STOP AND SMELL THE ROSES
Gerard Romano of Port Jefferson Station snapped this photo of roses in the Village of Port Jefferson last week. He writes, ‘These red beauties were planted at the main entrance to Danfords Hotel. I positioned my camera near the roses so that the gray and white railings provide a soft contrasting background.’
Send your Photo of the Week to [email protected].
By Barbara Beltrami
Even in these days of political dissent, I think and hope that we all still remember what the Fourth of July is really about, the achieving of independence from tyrannical rule and the birth of our nation and the good old red, white and blue of our flag.
Accordingly, I say Fourth of July food should be not just the traditional barbecue fare but also concoctions in red, white and blue. However, what blue foods are there except for blueberries and blue corn? So here in honor of Old Glory, our grand old flag, the birth and longevity of our nation, I offer you a cherry clafouti with mascarpone and blueberries, blue corn chip spread with sour cream and salsa, and watermelon, feta, cucumber and blueberry salad parfait.
Cherry Clafouti with Mascarpone and Blueberries
YIELD: Makes 6 servings
INGREDIENTS:
1¼ cups milk
1/3 cup sugar
3 eggs
1 tablespoon + 1 teaspoon vanilla
Pinch salt
½ cup flour
3 cups pitted fresh cherries
8 ounces mascarpone
1 pint fresh blueberries, washed
DIRECTIONS:
Preheat oven to 350 F. Vigorously whip together the milk, half the sugar, the eggs, vanilla, salt and flour until well emulsified. Grease a 2-quart casserole, then pour half the batter into it. Bake 7 to 10 minutes until it starts to set but a knife inserted in center does not come out clean. Remove from oven, evenly distribute cherries over top, sprinkle with remaining sugar, then remaining batter. Bake 45 to 60 minutes until clafouti is puffed and golden brown.
Remove from oven and serve warm with a dollop of mascarpone and a sprinkling of fresh blueberries.
Blue Corn Chip Spread
YIELD: Makes 8 to 12 servings
INGREDIENTS:
1 tablespoon olive oil
4 cups crumbled blue corn chips
One 8-ounce package cream cheese, softened
One 8-ounce container sour cream
Coarse salt and freshly ground pepper, to taste
1 to 2 tablespoons milk or cream
2 cups shredded manchego cheese
2 to 3 cups salsa
DIRECTIONS:
Grease a large deep pie plate or 9×13 shallow baking dish with olive oil. Spread the crumbled corn chips evenly on the bottom. In a blender or food processor combine the cream cheese, sour cream, salt and pepper and milk until they are well blended and the mixture is smooth but thick. Spread over the crumbled chips, then sprinkle with manchego cheese. Finally, spread the salsa over the top. Cover and refrigerate until ready to use. Serve with whole blue corn chips, crackers, cold beer, sangria, lemonade or soda.
Watermelon, Cucumber, Blueberry and Feta Salad Parfait
YIELD: Makes 4 servings
INGREDIENTS:
4 cups bite-size watermelon pieces
1 large cucumber, peeled, seeded and diced
2 cups fresh blueberries, washed and drained
1 cup crumbled feta cheese
½ cup extra virgin olive oil
3 tablespoons wine vinegar
1 tablespoon raspberry vinegar
Salt and freshly ground pepper, to taste
DIRECTIONS:
Place ½ cup watermelon pieces in each glass, next add 1/8 of the diced cucumber, then 1/8 cup blueberries and finally two tablespoons feta. Repeat procedure. Cover with plastic wrap and chill. Meanwhile in a small bowl whisk together the oil, vinegars, salt and pepper; keep at room temperature. When ready to serve, uncover and drizzle dressing evenly over each parfait. Serve as an appetizer or side dish with bread sticks, crusty rustic bread and extra virgin olive oil in which to dip the bread.
MEET MILA!
This long-haired beauty is Mila! A very sweet and affectionate 5-year-old, she is currently being taken care of at Kent Animal Shelter. This shelter life is not for her. She had a home once and is hoping that the next home she has is truly a forever home. Mila would make a wonderful companion and just dreams of the day she will once again have a nice warm lap to curl up on. Could that be with you? Mila comes spayed, microchipped and up to date on her vaccines.
Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open from 10 a.m. to 4 p.m. every day. For more information on Mila and other adoptable pets at Kent, visit www.kentanimalshelter.com or call 631-727-5731.
By Ernest J. Baptiste
Stroke can affect people of all ages and backgrounds. When you have a stroke, you lose nearly two million brain cells for each minute that passes until normal blood flow is restored to your brain. No wonder it’s a leading cause of disability. It’s also the fifth-leading cause of death for both men and women in the United States.
We’re encouraged that there has been a decline in stroke deaths over the past few years — due in part to increased awareness of the signs of stroke, people seeking treatment faster and improvements in the types of treatments available — but our work is far from done.
Knowing the signs of stroke and getting help quickly can save your life or that of a loved one. Signs include sudden loss of balance, sudden loss of vision in one or both eyes, an uneven facial expression, numbness or weakness in one arm and/or leg or disrupted speech. If you suspect you’re having a stroke, call 911 immediately. Let the operator know and ask to be taken to a stroke center where advanced treatments are available.
It is certainly a testament to the advanced level of quality stroke care provided at Stony Brook University Hospital that our stroke center was recently certified by The Joint Commission as a Comprehensive Stroke Center — the highest level a stroke center can achieve. To receive this advanced certification, we underwent a rigorous screening process.
This certification is awarded only to institutions that provide advanced care to patients with exceptional, around-the-clock treatment.
As the first and only certified Comprehensive Stroke Center in Suffolk County — the second on Long Island and one of only 11 in New York State — Stony Brook joins an elite group. Nationally, approximately 200 hospitals out of 5,800 have earned this designation.
While we hope that you or someone you love never experiences a stroke, it’s important to know that you have the most advanced level of stroke care just minutes away at SBU. For the thousands of Long Islanders who survive a stroke and face a tough road ahead, we offer help as well.
Our Stony Brook Stroke Support Group provides encouragement and feedback from others who can relate to a stroke survivor’s and/or their family member’s situation, as well as tips about helpful programs and resources.
Although this advanced certification is a significant achievement for Stony Brook University Hospital, it is our patients and the communities we serve who benefit the most from having this level of stroke care available close to home. As a certified comprehensive stroke center, we provide a level of care that few hospitals anywhere can match.
Ernest J. Baptiste is the chief executive officer at Stony Brook University Hospital.
By Matthew Kearns, DVM
I commonly get this question around this time of year, “What can I give my pet (usually my dog) for all the fireworks before, during and after July 4th?” One point I tell pet owners to keep in mind is fear of loud noises is a natural, instinctive behavior in dogs and cats, telling them to seek shelter temporarily, alerting them to potential predators in the area, etc. However, I agree that when a pet is oversensitive to this noise stimulus to the point where they cower, shake, pace, urinate/defecate in the house, destroy furniture or even try to climb on your lap that becomes a big problem.
Supplements: Alpha-casozepine, L-theanine (green tea extract) and aromatherapy (lavender, chamomile) are the safest and also have the widest range of efficacy in my opinion. I have had feedback from owners that report these supplements or homeopathic remedies are either “just what the doctor ordered” or are now of the opinion that I am more “snake-oil salesman” than veterinarian. My advice is it’s great to try these but have a backup plan.
Over-the-Counter Medications: The only over-the-counter medication that has been evaluated for sedation is diphenhydramine (Benadryl). Diphenhydramine can cause drowsiness, and I have heard a few owners tell me it is enough; but I have found that it is more effective for dogs that suffer from motion sickness during travel than sedating a dog climbing the walls from a noise phobia. My advice is the same. Have a backup plan.
Antidepressants and SSRIs: These medications can be quite effective; the mainstay of antidepressants in veterinary medicine is a tricyclic antidepressant (TCA) called clomipramine (Clomicalm). The mainstay of selected serotonin reuptake inhibitors (SSRI) is fluoxetine (Prozac). The problem is these medications can take a minimum of three weeks and sometimes up to 8 weeks to get to steady therapeutic levels. That means starting before Memorial Day, and my experience has been that pet owners (myself included) do not think that far ahead.
Benzodiazepines: The mainstay of benzodiazepines in veterinary medicine is alprazolam (Xanax). This medication has been studied extensively for all sorts of anxiety and phobias in dogs. It is helpful, but I have to admit that I have been less than impressed with the results with the use of benzodiazepines by themselves. These medications are designed to be used in conjunction with a TCA or SSRI where the TCA/SSRI is a maintenance medication and the benzodiazepine is situational. The problem is what is described above: It takes one to two months of steady use of the TCA or SSRI for the addition of a benzodiazepine to be effective.
Phenothiazine: Phenothiazines are tranquilizers, and the most widely used phenothiazine tranquilizer in veterinary medicine is acepromazine. Using acepromazine to sedate a dog is wonderful if one is looking to keep them still (and not destroy the house), but it does not address phobias or anxiety. I do prescribe it routinely around the 4th of July because it works so well in a “real time” basis, but I do not recommend it as a long-term medication.
Dexmedetomidine: This medication is the newest kid on the block. Initially used for sedation prior to procedures, dexmedetomidine (Sileo) is now used to treat anxiety on a short-term basis similar to acepromazine.
There are several choices for sedating our dogs for noise phobias this July 4th. Please check with your veterinarian to determine which is both effective and safe for your dog. Have a happy and safe 4th of July.
Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.
First of all, we’re going to need a big cake. No, I know you think most cakes are big and that most people’s eyes are bigger than their stomachs, but this one is going to have to be huge.
You see, we’re about to celebrate an important birthday. Next week, it’s the 242nd birthday of the country, so we’ll need a place to put all the candles.
So, what do we get for the country that has everything?
Well, for starters, it depends on what you imagine represents the country. Is it the Statue of Liberty? The bald eagle? A baseball game? Mount Rushmore? The Grand Canyon?
Seriously, this is one huge country and we haven’t even discussed the last two states to join the union.
Alaska is a gem, with vistas stretching as far as the eye can see, as shimmering spawning salmon make streams and rivers glow orange, while bears nibble here and there as cars and buses pass them along the sides of the highways.
Hawaii reminded everyone this year that it’s a volcanic archipelago. It’s a magnificent and lush combination of majestic mountains, bamboo forests and striking cliffs.
So, what would this great country of ours want for its birthday?
Well, maybe it would want us, even for a day, to all get along. We are all Americans, we have all heard the
stories about the forefathers who fought for this country, who defied the British, and who wanted what was best for them and, all these years later, us.
Maybe it would want us to tidy up. After all, who doesn’t want to look good on their birthday, right? We could clean up our yards, clean up our neighbor’s yard, remove trash from the area around the school, a place so many enthusiastic children recently abandoned for the start of the summer.
Maybe we should take a moment to think about how we are helping ourselves, or others, reach the American Dream. We all want life to be better, but maybe we can encourage others to strive for, and reach, a dream that anyone from anywhere could reach greatness. We are not like Europeans of past centuries, who limited
opportunities for success by class, gender or ancestry.
The home of the free and the land of the brave is all about allowing anyone from any walk of life to reach their potential and, more importantly, to decide their potential.
America is about celebrating youth. We are a young country, filled with hope for the future, unbridled
optimism and joy.
Regardless of what politicians in Washington say, we are also a country that likes to laugh, even at ourselves. We have a great sense of humor. Need a laugh? Watch “Bridesmaids” or “Groundhog Day” — or if in the mood for something older, “Animal House.”
We pull apart and then we come together. We speak with different accents, depending on where we come from or what part of the world our ancestors originally inhabited.
When we come together, we are unstoppable, finding our best selves from the roles we play in companies, on teams, or in close-knit families that stand ready, willing and able to support each other through any challenge.
Sure, we can hang the flag, eat a hot dog, have a barbecue and sing a few American songs to celebrate our country. But, hey, maybe we can also look for the best in each other and in ourselves as we again give hope to the notion that a rising tide of optimism, of cooperation, of compassion lifts all boats.
By David Dunaief, M.D.
Heart disease is the most common chronic disease in America. When we refer to heart disease, it is an umbrella term; heart attacks are one component. Fortunately, the incidence of heart attacks has decreased over the last several decades, as have deaths from heart attacks. However, there are still 720,000 heart attacks every year, and more than two-thirds are first heart attacks (1).
How can we further improve these statistics and save more lives? We can do this by increasing awareness and education about heart attacks. It is a multifaceted approach: recognizing the symptoms and knowing what to do if you think you’re having a heart attack.
If you think someone is having a heart attack, call 911 as quickly as possible and have the patient chew an adult aspirin (325 mg) or four baby aspirins. Note that the Food and Drug Administration does not recommend aspirin for primary prevention of a heart attack. However, the use of aspirin here is for treatment of a potential heart attack, not prevention. It is also very important to know the risk factors and how to potentially modify them.
Heart attack symptoms
The main symptom is chest pain, which most people don’t have trouble recognizing. However, there are a number of other, more subtle, symptoms such as discomfort or pain in the jaw, neck, back, arms and epigastric, or upper abdominal, areas. Others include nausea, shortness of breath, sweating, light-headedness and tachycardia (racing heart rate). One problem is that less than one-third of people know these other major symptoms (2). About 10 percent of patients present with atypical symptoms — without chest pain — according to one study (3).
It is not only difficult for the patient but also for the medical community, especially the emergency room, to determine who is having a heart attack. Fortunately, approximately 80 to 85 percent of chest pain sufferers are not having a heart attack. More likely, they have indigestion, reflux or other non-life-threatening ailments.
There has been a raging debate about whether men and women have different symptoms when it comes to heart attacks. Several studies speak to this topic. Let’s look at the evidence.
Men vs. women
There is data showing that, although men have heart attacks more commonly, women are more likely to die from a heart attack (4). In a Swedish prospective (forward-looking) study, after having a heart attack, a significantly greater number of women died in hospital or near-term when compared to men. The women received reperfusion therapy, artery opening treatment that consisted of medications or invasive procedures less often than the men.
However, recurrent heart attacks occurred at the same rate, regardless of sex. Both men and women had similar findings on an electrocardiogram; they both had what we call ST elevations. This was a study involving approximately 54,000 heart attack patients, with one-third of them being women.
One theory about why women are treated less aggressively when first presenting in the ER is that they have different and more subtle symptoms — even chest pain symptoms may be different. Women’s symptoms may include pain in the lower portion of the chest or upper portion of the abdomen and may have significantly less severe pain that could radiate or spread to the arms. But, is this true? Not according to several studies.
In one observational study, results showed that, though there were some subtle differences in chest pain, on the whole, when men and women presented with this main symptom, it was of a similar nature (5). There were 34 chest pain characteristic questions used to determine if a difference existed. These included location, quality or type of pain and duration. Of these, there was some small amount of divergence: The duration was shorter for a man (2 to 30 minutes), and pain subsided more for men than for women. The study included approximately 2,500 patients, all of whom had chest pain. The authors concluded that determination of heart attacks with chest pain symptoms should not factor in the sex of patients.
This trial involved an older population; patients were a median age of 70 for women and 59 for men, with more men having had a prior heart attack. This was a conspicuous weakness of an otherwise mostly solid study, since age and previous heart attack history are important factors.
Therefore, I thought it apt to present another observational study with a younger population, where there was no significant difference in age; the median age of both men and women was 49. In this GENESIS-PRAXY study, results showed that chest pain remained the most prevalent presenting symptom in both men and women (6). However, of the patients who presented without distinct chest pain and with less specific EKG findings (non-ST elevations), significantly more were women than men. Those who did not have chest pain symptoms may have had some of the following symptoms: back discomfort, weakness, discomfort or pain in the throat, neck, right arm and/or shoulder, flushing, nausea, vomiting and headache.
If the patients did not have chest pain, regardless of sex, the symptoms were, unfortunately, diffuse and nonspecific. The researchers were looking at acute coronary syndrome, which encompasses heart attacks. In this case, independent risk factors for disease not related to chest pain included both tachycardia (rapid heart rate) and being female. The authors concluded that there need to be better ways to calibrate non-chest pain symptoms.Some studies imply that as much as 35 percent of patients do not present with chest pain as their primary complaint (7).
Let’s summarize
So what have we learned about heart attack symptoms? The simplest lessons are that most patients have chest pain, and that both men and women have similar types of chest pain. However, this is where the simplicity stops and the complexity begins. The percentage of patients who present without chest pain seems to vary significantly depending on the study — ranging from less than 10 percent to 35 percent.
Therefore, it is even difficult to quantify the number of non-chest pain heart attacks. This is why it is even more important to be aware of the symptoms. Non-chest pain heart attacks have a bevy of diffuse symptoms, including obscure pain, nausea, shortness of breath and light-headedness. This is seen in both men and women, although it occurs more often in women. When it comes to heart attacks, suspicion should be based on the same symptoms for both sexes. Therefore, know the symptoms, for it may be your life or a loved one’s that depends on it.
References:
(1) Circulation. 2014;128. (2) MMWR. 2008;57:175–179. (3) Chest. 2004;126:461-469. (4) Int J Cardiol. 2013;168:1041-1047. (5) JAMA Intern Med. 2014 Feb. 1;174:241-249. (6) JAMA Intern Med. 2013;173:1863-1871. (7) JAMA. 2012;307:813-822.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management.
By Judie Gorenstein
Our democracy works best when everyone participates. Although the League of Women Voters works diligently to encourage all citizens to be informed and active participants in our government, engaging and motivating our youth is a particularly important challenge. Nationwide the young are the least likely to turn out to vote. In the 2016 presidential election, only 50 percent of young people voted. Reasons varied from apathy to alienation, from not feeling their votes counted or mattered to not seeing voting as being important.
Over the past few years local leagues in Suffolk County have made great efforts to transform students into educated and motivated voters, and 2018 is a good example.
Voter registration drives are held at both colleges and high schools.
Vote 18 is an interactive lesson plan for government classes. This program does more than just register students. It takes them first through the history of voting followed by participation in a mock election for a political office. Following the discussion, the students running for office make their speeches, and before a vote is taken a percentage of students are not given ballots and not allowed to vote. Students see for themselves how nonvoters make a difference in election results. The message is strong: Do not give up your power. Your vote does matter. It is not only important to register but to vote. The majority of students register to vote at the end of this lesson.
Students Inside Albany is a selective, three-day program with 60 students chosen by local leagues from all over the state. They have the wonderful experience of seeing for themselves how their government works. They tour the capitol building in Albany, shadow their NYS Senate and NYS Assembly members, sit in on a legislative session, learn how to lobby and much more. The students are often amazed that it is so different from what they anticipated and often are motivated to explore a political career. Some students have even been given summer internships with their elected officials.
Student Day at the Suffolk County Legislature is co-sponsored by the LWV and the Suffolk County Legislature. High school students take a day to learn about their county government by meeting and hearing from the presiding officer and members of the Legislature and department heads and then prepare for and participate in a mock legislative session where they debate and vote on a bill.
Running and Winning is a one-day workshop for girls from local high schools to encourage them to consider a political career. Women public officials make brief presentations and then are each interviewed by a group of students who design and present their own political campaign for a virtual woman candidate. Many girls who have never considered political careers leave feeling they can do and be anything they want and will consider public service.
We strive to develop and present programs that will engage students, which has often been difficult. Recently things began to change. Student groups sought out the league and became student members and learned from us.
Next Generation Politics, a youth nonpartisan political group asked the LWV of Huntington to help with its first event, a public debate on the electoral college versus the popular vote. This group has now affiliated with over 50 chapters in 15 states and works to promote its mission of nonpartisanship and civic engagement.
Girl Scout troops called the LWV of the Hamptons to develop a program to help their girls earn their suffrage badge. Libraries and high schools have contacted us asking to do youth programs because of a need and interest in their community.
On college campuses, students came up to our voter registration table and thanked us for being there.
After the shooting at Parkland High and the youth-created activist movement March for Our Lives, students everywhere are seeing the need to act, to speak out and to have their voices heard. They are now engaging each other, realizing the power of their vote and wanting to make a difference as the future leaders of our country.
Judie Gorenstein is vice president for voter services of the League of Women Voters of Suffolk County, a nonprofit, nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. For more information, visit www.lwv-suffolkcounty.org, email [email protected] or call 631-862-6860.
By Elof Axel Carlson
I got my doctorate working with a model organism, the fruit fly, Drosophila melanogaster. It was introduced to science about 1905 at Harvard where William Castle and his students studied the wing veins of these flies for subtle changes that Darwin’s theory of natural selection proposed. Castle suggested to Thomas Morgan at Columbia that he could use fruit flies for a study of mutations that Morgan hoped to launch.
Morgan was luckier than Castle because his use of fruit flies led to the discovery of sex-linked inheritance and a process of shifting genes between matched chromosomes. It led to the chromosome theory of heredity and the theory of the gene as a unit of inheritance present in chromosomes.
Botanists found corn or maize (Zea mays) an ideal organism and classical genetics had inputs from both fruit flies and maize. The most famous contributor to maize genetics was Barbara McClintock who worked out a field of cytogenetics by isolating structural components and consequences for broken chromosomes that experienced rearrangements.
The bacteriophage viruses and bacteria like Escherichia coli were major contributors to molecular biology. Bacteria are cells but viruses are not. Viruses do have a life cycle, living as destructive parasites or beneficial insertions into bacterial chromosomes. Bacteriophage studies confirmed many of the predictions of DNA as the chemical basis of heredity. They also confirmed that a virus’ proteins are not needed to produce the proteins of its progeny.
The flow of information goes from the genes as DNA to molecules of RNA carrying the genetic messages to cellular units that translate them into proteins. Bacteria were also used to work out how genes are switched on and off, an important process that regulates how cells work. Most of these early studies in molecular genetics were initiated by Max Delbrück for bacteriophage viruses and by Joshua Lederberg for bacteria.
For higher organisms a life cycle involves fertilization of an egg by a sperm and the formation of an embryo, which forms different organs with the resulting baby turning into an infant or child and eventually a mature adult and lastly an aged or senescent individual who dies. Sydney Brenner in 1963 suggested using a nematode, the roundworm found in the soil, Caenorhabditis elegans, to work out how this life cycle can be studied at a molecular level. They are similar to the roundworms called vinegar eels seen in flasks of organic apple cider vinegar.
Genetics is a composite of the work with many different organisms in plant, animal, and microbial worlds of life. The designation model organism for research biologists distinguishes the usage of research organisms. Applied genetics is often used with specific purposes in mind that benefit the economy. Silkworms are popular among Japanese geneticists because of the silk industry. Tomato geneticists are interested in color, flavor, texture, size and shelf life as they are for most vegetable crops, applying genetics to improve varieties.
Model organisms were chosen to explore the biology, especially the genetics, reproduction, embryology, metabolism, neurobiology or other fundamental ways living organisms have adapted to their environments and evolved. Biologists working with model organisms often find that once the basic biology is worked out it can be applied to benefit health and the economy. It may take decades before that happens.
When Calvin Bridges in Morgan’s laboratory found extra or missing chromosomes associated with fruit flies, he did not know that some 40 years later extra chromosomes would be associated with birth defects or disorders in humans such as Down syndrome (trisomy 21) or Klinefelter syndrome (XXY males).
In some ways humans serve as a model organism. Linus Pauling was interested in how red blood cells carry oxygen from the air and discharge carbon dioxide into it. His curiosity led to a working out of the structure of the hemoglobin molecule and its mutational difference when healthy individuals have their hemoglobin analyzed and compared to that of persons with sickle cell anemia. Pauling called sickle cell anemia a molecular disease. Note that Pauling’s motivation was not that of a physician seeking a cure for a disease but that of a chemist seeking the molecular basis of how we breathe and why oxygen and carbon dioxide ended up exchanging places in red blood cells.
Humans are also model organisms for the field of neurobiology, especially for processes like memory, learning, association, pattern recognition and speech, most of which would be difficult to infer from the study of a roundworm’s much limited nervous system. This human study is more likely to be at the physiological and anatomical level rather than the molecular level because there are numerous brain injuries and genetic disorders of the nervous system that can be used to identify where to look for these functions.
Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.
By Daniel Dunaief
What if doctors could copy human cancers, test drugs on the copies to find the most effective treatment, and then decide on a therapy based on that work?
Hervé Tiriac, a research investigator at Cold Spring Harbor Laboratory, moved an important step closer to that possibility with pancreatic cancer recently.
Tiriac, who works in the Cancer Center Director Dave Tuveson’s lab, used so-called organoids from 66 patients with pancreatic ductal adenocarcinoma tumors. These organoids reacted to chemotherapy in the same way that patients had.
“This is a huge step forward,” Tiriac said, because of the potential to use organoids to identify the best treatments for patients.
Tuveson’s lab has been developing an expertise in growing these organoids from a biopsy of human tumors. The hope throughout the process has been that these models would become an effective tool in understanding the fourth most common type of cancer death in men and women. The survival rate five years after diagnosis is 8 percent, according to the American Cancer Society.
The study, which was published in the journal Cancer Discovery, “shows real promise that the organoids can be used to identify therapies that are active for pancreatic cancer patients,” Tuveson explained in an email. “This may be a meaningful advance for our field and likely will have effects on other cancer types.”
Kerri Kaplan, the president and CEO of the Lustgarten Foundation, which has provided $150 million in financial support to research including in Tuveson’s lab, is pleased with the progress in the field.
“There’s so much momentum,” Kaplan said. “The work is translational and it’s going to make a difference in patients’ lives. We couldn’t ask for a better return on investment.”
Tiriac cautions that, while the work he and his collaborators performed on these organoids provides an important and encouraging sign, the work was not a clinical trial. Instead, the researchers retrospectively analyzed the drug screening data from the organoids and compared them to patient outcomes.
“We were able to show there were parallels,” he said. “That was satisfying and good for the field” as organoids recapitulated outcomes from chemotherapy.
Additionally, Tiriac’s research showed a molecular signature that represents a sensitivity to chemotherapy. A combination of RNA sequences showed patterns that reflected the sensitivity for the two dominant chemotherapeutic treatments. “It was part of the intended goal to try to identify a biomarker,” which would show treatment sensitivity, he said.
While these are promising results and encourage further study, researchers remain cautious about their use in the short term because several technical hurdles remain.
For starters, the cells in the organoids take time to grow. At best right now, researchers can grow them in two to four weeks. Drug testing would take another few weeks.
That is too slow to identify the best first-line treatment for patients with advanced pancreatic cancer, Tiriac explained. “We have to try to see if the organoids could identify these biomarkers that could be used on a much shorter time frame,” he added.
Tuveson’s lab is working on parallel studies to accelerate the growth and miniature the assays. These efforts may reduce the time frame to allow patients to make informed clinical decisions about their specific type of cancer.
As for the RNA signatures, Tiriac believes this is a first step in searching for a biomarker. They could be used in clinical trials as is, but ideally would be refined to the minimal core gene signatures to provide a quick and robust assay. It is faster to screen for a few genes than for hundreds of them. He is studying some of these genes in the lab.
Researchers in Tuveson’s lab will also continue to explore biochemistry and metabolism of the organoids, hoping to gain a better insight into the mechanisms involved in pancreatic cancer.
Going forward, Tiriac suggested that his main goal is to take the gene signatures he published and refine them to the point where they are usable in clinical trials. “I would like to see if we can use the same approach to identify biomarkers for clinical trial agents or targets that may have a greater chance of impact on the patients,” he said.
The research investigator has been working at Tuveson’s lab in Cold Spring Harbor since the summer of 2012.
Tuveson applauded Tiriac’s commitment to the work. Without Tiriac’s dedication, “there would be no Organoid Profiling project,” Tuveson said. “He deserves full credit for this accomplishment.”
Tiriac lives in Huntington Station with his wife Dannielle Engle, who is a postdoctoral researcher in the same lab. He “really enjoyed his time on Long Island,” and suggested that “Cold Spring Harbor has been a fantastic place to work. It’s probably the best institution I’ve worked at so far.”
He appreciates the chance to share the excitement of his work with Engle. “You share a professional passion with your loved one that is beyond the relationship. We’re able to communicate on a scientific level that is very stimulating intellectually.”
Born in Romania, Tiriac moved to France when his family fled communism. He eventually wound up studying in California, where he met Engle.
Tuveson is appreciative of the contributions the tandem has made to his lab and to pancreatic cancer research.
“Although I could not have imagined their meritorious accomplishments when I interviewed them, [Tiriac and Engle] are rising stars in the cancer research field,” he said. “They will go far in their next chapter, and humanity will benefit.”
Kaplan suggested that this kind of research has enormous potential. “I feel like it’s a new time,” she said. “I feel very different coming into work than I did five years ago.”
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