Already known for its medical discoveries,
ECU now pursues a broader research mission
By Marion Blackburn
on’t be surprised if you pick up the paper one day soon and read that researchers at East Carolina University have discovered cures for obesity and diabetes, giving hope to the hundreds of thousands of people who suffer the deadly consequences of those diseases.
It was an ECU doctor, after all, who helped perfect the first proven treatment for obesity with his refinements to gastric bypass surgery more than 20 years ago. What’s more, studies by bariatric surgery pioneer Dr. Walter Pories produced the stunning insight that diabetes disappeared in most patients who have the so-called “Greenville gastric bypass,” which reduces stomach size and reroutes part of the small intestine.
That discovery led ECU researchers, including Dr. Joseph Houmard (
left), to focus on an abnormality that directs the body to store fat from food rather than burning it as fuel.
The work by these teams of researchers recently caught the attention of Johnson & Johnson, the giant health care company, which believes ECU is close to finding solutions to the metabolic flaws that give rise to obesity and diabetes. It provided a major grant to support what many believe will be the end-stage research into drugs, which Johnson & Johnson would bring to market.
“There’s tremendous data at East Carolina that shows they’re onto something that could be a significant breakthrough,” North Carolina Sen. Richard Burr said at a meeting on campus announcing the gift.
Along with other health breakthroughs, including the SpeechEasy anti-stuttering device and successful clinical trials of the da Vinci robotic surgery system, ECU’s search for a cure for obesity and diabetes is putting Greenville on the map of major American research universities. That’s new terrain for a school that started out as a teacher training academy.
East Carolina always has counted improving the quality of life in eastern North Carolina among its core missions, and curing diabetes would do that in spades. Now the university is pursuing that mission in fields outside medicine while continuing to focus on achieving practical results important to the average person. Two years into an overhaul of its Division of Research and Graduate Studies, officials believe ECU’s new synergistic approach to research offers hope for solutions to some of eastern North Carolina’s most worrisome problems.
Exploring uncharted territory East Carolina needed to do two things to get to this point: It had to make research a primary focus of the entire faculty, and it had to create an administrative infrastructure and support services that would make it easier for faculty to pursue research grants. With federal dollars coming with more and more strings, when even the grant application process is entirely online, administrative support becomes critical.
Since the arrival on campus in 2005 of Dr. Dierdre Mageean as vice chancellor for research and graduate studies, the Division of Research and Graduate Studies (DRGS) has added several key staff and now has about 95 people. Several key DRGS support services have been grouped together, and the office’s new mission is to help researchers apply for grants and then ensure compliance with all stipulations that come with the grants. The office promotes ethical conduct and manages the institutional review boards for the university and the medical school. Those IRBs have the critical task of monitoring all research that involves human subjects, whether they are taking part of a new cancer treatment or participating in a sociology survey.
The division has gained new abilities to foster communication between the university, government agencies and large foundations, while helping bring discoveries to the public through licensing.
The swelling number and size of grants awarded to ECU researchers recently is proof that the new approach is working. Already this fiscal year, about $14.5 million in grants and other external funding has flowed into research projects at ECU, compared to about $9.5 million in the same period last year. If these trends continue, the total could exceed $50 million this year, compared to about $38 million last year, from agencies like the National Institutes of Health, NASA and the National Science Foundation.
While those amounts pale in comparison to the billions that some elite universities receive, ECU officials argue that effectiveness is what’s most important. They point to a recent report by the Milken Institute which ranked ECU sixth in the nation for inventions per million dollars of research, third for patents issued per million dollars of research and sixth for start-ups per million dollars of research. The growth in grant dollars also is concrete evidence that East Carolina has constructed a strong infrastructure to support its larger research mission.
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| 'Creating critical mass is important,
because it creates the dynamics for
research that will attract other graduate students and researchers.'
-- Dr. Dierdre Mageean, vice chancellor,
research and graduate studies
|
“It’s hard to measure success,” says Mageean (
right), who came to ECU from the University of Maine. “One way is dollars, but that doesn’t say it all. Creating critical mass is important, because it creates the dynamics for research that will attract other graduate students and researchers.”
A surge in Graduate School enrollment is another way to measure that success. In just the past five years, it has grown from about 3,400 to more than 5,100. Graduate students now make up about 22 percent of ECU’s total enrollment of more than 24,000.
Priming the pump As it enlarges its research capabilities, East Carolina is learning that you often have to spend money to make money. It’s doing that through several internal grant channels, including more than $1 million a year in “seed money” it doles out to help recruit promising new faculty and jump start their research projects. The start-up packages range from several thousand dollars to $200,000 and more, especially in fields like the physical sciences where the costs of establishing a research laboratory tend to be high.
One recipient of this seed money is associate professor Dr. Jennifer Bugos, the university’s first music researcher. She hopes to determine how music may help improve mental clarity in older people. She is working with colleagues in allied health and psychology to see how concentration and music instruction are related.
“The ECU community of researchers is very open, and that’s important in maintaining collaborations,” she says. “It’s a great community to be a part of.”
Faculty Research and Creative Activity Awards also can help cover the cost of initial data gathering, which is usually required before a researcher becomes eligible for outside funding.
Dr. Rebecca Torres, an assistant professor of geography, was able, with colleague Dr. Jeff Popke, to use such a grant to begin research into the demographics of Mexicans who come to North Carolina to work. She has since received a $430,000 grant from the National Science Foundation to continue her work on immigration to the rural south.
The research and graduate studies division also works closely with academic departments to shape the university’s goals of expanding creative projects and grant funding for them.
“We have to increase the numbers of faculty who are research productive,” says DRGS Associate Vice Chancellor Paul Gemperline (
left). “So while the message is coming from the deans and department chairs that people need to be more productive, we are also providing seed funds.”
Faculty are embracing the challenge of becoming more research oriented, Mageean says. “We’re really moving,” she says. “We’re agile and nimble, and not as heavily invested in traditional views the way some universities are.”
“This is how the model should work,” Burr said about ECU’s collaboration with Johnson & Johnson in medical research. “It’s leveraging all the assets we have in the United States that the rest of the world can’t do because they don’t have the infrastructure.”
While early indications are that ECU’s new research model is working well, the university has turned to outside experts to evaluate its effectiveness. It retained the Yardley Research Group to review all graduate research programs and make recommendations. The university now has received that report and is implementing many of its suggestions.
“We owe it to our students to expose them to cutting-edge research, to set a standard for the skill level we expect so they will be prepared,” Mageean says. “Our students deserve the best exposure to research in their education.”
“It’s important, as we move forward, that we focus our research on solving problems and helping with the health care needs of people in eastern North Carolina,” says Dr. Martha Engelke, associate dean for research and scholarship at the School of Nursing.
Regional problems, global approach Much of the new research being conducted at ECU focuses on wind and water—two vital yet unpredictable elements of the eastern North Carolina economy. With rising sea levels threatening many coastal counties and hurricanes regularly rampaging across the state, this research holds important implications for the future of eastern North Carolina.
At the heart of this effort is the Institute for Interdisciplinary Coastal Science and Policy, which brings together the doctoral program in coastal resources management and the Institute for Coastal and Marine Resources and several other areas. Coastal Systems Informatics and Modeling, known as C-SIM, will examine diverse hazards to determine how computer databases can help communities cope with natural disasters.
Through a $1.7 million, three-year grant from the Chapel Hill-based Renaissance Computing Institute, ECU is housing a database designed to keep public health, population and scientific records that focus on the region’s coastal areas.
Ernest Marshburn, DRGS director of strategic initiatives, said the initiative will pull together the region’s atmospheric, ecological, medical and economic data, with the goal of helping the region and its residents have the tools to be better prepared.
The data will also prove useful for medical and emergency responders, said Dr. Lloyd Novick, director of the Division of Community Health and Preventive Medicine at the Brody School of Medicine. “The most critical problems associated with disasters are protecting the health of the public and arranging for the ongoing care of individuals with existing chronic diseases,” said Novick. “The informatics project is a major step forward in meeting the health needs of eastern North Carolina and preparing for disaster.”
Meanwhile, ECU’s North Carolina Center for Sustainable Tourism will help small towns promote and protect their assets. “This is an area with lots of beautiful resources and people want to visit here,” Mageean says. “They want to visit our Outer Banks and inner banks, our historic towns. So how do we build that industry, but not have so much development that no one wants to come here?”
Attacking these problems can benefit those who haven’t even heard of eastern North Carolina. “We can have a global effect, since 80 percent of the world’s population lives within 100 miles of a coast,” says Dr. Patrick Pellicane, dean of graduate studies. “There are environmental, social and economic issues that are common denominators around the world.”
As those initiatives go forward, East Carolina is continuing to explore health-related research. The latest example of that is the East Carolina Heart Institute, a heart hospital, teaching and research center now under construction on the medical campus. The $60 million facility will house clinical, research and educational components where faculty and staff will work together in outpatient care, research, training and educational activities. The four-story, 206,000-square-foot facility will house science and clinical research, robotic-surgery training, future space for simulation laboratories, a clinical outpatient facility for cardiovascular diseases, a database center, offices and an auditorium.
Relishing the 'aha' moment 
After more than 20 years of research into what causes obesity and related diseases like diabetes, the moment of revelation was thrilling for the teams of ECU researchers. It came when follow-up studies on patients who had the “Greenville gastric bypass” showed that diabetes disappeared in four out of five of them. “The ‘aha!’ moment was when we saw reversal of diabetes in a week,” Dr. Lynis Dohm (
right) remembers.
Obesity causes 300,000 deaths and costs the U.S. health care system about $100 billion a year. It’s a greater threat to human health in the U.S. than tobacco. It robs people of their quality of life while killing them slowly with heart disease, high blood pressure, diabetes and chronic illness.
Researchers at ECU are working to crack the code of this epidemic, in hopes their discoveries will lead to better treatments. In the search for causes, they have some critical findings.
Ongoing studies at the Human Performance Lab, in tandem with the School of Medicine, have shown overweight people have a glitch in their inner furnace, making them unable to burn fat the way someone of normal weight does. Instead of burning fat, they store it, especially in muscle tissue. They gain weight and find it almost impossible to lose.
“Very overweight people really are different,” says Dr. Joseph Houmard, director of the Human Performance Lab, part of the College of Health and Human Performance. “It’s not just that they eat a lot and don’t do any physical activity. There are real metabolic problems. You may remember the kid in high school that could eat a lot and not gain weight, and others who seem to look at food and gain weight. They are different.”
The idea that obese people had a problem was not entirely new when the team began taking a closer look a few years ago, but ECU researchers were able to demonstrate it was true.
“The defect in fat oxidation answers a lot of questions about why people get obese,” Houmard says. “We have been part of the group that has proven it is real. We’ve shown it in human subjects, and we’ve also taken pieces of muscle and shown it there. We’ve also shown it in cell cultures that we grew from their muscle. So we have a comprehensive picture of it as a real phenomenon.”
Because the muscle tissue of overweight people doesn’t burn fat well, they become prone to insulin resistance, weight gain and diabetes.
Dr. Walter Pories, whose refinements to gastric bypass surgery more than 20 years ago at the ECU medical school helped make it a safe method of weight loss, launched these breakthrough studies with his discovery that the procedure appeared to reverse diabetes in obese patients.
What’s more, his patients’ diabetes went away even before they lost significant amounts of weight. “It’s evident that diabetes is probably caused by the intestine,” he says. “That’s a big deal.” Those results eventually caught the attention of Johnson & Johnson, which granted the university $491,000 in 2005 to fund further studies.
“Dr. Pories was the first to report that diabetes was reversed after gastric bypass,” recalls Dohm, a physiologist at the medical school who has worked closely with Pories for many years and today continues to study insulin’s signals to the cells.
These days Dohm continues to search for the possible defect that interferes with an obese person’s ability to use the hormone insulin, essential for human metabolism.
“I am interested in the insulin signaling pathway, and how it is blunted in the muscle of obese people, making them insulin resistant,” he says. “Those two seem to be linked—the fat that accumulates in the muscle tends to cause the insulin resistance. You have to figure out what fat oxidation does that reduces insulin signaling.”
Over the years, the research teams have included, in addition to Pories and Dohm, Drs. Hisham Barakat, research director of the Diabetes and Obesity Center at ECU, colleagues in Exercise and Sports Science including Ronald Cortright, Robert Hickner, Darrell Neufer, Scott Gordon and Timothy Gavin, endocrinologists Dr. Chris Newton and Dr. Robert Tanenberg, surgeon Dr. William Chapman, Dr. Edward Seidel and nurse Rita Bowden, among others.
They collaborate, yet pursue individual research that may one day lead to better treatments for obesity and diabetes. ECU is home to the Metabolic Institute, approved by the UNC Board of Governors in 2005 and of which Pories is chief.
“This university is one of the few places where lots of people get together to look at a major project,” Dohm says. “Joe and I have been partners for 15 years, Walter and I for more than 20 years. We have our individual projects but they are integrated in a way that supports each other.” —
Marion Blackburn 
