Racquetball Champion Diabetic Physician - Kresge Eye Institute

R esearcher Awarded 2 NEI Grants
G
laucoma Does Not Stop Racquetball Champion
Fu-Shin X. Yu, Ph.D., professor of
Ophthalmology and Anatomy/Cell Biology for
the Wayne State University School of Medicine,
and director of research at DMC Kresge Eye
Institute, has received two grants from the
National Eye Institute (NEI) of the National
Institutes of Health.
Molecular Regulation of Corneal Wound Healing
In 2008, Dr. Yu was awarded a five-year, $1.9 million Research Project Grant to
continue his study of “Molecular regulation of corneal wound healing.” Dr. Yu
has received funding for this project since 1995.
The study uses a variety of technologies to determine why diabetic patients experience
delayed healing of corneal wounds and attempts to identify therapeutics
that promote wound healing – an important topic with an ever-increasing
diabetic patient population.
Previously, the study had examined epidermal growth factor (EFG) as a therapeutic
to stimulate wound healing, but EGF has proven to be less effective in
diabetics than in non-diabetics.
The study also found that oxidative stress caused by long-term hypoglycemia
contributes to delayed wound healing. As a result, the research is investigating
whether a combination of an antioxidant and EGF may be appropriate for diabetic
patients who are undergoing surgery or who have a corneal wound.
Mechanisms of Flagellin-Induced Protection
Against Bacterial Keratitis
Dr. Yu was also awarded a second grant from the NEI to identify ways the eye
recognizes pathogens when the corneal barrier is breached. The study will investigate
ways to enhance the innate immunity of the eye against bacterial keratitis
and may lead to improvements in contact lens solution to prevent or reduce
corneal infections associated with contact lens use.
The $338,000 study is based on an understanding of toll-like receptors (TLR)
that was uncovered in 1996. TLR are a class of proteins that alert the immune
system to the presence of microbial infections and play a key role in activating
immune cell responses. TLR are present in most bodily tissues, but especially in
the cornea and the cilia of the lungs and intestine – parts of the body most exposed
to external pathogens. They are single membrane-spanning non-catalytic
receptors that recognize structurally conserved molecules derived from microbes.
It has been discovered that bacterial flagellin proteins activate the TLR, producing
anti-microbial peptides that prevent or significantly reduce infection.
Dr. Yu is working in collaboration with researchers at another university who
are applying the study results to pulmonary infection modeling.
Jim Hulen of Rochester Hills, Mich.,
is a three-time gold medalist in
racquetball in the Senior Olympics.
But the fit 75-year-old missed the
competition in 2007 due to eye
problems. However, Hulen has rallied
back after treatment at DMC Kresge
Eye Institute and hopes to return to
competition soon.
Four years after cataract surgery Hulen started
to have foggy vision in his right eye caused
by spiking eye pressure temporally related to
playing racquetball and running.
“My eye doctor said the lens was rubbing on
my iris and pigment was flaking off and this
caused fluid to not drain off properly,” Hulen
said.
After several visits and laser surgery, Hulen
was still having problems, including
intraocular pressure spiking to over 60
mmHg. Hulen was advised to have his lens
implant replaced. He was concerned about
undergoing further surgery and was not sure
what to do.
Finally, Hulen visited Anju Goyal, M.D.,
assistant professor of Ophthalmology, Wayne
State University School of Medicine, at KEI
in July 2007.
“During a slit lamp exam I noted that he had
pigmented and white cells in the anterior
chamber and translumination defects at
the intraocular lens-iris junction and a
few midperipherally. Gonioscopy revealed
increased pigmentation with an open angle.
These cells were causing the fogginess in
his vision,” said Dr. Goyal. “His vision was
20/20 so we wanted to avoid replacing
the lens implant if possible. We were able
to control his intraocular pressure for six
months with topical medication. He was
advised to monitor his physical activity,
which was disappointing to this very active
man.”
Despite this treatment and lifestyle change,
Hulen began experiencing symptoms with
and without exercise.
“When his eye pressure spiked without
any pigmentary-uveitic process and did
not respond to medication, we determined
the best course of action would be a
trabeculectomy with mitomycin C,” Dr.
Goyal said.
After surgery in January 2008, Hulen’s vision
returned to 20/20 and his eye pressure is
normal without medication.
Since the surgery Hulen has “had no
problems at all,” he said, and is back to his
active lifestyle.
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