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Our division is actively involved in both clinical (patient based) and basic science (laboratory) research. We have been awarded both federal and local funding for these endeavors. Funded research opportunities include the Management of Myelomeningocele Study (MOMS), an NIH multi-institutional trial studying prenatal and postnatal closure of spina bifida. Division Director John W. Brock,III, M.D., is primary investigator for urologic outcomes. John C. Pope, IV, M.D. has been awarded an NIH R01 grant to support his research into bladder fibrosis (scarring) in diseases such as spina bifida, posterior urethral valves, and other forms of bladder obstruction (blockage).
Research awards won by the division include Vanderbilt's Elliot V. Newman Award for Basic Science in 2006, the Society for Pediatric Urology's Basic Science Research Award in 2006, 2007, and 2008, and Vanderbilt's Turner Hazinski Award for Basic Science in 2010. The division was also a Basic Research Prize Finalist at the American Academy of Pediatrics Section on Urology National Meeting in 2005, 2006 (First Place), and 2007 (Second Place).
Learn more about our investigators and their ongoing research below.
Dr. Brock is a primary investigator for urologic outcomes in the NIH-funded MOMS trial. MOMS is a research study designed to compare two approaches to the treatment of babies with spina bifida: surgery before birth (prenatal or fetal surgery) and surgery after birth (postnatal surgery). In 1994 doctors began trying out various methods for closing spina bifida defects while the baby is still in the mother's womb. Since that time, many improvements have been made in the procedure. It is still not known, however, whether it is better to operate on a baby with spina bifida before or after it is born. MOMS is designed to answer that question. The National Institute of Child Health and Human Development (NICHD), a part of The National Institutes of Health (NIH), has funded this study to compare how babies who have prenatal surgery do compared to those who have postnatal surgery. There are three participating MOMS Centers: the University of California at San Francisco in San Francisco, California, The Children's Hospital of Philadelphia in Philadelphia, Pennsylvania and Vanderbilt University Medical Center in Nashville, Tennessee. The study will be coordinated by the Biostatistics Center of the George Washington University in Rockville, Maryland. The goal is to find out if either treatment is better for the baby. Learn more about the MOMS study.
Dr. Pope has been awarded a federal NIH grant (NIDDK 1 R01 DK068593-01A1) to support his current research. He is one of only a few pediatric urologists nationwide to receive this prestigious award. His current research involves the study of bladder fibrosis (scarring) in diseases such as spina bifida, posterior urethral valves, and other forms of bladder obstruction (blockage). In order for the urinary bladder to act as an adequate storage vessel, it must be compliant. This means that it must hold variable volumes of urine at low pressures. Failure of the bladder to do so results in elevated pressure that is then transferred to the kidney resulting in glomerular injury and ultimately renal failure. In children, bladder outlet/urethral obstruction and neurogenic bladder disease are the most common causes of decreased bladder compliance. These disorders are important because they remain the most common cause for renal failure and renal transplantation in the pediatric population. In addition, adult patients also develop bladder fibrosis from neurogenic bladder disease and benign prostatic hyperplasia. Bladder fibrosis results from the detrusor muscle's increased workload, and histologically appears as smooth muscle hypertrophy and hyperplasia along with increased amount of connective tissue/extracellular matrix.
The goal of this research is to find mechanistic pathways which lead to the causation and progression of fibrotic human bladder disease. An understanding of the mechanisms of bladder fibrosis will allow the development of new potential new therapies to limit, if not prevent these conditions in the pediatric and adult population and lessen the impact these disorders have on society.
Dr. Tanaka's research studies the use of stem cells derived from the bone marrow as a potential treatment for the injured fibrotic bladder. Normal bladder function involves two discrete processes: bladder filling and bladder emptying. As a normal bladder fills, urine is stored at low pressures. As a normal bladder empties, the bladder smooth muscle contracts in coordination with relaxation of the urinary sphincter. Bladder injury can occur when the bladder needs to work too hard against obstruction caused by an anatomic blockage. The bladder injury can persist even after relief of the obstruction. As the scarred bladder becomes less able to store urine at low pressures, it transmits increased pressure to the kidneys. Kidney disease due to obstruction remains one of the most common reasons for end stage renal disease in children.
In other damaged organs, the role of stem cells and their recruitment to injured tissue is an active area of research with many potential clinical applications. Bone marrow derived mesenchymal stem cells are a promising source of transplantable cells because of their ability to differentiate to many different types of cells, their ability to escape immune detection by the host, and the relative ease with which they can be isolated and cultured. Current projects are investigating the potential therapeutic role of these cells for the scarred bladder.
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