Text Alternative: Research for a Lifetime: The Journey Forward

To view the original video and read the News Release, please go to https://www.nichd.nih.gov/news/resources/spotlight/Pages/120412-scientific-colloquium.aspx

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National Institutes of Health, NICHD, 50 Years logo

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Camera zooms back to reveal that anniversary logo is on a tablet computer screen.

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Research for a Lifetime: The Journey Forward

 

 

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Alan Guttmacher, M.D. Director, NICHD

Dr. Alan Guttmacher: I think the significance of any anniversary, certainly one like the 50th anniversary, is both to have a celebration of what we've accomplished, to think about what we've accomplished, to think about who we are as an institution, and how did we get here. But I think even more importantly than thinking about the past, thinking about the future. So, how has what we've done in the past prepared us for the future? How do we perhaps need to refine some of our approaches, some of our emphases to make sure that we are productive, or even more productive over the next 50 years as we've been over the past 50 years?

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Early Development

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Lorette Javois, Ph.D. Health Scientist Administrator, NICHD

Animal models

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Dr. Lorette Javois: So in terms of birth defects research, every organ system, every major organ system that develops in a human baby also develops in the zebrafish.

Dr. Brant Weinstein speaks on screen. Many fish tanks are behind him.

 

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Brant Weinstein, Ph.D. Senior Investigator, NICHD

Zebrafish

Dr. Brant Weinstein: We've actually found that a number of genes that are known to cause defects in humans, cause hemorrhagic stroke defects in humans…

Close-up of zebrafish swimming.

Dr. Weinstein: …similarly cause fish to have hemorrhages in their heads when you knock these genes out in fish.

Dr. Weinstein speaks on screen. Many fish tanks are behind him.

Dr. Weinstein: We've gone and tried to understand more about this gene pathway and about how these genes work with an eye toward potentially helping people that have defects in these genes or that have hemorrhagic stroke defects to better understand what we can do to help those people.

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Healthy Pregnancy and Infants

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Video of Dr. Marian Willinger speaking appears, then becomes full screen.

 

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Marian Willinger, Ph.D. Acting Chief, Pregnancy and Perinatology Branch, NICHD

Preterm birth

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Dr. Marian Willinger: There are several negative outcomes for infants who are born preterm. For example, they are at greater risk of dying …

Baby in incubator.

Dr. Willinger: …18,000 infant deaths each year are to babies born preterm.

Dr. Willinger speaks on screen.

Dr. Willinger: There is a treatment for women who have recurring spontaneous preterm birth…

Pregnant woman in hospital, laying in bed.

Dr. Willinger: …and we did a study and found that if these women are treated…

Dr. Willinger speaks on screen.

 

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Reduce the chance of preterm birth by one-third

Dr. Willinger: …at 16 to 20 weeks with a hormone, progesterone, we can reduce the chance that these women will have a preterm birth by one third.

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Structural variations

Dr. Willinger: Myelomeningocele is a birth defect in which…

Illustration of baby with Myelomeningocele birth defect.

Dr. Willinger: …the spinal column doesn't close properly over the spinal cord. Traditionally…

Dr. Willinger speaks on screen.

Dr. Willinger: …babies who have myelomeningocele are, their spinal cord is repaired after birth. But we had reason to believe that if we repaired the spinal column in utero, then the brain and the spinal cord would have a better chance of developing normally, and, the baby would do better. And what we found was the babies who were repaired in the womb had much better outcomes. They were less likely to die or have shunt placement after birth…

Toddler walking with help of mother.

 

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Twice as many babies were able to walk

Dr. Willinger: …and they had less motor disability, and at 30 months twice as many of those babies were able to walk than the babies who had repair after birth.

Dr. Lynne Mofenson speaks on screen.

 

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Lynne M. Mofenson, M.D. Chief, Maternal and Pediatric Infectious Disease Branch, NICHD

HIV in children

Dr. Lynne Mofenson: HIV infection in children was basically a fatal disease and 60 percent of children died by the time they were aged two years and we first found that using one drug…

Drug capsules being counted.

Dr. Mofenson:…reduced the risk of disease progression and currently we use three or more drugs in these children…

Dr. Mofenson speaks on screen.

 

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Treatments have shifted HIV to a chronic disease

Dr. Mofenson: …and we're seeing increased survival into young adulthood. There's been a complete paradigm shift in HIV from a fatal disease to currently a chronic disease like diabetes.

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Mother-to-child HIV transmission

U.S. transmission rate is now less than 1%" text appears on screen.

Dr. Mofenson: Because HIV was a fatal disease in infants, we really needed to find a way to prevent mother to child transmission and in the early 1990s, the only drug available was zidovudine or AZT. And we gave that drug to the pregnant woman during pregnancy, during labor, and to the infant for six weeks, hoping that that would be effective. And I'll never forget, it was Presidents' Day weekend, 1994, when the Data and Safety Monitoring Board came back to us and said, you should stop the trial, this is 67 percent effective in reducing mother to child transmission, and you should let everyone know that this is an effective therapy.

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Healthy Children

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Melissa Parisi, M.D., Ph.D. Chief, Intellectual and Developmental Disabilities Branch, NICHD

Newborn Screening

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Dr. Melissa Parisi: Newborn screening is a nationwide screening program with well over 99 percent of children being screened. So that represents 4.3 million infants per year.

Newborn in hospital being wiped by nurse.

Dr. Parisi: Now most of those infants are perfectly normal and don't have any abnormalities detected by newborn screening…

Dr. Parisi speaks on screen.

Dr. Parisi: …but for those that do have an abnormality, you can institute treatments that can help prevent very severe complications, including intellectual disability, severe disabilities, or even death…

Image of nurse conducting a blood spot test on newborn's foot.

Dr. Parisi: The first condition screened for in most newborn screening programs was PKU or phenylkentonuria. In fact, in most newborn screening programs, even worldwide, that's one of the first tests that they usually start.

Dr. Parisi speaks on screen.

 

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Screen for more than 30 conditions

Dr. Parisi: It is remarkable to realize that in the past 50 years we've actually been able to expand newborn screening from that single test for PKU, to now 30 different conditions, and that's largely due to all the research that's been done to help us understand these conditions so much better.

Dr. Gilman Grave speaks on screen.

 

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Gilman Grave, M.D. Chief, Pediatric Growth and Nutrition Branch, NICHD

Childhood obesity

Dr. Gilman Grave: So, the newest and youngest of our longitudinal cohort studies is Project Viva to look, again, at precursors of childhood obesity, childhood hypertension, and early indications of the metabolic syndrome in children.

Sonogram in motion shows a fetus in utero with heart beating.

Dr. Grave: We've learned, for instance, that leptin levels in utero…

Dr. Grave speaks on screen.

Dr. Grave: …determine obesity later in life – that the lower the leptin levels the more likely by age three a child will be significantly obese.

Mother holding newborn in hospital room.

Dr. Grave: That babies who are born by cesarean section have twice the rate of obesity at age three than babies who are born vaginally…

Dr. Grave speaks on screen.

 

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Early events significantly influence childhood obesity

Dr. Grave: …and we've also learned that very early introduction of solid food before four months of age leads to a very surprising six times increase in the rate of childhood obesity by age three.

Dr. Valerie Maholmes speaks on screen.

 

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Valerie Malhomes, Ph.D., C.A.S. Acting Chief, Pediatric Trauma and Critical Illness Branch, NICHD

Family dynamics

Dr. Valerie Maholmes: With some of our basic foundational research, we're able to assess the prevalence and incidence of abuse and neglect and other kinds of relational issues that might occur within a home…

Family playing outdoors.

Dr. Maholmes: …so, looking at the family dynamics, how mom and dad interact with each other, how the parents interact with the children, and how the siblings interact with us…

Mother and toddler son playing on a playground.

Dr. Maholmes: …with each other, helps us to really understand what that dynamic is in the family…

Dr. Maholmes speaks on screen.

Dr. Maholmes: Because we start with our basic foundational questions. What is the prevalence and incidence of abuse and neglect, let's say for example, in families that are experiencing poverty, who are at or below the poverty level. What are the underlying mechanisms of poor child outcomes, especially children who might grow up in these kinds of contexts.

Mother playing with baby girl.

Dr. Maholmes: So, having descriptive studies or studies, epidemiological studies, or basic behavioral and biobehavioral research studies…

Dr. Maholmes speaks on screen.

 

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Studies lead to intervention possibilities

Dr. Maholmes: …that give us answers to those questions, then gives rise to the array of intervention possibilities.

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Healthy Adults and Families

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Alicia Armstrong, M.D. MHSCR Chief, Clinical Services, Program in Reproductive and Adult Endocrinology, NICHD

Uterine fibroids

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Dr. Alicia Armstrong : It's estimated that approximately 80% of African-American women and 70% of Caucasian women will have fibroids by the age of 50. Of those only about a quarter or 25% have symptoms.

Researcher in lab setting.

Dr. Armstrong: The work that we're doing here at NICHD I think will have…

Woman talking to her doctor in an exam room.

Dr. Armstrong: …innumerable effects on the reproductive health of women not just in the United States…

Dr. Armstrong speaks on screen.

 

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Global research efforts and resources

Dr. Armstrong: …but throughout the world. One of my colleagues Doctor James Segars, for example, has a fibroid tissue bank and he offers tissue specimens to researchers across the globe and so supports the research of investigators not only the United States but throughout the world.

Dr. Michael Weinrich speaks on screen.

 

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Michael Weinrich, M.D. Director, National Center for Medical Rehabilitation Research, NICHD

Medical rehabilitation

Dr. Michael Weinrich: So the overall goals of rehabilitation research at the NICHD are to improve the function and quality of life for individuals who have…

Image of brain scans.

Dr. Weinrich: …suffered illness or injury of all kinds, including traumatic brain injury.

Robotic hand grabs beverage.

Dr. Weinrich: BrainGate is a multi-electrode array of…

Dr. Weinrich speaks on screen.

Dr. Weinrich: …tiny microelectrodes which are directly implanted…

Animation of BrainGate system connected to a man in a wheelchair who is looking at a computer monitor.

Dr. Weinrich: …into the cerebral cortex, to the outer layer of the brain.

Dr. Weinrich speaks on screen.

Dr. Weinrich: These electrodes can record signals from individual nerve cells, and they are processed by some very sophisticated computer algorithms to allow patients to…

Woman uses BrainGate system to control robotic arm and drink beverage. The woman and a researcher in the background both smile after she is able to take a drink.

Dr. Weinrich: …actually control external devices by using the signals from the brain, by actually thinking about doing something.

Dr. Peter Basser speaks on screen.

 

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Peter Basser, Ph.D. Senior Investigator, NICHD

Diffusion-tensor magnetic resonance imaging

Dr. Peter Basser: DT-MRI provides information about, primarily about wiring in the brain, the white matter, the nerves that traverse the brain.

Colorful brain scan image.

Dr. Basser: It can provide information about the clinical conditions, such as autism or schizophrenia --

Dr. Basser speaks on screen.

Dr. Basser: things that have been very difficult to analyze or describe…

Image of genetic sequence.

Dr. Basser: …using conventional imaging methods, or even genetics.

Dr. Basser speaks on screen.

Dr. Basser: It provides information about the viability of the fetus in utero and the health of the mother and allows us to look at the brain structure from womb to tomb.

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Research Strategies

Illustration of a microscope.

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Finger swipes tablet screen. Video of Dr. Constantine Stratakis speaking in a laboratory setting.

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Constantine, Stratakis, M.D., D (Med) Sc Scientific Director, NICHD

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Dr. Constantine Stratakis: What makes our intramural research program unique is that it doesn't necessarily focus on a single disease…

Researcher looking at molecular model on computer screen.

Dr. Stratakis: …or on a single system. It is focusing on human development.

Dr. Stratakis speaks on screen in a laboratory setting.

Dr. Stratakis: We are uniquely positioned within one of the largest research campuses in the world, next to a wonderful clinical research center…

Silent video from another time of Dr. Stratakis walking into the pediatric day hospital of the NIH clinical center.

He talks to other medical professionals.

Dr. Stratakis: …where we can see this basic science being conducted…

Silent video from another time of Dr. Stratakis walking down a hallway reading a patient's medical record.

Dr. Stratakis: …right next to where the patients are…

Dr. Stratakis speaks on screen in a laboratory setting.

Dr. Stratakis: …and, so, we can translate these findings immediately to clinical applications.

Dr. Catherine Spong speaks on screen.

 

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Catherine Y. Spong, M.D. Associate Director for Extramural Research, NICHD

Dr. Catherine Spong: Now, the NICHD mission is broad. It encompasses all of development, from basic biology, through translation medicine, through clinical trials. It includes pediatrics, obstetrics, rehabilitative medicine as well as basic science research and demography and behavioral research.

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Dr. Spong: speaks on screen.

Dr. Spong: NICHD actively works with cross collaboration both within the Institute across different branches as well as outside the Institute…

Image of professionals in a meeting.

Dr. Spong:: …to other institutes, agencies, and other professional societies and organizations.

Dr. Yvonne Maddox speaks on screen.

 

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Yvonne T. Maddox, Ph.D. Deputy Director, NICHD

Dr. Yvonne Maddox: One of the many areas about the NICHD that I am particularly proud of is our commitment to health equity.

Man in wheelchair and nurse interacting.

Dr. Maddox: We know that there are health inequities in terms of length of life, the quality of life,

Man and woman at the hospital, man is being examined by doctor.

Dr. Maddox:  the different rates of infant mortality and preterm birth,…

Nurse examining a toddler who is playing with the stethoscope.

Dr. Maddox: …childhood obesity and diabetes, to name a few.

Dr. Maddox speaks on screen.

Dr. Maddox: But our research is peeling away, layer by layer, some of the underlying biological and behavioral reasons for these health inequities.

Researcher in lab.

Dr. Maddox: And as the research looks more closely at the concept of developmental origins of health and disease, with an emphasis on the role of environment, we're likely to have great success against these health inequities…

Dr. Maddox speaks on screen.

Dr. Maddox: …and move towards an optimum health for all Americans.

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Looking to the future

Illustrations of a fish, pregnant woman, child on a swing, four adults, and a microscope.

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Video of Dr. Guttmacher speaking appears, then becomes full screen.

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Dr. Guttmacher: Well the possibilities are great, across all of the areas of our mission. They are different kinds of possibilities. What they have in common is that we have some new scientific research tools and they're just opening new doors of exploration for us and doors of exploration that we think will be satisfying to walk through but also in doing that, really will give us new tools to prevent disease, to be able to look at, using the developmental lens we always have, to be able for instance to get real with the idea that the child is father of the man and mother of the woman, to really understand how early life influences -- even back in pregnancy -- have a lifelong impact on people's health and wellbeing, and to use that knowledge in a way to really improve not just health of children but health of all individuals.

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Research for a Lifetime: The Journey Forward

Illustrations of a fish, pregnant woman, child on a swing, four adults, and a microscope.

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Finger swipes tablet screen, the Anniversary logo for the NICHD 50th Anniversary appears on a tablet computer screen.

 

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The Anniversary logo becomes full screen.

 

 

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