All right thank you all I'm going
to tell you about a little bout

what's going on at
Georgia Health Sciences University.

One of the kind of
qualified to get started.

I am the newest member of the group.

So I was elected to come down and
to speak with you about all the different

projects so I don't have as much
detail about the cool Laurie.

Has a rule clinics and
he had to be a clinic today.

So I foolishly volunteered to do this.

So let me just tell you first
about the different members of

our group at G H S shoe Abdo
provides most of the leadership.

He's the adult.

Director of the adult Sickle Cell Program.

We have the pediatric group myself and
Roger Vega we work together with a bill.

We have people in allied health.

Robert Gibson who works with him in
some of the public education and so

forth in biochemistry and
molecular biology.

Dorothy Twan is also a member
of our sickle So group and

then the department of anaesthesia.

Stepha Myler and
to ruin kuta is involved as well.

So this is our group of the main P I's and
faculty members and

then we have a host of union VESA
gators who work with us as well to do.

I just tap them.

OK so
here are some mug shots of all of us.

So here's Raj of a good just come in for

the face with the names you are probably
know Roger uses chief of P.C. mount.

On the newest member of the he
Mum pediatric a month division.

Three So Horne is our nurse practitioner
pediatric nurse practitioner she does

all of our sickle cell follow up etc and

then Beverly Blanchard is involved
as a newborn screening coordinator.

At G.H. a shoot.

And then in July.

We're going to actually have a new
person join Sidney neutered who's also.

Interested in sickle cell disease so
well as someone to the pediatric group.

Now as you can see the adult program
is much further along in much.

Well much more developed than Pete.

We have Abdullah who is the mighty
director of the sickle cell center and

he provides great leadership
in bringing us together.

NATARUS John she's a he month fellow
who's involved have Lisa who's

a physician assistant Nady who's nurse
practitioner couple office managers

Aryans and then we also have social worker
and this is all part of the adult program

which is much further along and so
hopefully we'll be able to become

a stronger cohesive group and we're really
trying to work together to bring peace and

adult hematology together for
sickle cell disease.

What it what a bill of mainly want
me to highlight is the Centers for

excellence which was funded at G.H. su.

A couple years ago is
an outstanding grant program.

And it's basically the in C.H. in C M H D.

Which is the minority health and

disparity sister to southeast exploratory
sickle cell centers of excellence.

The principal investigator
investigators in Robert Gibson.

Now I tell you a little bit
about what's going on in that.

They're also part of the participating
institutions just to

Morehouse School of Medicine and I see
from my collaborative in the billions and

the University of Florida.

Those are the three main institutions.

It's a five year grant over
eight million dollars to really

accomplish quite a bit and develop the
Centers of Excellence at the age issue.

There are several who are so these
There's the administrative Corps headed

up by Robert Gibson a rich Lomberg which
I'm sure a lot of you know does a dog

medicine in Florida and
then you need the new statistics and

the office manager Betty where
we have a research Corps.

Dr Dorothy twoness of.

For that training education.

Thomas at a mic with advocates a writer.

Thomas from Morehouse is part of
the training and education Corps and

a community engagement and
outreach is Robert Gibson.

So there are three major research
projects in the centers of excellence.

There's a new opioid polymorphisms as
genetic marker modifiers of pain and

opioids and sickle cell disease
as a really nice project where

dual is recruiting patients
to look at their genetic

polymorphisms in the new opioid
gene because that's important for

metabolize in some way or pure drugs
that are used for paying control and

trying to correlate between genotype and
response to the opioid medications.

He's working with Doc to weigh in on
this project and he's shown here.

And Dr Cool R. F. who are his wife.

OK And then also they're looking at all
the rhythm for testing a pain threshold

doc to fill in Jan from Florida really
an expert in pain management and

looking at how you can develop ways to see
how much pain patients actually have and

so they're making great
strides with that and

then the third component is with
step the Myler from anaesthesia.

As an anesthesiologist they do a liar
know a lot about the physiology of

pain treatment.

And so Stephan is helping him
with looking at pain medication

looking at the appropriate and
optimal dosing and

also recently in anesthesia they
started a pain fellowship program.

So the actually formally trained
people on how to treat pain and

this will become very important
I think for sickle cell disease.

The second.

Research Project is headed by Dr Dorothy
Kwan she's looking now at the role of got

a one in a switch and fetal hemoglobin
induction after treatment would hide drug.

Syria and she wants to determine
mechanism by which hydroxyurea

helps alleviate complications of disease
looking at how it activates feel

hemoglobin at a molecular level and then
hopefully this will ultimately lead to new

drug treatments targeted drug
treatments for sickle cell disease.

The third research project
is held up by a cooter and

again looking at mechanisms of hydroxyurea
but more from a cellular level.

Dorothy's looking at the molecular level
looking at intercellular signaling

pathways and what critical role they
play in hydroxyurea induction of

fetal hemoglobin and then also
looking at the the role of compound

anation they are people have been in the
past for dire straits inhibitors to help

treat sickle cell disease and to actually
potentiate the effects of hydroxyurea So

he's make great strides in looking
at some of the cell signalling and

this work is done in
collaboration with back to Myla

from the research and
training education Corps.

Thomas is working from Morehouse School
of Medicine heading up and developing

an ongoing education program for President
future family medicine physicians and

we've gotten him involved in the care of
in the visual sickle cell disease and

he's collaborating with forty hops and
this information.

Also with the incorporate some of
the newer technology as well for

educating individuals
with sickle cell disease.

So we're really happy about getting
family medicine people involved.

And then the last Corps is headed
by Robert Gibson looking at health

transition transition from pediatric to
a health care of young people literacy

related to sickle cell disease looking at
complications of bays Oku surprises and

he's collaborating this is a Gibson
on top with Matthew Ryan and

then Dr Lydenberg of Florida is.

Looking at the medical home individuals
with sickle cell disease and

trying to develop this concept
related to sickle cell disease.

So some of the newest
member of the lab and

I was unfortunate at the get in
on their centers of excellence.

But I learned the next time around.

I do my own independent
laboratory research and

mostly you know my lab is really really
focused on fetal hemoglobin induction.

So we're continuing the so
this is the four main major projects and

I won't go into detail looking at
protein complexes that bind to the gamma

promoter that control fetal hemoglobin
expression I'm working with her.

Sherman Weissman at Yale University and
we've done some really

nice proteomics work to define
complexes Gene profile and I'll show

you a little bit of that on the next slide
that we're working with Dr story at U.T.

Southwestern again to identify
switching mechanisms high throughput

drug screen we screen the big chemical
library and we have some very exciting

new hits that I'm working with Dr Peterson
that we think will be promising wages and

then I work with some of the people in the
room on genome wide association studies

we put in for Grant didn't get funded so
I don't know where this is going to go but

we're hoping that we'll be able
to continue this research.

And this is a shining example of some of
the do you know my profile in that we're

doing what we try to establish three major
profiles of the genes that are involved

in red for that so maturation and

he has particular hemoglobin expression we
have the genes that turn off turn on and

those that are activated during the switch
and it actually has been fruitful we

already identified a left or
positive regulator of gamma globin and

we recently published that in a British
journal hematology So we think this will

be a good way to identify proteins that
actually regulate gamma globin and

this is adult projectors and
will soon do it in fetal cells as well.

Dr milers lab here.

He's also I don't know if he's part
of the same nanomedicine center.

OK That's OK That what I saw that you
don't see I really don't know what's

going on but what I saw that I say
at that they're from the same group.

OK so I learned something here today too.

And I am assuming maybe the project that
he's working on with the same thing or

nucleus is also in collaboration with
the people here but he's actually sent

a couple of flies looking at the work that
he's doing and then a medicine center.

Are looking at gene correction of
sickle cell mutation much like

with you talked about earlier and

then the second one is the drug discovery
looking at the circle so mouse model.

He recently had a paper blood.

Looking at polygamy and so
he's basically has a good system for

testing drugs and
Bebo as people Him go up and induces and

they will collaborate on something
looking at mathematical models for.

Identifying drug inductions and just
briefly a balancing thing a nucleus is

there protein explained earlier they can.

Nick D.N.A. hopefully facilitate
correction of the gene and he wanted to

show one of his pretty pictures so
I'll put it up to see if he felt it and

basically this is showing he's at
take a little bit different approach.

I guess is using a receptor mediated
uptake of the zinc finger nucleus and

this is showing you the intake of
the nucleus by induced psychosis and

then this is shown in
the nuclear strains the show.

This is like the in the in
Colo causation of the nucleus.

Nuclear is in the nucleus and so
he's actually working with the he.

And Gene as trying to do.

Correction with G.R.P.

first and then I assume you move
on to the beta globin genus well.

In the in just the in clinical
trials research going on but

there's a lot of clinical trial activity
on campus fetal hemoglobin induction

still the most popular.

There's a phase one study with
the pulling of my drug that was shown to

be effective with Celgene.

A Pace was studied with
penned by an aside.

That also with the BARDAS and
the end of oral beauty rate derivative

with Hema ques all of these as
potential fetal hemoglobin inducers

a bill also involved in a multi-center
are in overload trial and

in G M ten seventy invasive
occlusive now really total bit about

the new opioids so a lot going on
on campus law to get involved.

We're all looking for collaboration so

we look forward to talking with
you all the moving forward.

Thank you.

Actually you were one here.

So the question is why do we
see to it such a variability in

response to hide bacteria from
individuals with sickle cell disease.

I think is because of the differences
in genetic background and

I believe if we do approach it from a
genome wide point of view we can start to

identify the other epigenetic markers or
or modifiers of fetal hemoglobin.

So that you have may have even without
hydroxyurea there's a lot of variation

in fetal hemoglobin levels related
to probably other biomarkers.

And so once we get a better understanding
of what the other biomarkers are and

bring that into the equation.

I think we'll be able to have a better
risk assessment or predictive

value model for who will respond and
then we can bring all of that into

you know into the equation not only to
hard drugs should be about some of the on.

Drugs as well.

It's all the same.

So I think there's other genetic
markers we need to identify.

So that's five plus a genome wide study so
yeah.

OK.

For there was a question.

Well I think it may be more related to
Bay's Okuda an empty plate less you know

cloud and based on that and there is some
feeling that there's an increased risk for

dumbos I'm not an adult person but
is I think is based on then and

maybe decreasing risk of a so-called And
I don't I'm not sure what do you think you

have a we use an ad.

OK OK.

So Bailey platelets and fetal globin but
he's just looking at the feet of that.

OK OK OK but that's similar to hydroxyurea

you know induce a Speedo anti-inflammatory
So you look at all the different effects.