TAG: "Dentistry"

Pediatric dentist applies science to prevent cavities


UCSF’s Ling Zhan is an emerging leader in use of xylitol to prevent tooth decay in children.

Ling Zhan, UC San Francisco

Pediatric dentist Ling Zhan, D.D.S., Ph.D., an assistant professor in the UCSF School of Dentistry, is building a path to something children and parents the world over welcome: fewer cavities.

Cavities are the number one infectious disease in children in the U.S. Every year, nearly $4.5 billion is spent to treat them and about 1.6 million school days are missed annually related to dental decay. The prevalence of this disease is five times higher than asthma.

Zhan is an emerging leader in the use of xylitol, a naturally occurring sugar alcohol, to prevent tooth decay in children. Research shows that the sweet-tasting substance, which is extracted from the fibers of fruits, vegetables and other vegetation, have the potential to prevent cavities. Xylitol, commercially used as a sugar substitute, is lower in calories than sucrose and appears to diminish the negative dental effects of oral bacteria.

Many of the children Zhan sees in her research and clinic are suffering from significant tooth decay.

“In the traditional dental clinic, we’re normally only fixing the cavities, but not treating the cause,” Zhan said. “I’m a dentist, but also a dental scientist. Cavities can be readily prevented, and I want to see if there’s anything I can apply from basic science to fix this.”

In a recent study, Zhan and her team found that xylitol can prevent cavities in infants. In the findings, which Zhan presented in the 2nd International Conference on Novel Anticaries and Remineralizing Agents, infants whose gums were wiped daily with xylitol by their parents had nearly eight times fewer dental carries after one year than those who used wipes without xylitol. The study will be published in the Journal of Dental Research later this year.

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Stem cell odyssey leads from tusks & teeth to gut


Stem cell research by UCSF’s Ophir Klein targets craniofacial abnormalities.

Look at the teeth on the lab specimen here. Is this the work of a mad scientist?

It’s true that UCSF’s Ophir Klein, M.D., Ph.D., was quite satisfied to have produced mice with incisors that more closely resemble woolly mammoth tusks than the more modest choppers sported by your average Mus musculus.

Ophir Klein, UC San Francisco

And he is indeed a laboratory scientist – a fast-rising one and the recipient of a highly competitive, $2.3 million Director’s New Innovator Award fron the National Institutes of Health. But Klein also is a practicing medical geneticist, part of a UCSF clinical team that aims to better diagnose and treat dental and facial abnormalities in young patients.

The mouse studies are a way to learn more about how such disfiguring developments arise. Klein also hopes to use the knowledge gained to develop strategies for regenerating tissues, including teeth, for use in new treatments.

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San Francisco partnership tackles public health problems


SF HIP aims to connect UCSF’s research capital with community partners to improve health.

UCSF's Kevin Grumbach (left) and Laura Schmidt (right) at SF HIP coordinating council meeting

UC San Francisco and an array of community, academic and civic collaborators are wrapping up the first year of an ambitious effort to build partnerships to enhance the well-being of San Francisco residents and eliminate health disparities.

San Francisco Health Improvement Partnerships (SF HIP), a cross-cutting initiative of the UCSF Clinical and Translational Science Institute (CTSI), aims to connect the university’s research capital with the expertise and needs of community partners. The goal is to implement strategies to measurably impact health in San Francisco — and to promote health equity along the way.

“In the past, research has often been seen as unilaterally serving the needs of the researchers rather than the community,” said Kevin Grumbach, M.D., co-director of CTSI’s Community Engagement and Health Policy (CEHP) Program. “SF HIP is an effort to do it differently; to have the outcome not be theoretical, but rather a discrete and sustainable change in community health.”

SF HIP is conducted in a spirit of participatory research with oversight by its Coordinating Council. Community partners include representatives from CTSI, the San Francisco Department of Public Health, San Francisco Unified School District, San Francisco Hospital Council, Mayor’s Office of Housing and Community Development, and health equity coalitions representing the African American, Latino and Asian/Pacific Islander communities. CTSI’s CEHP program serves as the administrative core of the initiative and provides planning funds.

“SF HIP brings UCSF and its resources closer to the community, and all the important stakeholders together to improve community health,” said Amor Santiago, DPM, MPH, executive director of APA Family Support Services, and representative of the Asian/Pacific Islander Health Parity Coalition on the SF HIP Coordinating Council. “This effort has the potential to lead and coordinate public health efforts across the spectrum of providers in medical, mental and social health emphasizing prevention.”

So far, SF HIP working groups have been launched to focus on four pressing needs: physical activity and nutrition, hepatitis B, alcohol abuse and dental caries in children.

“Part of this effort involves laying a foundation for long-term collaboration,” said Ellen Goldstein, M.A., program manager of the CEHP program. “That includes developing an ongoing framework for UCSF to productively engage with a wide range of community partners to tackle our city’s most compelling health problems.”

[Related: View more about UCSF's commitment to the community]

SF HIP is part of UCSF’s expansive community service efforts that span outreach in local, regional and global communities.

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New method for generating stem cell-like cells from human skin


UCLA researchers demonstrate that new cells can be triggered to form bone-like tissues.

Mo Kang, UCLA

Researchers from the UCLA School of Dentistry investigating how stem cells can be used to regenerate dental tissue have discovered a way to produce cells with stem cell-like characteristics from the most common type of human skin cell in the epidermis.

These skin cells, called keratinocytes, form the outermost layer of skin and can be cultured from discarded skin tissues or biopsy specimens.

The findings, published in the Nov. 4 edition of the peer-reviewed Journal of Biological Chemistry, may be beneficial for individuals with limited sources of endogenous stem cells.

The gene known as ∆Np63α is highly synthesized in regenerating cells of various tissues. The UCLA researchers found that introducing ∆Np63α into skin keratinocytes makes them lose their skin-cell characteristics and de-differentiate to resemble mesenchymal stem cells (MSCs), undifferentiated cells that can self-renew and differentiate to yield specialized cells of various tissue types.

MSCs may serve as an internal repair system by replenishing cells needed for tissue regeneration and homeostasis and are currently being investigated for a number of regenerative therapeutics.

The conversion of keratinocytes into mesenchymal-like cells involves a process known as epithelial-mesenchymal transition. This is the first study to show that the gene ∆Np63α triggers this process in human skin keratinocytes and that the transformed cells acquire multipotent stem cell characteristics.

Since the skin cells transformed by ∆Np63α are induced to acquire the mesenchymal and stem cell characteristics, the research team named them “induced mesenchymal stem cells,” or iMSCs. Specifically, the researchers demonstrated that iMSCs can be triggered to form bone-like tissues or become fat tissues in a laboratory setting.

Dr. Mo K. Kang, the Jack A. Weichman Chair of Endodontics at the UCLA School of Dentistry and a member of the research team, said the finding had great significance for human health.

“Since iMSCs may be obtained by taking a small punch-biopsy of skin tissues from patients, these cells are an easily accessible, patient-specific source of stem cells, which can be used for regenerative purposes,” Kang said.

Stem cell-based therapies are currently being developed to treat degenerative conditions such as heart disease, diabetes, neuronal disorders and liver diseases. Many of these diseases are strongly associated with aging. Endogeneous MSCs found in various tissues, such as bone marrow, fat tissues and, in certain cases, dental tissues such as dental pulp, lose their regenerative potential during the aging process.

“It is possible that iMSCs retain their stem-cell characteristics even when derived from aged patients,” Kang said. “In such cases, this new approach may be useful, especially for geriatric patients or individuals with limited therapeutic value of their endogenous stem cells.”

“The UCLA School of Dentistry is very proud to be at the forefront of this research inquiry, which may facilitate future advances in regenerative dentistry and medicine,” said Dr. No-Hee Park, dean of the UCLA School of Dentistry and one of the study’s co-authors. “While the focus of this study was on the use of adult stem cells to regenerate dental tissue, including dental pulp and periodontal ligament, these findings could lead to further development of a variety of cell-based therapies.”

The research was funded in part by the National Institute of Dental and Craniofacial Research and the Jack A. Weichman Endowed Fund.

The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.

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Targeting tooth decay


New mouthwash targeting harmful bacteria may render tooth decay a thing of the past.

Wenyuan Shi, UCLA

A new mouthwash developed by a microbiologist at the UCLA School of Dentistry is highly successful in targeting the harmful Streptococcus mutans bacteria that is the principal cause tooth decay and cavities.

In a recent clinical study, 12 subjects who rinsed just one time with the experimental mouthwash experienced a nearly complete elimination of the S. mutans bacteria over the entire four-day testing period. The findings from the small-scale study are published in the current edition of the international dental journal Caries Research.

Dental caries, commonly known as tooth decay or cavities, is one of the most common and costly infectious diseases in the United States, affecting more than 50 percent of children and the vast majority of adults aged 18 and older. Americans spend more than $70 billion each year on dental services, with the majority of that amount going toward the treatment of dental caries.

This new mouthwash is the product of nearly a decade of research conducted by Wenyuan Shi, chair of the oral biology section at the UCLA School of Dentistry. Shi developed a new antimicrobial technology called STAMP (specifically targeted anti-microbial peptides) with support from Colgate-Palmolive and from C3-Jian Inc., a company he founded around patent rights he developed at UCLA; the patents were exclusively licensed by UCLA to C3-Jian. The mouthwash uses a STAMP known as C16G2.

The human body is home to millions of different bacteria, some of which cause diseases such as dental caries but many of which are vital for optimum health. Most common broad-spectrum antibiotics, like conventional mouthwash, indiscriminately kill both benign and harmful pathogenic organisms and only do so for a 12-hour time period.

The overuse of broad-spectrum antibiotics can seriously disrupt the body’s normal ecological balance, rendering humans more susceptible to bacterial, yeast and parasitic infections.

Shi’s Sm STAMP C16G2 investigational drug, tested in the clinical study, acts as a sort of “smart bomb,” eliminating only the harmful bacteria and remaining effective for an extended period.

Based on the success of this limited clinical trial, C3-Jian Inc. has filed a New Investigational Drug application with the U.S. Food and Drug Administration, which is expected to begin more extensive clinical trials in March 2012. If the FDA ultimately approves Sm STAMP C16G2 for general use, it will be the first such anti–dental caries drug since fluoride was licensed nearly 60 years ago.

“With this new antimicrobial technology, we have the prospect of actually wiping out tooth decay in our lifetime,” said Shi, who noted that this work may lay the foundation for developing additional target-specific “smart bomb” antimicrobials to combat other diseases.

“The work conducted by Dr. Shi’s laboratory will help transform the concept of targeted antimicrobial therapy into a reality,” said Dr. No-Hee Park, dean of the UCLA School of Dentistry. “We are proud that UCLA will become known as the birthplace of this significant treatment innovation.”

The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.

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UCSF works to improve lives of Oakland middle school students


$1.75M grant will allow UCSF faculty, students to provide integrated model for delivering primary health, dental care to children at five Oakland middle schools.

The Havenscourt Health Center recently opened in an Oakland middle school to serve youth and families as part of the Elev8 project.

UC San Francisco, the Oakland Unified School District and an array of community-based partners are embarking on a quest to improve the lives of disadvantaged middle-school students, thanks to a $1.75 million grant from The Atlantic Philanthropies.

The three-year award to UCSF’s Elev8 Healthy Students and Families project will allow faculty and students from UCSF’s schools of nursing and dentistry to provide a new, integrated model for delivering primary health and dental care to children at five Oakland middle schools. The project also will increase health education and expose middle school youth and their families to health careers.

“Good health is fundamental to children reaching their full potential in school and in life and so our UCSF Elev8 Healthy Students and Families project dovetails perfectly with the work of our partners,” said lead applicant, Linda Franck, R.N., Ph.D., chair of the Department of Family Health Care Nursing at UCSF.

The program also offers UCSF nursing and dental students important learning opportunities, says co-leader Bill Bird, D.D.S., M.P.H., Dr.P.H., a professor in the Department of Preventive and Restorative Dental Sciences.

“This project gives us the opportunity to establish a new model for interdisciplinary education of advanced practice nursing and dental students in community-based health care,” Bird said, “and builds a health workforce for the future that is better equipped to work for and meet the health needs of disadvantaged communities.”

Elev8 is a national initiative funded by The Atlantic Philanthropies that brings together schools, families and the community in underserved neighborhoods to help students succeed in school and in life. Work is underway in Chicago, Baltimore and New Mexico. In Oakland, the new grant will augment a previous Elev8 grant that will:

  • Provide coordinated health, mental health and dental services,
  • Engage families to support and advocate for their youth, and
  • Offer academic and mentoring support in extended day, Saturday and summer programs.

Alameda County has supported school-based health centers for more than 15 years. Through the UCSF Elev8 project, faculty, nurse practitioner and dental students will enhance and expand primary care services at these existing Federally Qualified Health Center partners and increase preventative services, particularly in the areas of dental care and healthy lifestyles, as well as treat children with chronic health conditions.

The youth who will benefit from the new funds are sixth-to-eighth-graders at five Oakland campuses: Roosevelt, Havenscourt, Madison, West Oakland and United for Success. In fall 2010, these schools enrolled 1,639 students, of whom 763 were Latino, 480 were African American, 247 were Asian and 1,259 were economically disadvantaged. In fact, more than 85 percent of students at Elev8 Oakland schools are living in poverty.

These students face a variety of other challenges: violence, safety concerns, drugs, health problems, and parents with low levels of education and high levels of unemployment. These factors can negatively affect the health and academic achievement of students, according to Elev8 Oakland. The project targets middle-school students because research shows that children who make the transition to high school smoothly are more likely to graduate and go on to and finish college.

“We’re really excited about the chance to enliven our curriculum and to add a social justice component,” said Naomi Schapiro, R.N., Ph.D., C.P.N.P. “Middle-school students are not on people’s radar. They are at the cusp between being children and adolescents. And they’re going through a lot of physical and developmental changes.”

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Obituary: Bernard Sarnat, 99, UCLA professor


Plastic surgeon was pioneer in field of craniofacial biology.

Bernard Sarnat

Dr. Bernard G. Sarnat, D.D.S., an eminent plastic surgeon and research scientist who made pioneering contributions to the understanding of craniofacial development and the causes of facial deformities, died Oct. 21 in Los Angeles of respiratory failure. He was 99.

Sarnat joined the UCLA School of Dentistry in 1969 as an adjunct professor of oral biology and in 1974 received a joint appointment in the UCLA School of Medicine’s division of plastic surgery. He also operated a private practice as a plastic surgeon in Beverly Hills and was associated with Cedars–Sinai Medical Center for more than 20 years, first as chief of plastic surgery and later as a senior research scientist.

Sarnat’s groundbreaking studies of how biology influences medical and dental treatment led to major improvements in the field. He was one of the first researchers to use the stain known as alizarin red S to document the pattern of growth in bones and teeth. He was particularly concerned with craniofacial development and the biological circumstances that lead to deformities of the facial structures, especially as they affect surgical procedures.

“Dr. Bernard Sarnat was a true surgeon–scientist,” said Dr. James Bradley, professor of plastic surgery and holder of the Bernard G. Sarnat, M.D., Endowed Chair in Craniofacial Biology at the David Geffen School of Medicine at UCLA. “His quest to answer questions in the field of craniofacial biology led to landmark discoveries that are used to benefit countless children today.”

Sarnat’s generous nature was exemplified by the numerous lectureships he endowed, including the Bernard G. Sarnat International Lectureship in Bone Biology at UCLA, which since its inception in 1984 has presented the research of scores of internationally renowned investigators.

In 1999, Sarnat provided funds for the establishment of the Bernard G. Sarnat Endowed Chair in Craniofacial Biology at the Geffen School of Medicine, for use by the division of plastic surgery in conducting research in the area of craniofacial biology, with an emphasis on the etiology and prevention of craniofacial deformities. He established a similar endowed chair at the University of Chicago.

Sarnat was born in Chicago in 1912, a child of immigrant parents from Russia, where his two older siblings were born. He earned his medical degree from the University of Chicago and a master’s of science degree and doctor of dental surgery degree from the University of Illinois. After World War II, he pioneered an early model for distance-education by setting up a telephone network to simultaneously broadcast a series of lectures on dental topics to 260 cities and more than 12,000 students.

Sarnat helped establish the Plastic Surgery Research Council, a preeminent plastic surgery research group, more than 50 years ago. The author or co-author of more than 220 scientific journal papers and books, Sarnat lectured extensively at universities and professional societies throughout the U.S. and the world. His research earned wide recognition, and he was honored with more than 25 prestigious awards from around the globe.

During his career, Sarnat was recognized as a caring, skillful and compassionate plastic surgeon and was nicknamed the “Dean of Plastic Surgery” by his colleagues.

Sarnat retired from surgical practice in 1991 but was still working hard through early 2010 to publish his book “Craniofacial Biology and Craniofacial Surgery” (World Scientific Publishing Co., 2010), which encompasses more than 60 years of basic science discovery. As recently as spring 2011, he was still in his office, putting the finishing touches on academic works.

Sarnat died just short of his 70th wedding anniversary, which would have been Christmas Day.

He is survived by wife, Rhoda, of Los Angeles; son Gerry of Portola Valley; daughter Joan of Berkeley; grandchildren Zoe, Eli and Emma Sarnat, and Jascha and Michael Hoffman; and great-grandchildren Elliot and Simon Aron.

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UCLA volunteers provide free health care at clinic in downtown LA


CareNow clinic delivers health care of last resort.

Four-year-old Nayeli Valdez lay back in a dental chair Friday morning, gazing up at the cavernous ceiling of the L.A. Sports Arena during her very first trip to the dentist.

She was one of an estimated 1,200 people at the arena receiving free medical, dental and eye care that day at the CareNow/LA health clinic, to which UCLA sent scores of volunteer health care providers and students.

While UCLA dentist Edmond Hewlett cleaned Nayeli’s teeth and filled a cavity, her father Francisco Valdez said through an interpreter that the clinic was his only option for dental care.

“He’s very happy that they were able to be seen,” the interpreter said. “They’re from a low-income family, so they can’t afford stuff like this.”

UCLA Dentist Edmond Hewlett treats a 4-year-old girl.

It was one of many wrenching cases for Hewlett that day. He wanted to do more to help Nayeli, who had “a mouthful of cavities.” Although Hewlett filled one, the others would need attention soon, he said. For the UCLA dentist, helping people like Nayeli was one of the joys — and pains — of volunteering at the clinic.

“On the one hand, it’s gratifying, and on the other hand, you see how much more need there is, and we can’t do enough,” said Hewlett. “It breaks your heart.”

It was a sentiment repeated by several of the more than 70 UCLA health care providers — physicians, dentists, ophthalmologists and more — volunteering at the CareNow/LA free clinic from Oct. 20 to 23. They and hundreds of other L.A. area doctors filled cavities, provided mammograms, screened patients for cancer, glaucoma and cataracts, and donated many other services.

The four-day clinic, which CareNow described as the largest free health care clinic in the country, served an estimated 5,000 patients who waited in line for hours earlier in the week to claim one of the coveted appointments.

Michelle Bholat, UCLA

The clinic brought much-needed assistance to people who had fallen through the cracks, said Dr. Michelle Bholat, the vice chair of the UCLA Department of Family Medicine. She estimated that more than half of those she had seen said they had been incarcerated, making it harder for them to get work and health coverage. Bholat recalled one such patient in her early 30s who recently lost her job and health insurance. The woman had high blood pressure, diabetes and high cholesterol.

“She was the typical patient at the clinic, the one who’s falling through the cracks, and if we don’t help her, in two years we’ll see her in the emergency room for kidney failure or a stroke,” Bholat said. The physician was able to give her some important screening tests and connect her to clinics that could provide follow-up care. But that’s not enough, she said.

“We really have a crisis on our hands,” Bholat said. “This clinic is fantastic, but we need care that’s sustainable.”

Patients were touchingly grateful to her and to her colleagues, she noted.

“Everyone said they were so impressed by our bedside manner,” Bholat said. “So many of them said this was the first time they felt like they had a personal physician — even in an arena with thousands of other people.”

Ravi Dave, UCLA

UCLA cardiologist Dr. Ravi Dave (pronounced Da-vay) spent his day helping patients like Edmund Dominguez, a 53-year-old whose blood pressure was so high that Dave warned him it was only a matter of time until he had a stroke if he didn’t take medication.

Treating patients in such serious need of care makes him feel like he’s really contributing, Dave said. When he works in UCLA hospitals, his patients are somewhat self-selecting, he said — only patients with insurance come in.

“Normally we see people who are doing things right and who have plenty of resources,” Dave said. “Today is special because we get to help the people who need help the most. It’s a little concerning because we’re seeing the big problem with health care in America. With so many resources, how are we finding so many people here today who have nowhere else to turn?”

But there was a silver lining, he noted: For Dave’s students, who normally see relatively healthy patients, the free clinic gave them months’ worth of experience examining different health problems in a few days.

Virginia Lalata was one of hundreds at the clinic on Friday who came for glasses and other eye care. After using hand-me-down glasses for years, she now needed a new prescription. “Without this, I don’t know what I’d do,” she said.

Lalata was one of about 500 vision patients over the weekend who received follow-up screenings from ophthalmologists in UCLA’s Mobile Eye Clinic for cataracts, glaucoma, macular degeneration and other eye disorders. UCLA selected 10 lucky patients for free eye surgery at the Jules Stein Eye Institute, said Faye Oelrich, the mobile clinic’s program manager.

“We’re seeing so many people whose vision has been blurry for years,” Oelrich said. “One of our most touching cases was a young woman who has had a crossed eye since childhood, which you could tell she was very self-conscious about. She came to tears when we told her we could correct her eye with free surgery.”

That wasn’t the only case of tears, Oelrich continued.

“I had another woman yesterday who has needed cataract surgery for years,” she said. “She wouldn’t have been able to pass the eye exam at the DMV, even with glasses, but she can’t afford surgery. She didn’t speak much English, but broke down sobbing when she understood we would give her the surgery, and said, ‘I’m crying because I’m so happy.’”

Several of the two dozen ophthalmologists volunteering at the clinic signed up for extra shifts, Oelrich said. “The work is so gratifying,” she said.

Dr. Laura Syniuta, an ophthalmologist with the mobile clinic, agreed.

“It’s a wonderful opportunity to make a difference to people with no other options right now,” Syniuta said. “I’m so proud of my colleagues.”

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$2.8M grant to develop saliva test to diagnose Sjögren’s syndrome


Clinical trial will test a new diagnostic approach for the disorder, which affects Venus Williams and millions of others.

David Wong, UCLA

In August, tennis star Venus Williams withdrew from the U.S. Open, saying she was suffering from fatigue and other symptoms related to Sjögren’s syndrome, an autoimmune disorder that results in the loss of the ability to produce saliva and tears. Her announcement focused public attention on this malady, which affects nearly 4 million Americans.

While women are nine times more likely than men to develop Sjögren’s, the disorder affects virtually every racial and ethnic group. Most patients develop symptoms after age 40, including dry eyes, dry mouth and often joint pain and chronic fatigue. And because of their paucity of saliva and the antibacterial chemicals it contains, patients may also develop tooth decay and cavities.

While much is known about the symptoms of Sjögren’s, the disease is complex and poorly understood, and in some cases, it can take more than six years to be diagnosed.

The UCLA School of Dentistry has now received a $2.8 million grant from the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health, to support a multi-center clinical trial of a diagnostic test that uses patients’ saliva to determine whether they have Sjögren’s syndrome. This simple, non-invasive test will permit a diagnosis within minutes, rather than the weeks currently required when using blood or other tissue samples.

The project will be led by Dr. David Wong, associate dean for research and the Felix and Mildred Yip Endowed Professor in Dentistry at the UCLA School of Dentistry. For Dr. Wong and his colleagues, who have been conducting research on using saliva as a diagnostic tool for biomarkers of oral cancer, early-stage pancreatic cancer and other maladies for several years, this is an important step in moving from the research realm to actual clinical trials and, eventually, to use by medical and dental practitioners.

“This clinical trial will make it possible to validate the effectiveness of salivary diagnosis and move us a step closer to eventual FDA approval and clinical product development,” Wong said. “The establishment of scientifically credible biomarkers for this chronic autoimmune disease that are not invasive, painful or embarrassing is our goal.”

Clinical trials will be conducted at three major rheumatology centers, at University Medical Center Groningen in the Netherlands, the University of Minnesota and the Oklahoma Medical Research Foundation. Centers will enroll patients exhibiting sicca symptoms of dry eye and dry mouth and will perform the saliva biomarker assay based on a panel of highly discriminatory salivary biomarkers developed at UCLA. Researchers will benchmark the outcome with the current clinical practice of six clinical tests, including serology and a lip biopsy, to diagnose Sjögren’s syndrome (AECC 2002 criteria).

“The UCLA School of Dentistry is very proud to be at the forefront of this international effort to advance the field of saliva diagnostics from the research laboratory to clinical trials,” said No-Hee Park, dean of the UCLA School of Dentistry. “The prospect of early detection of Sjögren’s syndrome, and possibly other serious illnesses, in the future through this methodology is truly exciting.”

The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.

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High-quality health care through interprofessional education


First-year UCSF students learn about other health professions.

UCSF dental student Vanessa Antolinez and medical student Andrew Lechner

The 475 future doctors, dentists, pharmacists, nurses and physical therapists in UCSF’s Millberry Union gym had just met but they already had a lot to talk about. They discussed what they’d order for their last meal, when and where they’d go if time travel were an option, and what they’d ask an omnipotent being if they had only one question to pose.

These “ice breakers” helped kick off Interprofessional Health Education Day, a mandatory event for all first-year students in UCSF’s health professions. It was designed to implant the notion of teamwork, a concept that is widely endorsed but often elusive. By introducing students early on, they can get acquainted with each other and their chosen fields in a relaxed way that will ease interactions in clinical settings later on.

“This is a really exciting opportunity for all of you to get to know each other a little better, and to work together and to model what we hope here at UCSF is a new way of providing high-quality health care to patients that so deserve it,” said Joseph Castro, Ph.D., vice chancellor for student academic affairs and a faculty member in the Department of Family and Community Medicine.

He also told the crowd that UCSF has established the Center for Innovation in Interprofessional Health Education and that the “world renowned” Scott Reeves, Ph.D., a sociologist who specializes in health education research from the University of Toronto, would be arriving in November to lead it.

The young people who filled the gym on Sept. 28 were assigned to one of 60 teams, each named after a San Francisco street, that included as much of a professional mix as possible, given the uneven distribution of students: 151 from the School of Medicine, 123 from the School of Pharmacy, 88 from the School of Dentistry, 77 from the School of Nursing and 36 from the physical therapy program.

“The idea is to learn now what other people do instead of when you’re on the job,” said Jessica Manley, a third-year physical therapy student and member of the development team that organized the event. “It’s so you’re on the same page as everyone else and can focus on patient care rather than turf wars. You learn where your expertise begins and where it ends. It all becomes less nebulous.”

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Study pinpoints types of bacteria in saliva associated with pancreatic cancer


UCLA findings may offer a new non-invasive biomarker to diagnose and track the disease.

James Farrell, UCLA

FINDINGS:
A UCLA study has found variations in the types of bacteria found in the saliva of patients with pancreatic cancer and pancreatitis, compared with healthy controls. The findings may offer a new non-invasive biomarker to diagnose and track the development of these diseases. Pancreatic cancer is extremely deadly — only 5 percent of patients survive five years after diagnosis.

Previous studies have highlighted periodontal disease, which is related to inflammation of the gums, as playing a possible role in the development of systemic diseases such as heart disease. The current study demonstrates a possible link between this type of inflammation and pancreatic cancer and pancreatitis.

IMPACT:
The findings add to growing evidence that saliva may be a credible biomarker source to track and diagnose non-oral diseases. The study also offers new research directions for focusing on inflammation as a contributor to pancreatic diseases. 

AUTHORS:
Dr. James Farrell, M.D., associate clinical professor of digestive diseases and director of the Pancreatic Diseases Program at UCLA, and Dr. David Wong, D.M.D., D.M.Sc., UCLA’s Felix and Mildred Yip Professor of Dentistry, associate dean of research at the UCLA School of Dentistry and director of the UCLA Dental Research Institute, are available for interviews.

FUNDING:
The National Institutes of Health funded the study.

JOURNAL:
The research appears in the Oct. 12 online edition of the peer‑reviewed journal Gut. A copy of the full study is available from UCLA media officers.

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Genetics symposium focuses on personalized medicine, gene discoveries


UCSF event held in honor of the late Charles Epstein, a pioneer in the study and treatment of Down syndrome.

(From left) Neil Risch, Ophir Klein, Francis Collins and Lauren Weiss

Personalized medicine and new gene discoveries in human disease were a focus of a daylong symposium hosted by the UCSF Institute for Human Genetics on the Mission Bay campus on Oct. 3.

The now-annual symposium was convened to honor the late Charles J. Epstein, M.D., a pioneer in the study and treatment of Down syndrome and other genetic diseases. Epstein’s advocacy led to the establishment of medical genetics as a field of specialized medicine. He died in February as a result of pancreatic cancer.

Epstein trained many leading geneticists, including several of the symposium speakers. Other speakers, such as Francis Collins, M.D., Ph.D., director of the National Institutes of Health (NIH), were long-time friends and associates.

Collins, this year’s Charles J. and Lois B. Epstein Visiting Professor, gave a talk titled “Achieving Charlie’s Vision: The Science is Finally Catching Up with the Clinic.” Collins, who headed the Human Genome Project from 1993 to 2008, said that Epstein in his Down syndrome research pioneered the discovery of genetic and biochemical abnormalities that cause disease symptoms four decades ago, “when there were very few genes mapped to any chromosome.”

“Over the course of 40 years he brought together the clinical aspects of genetics and the research aspects in a way that has profoundly changed our understanding for all time and brought us into an era when clinical genetics, I think, has a remarkable future,” Collins said.

Through the Human Genome Project, researchers completely spelled out the DNA sequence of an entire human genome for the first time. That milestone, achieved in 2003, required more than a decade and nearly $3 billion.

With ever-improving technology and analytic tools, the cost of reading out an individual’s genome has continued to plummet while sequencing has sped up enormously. Today, Collins said, “We are on a trajectory toward the $1,000 genome.”  In the not-so-distant future the cost of obtaining an entire read-out of an individual’s DNA for use in personalizing medical care might no longer be prohibitively expensive.

Within a year the NIH will make available for research purposes a database containing all the protein-encoding genes for 75,000 individuals, including complete genomic DNA sequences for many of them, Collins said. Making this data available to researchers should greatly aid efforts to identify genetic causes of disease.

Collins described newer NIH grant competitions that put young scientists, including geneticists, on the fast track so that they can quickly begin directing more creative research in their own laboratories. Two symposium speakers, Ophir Klein, MD, PhD, and Lauren Weiss, PhD, are each recipients of one of these grants, called the NIH Director’s New Innovator Award.

Klein discussed his research on stem cells in teeth and the intestinal tract. His work is leading to basic discoveries about how stem cell populations guide the fate of cells and tissues during development. Weiss described populations studies aimed at identifying genetic mutations that may be responsible for many cases of autism.

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