More than 50 billion cells die in the human body every day, a spectacle of programmed cell death called apoptosis. These cells undergo internal degradation and then fracture into apoptotic bodies that are scavenged by immune cells, all without triggering the body’s immune system defense.
One of the most dangerous places for cells to die is near the follicles of the spleen. The follicles are primed to mount intense immune attacks against infectious bacteria or viruses. If an apoptotic cell (AC) goes into the follicle, it can trigger an autoimmune response. This can lead to autoimmune diseases like systemic lupus erythematosus, where the immune system attacks its own body.
Macrophages in the spleen marginal zone around the follicles keep the ACs out, acting like the defensive line in football,” says John Mountz, MD, PhD, professor of medicine in the UAB Division of Clinical Immunology and Rheumatology.
In a paper published online in the Journal of Clinical Investigation, Mountz and colleagues, including Hui-Chen Hsu, PhD, and Hao Li, PhD, present a new model of why this defensive line becomes porous in mouse models of lupus, and they show the mechanism that underlies this breakdown. Just as “location, location, location” is the difference between good and bad real estate, the Mountz group say that the location of immune system B cells is a key difference between healthy animals and those that develop autoimmune disease. The wrong location leads to macrophage cells that have problems in their cytoskeletons — they become too stiff to engulf and digest dead cells.
Mountz found that the presence of B cells in the marginal zone outside the follicle is essential to maintain the defensive line of macrophages. They found that type I interferon — which is elevated in lupus — causes the B cells to migrate away from the marginal zone and into the follicle, which interrupts vital cross-talk between the B cells and the marginal zone macrophages. In this model, the definition of an autoimmune pathogenic B cell is now based on its anatomic location.
Experiments by the Mountz group show the mechanism of this cross-talk: B cells in the marginal zone of the follicle interact with the marginal zone macrophages by means of a membrane lymphotoxin present on the surface of the B cells. This lymphotoxin binds to a lymphotoxin receptor on the surface of the macrophages. That connection stimulates a mechanosensing complex in the macrophage, triggering the production of a gene regulator called megakaryoblastic leukemia 1 (MKL1) that regulates the cell’s actin cytoskeleton and enables a macrophage to respond to and engulf ACs. Without that B cell interaction, MKL1 expression in the macrophage decreases, changing the activity of the actin cytoskeleton.
This signaling axis — from B cell to macrophage to mechanosensing signaling — keeps the defensive line of macrophages strong. In contrast, mice that have had the MKL1 gene knocked out begin to resemble lupus-model mice as they age. They show decreased AC clearance, a deficiency of macrophages in the marginal zone of spleen follicles and increased production of autoimmune antibodies. This suggests a key role for macrophage mechanosensing signaling in lupus.
Examination of slides of spleens from human systemic lupus erythematosus patients showed a pattern similar to that seen in mouse models of lupus: reduced numbers of B cells surrounding the follicle, increased numbers of B cells inside the follicle and a loss of MKL1 expression in the marginal zone.
Princeton Baptist One of Seven Hospitals in the U.S. to Receive MAP Award
Princeton Baptist Medical Center has been named as a recipient of the 2015 MAP Award for High Performance in Revenue Cycle, sponsored by the Healthcare Financial Management Association (HFMA). Winners of this national award demonstrate inventive, patient-centered revenue cycle practices that deliver sustainable financial performance. Princeton Baptist is one of only seven hospitals in the U.S. to achieve this distinction and the only hospital in Alabama and the Southeast.
This is Princeton’s fourth year to earn this honor. As an award winner, Princeton has excelled in meeting industry standard revenue cycle benchmarks, implementing the patient-centered best practices embodied in HFMA’s Healthcare Dollars & Sense™ initiatives, and achieving outstanding patient satisfaction.
Doughty Named Senior VP of Operations at Huntsville Hospital
Tracy T. Doughty has been promoted to Senior Vice President of Operations at Huntsville Hospital. Doughty’s expanded responsibilities will focus on “operations at the Main/Adult Hospital campus on Gallatin Street.
Doughty has served as Vice President of Emergency & Trauma Services and the hospital’s Physician Network since 2010. His career at Huntsville Hospital began in 1998 as a surgical/trauma nurse. Since then, he has served in a variety of clinical and administrative roles.
Doughty’ s education includes two post graduate degrees from UAB: a Master’s degree in Health Administration in 2007 and a Master’s degree in Quality and Outcomes Management in Health Systems in 2004. He earned his Bachelor’s degree in nursing from the University of North Alabama in 1997.
Doughty served as a commissioned officer in the U.S. Army Reserves from 2001to 2007. He is active in many local and regional organizations, serving on the boards of the Community Free Clinic, HEALS Clinic, Calhoun Community College Foundation, and the Huntsville Housing Authority Advisory Board. He is a graduate of Leadership Huntsville/Madison County and Leadership Alabama.
He is also a past board member of the Huntsville Madison County Chamber of Commerce, North Alabama African American Chamber of Commerce, and previously served as the Young Executive Chair of the Committee of 100. Professionally, Doughty is a member of the American College of Healthcare Executives and the National Society of Health Services Executives.
National Search Yields New Leader for UAB Biomedical Engineering
Jianyi Zhang, MD, PhD, a national leader in myocardial bioenergetics, biomaterial and stem cells for cardiac repair, has been named the chair of the UAB Department of Biomedical Engineering, a joint department in the schools of Medicine and Engineering.
Zhang will come to UAB from the University of Minnesota Medical School, where he is the Engdahl Family Foundation Chair in Cardiovascular Regenerative Therapies and a professor of medicine and biomedical, electrical and computer engineering. He was chosen to lead the Department of Biomedical Engineering after a national search.
Zhang will succeed longtime department chair Timothy Wick, PhD, who stepped down last year to accept a role as senior associate dean in the School of Engineering.
Zhang’s research is leading the field in myocardial energetics in hearts with postinfarction left-ventricle remodeling and congestive heart failure, biomaterials, and stem cells for cardiac repair.
The research evaluates myocardial high-energy phosphates using nuclear magnet resonance spectroscopy to examine the mechanisms of energy production, transportation and utilization in the in vivo heart during normal and diseased conditions, as well as in response to different therapeutic interventions. Findings may lead to better diagnostic and therapeutic modalities for patients with heart failure.
Born in Shanghai, China, Zhang earned his MD from Shanghai Medical University in 1983 and his doctorate in biomedical engineering from the University of Minnesota in 1992. He also earned a Master of Science degree in engineering in 1987 and a certificate of business administration in 1987 from Tufts University. Prior to joining the faculty at Minnesota, Zhang completed postdoctoral work in the university’s cardiovascular division.
Samford’s Ida V. Moffett School of Nursing Receives $1.7 Million Grant
Samford University’s Ida V. Moffett School of Nursing has received the second largest award nationally of the 86 Nurse Faculty Loan Program (NFLP) grants for 2015-16. This is the 13th year for Samford to receive the grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA).
Samford’s grant of $1,741,140 is second only to Case Western Reserve University in Ohio. It is one of only five grants nationally that exceed $1 million.
NFLP grants are designed to help ease a national shortage of nursing educators, according to Jane Martin, associate nursing dean and the HRSA grant administrator at Samford. Students who receive loans for master’s or doctoral degree programs can have up to 85 percent of the loan forgiven in exchange for service as full-time nursing faculty members at an accredited school of nursing.
“Across the country, the faculty shortage is impeding our ability to address the increased demand for nursing professionals,” said Eleanor V. Howell, dean of Samford’s nursing school. “As we prepare for the projected need of more than 900,000 RN positions in the U.S. by 2020, this Nurse Faculty Loan award allows the Ida V. Moffett School of Nursing to address this need.”
According to a report by the American Association of Colleges of Nursing (AACN), U.S. nursing schools turned away 68,938 qualified applicants from baccalaureate and graduate nursing programs in 2014. Almost two-thirds of the nursing schools responding to the survey pointed to faculty shortages as a reason for not accepting all qualified applicants.
The NFLP was approved by Congress in 2002, and Samford was one of the first 55 nursing schools from across the U.S. to receive funds. Samford’s NFLP grants now total more than $7.1 million and more than 300 students have benefitted from NFLP awards at Samford.
The 2015-16 grant is expected to help at least 111 students from 17 states in Samford’s master’s and doctoral nursing education programs.
Priority Ambulance Hits Milestone
Priority Ambulance has logged a significant milestone: The company currently transports more than 100,000 patients per year across its six-state footprint.
Priority Ambulance operates at Shoals Ambulance in Alabama. The company is the exclusive emergency ambulance provider for the City of Florence, Lauderdale County and Franklin County and provides emergency and nonemergency service to the City of Bessemer, Birmingham and Jefferson County.
Headquartered in Tennessee, Priority Ambulance was founded by Bryan Gibson, who has over 30 years’ experience managing ambulance operations. Gibson founded Shoals Ambulance in 2012, which merged with the national company when he started Priority Ambulance in 2014. Today, the company includes more than 600 employees and 100 ambulances in six states.
St. Vincent’s One Nineteen Holds Block Party
St. Vincent’s One Nineteen held its 9th annual Block Party and Health Festival on Saturday, June 13. This year’s event was a celebration of its 10th anniversary, as well as its expansion project to be completed later this year.
The Block Party featured a wide range of offerings, including live music, healthy information booths, bubble soccer, a rock climbing wall, a 70-foot inflatable obstacle course, food vendors, and more. In addition, community members had the opportunity to meet local physicians and participate in free health screenings. Admission to the event was free.
Block Party attendees also celebrated the St. Vincent’s One Nineteen expansion project by signing a beam to be placed in the completed building. The expansion will offer urgent care, outpatient surgery and more physician offices to the community.
UAB named among top for cancer care in the United States
UAB Hospital has received a 2015 Women’s Choice Award for being named one of America’s Best Hospitals for Cancer Care. Women’s Choice Award is a consumer advocacy group that has recognized an elite group of about 340 hospitals, out of 1,300 that were analyzed, as America’s Best Hospitals for Cancer Care.
UAB Hospital was selected based on being accredited by the American College of Surgeons Commission on Cancer, having an above-average patient recommendation rating from the Centers for Medicare and Medicaid Services, having available chemotherapy, radiation and hospice services on-site, participation in clinical trials and research, and satisfactory clinical performance with regard to patient safety measures.
The UAB Comprehensive Cancer Center is the only National Cancer Institute-designated comprehensive cancer center located in the six-state area including Alabama, Arkansas, Georgia, Louisiana, Mississippi, and South Carolina.
UAB was also named one of the top breast health centers in the U.S. by the WCA earlier this year.
Trinity Names Assistant CEO
Justin Bryant, RN, has been named Assistant Chief Executive Officer at Trinity Medical Center. Prior to this appointment, Bryant served as an Administrative Specialist at Flowers Hospital in Dothan and five years in a clinical setting as a staff nurse in CVR/CVSU.
Bryant is a graduate of Auburn University where he earned a Bachelor of Science degree in 2005. He completed a Bachelor of Science degree in Nursing from UAB in 2008, followed by a Master of Business Administration degree from UAB in 2013 and a Master of Science in Health Administration from UAB in 2014.
Bryant is a member of the American College of Healthcare Executives and the American Association of Critical Care Nurses.
Trinity Receives Blue Distinction® for Bariatric
Blue Cross and Blue Shield of Alabama has recognized Trinity Medical Center as one of the first healthcare facilities in the nation to receive a Blue Distinction® Center+ designation in the area of bariatric surgery.
To receive a Blue Distinction Center+ for Bariatric Surgery designation, a healthcare facility must demonstrate success in meeting patient safety as well as bariatric-specific quality measures, including complications and readmissions, for gastric stapling and/or gastric banding procedures. A healthcare facility must also have earned national accreditations at both the facility level and the bariatric care-specific level, as well as demonstrate better cost efficiency relative to its peers.