to infection, especially to new strains of flu, and
• how such knowledge can help identify novel targets for antiviral medicines and improved vaccines, including how human genes might be “silenced” to decrease or eliminate flu infection.

HIV/AIDS clinical trials
The NIH selected Emory’s HIV/AIDS Clinical Trials Unit as a major component of both the premier national clinical trials group for new AIDS treatments and the national network for AIDS vaccine prevention trials, a multi-site effort that includes clinical trial units on five continents.
     HIV/AIDS research has been a strength at Emory for years, both in terms of treatment and in efforts to develop more effective vaccines. At the Ponce Center, one of the largest, most comprehensive HIV/AIDS treatment facilities in the world, Emory medical faculty continue to conductEmory is part of a network for HIV vaccine trials that spans five continents numerous clinical trials, while the Hope Clinic, the clinical arm of the Emory Vaccine Center, remains one of the nation’s top enrolling sites for HIV/AIDS vaccine trials.
     During the past year, an HIV/AIDS vaccine developed at Emory moved forward in human clinical trials, and the Emory Vaccine Center joined forces with the leading genetic engineering and biotechnology center in India to create a new center to enhance vaccine development for HIV/AIDS and other infectious diseases, especially those that disproportionately affect the developing world.

Big support for small things
nano particlesNanotechnology for DNA repair—Medical faculty in the Coulter Department of Biomedical Engineering, a joint department between Emory and Georgia Institute of Technology, are involved in a new Nanomedicine Center for Nucleoprotein Machines, funded by a major grant to Georgia Tech, Emory, and the Medical College of Georgia. The center, the third NIH-established nanomedicine and nanotechnology center involving Emory faculty and colleagues in less than two years, focuses on understanding how the body repairs damage to DNA. (The other Emory centers focus on cardiovascular plaque and personalized cancer treatments.)
     Cancer and bioterrorism—Researchers at the Emory/Georgia Tech Center for Cancer Nanotechnology developed and shared clinical protocols for the use of bioconjugated quantum dots—luminescent nanoparticles linked to biologic molecules—to track molecular biomarkers in cancer tissue. The tour de force project, which took two years and involved 12 investigators in five academic departments at Emory and Georgia Tech, is expected to help clinicians diagnose and determine cancer prognosis based on a patient’s individual molecular profile. The dots also are expected to be useful in detection of bioterrorism agents such as anthrax and plague, even at low concentrations.

Aging, memory, and Alzheimer’s
Medical school faculty at Yerkes National Primate Center received $10 million from the National Institute on Aging to compare changes that occur in aging humans—some normal, others indicating mild cognitive impairment or Alzheimer’s disease—with those that occur in nonhuman primates. The study is the first anywhere to examine chimpanzee cognition in correlation with other aspects of aging. And Yerkes, with its well-established colony of chimpanzees, on-site state-of-the-Molecular protein work is helping illuminate why plaques form in the brain to cause Alzheimer'sart imaging facilities, and extensive experience in cognitive research, is one of the few research centers that could even undertake such an extensive study. The goal is to develop methods of earlier diagnosis and new treatments based on specific physiologic changes.

Genome variations in schizophrenia
Scientists believe that each individual has as many as 100 DNA copy-number variations—a recently discovered category of differences in the human genome. While these previously unrecognized deletions and duplications of DNA segments generally cause no problems on their own, they may combine with other genetic changes and/or environmental factors to contribute to overall risk of specific diseases, including schizophrenia. Using new high-performance supercomputingMaps of insertions and deletions in the human genome will help account for mutations causing various types of cancer technology available only to a few major research centers and supported by a $3.6 million award from the National Institute of Mental Health, Emory geneticists are now searching for identifiable differences in the entire genome of 500 schizophrenia patients and 500 controls.

Gene for restless legs syndrome
A team of scientists at the Emory Sleep Center worked with deCODE Genetics, a genomics company in Iceland, to identify the first gene associated with restless legs syndrome (RLS), a sleep disorder affecting one in every 10 Americans. The finding provides concrete evidence that RLS is a genuine disorder with a definable phenotype and biologic basis and is the result of a four-year international study of genome-wide scans of nearly 1,500 Icelanders and 400 Americans.
     Study results suggest that multiple genes contribute to RLS, but one copy of a newly discovered variant confers nearly double the risk for developing RLS, while two copies increase a person’s risk to four times that of the general population.

Common genetic variant and risk for heart attack
In a study of almost 5,000 patients who had suffered myocardial infarctions (along with almost 13,000 controls), a team from Emory, deCODE Genetics, and University ofA genetic variation found in 21% of people of European descent causes a two-fold risk of heart attack early in life. Pennsylvania discovered a common genetic variation that causes a two-fold increase in risk of heart attack early in life (before age 50 for men and 60 for women). Approximately 21% of people of European descent carry two copies of the variation, found on chromosome 9p21. This is the first common variant found to be consistently linked to substantial risk of heart attack in multiple case-control groups in this population.

Faster, more accurate genetic tests
Lysosomal storage diseases—Clinicians throughout the country now have access to a new set of Emory-developed genetic tests that can yield more accurate and rapid diagnosis of 24 different types of these diseases. Potentially life-threatening, lysosomal storage diseases cause enzymes to malfunction, leading to the accumulation of waste products that damage organs and tissues. Early diagnosis is critically important to prevent such damage, but these diseases are difficult to identify clinically because symptoms often mimic those of more common diseases.
     Muscular dystrophy—A new genetic test developed at Emory that targets mutations in the dystrophine gene is far quicker and more accurate than existing tests for the most common types of this disorder. It can be used to confirm clinical diagnoses, test female family members who may be carriers, and perform prenatal testing.

Pig islets for transplant
The Juvenile Diabetes Research Foundation (JDRF) gave the Emory Transplant Center $2.5 million to use a nonhuman primate model at the Yerkes National Primate Research Center to develop a porcine islet transplant strategy. This research focuses on ways to circumvent immunologic rejection of the xenograft as well as minimizing risk of transmission of porcine pathogens. The grant is in addition to last year’s $8.5 million grant renewing the Emory JDRF Center for Islet Transplantation, one of a handful of such centers in the country dedicated to addressing large-scale strategies to replace the insulin that people with Type 1 diabetes are unable to produce. Emory was the first and remains the only center in Georgia that performs human islet transplants and is a leader in efforts to develop less toxic immunosuppressant drugs for both islet and solid organ transplants.

Brain tumor biomarker
Medical school researchers at the Winship Cancer Institute identified a biomarker for brain tumors—a protein known as soluble attractin that is elevated in the cerebrospinal fluid of A high-throughput molecular screening center at Emory can screen hundreds of thousands of compounds with potential as drugs against protein targetspatients with malignant astrocytoma. They also uncovered the role that attractin may play when astrocytoma spreads or recurs after treatment. Being able to detect attractin gives physicians a new minimally invasive method to monitor how well a tumor is responding to specific treatments. That’s now. In the future, since the protein induces cancer cells to migrate and possibly recur, attractin may prove to be a good target for therapeutic intervention.

Invented here
The Association of University Technology Managers ranked Emory first in the nation this year in commercialization revenue of research discoveries. The report compared institutional data from 2005, a year in which Emory created four start-up companies from medical school research, executed 30 licenses, filed 54 new patent applications, andFive initial areas (transplant, neuroscience, lung health, heart and vascular disease, and cancer) are being targeted to integrate research and patient care, with new faculty recruited based on their credentials in translating discoveries to the bedside. earned more than $585 million in licensing revenue.
     New companies developing therapies based on Emory research include one focused on blocking a protein that promotes cancer metastasis and one developing small-molecule drugs that can protect brain tissues from damage following stroke.
     Much of the huge licensing revenue for the year came from sale of future royalties from the Emory-discovered HIV/AIDS drug Emtriva. This widely used AIDS drug is one in a long list of Emory discoveries now commercially available for patients and physicians. Emory continues to reinvest revenue from technology transfer into research and science education, assuring that discoveries will continue to be moved along the pipeline to the marketplace.

Still growing
During this past year, the medical school markedly expanded and centralized its clinical trials office, with the aim of improving quality and efficiency and making more clinical trials available for patients, especially those in cancer. It also added two new Institutional Review Board committees, with the aim of speeding up the process of getting research projects approved and under way. Clinical trial efforts also got a recent major boost from a Clinical and Translational Science Award from the NIH, which Emory received in partnership with Georgia Institute of Technology, Morehouse School of Medicine, and Children’s Healthcare of Atlanta.
     Individual departments expanded structures to help their researchers and colleagues across the scientific community.Emory is developing a fast, cheap alternative to genome sequencing. These include establishment of a DNA databank for autism, one of 11 in the nation, and development of a gene-resequencing technique that allows small labs to rapidly and inexpensively compare genetic differences.
     Perhaps most striking, the acquisition of a new high-performance computational cluster this year placed Emory on the list of the world’s 500 most powerful supercomputing sites and immediately began making possible a variety of experiments that would have been impractical, impossible, or too costly using conventional laboratory methods. The technology is being used in the schizophrenia DNA study described earlier as well as to explore the amount of radiation patients receive from two new breast-imaging techniques that someday may provide clinicians with more detailed views of breast tissue than available ever before.

 
         
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