MSU Researcher links diabetic complication, nerve damage in bone marrow

A research team led by a Michigan State University professor has discovered a link between diabetes and bone marrow nerve damage that may help treat one of the disease's most common and potentially blindness-causing complications.
The key to better treating retinopathy - damage to blood vessels in the retina that affects up to 80 percent of diabetic patients - lies not in the retina but in damage to the nerves found in bone marrow that leads to the abnormal release of stem cells, said Julia Busik, an associate professor in MSU's Department of Physiology.
"With retinopathy, blood vessels grow abnormally in the retina, distort vision and eventually can cause blindness," said Busik, whose research appears in a recent issue of the Journal of Experimental Medicine. "There has been a lot of progress in treating the complication, but most treatments use a laser that is painful to the patient and destroys parts of the retina."
Busik and her team found that nerve damage in diabetic bone marrow - where stem cells known as endothelial progenitor cells reside - affects the daily release of those EPCs into the bloodstream. Normally EPCs would exit the bone marrow and repair damage done in the vascular system during sleep.
Using animal models, the research team observed that the pattern of EPC release is faulty in diabetic bone marrow, creating abnormally low levels of EPCs during sleep, when they are needed most. That decrease in EPC release from a diabetic patient's bone marrow preceded the development of retinopathy.
"When the bone marrow suffers nerve damage in diabetic patients, it no longer provides a signal for the timely release of these reparative stem cells," Busik said.
This novel finding shows that bone marrow nerve damage represents a new therapeutic target for treatment of all diabetic vascular complications, such as retinopathy.
"This opens up new avenues to better treatments outside of the retina that focus on stem cells and the causes of the nerve damage in bone marrow," said Busik, whose collaborators included other researchers from MSU and the University of Florida. "We know what happens in the retina and have treatments that are very invasive; we now can look at a host of other options."
Those options include looking at ways to prevent the original nerve damage in the bone marrow and potentially repairing or replacing the damaged endothelial progenitor cells.
Busik's work was funded by the National Institutes of Health, the Juvenile Diabetes Research Foundation and the Michigan Agricultural Experiment Station.
Future work needs to be done to explain why the nerve damage in bone marrow occurs in diabetic patients to begin with, she said.

Western U.P. Health Department and Aspirus Open New Home Care

Aspirus Superior Home Health and Hospice opened it’s doors to business on October 17. For Guy St. Germain, the change at the home care part of the Western Upper Peninsula Health Department is a continuation of services historically offered, and more. St. Germain, executive officer and health officer for the health department, said although the partnership between the health department’s Superior Home Health and Hospice and the Wisconsin-based Aspirus health system was announced in July, it didn’t actually begin operations until last month. “The finishing touches on all the business aspects were completed October 17,” he said.

St. Germain said the new entity created by the merger, Aspirus Superior Home Health and Hospice, as joint venture of a private corporation and a government agency, is the only one of its kind in the state. “It is probably the most unique home care company in Michigan.” he said. “Aspirus Superior is the only model of a health department venturing with a hospital system to create a whole new company. You don’t routinely see public-private partnerships in health care.”

St. Germain said the health department is the majority owner of the new non-profit company, and Aspirus VNA Home Health, and Keweenaw Health Foundation, an arm of Aspirus Keweenaw, are the other owners. “It’s a perfect fit for these two entities to work together, because we both have a mission to serve the region,” he said. “The health department has a 70 year history of providing the area with home health services, and this partnership will build on that history, and continue our mission to serve everyone in the five counties of Baraga, Gogebic, Ontonagon, Houghton and Keweenaw.”

St. Germain said Superior Home Care and Hospice patients were told of the change to the new home care company, and they all chose to stay as patients. “(The change) was invisible to all our patients,” he said. There were no layoffs of employees of the former company, St. Germain said, and they all chose to stay on with Aspirus Superior, also.

St. Germain said because of the merger, there is an intention to eventually move the company into Wisconsin and other parts of Michigan. “With the new company, we have the ability to expand, both in geographic terms and in the depth and breadth of our services,” he said.

Western U.P. Health Department provides public health services to residents in Houghton, Keweenaw, Baraga, Ontonagon, and Gogebic counties. In addition, the new Aspirus Superior Home Health and Hospice company, provides skilled home nursing and hospice services in the five counties. Western U.P Health Department and Aspirus Superior Home Health and Hospice have offices in Hancock, L’Anse, Ontonagon and Bessemer.

First H1N1 Flu Case
Confirmed in Houghton County

Western Upper Peninsula District Health Department reports the first confirmed case of H1N1 (Swine) flu in Houghton County. At this time, the other four counties in the district (Baraga, Keweenaw, Ontonagon and Gogebic) have no confirmed cases. "The person affected is an adolescent who is doing well and recovering at home," says Dr. Frankovich, the health department's medical director. The H1N1 flu continues to spread nationally more than 27,000 confirmed cases reported in the U.S. as of June 26. In Michigan, more than 600 cases have been confirmed and there are hundreds of additional cases of flu-like illness suspected to be H1N1. To date, there have been few cases reported in the Upper Peninsula.

The H1N1 flu continues to be generally mild with fever, cough, sore throat and nasal congestion. But just as with seasonal flu, a smaller number of people have had more severe illness. People traditionally considered at higher risk of more serious influenza illness include children under 5 years, adults 65 years and older, pregnant women and anyone with one of a number of chronic diseases including respiratory disease, heart disease, diabetes or decreased immune function. Your doctor will know if you have an important risk factor.

"Interestingly, there have been few cases of H1N1 virus infection in older adults to date and it appears that at least some individuals in their 60's and older, have some level of immunity to this new virus. This is likely due to past exposure to a similar strain," according to Frankovich.

Good hygiene techniques are still the key in preventing illness with this flu. Wash your hands frequently or use hand sanitizer, if soap and water are not available. Washing your hands before eating or when you first get home after being out and about, is especially important. Avoid touching your eyes, nose or mouth unless your hands are freshly washed. If you are ill, stay at home and cover your nose and mouth when coughing or sneezing, since flu viruses are typically best spread through the droplets sprayed with coughing and sneezing. Individuals with H1N1 flu need to stay at home for 7 days or until 24 hours after their symptoms resolve, whichever is longer. This will help to limit the spread of the virus in the community.

If you have flu-like symptoms and are concerned, call your healthcare provider for advice. There are medications that help shorten the flu and decrease its severity. They may also help to prevent you from developing the flu if you have been in close contact with someone who has H1N1. Not everyone will need to be treated or receive preventive medicine. Your healthcare provider will talk with you about what is recommended in your particular case.

It is likely that we will see additional cases over the summer months with an increase in illness during the fall/winter flu season. Whatever the season, good prevention efforts are the key to staying healthy.
 

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