February 23, 2024

In Pursuit Podcast: A Global Approach to HIV Maternal Child Health

With guest Jennifer Jao, MD, MPH

As an infectious disease specialist focused on HIV maternal child health, Jennifer Jao, MD, MPH, splits her time between sub-Saharan Africa and Chicago, investigating the long-term metabolic effects of in utero exposure to HIV and antiretroviral medications. In this episode, Jao retraces her path to global health and infectious diseases, and offers a deeper understanding of the complexities surrounding HIV/AIDS and the ongoing efforts to improve care and prevention strategies in women and children.

Manne Research Institute's Commitment to Advancing Pediatric

Early-Phase Clinical Trials

Manne Research Institute's latest President's Message from Dr. Patrick Seed

Stanley Manne Children’s Research Institute’s focus on pioneering first-in-child early-phase clinical trials drives breakthroughs in pediatric healthcare. Building out a world-class first-in-child early-phase clinical trials unit will provide critically ill children with limited options access to cutting-edge therapies and give hope to the families that there might be something better for their child and children in the future. In the latest President’s Message, President and Chief Research Officer Patrick Seed, MD, PhD, FAAP, FIDSA, explains how we drive the field of pediatric clinical trials forward.

SCIENCE SHOWCASE

Lauren Sorce Named President of the Society of Critical Care Medicine 

Lauren Sorce, PhD, APRN-NP, FAAN, Founders’ Board Nurse Scientist and Associate Director of Nursing Research at Ann & Robert H. Lurie Children’s Hospital of Chicago, is the new president of the Society of Critical Care Medicine. She has contributed her expertise as an advanced practice registered nurse to the exploration of the first acute care pediatric nurse practitioner certification examination and to the development of the first national certifying examination for pediatric acute care nurse practitioners through the Pediatric Nursing Certification Board. Her extensive leadership experience includes serving as the vice president of nursing on the board of directors of the World Federation of Pediatric Intensive and Critical Care Societies and in various leadership roles for local and international committees. Dr. Sorce led her own funded multicenter research and has been a member of numerous research teams focused on the area of critical care medicine, including leading an international group of experts who developed and validated new data-based criteria for sepsis in children. 

Kyle MacQuarrie Receives $800,000 Grant from the Alex’s Lemonade Stand Foundation 

Kyle MacQuarrie, MD, PhD, an attending physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, received an ‘A’ Award Grant from the Alex’s Lemonade Stand Foundation for $800,000 to support his research on rhabdomyosarcoma tumor cells and their resistance to chemotherapy. 

Rhabdomyosarcoma, a rare and aggressive pediatric cancer of the muscle, is treated with chemotherapy. Some patients respond well to chemotherapy, but others experience a relapse with tumors that are much more resistant to the treatment. Previous research has focused on identifying individual genes that cause resistance, but new insights have led to thoughts that rhabdomyosarcoma tumor cells are affected by the way the parts of the cell nucleus are organized. 

To better understand chemotherapy resistance in rhabdomyosarcoma cells, Dr. MacQuarrie’s research will investigate the level of the organization in the cells’ nucleus over time, rather than comparing cells with no resistance to those that are resistant. Specifically, he will look for differences in various aspects of organization of the nucleus, and then link those differences to the ability of tumor cells to survive chemotherapy treatment with the aim to find at least one new approach to making the cells more vulnerable to chemotherapy. One of the techniques Dr. MacQuarrie will use to study the changes in the cells’ nuclear organization is partial wave spectroscopic microscopy, which has been used successfully to better understand the resistance of adult tumors to chemotherapy. Before Dr. MacQuarrie’s work, partial wave spectroscopic microscopy was largely confined to tumors of adult origin. 

Dr. MacQuarrie holds the Sharon B. Murphy, MD and Steven T. Rosen, MD Research Professorship in Cancer Biology & Chemotherapy at Lurie Children’s and is an assistant professor of pediatrics at Northwestern University Feinberg School of Medicine. The award period for his ‘A’ Award Grant is February 2024–February 2028. 

Pediatric research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. 

NEWS FROM THE RESEARCH PILLARS

Functional Bladder Tissue Regenerated Using Bone Marrow Cells

Scientists from Stanley Manne Children’s Research Institute at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University succeeded in regenerating fully functional urinary bladder tissue in a long-term study utilizing a non-human primate model. This unique model initially created by the Sharma (Arun) Laboratory explores long term bladder tissue regeneration at both anatomical and physiological levels. The group used a novel biodegradable scaffold seeded with stem and progenitor cells from the animal’s own bone marrow, which demonstrated a higher degree of success than intestinal segments that are traditionally used to treat different types of bladder dysfunction. The regenerated bladder tissue was healthy after two years of monitoring and serves as a pre-clinical model for humans. Their findings were published in the Proceedings of the National Academy of Sciences (PNAS) Nexus.

“Our results were fantastic and point to a new direction in the field,” said senior author Arun Sharma, PhD, Director of Pediatric Urological Regenerative Medicine at Manne Research Institute at Lurie Children’s and Research Associate Professor of Urology at Northwestern University Feinberg School of Medicine. “The likelihood that our innovative platform will be feasible in humans is very high and we anticipate launching a clinical trial soon."

Image: Immunofluorescence staining [magnified image] from Bury et al. (2024). Multipotent bone marrow cell-seeded polymeric composites drive long-term, definitive urinary bladder tissue regeneration. PNAS Nexus, pgae038, https://doi.org/10.1093/pnasnexus/pgae038.

Clinician-scientists from Ann & Robert H. Lurie Children’s Hospital of Chicago were among a diverse, international group of experts tasked by the Society of Critical Care Medicine (SCCM) with developing and validating new data-based criteria for sepsis in children. Sepsis is a major public heath burden, claiming the lives of over 3.3 million children worldwide every year. The new pediatric sepsis criteria – called the Phoenix criteria – follow the paradigm shift in the recent adult criteria that define sepsis as severe response to infection involving organ dysfunction, as opposed to an earlier focus on systemic inflammation. The new pediatric sepsis criteria and their development are presented in two papers published in JAMA on January 21, and concurrently announced at the SCCM Critical Care Congress in Phoenix, Arizona.

“The last pediatric sepsis criteria were developed nearly 20 years ago and were based on expert opinion, whereas the new criteria we derived are based on data from electronic health records and analysis of more than 3 million pediatric healthcare encounters from 10 hospitals around the world, including in low-resource settings,” said lead author of one of the papers L. Nelson Sanchez-Pinto, MD, MBI, critical care physician at Lurie Children’s who co-led the data group of the SCCM task force with Tellen D. Bennett, MD, MS, at the University of Colorado. “We used a machine learning approach to narrow down elements that were most effective in identifying children at high risk of dying from organ dysfunction in the setting of an infection. The criteria we developed rely on four systems – cardiovascular, respiratory, neurological and coagulation. These criteria are better than the old ones at identifying children with infections at higher risk of poor outcomes and are globally applicable, including in low-resource settings.”

From neonatal and primary care to emergency medicine and surgery, the quality of health care received by racial and minority ethnic children in the U.S. is almost universally worse compared to their white peers, according to new findings from scientists at Northwestern University, Ann & Robert H. Lurie Children’s Hospital of Chicago and several other institutions. The findings reveal extensive inequities in care across pediatric specialties, including neonatal care, emergency medicine and palliative care. Overcoming these pervasive health care inequities — borne of structural racism — requires policy changes in multiple sectors of wider society, including housing, health insurance and the criminal justice system, the study authors said. The findings published in The Lancet Child & Adolescent Health journal in a two-paper series.

Survey Finds Most Illinois Parents and Caregivers Do Not Ask About Firearms in the Home

An international study of COVID-19 in pregnancy, which included Ann & Robert H. Lurie Children’s Hospital of Chicago, found that neonates of booster-vaccinated mothers had less risk of being infected with COVID-19 compared to those of unvaccinated mothers. Babies of booster-vaccinated mothers also had the lowest rates of preterm birth, respiratory distress syndrome and days in the neonatal intensive care unit (NICU). Neonates of unvaccinated mothers, however, died twice as frequently as those of vaccinated mothers. The study was conducted when Omicron was the variant of concern. Findings were published in the American Journal of Obstetrics and Gynecology.

“Our study demonstrates the clear benefits of COVID-19 vaccination for pregnant women and their infants,” said co-author Jagjit Teji, MD, neonatologist and site Principal Investigator at Lurie Children’s, and Health System Clinician of Pediatrics at Northwestern University Feinberg School of Medicine. “As the protective effect of COVID-19 vaccination decreases with time, to ensure that newborns are maximally protected against COVID-19, women should receive a vaccine or booster dose no more than 14 weeks before the expected date of delivery.”  

MANNE RESEARCH INSTITUTE IN THE MEDIA

• Study: Fewer Kids in the ED Means More Missed Diagnoses – MedPage Today
• Sibel Announces Its 4th FDA Clearance for Continuous Wearable Vital Signs Monitoring with ANNE® One and Additional Strategic Collaboration with Ann & Robert H. Lurie Children's Hospital of Chicago – PRN
• Bone Marrow Cells Renew Functional Bladder Tissue in Animal Model – Genetic Engineering & Biotechnology News
• Kids of Color Get Worse Health Care Across the Board in the U.S., Research Finds – NPR

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