February 7, 2017

2817LaurenKANE175Congenital heart surgeon Dr. Lauren Kane was recently awarded the Carolyn E. Reed Traveling Fellowship from The Thoracic Surgery Foundation (TSF). Kane is the first congenital heart surgeon to receive the distinguished honor.

Established in 2013 in conjunction with Women in Thoracic Surgery, The Carolyn E. Reed Traveling Fellowship is an annual award presented to an established female thoracic or cardiac surgeon. The award provides recipients the opportunity to travel to another institution to learn a new skill or technology.

“I am truly honored to receive this award,” Kane said. “Carolyn was a wonderful, well-respected and beloved leader in the field of cardiothoracic surgery. I am thrilled to have the opportunity to pay tribute to her legacy as I collaborate with surgeons internationally who share my passion for enriching the lives of children with congenital heart disease and defects.”

Kane plans to travel to New Delhi, India to collaborate with an outstanding program there focused on advanced congenital heart disease.

“Dr. Kane is a vital member of our team and I am proud that she has been recognized with this coveted fellowship,” said Surgeon-in-Chief Dr. Charles D. Fraser Jr. “I look forward to her returning from her travels with a unique perspective of the keys to success of international programs similar to ours.”

Texas Children’s Heart Center is ranked No. 2 nationally in cardiology and heart surgery by U.S. News & World Report. The Congenital Heart Surgery Service offers a comprehensive surgical program that includes every procedure available for the treatment of pediatric heart disease and defects. The team cares for children of every age, including preterm and low-birth-weight newborns, tailoring procedures and treatments to the needs of each individual child and his or her family. During surgery, this individualized approach includes cardiopulmonary bypass and neuroprotection strategies customized to each patient’s condition and needs, helping to ensure optimal outcomes are achieved. For more information visit texaschildrens.org/heart.

For more information about the fellowship visit TSF’s website.

January 31, 2017

2117heartmarathoninside640When Jack Guyre was born, he was diagnosed with a congenital heart defect called Tetralogy of Fallot, which changes the normal flow of blood through the heart. Surgeon-in-Chief Dr. Charles Fraser Jr. repaired the defect when Jack was 9 months old. Following a relatively healthy childhood combined with monitoring by Texas Children’s cardiologists, Dr. Henri Justino placed a stent via catheter in Jack’s heart in 2014.

Jack, now 12, isn’t restricted in his activity, and he is not on any medication. He visits Texas Children’s once a year for a check-up and enjoys playing competitive soccer. With the approval of his cardiologist, Dr. Daniel Penny, Texas Children’s cardiology chief, Jack set out to accomplish a bucket list goal – completing the 2017 Aramco Houston Half Marathon.

On January 15, in a sea thousands, Jack crossed the finish line alongside his mom and dad with an impressive time of 2:44:25. Though he will likely need to undergo heart surgery again in the future, his parents and doctors couldn’t be prouder.

“Jack has overcome challenges that none of us, thankfully, have had to face,” Penny said. “And he’s come through those with great spirit and determination.”

Click here to watch Channel 11 KHOU’s story about Jack’s extraordinary accomplishment.

December 20, 2016

122116chdpajamasinside250When Anne Currie was 5-years-old, she underwent her first congenital heart surgery at Texas Children’s Hospital. Following additional procedures, Currie, now in her 30s, leads a happy and healthy life and comes back to Texas Children’s for regular check-ups with the Adult Congenital Heart Disease Program (ACHD) team.

Texas Children’s ACHD Program enables patients with congenital heart disease to receive seamless continuation of care from birth to adulthood. Members of the multidisciplinary team, who are trained in both pediatric and adult congenital heart disease, offer a full spectrum of services and advise patients on the wide spectrum of medical problems that patients like Currie experience throughout their lives.

To celebrate the 30th anniversary of her first surgery, Currie enlisted the help of her friend and fellow adult congenital heart disease patient, Holly Hancock, to surprise heart patients at the hospital with specially-designed pajamas from Heroic Hearts®, a company Hancock created.

Hancock, who underwent her first heart surgery at just hours old, spent time at Texas Children’s when she was 9 and continues to be seen by Texas Children’s ACHD team, too. As a young patient, she dreaded putting on a drab hospital gown as the excess fabric made it hard to move around and was thin causing her to always be cold. Little Heroes® by Heroic Hearts® offers comfortable, creative, hospital-friendly apparel tailored to young heart patients.

Recently, the pair, alongside Hancock’s husband and parents and Currie’s mom, gifted 10 current Texas Children’s heart patients and their families with pairs of the pajamas. The group shared stories with families about their time in the hospital and inspired them as the families were able to see how well the women are doing today. In addition to the pajamas, patients received stuffed animals named Ruby and Beau, who star in the hospital’s one-of-a-kind animated series of videos designed to educate families about complex heart conditions. To watch the series visit texaschildrens.org/hearteducation.

“My heart is so full and grateful going into this holiday season all because of you,” Currie said of the patients she met during her visit to Texas Children’s. “I hope they all understand that Texas Children’s is for life, not just for kids.”

December 13, 2016

121416perfusionists640When a child has open heart surgery at Texas Children’s Hospital, they receive some of the best care in the country. Our Heart Center, ranked No. 2 in the nation, is equipped with state-of-the art technology, highly trained and skilled surgeons and anesthesiologists, as well as a team of unsung heroes called perfusionists.

Perfusionists operate the heart lung bypass machine needed to keep a patient alive during open heart surgery. The machine takes deoxygenated blood out of a patient’s body, runs it through an artificial lung to give it oxygen, and then pumps it back into the patient’s blood stream.

While the idea may sound simple, the procedure and process is not and is performed at the Heart Center by a longstanding team of experienced and professional perfusionists.

“Perfusionists are absolutely vital when we perform open heart surgery,” said Surgeon-in-Chief Dr. Charles D. Fraser Jr. “What they do is extraordinary and allows us to do very complicated operations on children who otherwise would not be able to survive.”

Fraser recognized the benefit of a strong perfusion team early on and is responsible for creating a dedicated pediatric team at Texas Children’s in 1995 shortly after being named chief of Congenital Heart Surgery. All three members of the original team – Mary Claire McGarry, Maryann Mueller and Deb Surprise – are still working in the Cardiovascular Operating rooms today and remember what it was like in the beginning.

Mueller remembered Fraser recruited her and her colleagues from the Texas Heart Institute where they worked with both adult and pediatric patients. The first few years at Texas Children’s, she said, were spent honing their skills to provide the best perfusion for children.

Surprise recalled how Fraser brought with him a new approach to pediatric perfusion. His idea was to create a specialized pediatric protocol that would be tailored to each individual child.

“Everyone was invested in the success of Dr. Fraser and what he was trying to accomplish,” Mueller said. “We wanted him to be successful – and for our patients to come in, have surgery and then head home to lead healthy lives.”

Over time the team grew to what it is today, eight perfusionists who work closely with the surgical team. Due to their ever evolving skill levels, the team continues to see more complex patients, many of whom have benefited from the hard work of the surgeons and clinical staff at Texas Children’s Heart Center.

Fraser and his team recently performed their 10,000th heart procedure with the use of heart lung bypass on Adult Congenital Heart Disease Program patient 31-year-old Stephanie Granger, who was born with a congenital heart defect and had two surgeries as a baby and another when she was 6. Years later, she developed secondary problems from her heart defect.

“I started having some abdomen pain, so I went to my primary doctor,” Granger said. “They ran a CT scan and found there was a problem with my liver due to my heart.”

Soon thereafter, Granger scheduled heart surgery at Texas Children’s not only for herself but for her newly adopted daughter, Zoey, as well. Zoey was born with a similar congenital heart defect and needed surgery just like her mother.

“When we adopted her, we told them we were open to various conditions,” Granger said. “We told them we had a family history of congenital heart disease and that we fully understood it.”

McGarry said she can’t believe the team just reached the 10,000 pump case milestone and that it’s a testament to how far they’ve come.

“People now from all over the world come to see what we do,” she said. “It’s amazing and makes me very proud to have been a part of the program for so long.”

December 6, 2016

113016juliekuzin175Julie Kuzin, a nurse practitioner at Texas Children’s Heart Center, recently received the 2017 American Association of Nurse Practitioners State Award for Excellence. This prestigious award is given annually to a dedicated nurse practitioner in each state who demonstrates excellence in their area of practice.

“Since joining the cardiology team in 2004, Kuzin has cemented her place as a smart and thorough clinician who delivers safe, effective, and efficient care to our patients and their families,” said Angela Gooden, a pediatric nurse practitioner and manager of Advanced Practice Providers in Cardiology, who nominated Kuzin for this award. “We applaud Julie for the outstanding contributions she has made to the APRN practice at Texas Children’s Hospital and across the state of Texas.”

Kuzin was recognized for a number of achievements, including her leadership in advancing professional standards and practice guidelines across the organization. In partnership with Texas Children’s, Kuzin was instrumental in developing a post-master’s Acute Care PNP certification program at Texas Tech University School of Nursing in 2014 to meet professional practice needs for increased access.

Kuzin has been an active participant in efforts to reform NP practice in the state of Texas. She has travelled to multiple legislative sessions and has disseminated key information from those visits. Her fervent commitment to advancing the scope of practice at Texas Children’s was most inspiring by her colleagues when she served as the first assistant director of Acute Care Advanced Practice Providers prior to taking on faculty duties with Texas Tech. Also, Kuzin has served as a model and mentor to providers with her participation in evidenced-based practice and research.

“Many of our APRNs are unsung heroes in their practice, doing what is ordinary to advanced nursing practice but is seen as extraordinary to patients and families,” said Charley Elliott, director of Advanced Practice Providers at Texas Children’s. “We congratulate Julie for achieving this prestigious state award of excellence.”

12716pediatricpilotawardinside900Dr. Jordan Orange, vice chair of research in the Department of Pediatrics, announced the winners of the 2016 Pediatric Pilot Awards Research Grant Program. Ten research applications were chosen by review committee members to receive grant funding in the amount of up to $50,000 for their projects.

The Pediatric Pilot Awards Research Grant Program provides initial start-up “seed funding” to support research projects. This grant program provides opportunities for new or less established researchers as well as experienced researchers who desire to expand their area of research. The grant projects are awarded based upon their scientific merit and the potential to generate the initial data necessary for a successful grant application submission to the National Institutes of Health or other external, peer-reviewed funding mechanisms.

The pilot award program is a collaborative effort between Texas Children’s Hospital and its academic partner, Baylor College of Medicine.

Congratulations to the following 2016 pilot grant awardees. View the names below to learn more about the research project being funded.

12716drsaurabhagarwal175Saurabh Agarwal, Ph.D.
Pediatrics – Hematology/Oncology
Epigenetic targeting of neuroblastoma cancer stem cells

More than half of the patients with high-risk neuroblastoma (NB) will relapse despite intensive multimodal therapy. Treatments for these patients are challenging due to disease heterogeneity, drug resistance, and toxicity. Thus, novel effective therapies are urgently required to specifically target those tumor cells which escape initial treatment and regenerate chemotherapy resistant recurrent disease.

We identified a G-CSF receptor expressing (CD114+) neuroblastoma cancer stem cell (CSC) subpopulation that is drug resistant, drives metastasis and may cause drug resistant relapse. These highly tumorigenic CSCs are distinguished by specific epigenetic alterations that lead to the expression of specific stem cell genes and maintenance of neuroblastoma CSCs.

We found that epigenetic modifiers MLL1 and JMJD3 increase the expression of G-CSF receptor gene (CSF3R) in NB CSCs by maintaining active histone modifications. Our pre-clinical studies show that blocking these epigenetic modifiers with specific small molecule inhibitors leads to neuroblastoma tumor regression and blockage of metastasis in vivo.

This pilot award will further enable us to test novel dual therapeutic approach by combining epigenetic inhibitors with standard chemotherapy for targeting both stem and non-stem neuroblastoma subpopulations. These studies will define specific epigenetic mechanisms contributing to the maintenance and tumorigenicity of NB CSCs, and pave the way for further clinical translation of our findings to block NB CSC-driven relapse and to advance a novel curative approach to neuroblastoma.
12716drwendyallenrhoades175Wendy Allen-Rhoades, M.D.
Pediatrics – Hematology/Oncology
Validation of a plasma microRNA panel as a biomarker for osteosarcoma

Osteosarcoma is the primary bone cancer in children and young adults. Currently, there are no reliable, non-invasive biological markers to detect the presence or progression of disease, assess therapy response or provide upfront prognostic insights. MicroRNAs (miRNAs) are evolutionarily conserved, stable, small non-coding RNA molecules that are key post-transcriptional regulators and are ideal candidates for circulating biomarker development due to their stability in plasma, ease of isolation and the unique expressions associated with specific disease states.

In our previous work, we analyzed more than 750 plasma miRNAs from a genetically engineered mouse model of osteosarcoma and identified a diagnostic panel of four plasma miRNAs. This diagnostic panel was able discriminate healthy from diseased animals. Subsequent analysis of 70 human patient samples corroborated these results and the diagnostic panel could discriminate healthy patients from patients with osteosarcoma. Furthermore, low plasma levels of miRNA-214 in metastatic patients at time of diagnosis were prognostic and conveyed a significantly better overall survival.

With the funding from the Pediatric Pilot Award, we will continue the necessary steps to fully validate this novel biomarker by completing validation of the diagnostic and prognostic miRNA biomarkers in 200 additional human samples. The long-term goal of this project is to test these new biomarkers in a prospective clinical trial.
12716drsaraanvari175Sara Anvari, M.D.
Pediatrics – Immunology, Allergy and Rheumatology
Defining biomarkers of successful peanut oral immunotherapy

Peanut allergy is one of the most common causes of severe and fatal allergic reactions related to food. The prevalence of peanut allergy has nearly tripled in the last 20 years and current standard of care for peanut allergy is strict avoidance of peanuts and ready access to emergency medications. While recent research has demonstrated that early introduction of peanuts, instead of avoidance, during infancy can greatly reduce the risk of a peanut allergy, this strategy is not applicable to individuals who have already developed an allergy.

For older children, teens, and adults, peanut oral immunotherapy (pOIT) is one method by which peanut allergies can be treated through step-wise introduction of peanut protein. This introduction is an effort to manage and reduce the allergic reactions in patients. However, how pOIT alters patients’ immune systems to recognize peanut protein as benign instead of “dangerous” (the nature of severe allergy) is poorly understood. Additionally, biomarkers, or testable indicators of efficacy, for pOIT success in a given patient are also still unknown at this time.

Most current research is focused on how pOIT modifies a white blood cell population, called T regulatory cells, which help control the severity of inflammation caused by immune reactions inside the human body. But T regulatory cells are just one end point of a larger set of immune reactions to pOIT. My research program will focus upstream of T regulatory cells on another population of white blood cells, called dendritic cells, which can communicate with and modify T regulatory cell, as well as several other types of white blood cells.

Specifically, the research award will help (1) identify biomarkers to predict a patient’s success (i.e. peanut tolerance) or failure (i.e. persistent peanut allergy) early in the course of pOIT, without waiting to complete three years of therapy; (2) development of targeted therapies for peanut allergic individuals aimed at altering dendritic cell populations to better modulate T regulatory populations which aid in the reduction of severe inflammatory reactions which make peanut allergies so life threatening.
12716drevelinebarbieri175Eveline Barbieri, M.D.
Pediatrics – Hematology/Oncology
Targeting MYCN-amplified neuroblastoma through RORa activation

The MYCN oncogene is a transcription factor frequently upregulated in high-risk neuroblastoma, which is profoundly involved in neuroblastoma initiation and progression. Thus, strategies antagonizing MYCN activity are a vital need in neuroblastoma therapy and the focus of this proposal.

Our laboratory has discovered that MYCN-driven neuroblastoma has an increased dependence on glutamine and lipid metabolism. Recent findings in other tumor types suggest an important link between these metabolic pathways and the circadian clock, which is disrupted in aggressive malignancies.

This led us to investigate how MYCN oncogenic signaling, circadian clock, and neuroblastoma metabolic tumor reprogramming are interrelated. Intriguingly, we have found that RORα signaling, a central component of circadian clock, is lost in MYCN-amplified neuroblastoma and this contributes to aberrant tumor proliferation.

Our specific aims will: 1) determine the metabolic programs activated by RORα in MYCN-driven tumors, and 2) determine the in vivo anti-tumor effects of RORα reactivation in pre-clinical neuroblastoma models. These studies will offer insights into critical molecular and metabolic alterations, which will provide new and more sensitive targets that could be strategically deployed with currently available therapies to treat this highly aggressive disease. Moreover, many enzymes in this pathway are amenable to small molecule inhibitors and therapeutic targeting of RORα-mediated metabolism is moving to the clinic.
12716drjennydespotovic175Jenny Despotovic, D.O.
Pediatrics – Hematology/Oncology
Genetic variants and gene expression patterns in acute and chronic immune thrombocytopenia

Immune thrombocytopenia (ITP) is an autoimmune disorder and one of the most common causes of low platelets in children. Twenty-five percent of affected children develop chronic ITP and some have significant morbidity and mortality. Currently, it is impossible to predict an individual patient’s clinical course and likelihood of spontaneous remission at the time of diagnosis.

Identification of children more likely to develop chronic ITP at diagnosis would improve treatment decisions and could also help identify important mechanisms of disease that could lead to more tailored treatment. Based on strong preliminary data produced in our laboratory, we believe that acute and chronic ITP are distinct diseases that can be distinguished at diagnosis; and specific genetic changes and gene expression differences influence the development of chronic ITP.

In our study, we are collecting DNA at enrollment on all patients with ITP, as well as RNA on patients with acute ITP at the time of diagnosis and at the time of disease resolution. For patients with chronic ITP, we are obtaining RNA at several time points. We will use the most current sequencing technologies to look for changes that may help explain differences between these two disorders with the eventual goal of identifying markers that could be used to distinguish the two disorders at diagnosis so that we could determine how to best approach each patient.
12716drjohnhollier175John Hollier, M.D.
Pediatrics – Gastroenterology
Efficacy of pre-recorded guided imagery session on pediatric gastrointestinal pain disorders managed in primary care

Up to 20 percent of school-age children and adolescents throughout the world are afflicted by recurring abdominal pain that cannot be explained by routine medical laboratory tests or procedures. These children miss more school and rank their general well-being much lower than their healthy counterparts. These disorders also may be associated with psychological distress like anxiety and depression.

One of the most effective treatments for these “functional gastrointestinal pain disorders” (FGIDs) fall under the category of cognitive behavioral therapy. However, access to this type of therapy often is not available due to lack of insurance coverage and/or scarcity of trained healthcare professionals.

Researchers have previously demonstrated the success of guided imagery, a type of cognitive behavioral therapy in treating FGIDs. Guided imagery can be delivered via using compact disc players so that patients can receive therapy at home. Our goal is to find out if audio-recorded guided imagery can be used to treat FGIDs when children are seen in the primary care setting (i.e., by their pediatrician or nurse practitioner). If so, we would be able to get treatment to these children sooner and likely decrease the need for them to be referred to a specialist (gastroenterologist). Our long term research goal is to use mobile cost effective technologies to improve the clinical care of patients with FGIDs and other pediatric diseases.
12716drandrewlandstrom175Andrew Landstrom, M.D.
Pediatrics – Cardiology
The role of junctophilin-2 in the regulation of cardiac nodal tissue

Diseases that impact the nodal tissue of the heart, such as the heart’s pacemaker, can be life-threatening. Children can suffer from these arrhythmias following surgery, through inheritance within families or for no identifiable reason. These arrhythmias can cause fainting, inability to play with the same energy as other children, or even death from collapse of the circulatory system. Despite how serious nodal disease can be, little is known about how these cells beat and how misbeats can occur. Since basic science has limited understanding of this specialized tissue, the therapies levied against nodal disease are toxic and can be ineffective.

A major reason for the lack of specialized therapies is the absence of experimental models which accurately reflect the arrhythmia. We have created an unparalleled mouse model with cardiac nodal disease that can be molecularly triggered to have arrhythmias from the nodal tissue of the heart. This mouse hosts a molecular switch which allows exposure to a pharmacological trigger to decrease the amount of a protein named junctophilin-2 (Jph2) specifically in the heart.

We have previously shown that reduction in the normal amount of Jph2 in the muscle cells of the heart causes calcium to leak into the cell. This causes a loss of contractile force and cardiac failure. We have also found that human mutations in the gene which encodes Jph2 can lead to cardiac hypertrophy as well as atrial fibrillation. All of these diseases are associated with early, and sometimes sudden, death. We have recently found that expression silencing of Jph2 specifically in the nodal tissue results in a rapid resting heart rate and an arrhythmia known as accelerated junctional rhythm. Our early studies have given strong evidence that this mouse has nodal disease that is very similar to many of the children which suffer from nodal dysrhythmias.

With support from pilot research grant, we hope to delve into the physiology of the cardiac pacemaker and to discover the molecular causes of nodal arrhythmias. We believe that the same calcium signaling that becomes perturbed in the muscle cells of the heart may be to blame for these arrhythmias. Careful interrogation of this possibility, and dissection of the molecular underpinnings of this mouse’s arrhythmias, will offer the first insights into the nodal diseases which remain unexplained and ineffectively treated.
12716drjennettemoreno175Jennette Moreno, Ph.D.
Pediatrics – Nutrition
Assessment of differences in children’s circadian rhythms during the school year and summer vacation

Consistent evidence indicates that school age children demonstrate improvements in their weight status during the school year, yet gain substantial weight during summer. These summertime increases in body mass index (BMI) increase children’s risk for becoming overweight or obese. Further, children at risk for developing chronic health conditions associated with obesity are more likely to demonstrate increases in BMI during summer. Preventing increases in children’s weight during summer may be an important opportunity to address the obesity epidemic in children.

Obesity is conventionally considered a problem of imbalance in energy intake (diet) and expenditure (physical activity/sedentary behavior). There is growing awareness of the role of sleep and circadian rhythms in the development of obesity, yet differences in children’s sleep and circadian rhythms during the school year and summer have not been examined.

Circadian rhythms are internal processes present in all living things that operate on a roughly 24 hour cycle. Behavioral rhythms such as the timing of meals and going to bed and waking up at a consistent time are some of the behaviors known to promote stable circadian rhythms. Changes in sleep and behavioral rhythms may result in disruption of circadian rhythms. Because summer vacation is associated with changes in children’s sleep and behavioral rhythms, the school year and summer vacation paradigm offer an important opportunity to expand our scientific understanding of the role of disruptions in sleep and circadian rhythms on the development of obesity in children.

Little is known about differences in children’s sleep and circadian rhythms during the school year and summer. With the current proposal, we plan to address this gap in scientific knowledge by measuring differences in children’s sleep and circadian rhythms during the school year and summer. We will assess whether differences in sleep and circadian rhythms are related to changes in children’s weight during the school year and summer. These data will may lead to novel approaches to the prevention of obesity in children.
12716drrobinparihar175Robin Parihar, M.D.
Pediatrics –Hematology/Oncology
Testing a novel non-invasive method to assess efficacy of tumor microenvironment-directed immune therapy

Some children with cancer have solid tumors, or collections of abnormally growing cells, within their organs. These collections are made up of mostly cancer cells, but also of accessory cells that help the tumor hide from the body’s immune system and grow – collectively called the tumor microenvironment. Our laboratory created a new type of immune therapy to specifically target and destroy these accessory cells found within the tumor microenvironment so that they can’t help the cancer grow.

One of the main problems for testing our immune therapy in patients with solid tumors is that we can’t detect these accessory cells without performing a biopsy procedure of the tumor inside the body. In order to detect the accessory cells in patients at many different times during their therapy, we would have to perform repeated invasive biopsy procedures, which come with additional risks and costs. There is currently no non-invasive method by which to determine the effectiveness of therapies that target the tumor microenvironment. If strategies targeting the tumor microenvironment are to be tested in humans, non-invasive methods will need to be developed to evaluate their effectiveness, thereby circumventing the need for repeated invasive biopsies.

Our project involves the creation and testing of a new type of CAT scan that can indirectly detect the accessory cells of the tumor microenvironment. If successful, our new CAT scan can be used to detect changes in the number of accessory cells in patients receiving our new immune therapy, without the need for repeated invasive, risky, or costly procedures. This new CAT scan can be used in clinical trials of other immune therapies as well and may be applied to both children and adults with cancer. The long term goal of the project is to develop a clinical imaging tool that will allow doctors to follow changes within the tumor microenvironment induced by immune therapies.
12716drsarahsartain175Sarah Sartain, M.D.
Pediatrics – Hematology/Oncology
The linkage between hemostasis-thrombosis, complement, and inflammation in the pathophysiology of thrombotic microangiopathy

The goal of our research is to improve the health of patients with thrombotic microangiopathy, a group of disorders that cause anemia, low platelets, clots in the blood vessels, and blood vessel damage of the brain, heart, and kidneys. The mechanisms of small blood vessel damage in thrombotic microangiopathy are not precisely defined.

We will investigate the means by which thrombotic microangiopathy causes blood vessel injury and organ damage. We believe that the immune system is involved in the process of vessel injury in thrombotic microangiopathy. This is based on previous work showing that components of the immune system known as the “alternative complement pathway” bind to, and become activated on, long and sticky von Willebrand factor (VWF) strings secreted from blood vessel walls. These VWF strings normally attract platelets to initiate blood clot formation. We intend to determine if activated alternative complement components on these strings contribute to blood vessel injury. We will also determine if a powerful molecule produced during inflammation (known as “tumor necrosis factor”) controls activation of the alternative complement pathway on the VWF strings, contributing to heart, brain, and kidney blood vessel injury.

Our proposed research has long-term biomedical significance because determining the mechanisms of blood vessel/organ injury in thrombotic microangiopathy will lead to the development of therapies to improve the outcomes in this disorder and may be applicable to more common types of blood vessel injury in the general population.

October 18, 2016

101916toss640On October 6, more than 500 guests donned their boots and Texas-chic apparel at Houston Polo Club for the 4th annual Toss for Texas Children’s Heart Center. The tailgate meets Great Gatsby-themed event under the stars raised $180,000 for Texas Children’s Heart Center, which is ranked Number 2 in cardiology and heart surgery by U.S. News & World Report.

The bean bag tournament featured light bites and cocktails by A Fare Extraordinaire and a special performance by country music singer, Gary P. Nunn. The event was chaired by Staci & John Donovan and Brooke & Scott Hutson, both of whom have children who received expert care from Texas Children’s Heart Center. The “Toss” trophy was presented at a special awards ceremony to conclude the evening’s festivities.