AVB Training Program: Clinical Translation
This component of the AVB Program provides valuable clinical resources to trainees in any of the three basic areas described above. Trainees have access to a patient population with a wide range of lipid disorders seen by Drs. Christie M. Ballantyne, Peter H. Jones and Ryan C. Neal in the Lipid Metabolism and Atherosclerosis Clinic.
Dr. Ballantyne is director of The Maria and Alando J. Ballantyne, M.D., Atherosclerosis Clinical Research Laboratory and the Atherosclerosis Risk in Communities study lipid analysis laboratory, and has access to blood samples from over 15,000 subjects sampled from four different communities: Forsyth County, North Carolina; City of Jackson, Mississippi; the northwestern suburbs of Minneapolis, Minnesota; and Washington County, Maryland.
The extensive clinical data on these subjects amassed over the past twelve years provide an excellent data base for epidemiological studies. The Lipoprotein and Coronary Atherosclerosis Study (LCAS), a 2.5 year intervention study of fluvastatin efficacy for lowering plasma cholesterol and reducing coronary heart disease in 429 patients, was completed at Baylor College of Medicine in 1997. During the screening of 1,400 individuals over the two year recruitment phase, about 140 (10 percent) were found to have Lp[a] levels above 30 mg/dL, a level correlated with significant cardiovascular risk. Although these individuals did not qualify for the LCAS study, they were prime candidates for a study designed to evaluate the capacity of niacin to reduce the plasma levels of lipoprotein[a] (Drs. Jones and Morrisett). Trainees also have unusual access to clinical specimens.
For example, the large number of carotid endarterectomy procedures done at The Methodist Hospital (avg >400/yr) provides a plentiful supply of tissues for ex vivo imaging studies, correlative histologic experiments, and gene expression studies (Dr. Morrisett). Resection of aortic aneurysms provides the large amount of material needed for extraction of oxidized lipids and lipoproteins (Drs. Chu-Huang (Mendel) Chen and Chao-yuh Yang).
Similarly, the availability of about 50 intact cadaveric carotid pairs from the anatomy lab provides intact carotid trees for standardizing human MRI imagers for in vivo multi-site carotid plaque regression studies. Fresh blood samples from subjects participating in ongoing studies and frozen buffy coats from archived ARIC samples afford a trainee the opportunity to conduct large genetic studies on DNA samples. Likewise, fresh plasma samples are obtainable for the quantitation and study of individual lipoproteins (Drs. Henry Pownall and Wah Chiu), and fresh buffy coat fractions are available for monocyte isolation.
The geographic location and international character of the Houston metropolitan area provides a clinically rich and ethnically diverse patient population (30 percent Caucasian, 24 percent Black, 40 percent Hispanic, 5 percent Asian/Pacific Islander).