Medical Staff Pulse Newsletter

Physician News

Keith Black, M.D., was honored by the Cedars-Sinai Alumni Association, and John Harold, M.D., was named president-elect of the American College of Cardiology.

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Meetings and Events

Pharmacy Focus

Carisoprodol to Become Schedule IV Drug on Jan. 11, 2012

Due to the potential for abuse of carisoprodol, the Drug Enforcement Administration (DEA) made the decision to designate carisoprodol (SOMA) as a Schedule IV controlled substance.

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Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - December 2011 (PDF)

Grand Rounds

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An Eye to a Cure

C-S researchers look for novel ways to prevent corneal blindness from diabetes and other diseases of the eye

It's a well-known fact there's no cure for diabetes. Likewise, diseases of the eyes caused by diabetes are not curable .Often, they can lead to blindness. In diabetes the most common cause of blindness is due to retinal disease, but the cornea can also be affected.

Eye experts at Cedars-Sinai's Regenerative Medicine Institute and Department of Surgery are currently developing novel ways to prevent corneal blindness in diabetic patients through gene therapy and stem cells.

"We are developing a powerful research niche here," said Clive Svendsen, Ph.D., director of the Cedars-Sinai Regenerative Medicine Institute. "One major research focus of the Eye Program deals with corneal damage that occurs in individuals diagnosed with diabetes."

"Surgery has a longstanding commitment to ophthalmology and, in partnership with the Regenerative Medicine Institute, we are developing a world class Eye Program that will inevitably lead to exciting new clinical therapies in the future," said Bruce Gewertz, M.D., Chair of the Department of Surgery and Vice Dean of Academic Affairs.

Led by Alexander Ljubimov, Ph.D., the Eye Program has some of the nation's top scientists and clinicians including Yaron Rabinowitz, M.D., Homayon Ghiasi,Ph.D., and Shaomei Wang, M.D., Ph.D.

Ljubimov and his collaborators, Svendsen and Rabinowitz, were awarded a $3 million grant this spring from the National Eye Institute to develop gene therapy in corneal stem cells to alleviate damage to corneas that can cause vision loss. "It's a great example of how the Regenerative Medicine Institute is bringing together teams of researchers to tackle difficult medical issues with federal funding right here at Cedars-Sinai," says Svendsen.

Diabetes damages the eye's retina and eventually causes blindness. It also strikes the cornea - the clear, dome-shaped surface that covers the front of the eye. In healthy patients, the cornea's stem cells constantly regenerate. But, in diabetics, these cells become dysfunctional and prone to poor wound healing, a condition known as diabetic keratopathy.

Ljubimov said 43 percent of people with Type I diabetes and 60 percent of people with Type II diabetes will lose some vision within five years of the disease's onset, mainly due to diabetic retinopathy.

He said diabetics' corneal stem cells become abnormal because their corneas may stop producing certain proteins that enable normal functioning of corneal stem cells.

"Our goal is to do gene therapy on defective stem cells, restore them so that they function properly and then put them back into the patient. The patient will then have a much better possibility of having normal corneas," Ljubimov said. "This is only for patients with severe disease. If people have borderline disease,or the disease doesn't require drastic measures, then they can betreated with standard symptomatic therapy."

Rabinowitz leads his own corneal research projects looking at genetic defects in individuals with keratoconus. Keratoconus is a condition, in which the cornea assumes a conical shape and can lead to progressive loss of vision over time. It is the commonest cause for corneal transplants in Western developed countries.

"The purpose of identifying gene defects is that if we can determine the root cause then we may be able to develop a therapy to stop the progression and prevent the need for a cornea transplant," he said. Rabinowitz's research has been funded by the National Institutes of Health for the past 18 years. Recently his lab, in collaboration with the Medical Genetics Group at Cedars-Sinai, identified a gene locus for keratoconus. This work was published in the prestigious journal Human Molecular Genetics in November 2011.

In another study, Rabinowitz, Svendsen,and Ljubimov, together with Dhruv Sareen, PhD, who directs the Regenerative Medicine Institute Induced Pluripotent Stem Cell Core Facility, are isolating functional stem cells from adult post-mortem human corneas. The hope is to generate new lines of cells that can be expanded and then made into corneal tissue.

"This is for people with extreme disease of the cornea who may become blind, but do not qualify for transplants because their corneal stem cells are depleted. Corneal stem cells could also potentially be used to treat patients with keratoconus, who have thin corneas due to ‘programmed cell death.' Stem cells could be used as cell replacement therapy to thicken the cornea. In this way, stem cells and genetics can work together to treat a disease; genetics to retard the disease and stem cells to replace lost cells," said Rabinowitz, who is a leading corneal expert.

The institute also recently recruited Wang, who is a world expert intreating animal models of retinal diseases such as macular degeneration with stem cells. Macular degeneration is a leading cause of blindness in the aging population for which there is no cure. An estimated 30% of individuals over age 70 in the U.S. have some degree of macular degeneration. Wang leads a group that can perform complex retinal surgeries and detect how stem cells may bring back sight in rats with retinal degeneration. Hopefully, one day her work can be taken a step further and used in treatment for patients affected with age related macular degeneration. Her laboratory uses both fetal human stem cells produced by Svendsen and various sources of adult stem cells.

"These are very exciting times for regenerative medicine and eye diseases. We hope to develop the research to a point where we can bring therapies back to the patients with the help of the Department of Surgery," said Svendsen.