Virtual reality tool lets kids voyage through their own bodies

HealthVoyager - stomach
Traditionally, doctors share the findings of invasive tests using printouts that are highly text-based and filled with medical jargon. Some may have static thumbnail illustrations, but all in all they’re not especially patient friendly.

Michael Docktor, MD, a pediatric gastroenterologist at Boston Children’s Hospital, believed that if kids could really “see” inside themselves, they would have a better understanding of their disease and be more engaged in their treatment.

He connected with Klick Health, a health marketing and commercialization agency that develops digital solutions. Together, they created an entertaining “virtual reality” educational experience. It allows the physician to easily recreate a patient’s actual endoscopic procedure, and, like the Magic School Bus, enables kids to virtually tour their own bodies.

Boston Children’s and Klick Health officially unveiled the iPhone-friendly VR tool, called HealthVoyagerTM, in New York today.

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Maintaining mitochondria in neurons: A new lens for neurodegenerative disorders

cartoon of mitochondria being transported in neurons - part of mitostasis
In some neurons, mitochondria must travel several feet along an axon. (Elena Hartley illustration)

Tom Schwarz, PhD, is a neuroscientist at Boston Children’s Hospital’s F.M. Kirby Neurobiology Center, focusing on the cell biology of neurons. Tess Joosse is a biology major at Oberlin College. This article is condensed from a recent review article by Schwarz and Thomas Misgeld (Technical University of Munich).

Like all cells, the neurons of our nervous system depend on mitochondria to generate energy. Mitochondria need constant rejuvenation and turnover, and that’s especially true in neurons because of their high energy needs for signaling and “firing.” Mitochondria are especially abundant at presynaptic sites — the tips of axons that form synapses or junctions with other neurons and release neurotransmitters.

But the process of maintaining mitochondrial number and quality, known as mitostasis, also poses particular challenges in neurons. Increasingly, mitostasis is providing a helpful lens for understanding neurodegenerative disorders. Problems with mitostasis are implicated in Parkinson’s disease, Alzheimer’s disease, ALS, autism, stroke, multiple sclerosis, hypoxia and more.

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News Note: Why is this eye cancer making headlines?

This illustrations shows a catheter is used during intra-arterial chemotherapy for retinoblastoma.
During intra-arterial chemotherapy for retinoblastoma, a catheter is placed into the common femoral artery and threaded through a child’s vasculature to access the blood vessel of the affected eye and deliver a concentrated dose of chemotherapy. Illustration: Dana-Farber/Boston Children’s.

Retinoblastoma is a rare cancer that originates in the retina, the tissue in the back of the eye that converts light into visual information that is interpreted by the brain.

One retinoblastoma symptom in particular is finding itself in the spotlight. With a rise in social media use in recent years, retinoblastoma has attracted media attention for being a type of cancer that can sometimes be detected through photographs. Across the internet, news stories like this one abound in which friends or relatives have alerted parents to the potential risk of eye cancer after noticing that a child’s pupil appears white instead of red — a symptom called leukocoria — on photos posted to social media.

Fortunately, with proper diagnosis and treatment, 95 percent of children diagnosed with retinoblastoma can be cured. What’s more, a catheter-based treatment approach is now sparing patients from some of the side effects that can be expected from more traditional therapies.

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Lab-grown human cerebellar cells yield clues to autism

This Purkinje cell, made from a patient with tuberous sclerosis, will enable study of autism disorders. (Credit: Maria Sundberg)

Autism spectrum disorder (ASD) is increasingly linked with dysfunction of the cerebellum, but the details, to date, have been murky. Now, a rare genetic syndrome known as tuberous sclerosis complex (TSC) is providing a glimpse.

TSC includes features of ASD in about half of all cases. Previous brain autopsies have shown that patients with TSC, as well as patients with ASD in general, have reduced numbers of Purkinje cells, the main type of neuron that communicates out of the cerebellum.

In a 2012 mouse study, team led by Mustafa Sahin, MD, at Boston Children’s Hospital, knocked out a TSC gene (Tsc1) in Purkinje cells. They found social deficits and repetitive behaviors in the mice, together with abnormalities in the cells.

The new study, published last week in Molecular Psychiatry, takes the research into human cells, for the first time creating cerebellar cells known as Purkinje cells from patients with TSC.

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Intestine chip models gut function, in disease and in health

villus-like projections growing in gut chip
Villus-like extensions formed by small intestinal cells from patient biopsies, protruding into the Intestine Chip’s luminal channel. (Credit: Wyss Institute at Harvard University)

The small intestine is much more than a digestive organ. It’s a major home to our microbiome, it’s a key site where mucosal immunity develops and it provides a protective barrier against a variety of infections. Animal models don’t do justice to the human intestine in all its complexity.

Attempts to better model human intestinal function began with intestinal “organoids,” created from intestinal stem cells. The cells, from human biopsy samples, form hollowed balls or “mini-intestines” bearing all the cell types of the intestinal lining, or epithelium. Recently, intestinal organoids helped reveal how Clostridium difficile causes such devastating gastrointestinal infections.

But while organoids have all the right cells, they don’t fully replicate the environment of a real small intestine. Real intestines are awash in bacteria and nutrients, are fed by blood vessels and are stretched and compressed by peristalsis, the intestines’ cyclical muscular contractions that push nutrients forward.

Efforts to recreate that environment led to the Intestine Chip. An early version, created by the Wyss Institute for Biologically Inspired Engineering, cultured cells from a human intestinal tumor cell line.

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News Note: Norovirus outbreak threatens the Olympics

The HealthMap team at Boston Children's is currently tracking norovirus at the Olympics
The Computational Epidemiology Team at Boston Children’s Hospital tracks online, informal sources for disease outbreak monitoring and real-time surveillance of emerging public health threats through a platform called HealthMap. This is an image of what their surveillance dashboard is currently tracking (Feb. 15, 2018) in South Korea. Visit http://www.healthmap.org/en/ for more.

The 2018 Winter Olympics have brought nearly 3,000 delegates from 206 countries together in PyeongChang, South Korea. But just a week after kicking off on February 8, the games and its attendees are already being interrupted by a fast-spreading norovirus outbreak.

Norovirus is an extremely infectious disease transmitted through food, water or by touching a contaminated surface. Infection causes inflammation of the stomach and intestines, which can lead to symptoms including stomach pains, nausea, vomiting and diarrhea.

In PyeongChang, there have already been 199 confirmed cases of norovirus — many of those sickened have been security guards hired for the games. Due to severe gastrointestinal symptoms, 41 guards have been hospitalized and more than 1,200 were placed in quarantine. 

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Building a better bubble: Engineering tweaks bring safe IV oxygen delivery closer to reality

thin-shelled engineered oxygen bubbles
(Courtesy Yifeng Peng, Boston Children’s Hospital)

Everything from food aspiration to an asthma attack to heart failure can cause a patient to die from asphyxia, or lack of oxygen. For more than a decade, the Translational Research Laboratory (TRL) of Boston Children’s Hospital’s Heart Center has been pursuing a dream: tiny, oxygen-filled bubbles that can be safely injected directly into the blood, resuscitating patients who can’t breathe.

The lab’s first generation of bubbles were made with a fatty acid, but the lipid shells weren’t stable enough for long-term storage or clinical use. The bubbles popped open too easily.

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Breaking down brain disease one DNA break at a time

DNA breaks are depicted in this artistic renderingCells throughout the human body are constantly being damaged as a part of natural life, normal cellular processes, UV and chemical exposure and environmental factors — resulting in what are called DNA double-strand breaks. Thankfully, to prevent the accumulation of DNA damage that could eventually lead to cell dysfunction, cancer or death, the healthy human body has developed ways of locating and repairing the damage.

Unfortunately, these DNA repair mechanisms themselves are not impervious to genetic errors. Genetic mutations that disrupt DNA repair can contribute to devastating disease.

Across the early-stage progenitor cells that give rise to the human brain’s 80 billion neuronal cells, genomic alterations impacting DNA repair processes have been linked to neuropsychiatric disorders and the childhood brain cancer medulloblastoma. But until now, it was not known exactly which disruptions in DNA repair were involved.

A Boston Children’s Hospital team led by Frederick Alt, PhD, has finally changed that.

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Single-shot protection? Building a better hepatitis B vaccine for newborns

newborn vaccines
(Illustrations: Elena Hartley)

The hepatitis B vaccine is one of only three vaccines that are routinely given to newborns in the first days of life. But the current hepatitis B vaccine has limitations: multiple “booster” doses are needed, and it can’t be given to premature babies weighing less than 2 kg.

Annette Scheid, MD, a neonatologist at Brigham and Women’s Hospital, is interested in leveraging infant immune differences to create a better hepatitis B vaccine for newborns. “The reality is that we have to vaccinate several times,” she says. “But we all dream of a vaccine that you give only once.”

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Deconstructing neuropathic pain: Could it give clues to better drugs?

neuropathic pain

Neuropathic pain is chronic pain originating through some malfunction of the nervous system, often triggered by an injury. It causes hypersensitivity to innocuous stimuli and is often extremely debilitating. It doesn’t respond to existing painkillers — even opioids can’t reach it well.

New research in a mouse model, described last week in Cell Reports, deconstructed neuropathic pain and could offer new leads for treating it. The carefully done study showed that two major neuropathic pain symptoms in patients — extreme touch sensitivity and extreme cold sensitivity — operate through separate pathways.

“We think this separation will allow targeted drug-based therapies in the future,” says Michael Costigan, PhD, of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital, who was the study’s senior investigator. “If our results stand experimental scrutiny by others, this will be profoundly important in our overall understanding of neuropathic pain.”

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