Taking Research to the Community

Jeannette Ickovics has been studying, teaching and researching at the Yale School of Public Health since 1989. Now she feels it is time to give back to the New Haven community.

Last May, Ickovics became the director of Community Alliance for Research and Engagement (CARE), a new organization founded by the Yale Center for Clinical Investigation and New Haven leaders committed to improving New Haven’s health.

“Yale Center for Clinical Investigation is about bringing research from bench to bedside,” Ickovics said. “CARE will take it from the bedside into the community.”

CARE held its first community-outreach event, Diabetes Awareness Day, in November and has similar events for heart health, sexual education, childhood obesity and breast cancer planned for 2008.

Ickovics said her perspective as a professor of public health informs her “health-centric” opinion that good health is essential for community and economic prosperity.

Ickovics also directs the Connecticut Women’s Health Project, an organization founded in 1989 that searches for creative approaches to women’s health and women’s reproductive health.

The group is currently focused on providing group prenatal care to teen and young women, an approach which could cut costs and transform how health care is provided.

Unlocking the Secret of Hypertension

More than one billion people suffer from high blood pressure worldwide, but until recently, nobody knew exactly why.

“Hypertension is the most common disease in the adult population of the world, but until our work, its primary causes were unknown,” Sterling Professor and Chairman of Genetics Rick Lifton said. “We are trying to solve the problem by finding extreme genetic outliers — genes that drive blood pressure way up or way down.”

Lifton and his research team have used tools from the Human Genome Project to identify mutations in 20 genes that affect cardiovascular health.

They found that all the mutations had something in common — they affected the kidney’s regulation of salt in the body.

The discovery could have a huge impact on the national policy for treatment of hypertension, Lifton said.

Instead of focusing primarily on areas previously thought to be significant factors in high blood pressure, treatments will now aim to reduce the patient’s salt balance.

The team has also identified mutations that may help researchers find effective solutions without severe side affects.

Lifton’s current work focuses on resequencing genes from patients around the world to determine whether his findings about salt regulation extend beyond rare mutations to the more common forms of hypertension in the general population.

Preparing for Prevention

After taking Michael Bracken’s class on perinatal epidemiology as a doctoral student in the Yale School of Public Health, Kathleen Belanger decided to switch her focus from occupational health to prenatal, perinatal and pediatric health. Now, 20 years later, she and her former professor have been awarded a $15 million grant to take part in a research project on children from before birth to age 21.

The Yale Center for Perinatal, Pediatric and Environmental Epidemiology, of which Belanger is the deputy director and Bracken the co-director, will be one of 29 study centers throughout the country to participate in the National Children’s Study, run by the National Institute of Child Health and Development and the Institute for Environmental Health Sciences. The project will follow the growth and development of 100,000 children nationwide.

“There are some areas that we only just now have the technology to look at,” Belanger said. “If we can use it to learn about the underlying causes of these conditions, we may eventually be able to prevent them.”

Belanger said she and her colleagues are particularly focused on discovering the causes of problems especially prevalent among American children, such as diabetes and obesity, autism and asthma.

Stopping the Spread of New Viruses

When Erol Fikrig became a professor of Medicine and Epidemiology & Public Health 15 years ago, the West Nile virus was not well known in the United States. By 2000, the Centers for Disease Control and Prevention reported 21 human cases isolated in New York, Connecticut and New Jersey. Last year, that number had jumped to over 3,500, with outbreaks in 43 states.

“West Nile is a newly emerged virus in North America,” Fikrig said. “As it became more of a public-health concern, I became very interested in developing a new vaccine for the new disease.”

Fikrig has spent the past six years working on new vaccines and therapies for vector-borne diseases — illnesses carried by ticks or mosquitos. His work currently focuses on West Nile, Lyme disease and yellow fever.

“What we do is look at a specific region of the surface protein,” Fikrig explained. “We’re trying to find a region similar among the viruses and find antibodies that target that specific area.”

Fikrig has successfully identified antibodies that can both immunize against West Nile and cure cases of it in mice, but a vaccine for humans may be a long time coming.