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Solving Medical Mysteries

Eve Belson is a regular contributor to Orange County Life

People had been watching apples fall out of trees long before Sir Isaac Newton ever contemplated the notion of gravity. What led to his portentous theories about bodies in motion was his freshness of vision while sitting under the apple tree.

That ability to look at a phenomenon from an unorthodox angle or to recognize its potential is still the hallmark of scientific breakthrough.

Researchers at UC Irvine are currently working on a crop of inspired projects that may not only solve a number of medical conundrums but also change the way we view health and fitness over the next decade.

Until recently, back injuries were routinely treated with lots of rest, massage, hot packs and ultrasound. But Dr. Vert Mooney, chair of orthopedic surgery at UCI, is prescribing exercise--lots of it.

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“The project is to treat soft-tissue injuries, which is what a back injury basically is, in a sports medicine attitude,” he says. That means gradually progressive exercises, the kind that get top athletes back in action in days instead of the weeks and even months it normally takes using traditional methods.

Scientific studies indicate that only exercise can “tell” soft tissues to repair themselves. The absence of physical mechanical stress is essentially destructive, according to Mooney.

“This treatment is more rational if you start measuring what an individual can do rather than what they say they feel,” he says.

In other words, how much the treatment bothers the patient is not nearly as important as measuring the increasing strength of the back tissues.

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To document patient recovery, Mooney has been using computerized equipment to evaluate muscle function and back strength in back injury patients. Because 40% of all workers’ compensation cases involve back injuries, the long-term implications for insurance companies could be enormous if treatment time for such injuries could be reduced from months to weeks, or even days.

Our notions of environmental safety may be shaken up by two other studies at UCI.

The recent uproar over the spraying of malathion has prompted Elaine Vaughn, assistant professor of social ecology, to look into the psychology of risk perception.

In a study that will begin in late spring, Vaughn will test her hypothesis that factors other than pure scientific estimates cause people to perceive risks differently. To determine which factors most influence our risk perceptions, she will ask subjects to evaluate the severity of a fictitious pesticide risk based on simulated news broadcasts.

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The disparities that have been documented between experts and non-experts in their judgment of environmental hazards may be attributed to prior beliefs which they bring to the evaluation process, according to Vaughn. She hopes the study will help pinpoint whether the credibility of the source or the proximity of the risk can overcome previous bias.

Meanwhile, Dr. Robert Phalen, professor of community and environmental medicine, has shown that rats intermittently exposed to polluted air exhibited greater lung damage than rats constantly exposed to the same pollutants. These surprising results may indicate that lung tissues adjust and adapt under continuous exposure, while intermittent exposure does not allow that protection to develop.

Phalen is now seeking funding for a six-month study designed to verify his findings, which may eventually lead to a rethinking of air pollution control strategies. “The general concern that is emerging in the scientific community is that in the past we might have been focusing a little too much on the acute effects of air pollutants and not enough on longer term effects,” he says.

Pfizer Inc., the Connecticut-based pharmaceutical giant, recently awarded a two-year grant of $1.5 million to a UCI research project that has discovered the first molecular marker linking such autoimmune diseases as diabetes, multiple sclerosis, lupus and rheumatoid arthritis, which together affect between 150 million and 200 million people worldwide.

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“The discovery was pure chance,” says Dr. George Chandy, assistant professor of physiology and medicine, who heads the project along with Dr. Stephen Grissmer, a postdoctoral researcher, and Dr. Michael Cahalan, professor of physiology and biophysics.

As Chandy explains it, the researchers “were playing around” one Saturday night back in 1986 with a class of immune cells, called double negative T-cells, in mice infected with lupus.

They noticed that the cells exhibited abnormally high numbers of specific types of potassium channels, the protein on the cells’ surfaces which regulate the activity of the nervous system and the heart. It is these abnormal immune cells which appear to trigger other immune cells to destroy tissues in the body, a hallmark of autoimmune diseases.

The scientists believe that this channel abnormality might serve as a “diagnostic marker” for drugs designed to block the potassium channels and intervene in the development and progression of these diseases.

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The Pfizer grant will enable Grissmer to verify whether the team’s findings in mice are applicable to humans, while Chandy will try to identify the specific gene for the channel abnormality. “Only then will we be able to get a handle on drug design,” Chandy says.

The pharmaceutical industry is also closely watching the work of Dr. Daniel Hollander, professor of gastroenterology.

Aspirin, one of the century’s original miracle drugs, enjoyed renewed acclaim over the past decade when studies indicated that it could help reduce the risk of heart attacks and, more recently, even prevent strokes. Unfortunately, one of the side effects of increased aspirin use can be serious irritation of the stomach lining that can lead to gastrointestinal bleeding and ulcers.

But aspirin is not the lone culprit. Alcohol, for example, is an even more injurious agent than aspirin, so much of Hollander’s research over the past decade has been in trying to pinpoint common factors that could protect the delicate lining of the stomach from injury in general.

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Prostaglandins, natural compounds produced by the stomach, appear to minimize damage by both aspirin and alcohol. How they do that has been the focus of Hollander’s investigations. Researchers eventually hope to find a way to directly augment the supply of prostaglandins in the stomach, either through oral supplements or drugs that stimulate the stomach to produce more of its own.

Three years ago, Dr. Grant Gwinup, professor of endocrinology, was the first researcher to document the difference in weight loss between dieters who swam and those who practiced a land-based aerobic sport such as running or cycling. He theorized that the swimmers lost less weight because water conducts 30 times more heat away from a body than air and to compensate for the energy loss the body triggered an increase in appetite.

This year Gwinup has turned his attention to insulin toxicity, which he blames for “all the problems that besiege modern man.” He and his co-researcher, Dr. Alan Elias, consider the hoopla surrounding cholesterol ridiculous.

“All the cholesterol studies to date show no change in overall mortality,” he says, “yet there is this silly emphasis on getting your cholesterol down. We think you should be doing something to bring your insulin levels down.”

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Gwinup cites a body of international studies that document the relationship between high insulin levels and arterial disease. He and Elias theorize that insulin is responsible for the high rate of arterial damage in diabetics because of the way blood-vessels are bathed in insulin each time the hormone is administered by injection.

Gwinup believes that the great majority of hearty eaters--meaning Americans in general--are mild diabetics. “First they get high insulin levels,” he says. “The next thing, they are keeling over dead with arterial disease of one sort or another. Man was meant to be starved. Nobody ever dies of myocardial infarction in places like India.”

Until he completes his studies, he suggests that people have their insulin levels as well as their cholesterol levels checked on the next visit to the family doctor.


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