This biannual publication, reSearch, is dedicated to the mission of informing and inspiring readers by highlighting scientific performance at The Research Institute at Nationwide Children's Hospital.

1. listening to
the heart’s
smallest
messenger
How this device
gets cells to tell
research
A PublicAtion of The ReseaRch InsTITuTe aT naTIonwIde chIldRen’s hospITal

2. research is dedicated to the
mission of informing and inspiring
readers by highlighting scientific
table of contents a message from the president
performance at the Research
institute at nationwide children’s
Hospital. this publication is
produced biannually by the
Marketing and Public Relations
Department at nationwide
children’s Hospital.
Dear Friends and Colleagues:
One of the prevailing joys of being a scientist is the knowledge that each day could
fe at ure s
be a day of fascination and revelation. The intellectual pursuit of a life-altering
4 wanted: a Generation of Quitters discovery, particularly one that could improve the life of a child, drives us to
brady Reynolds, PhD, has never smoked a cigarette in his life.
continue our years of research.
Yet most of his day is spent trying to find ways to quit.
Our excitement and fascination shouldn’t stay within our walls. We want to share
le a deRs hIp 8 The Importance of studying adolescents these experiences with you. So welcome to our first issue of reSearch.
The Research Institute at What if in addition to the normal awkwardness of adolescence,
nationwide children’s hospital
you are diagnosed with an illness that will last a lifetime? findings Within these pages, you will discover how impulsive thought processes affect a teen’s
John a. Barnard, Md
suggest that adolescents shouldn’t be treated like adults, but they
President ability to quit smoking; be privy to the way heart cells “communicate” and what they
shouldn’t be treated like children either.
lauren o. Bakaletz, phd say about heart disease; and be revealed to the world of an adolescent facing a chronic
Vice President, Basic Sciences Research
Kelly Kelleher, Md, Mph
12 listening to the heart GI illness, and how we are searching for the ideal ways to treat this condition.
Vice President, Health Services Research Down at the cellular level lives the cardiac myocyte, the heart’s
smallest messenger. Although it is simply a microscopic cell extracted Join us in our enthusiasm for the future of pediatric research and in the milestones
Grant Morrow III, Md
Medical Director from the heart muscle, it has a story to tell. that is, if you’re listening. – sometimes incremental and sometimes monumental – we reach each day in our
daniel R. Mann pursuit of discovery.
Vice President, Research Administration
and Operations
e xt ras
Katherine s. Milem
Vice President, Research Business Services 7 noteworthy
news about the Research institute and its faculty.
research
Writer and editor 16 Into the Future John Barnard, Md
Melissa hamilton President
the look of Research in 2012.
the Research institute at nationwide children’s Hospital
Designer
Tanya Bender
Professor of Pediatrics
Photographers
o n tHe co v eR the ohio State university college of Medicine
Brad smith
dan smith Loren E. Wold, PhD, examines a device used to study the function of heart
muscle cells, a tool that could change the way science understands heart disease.
Manager, Research communications
Jan arthur
contact us at
ResearchMagazine@nationwidechildrens.org
research | 3

3. to complete the eDt, the participant
views a computer screen that displays
two monetary amounts, one that
offers a smaller immediate reward and
another that offers the possibility of a
larger reward at a delayed time. for
example, do you want 15 cents now or
the possibility of 30 cents 28 seconds
from now? if the participant clicks the
Wanted:
computer to choose 15 cents now,
coins come clinking out of a specialized
change machine that is connected to Brady Reynolds, PhD, demonstrates
the computer. the Experiential Discounting Task.
“that’s why it’s called the experiential
a Generation of Quitters Discounting task. Participants actually
experience the choice they make at
that moment,” said Dr. Reynolds.
the program at nationwide children’s
in January of 2006, one of the first-
and-only smoking cessation programs
these findings have implications for
designing effective smoking cessation
programs. “A person who discounts
HoW ReSeARcH iS finDing neW WAYS to HelP ADoleScentS Quit SMoking
for adolescents in central ohio. most by delay is someone whose
B
if the participant instead chooses 30 behavior is led by more immediate
rady Reynolds, phd, has to smoke into adulthood, practically a larger reward that is delayed for a cents, they have to wait a set period of Adolescents who enroll in this pro-
consequences. to reach an adoles-
never smoked a cigarette guaranteeing increased health risks, period of time. Delay discounting has time to see if they will actually receive gram attend a smoking cessation
cent smoker who discounts a great
in his life. Yet most of his since approximately half of people been shown to play an important role the money, since the delayed option class held at nationwide children’s
deal, you need to make the benefits
day is spent trying to find who smoke are expected to die from in cigarette smoking behavior. may not actually pay out each time. main campus once a week for 10
of quitting smoking more immediate.
ways to quit. smoking-related illnesses, according this time delay can vary from zero weeks. During the first half of the
Programs that stress the long-term
to further understand this relation- seconds, 7 seconds, 14 seconds, to program, participants are taught
to the World Health organization. effects of smoking are going to be less
You won’t see him crunching on a ship, Dr. Reynolds has developed a 28 seconds. After the time delay, the health and smoking education
effective for these
piece of nicotine gum or slapping on Although adolescent smokers often delay discounting task that he believes selected money adolescents,” said
nicotine patches. instead, you’ll find continue their habit into adulthood, overcomes some of the shortcomings amount appears “That’s why it’s called the experiential discounting Dr. Reynolds.
him crunching numbers and trying it may not always be clearly by of previously developed methods. in the computer’s
to patch holes in research about what choice. Sixty-one percent of adoles- “bank account” Task. participants actually experience the choice Although Dr.
Most delay discounting tasks ask
motivates adolescents to quit smoking. cents report wanting to quit smoking
participants to choose between
that will be cashed they make at that moment,” said dr. Reynolds. Reynolds is quick
cigarettes and 59 percent report a out once the par- to suggest his
that’s because as a principal investi- hypothetical situations, such as,
quit attempt in the past year. ticipant has completed the entire task. including the common myths of findings could be applied to current
gator in the center for biobehavioral would you prefer $10 now or $100
smoking. class five is the required smoking cessation programs, he says
Health at the Research institute at So why can’t they just quit? that’s one year from now. but according to every time the participant chooses “smoking quit date” for participants that even the best of research needs to
nationwide children’s Hospital Dr. what Dr. Reynolds wants to find out. Dr. Reynolds, this hypothetical method the smaller, immediate amount, that and the remaining sessions are used be strengthened by further evidence.
Reynolds is using research techniques can be tricky for adolescents. quantity goes down for the next choice
As a behavioral psychologist, Dr. as a support group to help deal with that’s why he has made the eDt
to learn how to help adolescents (the next option may give you 10
Reynolds has spent his career trying “because adolescents, particularly withdrawal and lifestyle changes available via the web for behavioral
become quitters. cents). this calculation helps provide a
to understand what motivates people younger adolescents, aren’t as psycho- associated with quitting smoking. laboratories throughout the world.
clearer measure of delay discounting. other investigators can access the
“Adolescence is a sensitive period to to certain behaviors. Although some logically developed in many ways as
those who chose the smaller, immedi- Participants of the n-o-t program at
begin smoking,” said Dr. Reynolds. motivators tied to cigarette smoking adults; they perceive information differ- software, purchase the appropriate
ate reward more often than the larger, nationwide children’s Hospital can
have already been identified, such as ently,” said Dr. Reynolds. “for example, coin machine and conduct their own
According to surveillance by the delayed option are described as being choose whether or not they want to
impulsivity, there is still a lot to learn. they don’t seem to understand the con- experiential delay discounting studies.
Morbidity and Mortality Weekly Report, more impulsive discounters. perform the delay discounting task
cept of time (like a year) as adults do.” Dr. Reynolds will then analyze their
approximately 2,000 adolescents “impulsivity is not described by one along with their participation in the
to determine how delay discounting findings from the eDt, in hopes that
initiate smoking each day. that means type of behavior. it is multifaceted,” that’s why Dr. Reynolds developed 10-week program. Dr. Reynolds’ delay
relates to cigarette smoking behavior, they can also help shape smoking
that every minute, an adolescent is said Dr. Reynolds. the experiential Discounting task discounting studies with this adolescent
the eDt is being evaluated with an cessation and education programs
trying a cigarette for the first time. (eDt), a computer-based program smoking population have shown that
A recently studied aspect of impulsivity adolescent smoking cessation program for adolescents.
that measures delay discounting by the adolescents who discount more
And that first time may not be the is delay discounting. Delay discount- called not-on-tobacco (n-o-t), the often are those who are less likely to More Smoke Signals
requiring participants to choose
last. Studies show that the majority of ing describes an individual’s preference official teen smoking cessation quit smoking, even after participating the eDt is not the only method
between moment-in-time situations as
adolescents who smoke daily continue for a smaller, immediate reward over program of the American lung in the n-o-t program. Dr. Reynolds is using to understand
opposed to hypothetical situations.
Association. Dr. Reynolds initiated
4 | research research | 5

4. Circulatory System Could Provide New Strategy for Mus-
cular Dystrophy Gene Therapy Future Study to Monitor
Medication Usage and Effects Technique Helps Diagnose
Asthma Attacks Circulatory System Could Provide New
Strategy for Muscular Dystrophy Gene Therapy Future
Study to Monitor Medication Usage and Effects Tech-
nique noteworthy |
Helps Diagnose Asthma Attacks Circulatory Sys-
tHe ReSeARcH inStitute At nAtionWiDe cHilDRen’S HoSPitAl
Circulatory System Could Provide the system alerts a trained psychiatric nurse to contact the
New Strategy for Muscular Dystrophy patient or parent and when necessary, contact the patient’s
Gene Therapy physician or hospital emergency services.
preliminary results have shown that the participants Although Dr. Reynolds would like to investigators at the Research institute have
delve into these new areas of research, the PhaSt project could provide medication monitoring in
significantly maintained abstinence from smoking received an $8.1 million grant from the
he is not abandoning the eDt. in fact, instances when families or the overstretched child mental
national institutes of Health to learn more
when they were being paid, even during a period at fellow principal investigators at the about strategies to treat muscular dystrophy, potentially
health systems do not have the resources to follow the
Research institute have plans to use it recommended–often weekly–physician visits.
the end of the program when it didn’t matter how leading to two new gene therapy approaches. the primary
to determine the role delay discounting research strategy will use the circulatory system for gene
much they smoked. plays in behaviors beyond smoking delivery of the dystrophin gene, as opposed to direct
the study is expected to begin in early 2008 and continue
through 2010. initial funding for the study was made
cessation. Planned studies include injections into individual muscles. this vascular delivery
smoking behavior. Working with program style would encourage possible by a collaborative grant between nationwide
measuring suicidal impulsivity and strategy provides a more favorable opportunity for
collaborators, he is collecting data from maintenance by providing the needed children’s and the ohio State university.
studying what makes people likely to correction of lost function throughout the body reaching
a web-based contingency management peer support group,” said Dr. Reynolds. use safety equipment, such as sports many muscles, as well as the heart. Study Helps Differentiate Between
program. Participants of this program safety equipment or parent use of infant
until then, the n-o-t program Asthma and Vocal Chord Dysfunction
are asked to record “video diaries” of car seats and home smoke alarms. Two Centers of Emphasis Obtain
continues to make an impact. of the Doctors at nationwide children’s Hospital
themselves three times a day using web Leadership
more than 60 adolescents who have performed a clinical study using spirometry
cameras. At the time of each “diary even though Dr. Reynolds’ original Bill smoyer, Md, Robert c. kelsch chair
participated in the n-o-t program at in the emergency Department to identify
entry” they blow into a picometer, a plans for the eDt were focused on of Pediatric nephrology at the university
nationwide children’s, 25 percent adolescents who had findings suggestive
device used to measure carbon adolescents, his findings may have of Michigan, has been appointed director
made a significant decrease in smoking of vocal chord dysfunction (vcD) compared to an acute
monoxide levels, a distinct marker implications for adult smokers. “the of the center for clinical and translational
frequency and many of the others asthma attack. the manuscript was published in the July
of how much tobacco someone has research would have to be explored, but Research at the Research institute. Dr. Smoyer will work
report at least some decrease. issue of Pediatric Pulmonology.
smoked in the past three to six hours. there are indications that these findings to orchestrate further development of clinical and
Participants are given money for Genetic Contributions may apply to the adult population since translational research across the organization. According to the study, 12 of the 17 adolescents who
continued abstinence during the beyond his current research methods, research has already shown that adult presented to the emergency Department with difficulty
treatment phases. Dr. Reynolds would like to further the smokers discount more than adult After serving in an interim position, breathing, but with high normal oxygen levels, were
understanding of adolescent smoking non-smokers,” he said. leif nelin, Md, has been appointed found to have evidence of vcD on spirometry. this led
Preliminary results have shown that the director of the center for Perinatal
cessation by investigating how genetics to a change in the therapy for these patients. Spirometry
participants significantly maintained for now, however, Dr. Reynolds plans Research at the Research institute.
contribute to smoking habits. He and used in the acute setting of difficulty breathing can help
abstinence from smoking when they to focus his research on ways to help Dr. nelin plans to continue to improve
chris bartlett, PhD, principal investiga- differentiate vcD from asthma attacks.
were being paid, even during a period adolescents specifically. “if we can the integration between the center for
tor in the center for Quantitative and change smoking habits during
at the end of the program when it Perinatal Research and the Division of neonatology, the study suggests that if more emergency departments
computational biology at the Research adolescence, we’ll be able to greatly
didn’t matter how much they smoked. an ability he demonstrated during his interim position. made use of the spirometry test, it could cut down on the
institute, are already collecting pilot data reduce the long-term effects of number of children who are misdiagnosed and potentially
With continued funding, Dr. Reynolds that involves isolating genes associated smoking,” said Dr. Reynolds. Future Study to Monitor Medication hospitalized.
hopes to maintain this method of with different neural systems in the Usage and Effects
research with the hopes of one day brain (many of which are associated For more information about the A research study is planned to trial a
combining the contingency manage- with addiction) to search for genetic not-on-Tobacco program at new technology that helps monitor how
ment model with the n-o-t program markers of delay discounting. nationwide children’s hospital, medications, specifically anti-depressants,
model, for a more comprehensive call (614) 355-3445, or click on are used in children and teens.
other hopeful genetic studies include “education classes” at
smoking cessation course.
investigating recent research in the field nationwidechildrens.org. the project, named “PhaSt”, or Pharmaceutical Safety
“by reinforcing positive behavior, that suggests the relationship between tracking: Managing Medications for Patient Safety, involves
Learn about more research
the contingency management portion smoking behavior in parents and their Further Reading: Reynolds, b.; Patak, M.; Shroff, an interactive voice response telephone system to contact news and highlights at
could help kids get through the children can most likely be accounted P. “Adolescent smokers rate delayed rewards as less
parents or teenage patients. the system requires simple yes
withdrawal stage that is common for by their genetic relatedness, not just
certain than adolescent nonsmokers.” Drug and Alcohol
Dependence, v. 90 issue 2-3, 2007, p. 301-3. or no answers to questions about the medications and their NationwideChildrens.org/research.
with the early days of smoking by a child mimicking parental behavior. side effects. When a parent or patient indicates a problem,
cessation. then combining the n-o-t
6 | research research | 7

5. “IBD is an ideal disease for investigating adolescent adjustment to
chronic illness, given its adolescent onset, and embarrassing, socially
limiting, and appearance-changing symptoms.”
children’s Hospital, are studying adolescents to better research on adolescent adjustment to other conditions,
understand how this patient population adjusts to either,” said Dr. Mackner.
chronic illness.
overall, a comprehensive adolescent perspective is lacking.
Although their research might not be poetic, what their “the research on psychosocial adjustment to pediatric
findings suggest seems to be worth writing home about: chronic illness has focused primarily on children. if adoles-
adolescents shouldn’t be treated like adults, but they cents are included in this research, they are often included
shouldn’t be treated like children either. in the same sample with younger children. even when
adolescents are the focus, development issues are often
The Uniqueness of Adolescence not taken into account,” said Dr. Mackner.
Adolescence involves more changes than any
developmental period other than infancy. When Drs. Mackner and crandall refer to adolescents, they
mean those age 11 through 18, since this is the period
these years are wrought with extreme biological changes when most changes in psychosocial adjustment appear.
including raging hormones, acne, and increased body So, why should an 11-year-old be categorized separately
odor and body hair. from an 8-year-old? When it comes to psychosocial
on top of the stressors normally associated with adoles- development, adolescence and childhood are worlds
cence, imagine having an incurable condition in which apart. Adolescents spend significantly more time with
your main symptoms include diarrhea, rectal bleeding, their peers than children do. close friends begin to
abdominal pain and delayed puberty. surpass parents as a primary source of social support and
Wallace Crandall, MD and Laura Mackner, PhD acceptance by peers plays an important part of adolescent
inflammatory bowel diseases (ibDs) such as crohn’s self-identity. involvement in extracurricular activities
disease and ulcerative colitis are chronic conditions in contributes not only to acceptance by peers, but also
The Importance of
which inflammation in the intestines can result in these takes on an important role for those planning to apply
sometimes embarrassing symptoms. Although ibD has to college. in addition, the development of romantic
typically been viewed in the medical community as an relationships becomes a significant focus.
Studying Adolescents adult disease, about 25 percent of ibD cases occur in the
pediatric population, with the majority beginning their
onset in adolescence. Adjusting to the normal changes
adolescence brings is tough enough; adolescents with
When Illness Adds Insult to Injury
With so many aspects of psychosocial development how
do you study whether or not an adolescent is adjusting
well to this new stage of life?
Researchers work to understand chronic ibD are given even more to adjust to.
Illness in a neglected Field of study “ibD is an ideal disease for investigating adolescent “there are two main aspects of studying psychosocial
adjustment to chronic illness, given its adolescent onset, functioning,” said Dr. Mackner. “one is psychological
A
and embarrassing, socially limiting, and appearance- functioning: Are they depressed? Do they have anxiety?
poet once remarked, “You don’t have to suffer to be a poet. Adolescence is enough
changing symptoms,” said Dr. Mackner. Do they have other types of behavioral problems? the
suffering for anyone.” but what if in addition to the normal awkwardness of
other is social functioning: How are they getting along
adolescence, you are diagnosed with an illness that actually will last a lifetime?
So how has research into this condition shed light on with friends? Do they have friends? Are they able to
laura Mackner, phd, an investigator in the center for biobehavioral Health at the how adolescents adjust to chronic illness? therein we participate in social activities at an age appropriate level?
Research institute at nationwide children’s Hospital, and wallace crandall, Md, Director find the issue. Are they able to attend school and do well?”
of the center for Pediatric and Adolescent inflammatory bowel Disease at nationwide
“When we first started investigating this area of research Drs. Mackner and crandall studied the psychological
about five years ago, there was little research focusing on and social aspects of adolescents with ibD in order to
the psychosocial aspects of ibD. there hasn’t been much
8 | research research | 9

6. understand whether people sooner, like psycholo- the inflammation of the intestine,” said Dr. crandall. be used to help identify risk factors, especially during
having the condition might gists and social workers to try “better control of stress could help with the psycho- the first year of diagnosis, when the majority of disease
affect psychosocial func- to help patients with that ad- social aspect, but could potentially help with disease adjustment is expected to occur.
tioning. What they found justment process as opposed control issues as well.”
• The role of social functioning: Although preliminary
was that adolescents with to waiting until there is some
Drs. crandall and Mackner would utilize behavioral results show that ibD has an adverse impact on
ibD have significantly fewer crisis,” said Dr. crandall.
measures to study patient stress levels, as well as adolescent social functioning, more research needs to
close friends than healthy
identifying risk factors could markers of inflammation at the bowel level to see be done to clearly identify the extent of disease impact.
adolescents and participate
also help identify appropriate if stressors predict flares in disease. Dr. Mackner identifies this as a vital need considering
in fewer organized activi-
treatment methods, such as social functioning is so important during adolescence.
ties. these results suggest Dr. crandall would also like to investigate the genetic
emphasizing coping strate- “Adolescents’ social lives are very complex and we don’t
that ibD has an adverse components of stress as it relates to ibD. there are
gies during therapy or group yet know how ibD affects them or how to best help
impact on adolescent social normal variations within a gene known as polymor-
intervention situations. adolescents in this area,” said Dr. Mackner.
functioning. this finding is phisms that result in different effects. these gene
important because research So Much More to Learn variations may influence the effect of stress on ibD. • The role of medication: “one of the medications used
has shown social function- More studies need to be to treat ibD is steroids and steroids have been associated
ing among children is an • The role of depression: “there is research that exists with depression and emotional liability,” said Dr. Mackner.
completed before the re-
important predictor of that shows that children with ibD have higher rates of “they also are associated with aspects of adolescence
search field is robust enough
difficulties later in life. depression than healthy kids,” said Dr. Mackner. “in the that can be additionally stressful like weight gain and
to start drawing conclusions
past, we always thought that it was a reaction to having increased acne.”
about adolescent adjustment
Drs. Mackner and crandall this disease since it is a disease that is often embarrassing
to chronic illness, especially
believe that these differ- to have.” However, new evidence suggests that there • The role of age at disease onset: “A lot of the chronic
adolescent adjustment in ibD.
ences in social functioning may be aspects of the inflammatory process that health conditions that have been studied from the
may be attributed to the “there are very few actually contribute to the development of depression. psychosocial research are ones that children are born
fact that ibD is more of researchers who focus on
a stigmatized disease. “A psychosocial issues in pedi-
lot of diseases, for lack of atric ibD,” said Dr. Mackner, “If there is a way to know up front who is going to have difficulties
better words, are socially who believes there are only down the line, we could involve the appropriate people sooner…”
acceptable,” said Dr. a few researchers in the
crandall. “everybody “Kids with IBD have a stigmatizing
nation doing so.
understands asthma, disease. They don’t want to talk about future studies would involve looking specifically at the with or acquire early in life,” said Dr. Mackner. “coping
everybody understands With continued funding,
the symptoms because they can be Drs. crandall and Mackner
role of pro-inflammatory cytokines in ibD. these proteins mechanisms involved in this situation are vastly different
cancer. if a kid with asthma that are released by white blood cells have been found to compared to being 13 and suddenly being diagnosed
or cancer goes to school, very embarrassing. It is a condition want not only to tackle the be byproducts of both inflammation and depression. with a chronic gastrointestinal disorder.” future research
kids rally around them; that can be quite isolating.” unanswered questions that would investigate how age at disease onset affects
they don’t think they’re their previous research has “there is a substance known as tumor necrosis factor psychosocial functioning in adolescence.
going to catch it. kids with raised, but also focus on the alpha that is known to be an important contributor to
ibD have a stigmatizing bi-directional nature of ibD, the inflammatory process in crohn’s disease,” said Dr. even though Drs. Mackner and crandall have earmarked
disease. they don’t want to the relationship between crandall. “Another one of its effects is causing a poor these as areas that need further research, they probably
talk about the symptoms because they can be very mind and body. appetite. So if a patient comes in and says ‘i’m tired; won’t stop there. “Just being in the clinic and interacting
embarrassing. it is a condition that can be quite isolating.” i’ve been having trouble sleeping; i don’t want to eat,’ with ibD patients helps spark new research ideas,” said
“Disease affects psychosocial factors and psychosocial factors are they depressed or is it a symptom of the crohn’s Dr. Mackner.
Although they have identified the fact that social functioning affect disease,” said Dr. crandall. “When you’re treating one disease?” Questions like these are of special importance
may be impaired in patients with this condition, that’s just of these things, you’re potentially treating both sides of the What a good problem to have. More data would bring
to an adolescent population since Drs. Mackner and
half the battle. “the extent of the difficulties is unknown,” equation. We need to continue research to tease out how the health care field a little closer to providing new
crandall think that kids with ibD who are more
said Dr. Mackner. much of it is a psychological effect and how much of it is a answers to the question that Dr. crandall says is of
depressed are going to have more problems with
disease effect.” utmost importance.
social functioning.
learning more about the extent of the difficulties may
help identify risk factors for this patient population. “once To do so, they’d like to focus research on the • The role of the adjustment process: Drs. crandall and
“How do adolescents adjust to chronic illness? the
we identify risk factors, we’ll be able to identify which following role players: Mackner would like to develop a web-based program in
answer is we don’t know, but we need to find out.”
adolescents are likely to have problems in adjustment,” • The role of stress: “there is some thought that stress which adolescents with ibD would fill out questionnaires
may affect the disease activity, rather than just the way Further Reading: Mackner, lM.; crandall, Wv. “Psychological factors
said Dr. Mackner. quarterly regarding stress, coping skills, social support affecting pediatric inflammatory bowel disease.” Current Opinion in
that patients deal with it. Stress does cause a physiologic and disease activity during their first year of diagnosis. Pediatrics, v. 19 issue 5, 2007, p. 548-52.
“if there is a way to know up front who is going to have response, but may cause one that actually increases this would help create a data entry system that could
difficulties down the line, we could involve the appropriate
10 | research research | 11

7. Getting Cells to Tell are released, but these ions
How do you get cells to tell have to return to their “stor-
you what is happening? age facility” before the cell
first, you have to make can contract again. When the
them feel at home. cell isn’t functioning properly,
it takes longer for the calcium
When an organ is housed ions to return, slowing the
inside the human body, it beating process, which is
is exposed to blood, which represented by a flattened
serves as the major source of out slope on the graph.
energy. to extract cells from
an organ outside of the body, When Cells Tell of
you must supply an energy Heartbreaking News
source. So the organ is “per- the ability to show exactly
These graphs show the shortening and the relength-
fused” by being placed in a what is going wrong within
ening of a cardiac myocyte, a representation of its
solution that is chemically a cell is proving to be an
“heartbeat.”
representative of blood. “We important part of disease
try to trick them into think- diagnosis. “What we’ve
ing they’re still in the body found is that the cells
motion and performs mathematical
and still healthy, but they’re actually in respond similarly to the whole organ
conversions to represent the beat
a dish in an incubator in artificial fluid,” and the whole organism,” said Dr.
graphically, similar to the graph of a
said Dr. Wold. this artificial fluid also Wold. once you get cells in the mood
heart monitor. investigators can then
contains an enzyme that breaks apart to communicate, they have plenty
analyze the slopes on the graph to
all of the scaffolding around the cells. to say about heart harming disease,
determine whether or not the beating
once the cells are exposed at their including type 2 diabetes.
cell is functioning properly.
rawest level, they are “suspended,” a
As opposed to type 1 diabetes, in
process that leaves them unattached if the graphical results reveal that the
which a malfunctioning immune
and floating in a special liquid bath. cell is not functioning properly, it is
system doesn’t allow the pancreas to
time to find out why. one way is by
now the real, nitty gritty investigation produce insulin, the pancreas of a type
looking at molecules involved in cell
can begin. 2 diabetic creates plenty of insulin, but
Listening to the Heart
signaling. “cell signaling is the way
the body stops reacting to it properly.
“cardiac myocytes actually beat when a cell communicates within itself and
this malfunction can lead to serious
stimulated, just like the heart does. with other cells,” said Dr. Wold. one
impacts on many systems of the body,
that’s what makes up the of the cell signaling molecules of most
including the heart.
mechanics of the heart,”
inSigHt fRoM tHe HeARt’S SMAlleSt MeSSengeRS said Dr. Wold. studying disease at the cellular level doesn’t “the main killer of
ReveAlS eARlY WARningS of HeARt DiSeASe only help identify what doesn’t work for the diabetics is heart
to get the cells to beat, disease. Most people
more coaxing is required. heart, but also what does work, including
W
hen’s the last time you fist-sized organ is responsible for heart muscle, it has a story to tell. think that if diabetics
talked to yourself? the truth one of the most vital life functions, that is, if you’re listening.
“We use a device that therapeutic interventions like medication. take their medicine,
stimulates the cell in
is you’re doing it right now. pumping oxygen-rich blood through they’ll be fine, but that’s
loren e. wold, phd, is listening. As the same way that the interest to Dr. Wold is the calcium ion
blood vessels to reach the rest of the not the case,” said Dr. Wold.
cells in the human body are living a principal investigator in the center nervous system would stimulate the because it regulates contraction and
body. Although we are most used to heart to contract,” said Dr. Wold. While When type 2 diabetes is investigated at
gossip mills. Sending and receiving for cardiovascular Medicine at the relaxation of the cell.
listening to this big communicator this superfusion/stimulation chamber, the cellular level, the slope representing
chemical messages along neural Research institute at nationwide
with a stethoscope, research is which looks like a shallow, cylindrical Just like when the heart beats, there the relaxation phase of the heart beat
pathways, firing synapses, exchang- children’s Hospital, Dr. Wold is
showing that it’s worth getting dish with horizontal, metallic prongs are two phases involved when the cell is flattened out more than it would be
ing gasses and elements, regulating studying heart function by taking a
another perspective when it comes pointing inward, makes the cell beat, beats. the cell squeezes together in a healthy cell. this means that the
temperature and cellular growth, big look at the smallest of parts.
to studying heart disease. investigators view the cell through a during a contraction phase and then heart muscle is weakened for some
your body is in constant conversation
“in order to understand cardiology, you specialized microscope that captures returns to resting state (relaxation reason, which impacts the functioning
with itself. Down at the cellular level lives the
need to understand what is happening images of the beating in real time. A phase) before it can contract again. of the whole heart.
cardiac myocyte, the heart’s smallest
of all of the body’s conversationalists, at the cell level,” said Dr. Wold. program then analyzes the cell’s When the cell contracts, calcium ions
messenger. Although it is simply a
the heart is one of the biggest. this
microscopic cell extracted from the
12 | research research | 13