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Pioneering Research Means Hope

R R e s e a r c h c o n n e c t s o u r p a t i e n t s t o d a y t o t h e m o s t a d v a n c e d m e t h o d s o f d e t e c t i o n a n d t r e a t m e n t . T h e m o s t i n n o v a t i v e r e s e a r c h c o n n e c t s u s a l l t o t h e f u t u r e , t o h o p e f o r e n h a n c e d c o m m u n i t y h e a l t h a n d e v e n b e t t e r w a y s o f p r e v e n t i n g , d i a g n o s - i n g a n d t r e a t i n g d i s e a s e M a d e l e i n e S h a l o w i t z , M D , M B A , s p e n t m a n y y e a r s a s a p e d i a t r i c i a n c a r i n g f o r c h i l d r e n w i t h c o m p l e x , c h r o n i c i s s u e s ; c h i l d r e n w h o w e r e f a i l i n g t o t h r i v e a n d s t r u g g l i n g w i t h d e v e l o p - m e n t a l i s s u e s . W h i l e i t w a s v e r y s a t i s f y i n g h e l p i n g i n d i v i d u a l children and families, Shalowitz said she was frustrated that overall health conditions for many children were not improving.

Dr. Shalowitz is quick to cite some staggering statistics including the fact that 50 years ago an African American woman was more likely to deliver a premature infant than a white woman—the same holds true today.

Health disparities in pregnancy, infancy and early childhood have been well documented across racial, ethnic and socioeco- nomic dimensions, but decades of research have failed to really explain the disparities, or provide the information to start making positive changes.

Dr. Shalowitz is leading an innovative academic-community partnership designed to both develop better research methods and to empower the community with the right skills to ultimately inform public policy and bring about improved programs and services for children and families.

Joining forces with the Lake County Health Department Community Health Center, Dr. Shalowitz formed Community Action for Child Health Equity (CACHE) in 2003 after earning

Pablo Gejman, MD

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a major award from the National Institute of Child Health and Human Development (NICHD). CACHE is one of just five academic-community partnerships in the country similarly funded.

A new $3 million NICHD grant has helped launch Phase 2 which will study the influences of stress and resilience on mothers’ health and birth outcomes. Researchers will consider things like physiologi- cal changes in the fetus and how they may predispose children to certain problems and conditions like asthma and obesity, both known to be related to stress. Close to 500 families in Lake County will be enrolled in this study.

“The members of the community are actively engaged, they really are 50 percent partners in this and are part of bringing about the positive changes,” said Dr. Shalowitz. “The hope is that once we understand the pathways to these conditions we will understand the avenues for intervention.”

Pablo Gejman, MD, leads the Center for Psychiatric Genetics at Evanston Northwestern Healthcare where he studies clinical and biologic inherited factors in schizophrenia. He is an internationally prominent researcher who described an association between the trace amine receptor gene 4 and schizophrenia. Schizophrenia, a chronic condition resulting in severe incapacitation and suffering, affects about one percent of the population. Schizophrenia is similarly prevalent in countries around the world, and is known to cluster in some families. About 10 percent of the schizophrenic patients also suffer long and severe depression and/or manic periods, and are diagnosed with schizoaffective disorder. There is currently much more information on many rare genetic disorders caused by single genes, than there is for more common conditions, such as schizophrenia, which involve many genes and therefore are far more complex and difficult to study.

Dr. Gejman’s team and nine other collaborating institutions (eight in the US and one in Brisbane, Australia) have collected a sample of 4,500 persons with schizophrenia and 4,500 controls from the general population to conduct new studies designed to improve the understanding of the biological mechanisms that lead to schizophre- nia, and how they interact with the environmental risks.

Last year, Dr. Gejman was selected by the Genetic Association Information Network (GAIN) of the National Institutes of Health (NIH) to conduct a genome-wide experiment of schizophrenia, which will interrogate 900,000 genetic polymorphisms in patients and in controls to identify susceptibility genes for schizophrenia and schizoaffective disorder. This will be among the largest and most definitive genetic experiments conducted on the disease. He also received a new $5 million research grant from the NIH to support subsequent experiments aimed at characterizing the genes identified in the “GAIN” experiment, in more detail.

Dr. Gejman is hopeful that his research will lead to better treatment and earlier diagnosis. “This research and discovery can make a real difference in patients’ lives,” he said.

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