2024 Awardees
Six early-stage research projects that seek to expand the boundaries of integrative healthcare have been awarded UC Irvine Susan Samueli Integrative Health Institute Pilot Program grants for 2024.
Projects were selected based on their potential to transform medicine by generating new insights into the mechanistic basis of integrative therapies or producing evidence of their clinical outcomes. Each study demonstrated a clear evolution towards novel, relevant, and untested research areas. Recipients receive a one-year award of $25,000.
The institute partners with the UC Irvine Institute for Clinical and Translational Science on the award, participating in a national Clinical Translational Science Awards External Reviewer Exchange Consortium (CEREC), to provide a fair scientific review process and better match applicants with feedback from experts in their respective fields.
Congratulations to the following teams and individuals.
Beyond Antibiotics: Advancing Phage Therapy at UC Irvine and in California
In the face of rising antibiotic resistance, finding effective alternatives to treat bacterial infections has become a pressing need in the medical community. At the University of California, Irvine (UC Irvine), we are working toward establishing infrastructure to enable exploring phage therapy—a promising approach using bacteriophages, which are viruses that specifically target and kill bacteria. This project focuses on getting past the first step of screening for an effective phage in three active cases at UC Irvine. We aim to improve treatment in more chronic infections, when there is enough time to find and produce a phage. Persistent urinary tract infections (UTIs) that are resistant to conventional antibiotics are a particular focus of the team. Led by a team including phage scientists, infectious disease and UTI expert clinicians, at both UC Irvine and the University of California, San Diego (UC San Diego), the research aims to develop and refine phage therapy protocols. These procedures could open a critical door to alternatives for how antibiotic resistant infections are treated, not just at UC Irvine, but throughout Southern California. Phage therapy offers a targeted approach to infection treatment, and in the long term could potentially avoid the side effects and complications associated with broad-spectrum antibiotics. This research could significantly impact patient care by establishing a pipeline for battling recalcitrant, chronic, antibiotic-resistant infections. By integrating advanced research with clinical applications, the project hopes to pave the way for new standards in infectious disease treatment and integrative health.
Impact of Sodium Bicarbonate (baking soda) on 24-hour Urine Parameters in Hypocitriuric and Uric Acid Stone Formers
The incidence of kidney stone disease continues to rise globally. Although the treatment of kidney stone disease has dramatically improved in recent years, surgical management remains invasive and expensive. Patients who develop kidney stones are at high risk of recurrence during their lifetime; therefore, prevention of stones should be a primary focus. Low levels of citrate and acidic urine are risk factors for the formation of kidney stones such as calcium oxalate and uric acid, respectively. Calcium oxalate stones are the predominant stone composition in the United States, accounting for over 75% of stones. Citrate is a key inhibitor of calcium oxalate crystal formation and thus increasing it in the urine of a calcium oxalate stone former is beneficial. Uric acid stones account for approximately 10% of all stone types. These stones form primarily due to an acidic urinary environment which is a prerequisite for crystal formation. Common medications for stone formers include potassium citrate which helps to increase urinary citrate levels and to make the urine more alkaline. Although effective, these medications have side effects and are expensive (upwards of $450/month for Urocit®-K). Earlier work by us and others has shown that consuming Baking Soda (sodium bicarbonate) may prove to be an equally effective, inexpensive alternative ($0.34/month) with respect to increasing urinary citrate levels and alkalinizing the urine. We hypothesize that twice a day, oral Baking Soda in a liquid medium (e.g., water, orange juice, soda, etc.) can be an effective and inexpensive alternative to standard potassium citrate therapy with regard to alkalinizing the urine and raising urinary citrate levels. A definitive clinical trial in this regard has yet to be performed.
Neuroscience Education as a Tool to Improve Exposure Therapy for Anxiety
Anxiety disorders are the most common psychiatric disorders, affecting about a third of U.S. adults in their lifetime. The high prevalence of anxiety is particularly concerning because anxiety disorders may lead to or worsen other health conditions, such as ulcers and cardiovascular disease. Exposure therapy is a well-established and effective treatment for anxiety-related disorders, but many patients do not complete therapy or continue to have symptoms after treatment. Therefore, researchers are looking for ways to improve exposure therapy outcomes. One promising approach for improving psychotherapy compliance and outcome is neuroscience education (neuro-education) – teaching patients about how their brain works, and how it processes stress and anxiety. Studies show that when we explain psychological phenomena using information from neuroscience, people are more likely to find the explanation convincing and appealing. Studies also show that teaching patients with chronic pain about how the brain processes and regulates pain substantially reduces pain and disability. However, no study has tested whether neuro-education about how the brain regulates stress and emotions can help people manage their stress and emotions. Therefore, we propose to develop neuro-education videos to test whether neuro-education can improve the outcome of exposure therapy for anxiety. We will recruit adults with anxiety, and clinicians who administer exposure therapy, to test the acceptability of the videos as an add-on to exposure therapy. Then, an additional group of adults with anxiety will be recruited and randomly assigned to receive either neuro-education or a control treatment to test the preliminary efficacy of neuro-education. This study can help establish neuro-education as a new tool for improving standard therapies for various anxiety-related disorders, in the same way that neuro-education has improved standard therapy for chronic pain. If successful, this tool could also be applied to other conditions related to self-regulation, such as addiction and mood disorders.
Effects of a Targeted Nutritional Supplement on Postoperative Complications and Muscle Wasting after Posterior Lumbar Decompression Surgery: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial
An increasing number of candidates for lumbar spine surgery are elderly, frail, and malnourished. Paraspinal muscle atrophy following surgery has been correlated with worse clinical outcomes, pain, and progression of sagittal imbalance. Our goal is to investigate the effect of essential amino acid supplementation on the preservation of native paraspinal muscle volume and factors that may explain variability in muscle volume measured after lumbar spine surgery, including functional status, postoperative pain, and opioid consumption. We hypothesize that twice daily supplementation for 3 weeks perioperatively with a commercially available medical food will result in enhanced paraspinal muscle preservation postoperatively, which may also serve to improve functional outcomes, reduce postoperative complications, decrease postoperative pain and opioid use, and preserve spinal sagittal alignment. To test our hypothesis, we propose a two-arm, randomized, placebo-controlled, double-blinded, single-center clinical trial to elucidate the effects of perioperative essential amino acid supplementation. We aim to enroll a minimum of 88 patients with 44 in each group. Demographic and baseline information regarding nutritional and functional status will be collected at the baseline visit, including ambulatory status, food preferences, Protein Screener 55+, modified Fragility Index, and baseline labs (serum albumin, prealbumin, and transferrin), functionality, pain scores, and medication use. From one week prior to surgery until two weeks postoperatively, patients will consume either 20g of amino acid supplement twice daily or a volume-matched control consisting of alanine powder. Fellowship-trained spine surgeons will perform all lumbar spine surgeries using the same operative approach. Repeat lumbar spine MRI at eight to 10 weeks postoperatively with cross-sectional area measurements of paraspinal muscles and spinopelvic measurements, labs, functional assessments, and pain/opioid records will be evaluated at follow-up visits.
Measuring Diet-Related Small Habits in Cancer Survivors: A Pilot Study
The incidence of cancer survivorship in the United States is increasing rapidly, with a projection of 22.2 million by 2030. Adherence to general healthy dietary recommendations, e.g., achieving a healthy body weight, being physically active, and following a dietary pattern rich in whole grains, fruits, and vegetables, has been correlated with improved outcomes in cancer survivors. However, previous studies have found low adherence to these guidelines in cancer survivors. In response to this issue, we are developing an AI-assisted intervention program tailored to promote Diet-Related Small Habits (DISHs) among cancer survivors. The concept of DISH comprises a series of small daily behaviors that directly or indirectly affect dietary intake. These behaviors have been recognized and recommended by nutritional and behavioral scientists in previous studies. However, they have not been thoroughly analyzed or deliberately cultivated into daily habits. To advance this initiative, we have constructed a survey aimed at evaluating the awareness and behaviors of DISHs. In the next phase, we will design a personalized intervention utilizing machine learning techniques to enhance the efficacy of these dietary habits. To ensure the feasibility of this intervention on a larger scale of people, we are initiating a pilot study with a small number of cancer survivors. This study will assess participants’ awareness of DISHs, evaluate their dietary intake, and gather their medical histories. Based on the data collected, we will develop a personalized intervention program informed by predictive models derived from machine learning algorithms. The outcomes of this pilot study will provide essential data to inform the planning and execution of a subsequent randomized clinical trial.
Utilizing EndoPAT Device for Endothelial Dysfunction Assessment in Erectile Dysfunction and During Hypogonadal Therapy
Endothelial dysfunction is increasingly recognized as a crucial factor in various pathophysiological conditions, including erectile dysfunction (ED) and hormonal therapy-related complications. This proposal seeks to leverage the EndoPAT device, a non-invasive tool for assessing endothelial function, to explore the interplay between endothelial health, ED, and hormonal therapies. The primary objectives of this study are threefold. Firstly, we aim to evaluate endothelial dysfunction in young men (aged 30-50) presenting with vasculogenic ED, identified through penile Doppler ultrasound. Secondly, we intend to assess changes in endothelial function using the EndoPAT device before and 3-6 months after initiating daily low-dose phosphodiesterase type 5 (PDE5) inhibitor therapy. Lastly, we seek to investigate alterations in endothelial function among hypogonadal patients before and after initiating testosterone (T) therapy. Participants will be recruited from the UCI Men’s Health Clinic following ethical approval. Endothelial function assessments will be conducted using the EndoPAT device following standardized protocols. Intervention strategies will include penile Doppler ultrasound for ED patients, daily low-dose PDE5 inhibitor therapy, or initiation of T therapy for hypogonadal patients. Follow-up assessments will occur at 3- and 6-month intervals post-intervention, with data analyzed using appropriate statistical methods. Anticipated outcomes include the identification of endothelial dysfunction prevalence in young men with vasculogenic ED, insights into the impact of low-dose PDE5 inhibitors on endothelial function, and understanding endothelial alterations in hypogonadal patients undergoing T therapy. In conclusion, employing the EndoPAT device for assessing endothelial dysfunction in ED and hormonal therapy settings holds promise for yielding valuable insights into cardiovascular health and treatment efficacy, potentially informing clinical practice and therapeutic strategies.
