The Upside of Three on a Match: NCCAM fellow Marni Silverman (center) and her two mentors, NIMH's Esther Sternberg and NCCAM's Patrick Mansky. "Marni," says Sternberg,"is the glue between us"

The first two winners of the NCCAM Director's Fellowship have been  named: Marni Silverman, whose doctorate is in neuroscience, has already arrived at NIH, and Patrick McCue, whose degree is in molecular and cellular biology, is due in July. 

Silverman began work at NIH in February after receiving her Ph.D. in neuroscience from Emory University in Atlanta.

Her motivation in applying for the NCCAM fellowship, she says, was to examine the "physiological and molecular mechanisms by which CAM therapies, or mind-body interventions, are effective in alleviating depressive symptomatology in the medically ill." 

She is based in the lab of Esther Sternberg, head of the Section on Neuroendocrine Immunology and Behavior, NIMH. Her selection in the NCCAM competition was based not only on her own qualifications and the nature of the proposed research but also on the capabilites and relevance of the lab she designated as her desired base. "There  had to be a good match between the postdoctoral fellow and the lab," Sternberg notes.

The Cortisol Connection

Silverman's fellowship comprises two research projects: One explores the relationship of glucocorticoid resistance and inflammation vulnerability to genetic variants in the glucocorticoid receptor (GR); the other explores the effects of tai chi on the quality of life of cancer survivors.

Glucocorticoids such as cortisol are the brain's messengers in mediating the body's stress response and are potent modulators of the immune system, Silverman notes.

"Intriguingly," she says, "we can study both ends of the workings of cortisol, from the [mechanisms by which] cells receive the cortisol signal to the effect of tai chi on cortisol levels."

Noting that her dissertation centered on neuroendocrine-immune interactions—cytokine activation of glucocorticoid responses—Silverman says she is eager to piece together the genetic component of this dynamic and the related behavioral interventions  that can have a clinical effect.

The project, observes Sternberg, "fulfills both objectives" of the NCCAM director's fellowship—"basic research relevant to the [patient-care] issue and clinical research central to the issue." 

In the basic-research project, Silverman is hoping to substantiate a role for genetic variants of GR in the susceptibility to inflammatory syndromes that could be extended to immune-related diseases, such as asthma and rheumatoid arthritis.

This research might also shed light on reasons for individual differences in responsiveness to CAM therapies, Silverman says.http://intramural.nimh.nih.gov/snib/index.htm

Fellowship Promotes Evidence-Based CAMaraderie

Good Fellowship: (left to right): Patrick Mansky, NCCAM clinician; Marni Silverman, NCCAM director's fellow; Esther Sternberg, NIMH section head; and Andrea Deak, NIMH postdoc in Sternberg's lab, chose a photogenic place in the Clinical Research Center to hold a meeting to discuss Silverman's NCCAM fellowship projects, which connect the research interests of both ICs Complementary and alternative medicine (CAM) is used by 36 percent  of American adults to treat a spectrum of diseases and conditions. Because of the breadth of health conditions for which CAM is used, NCCAM has collaborated in its research efforts with many of the NIH institutes and centers (ICs). Recently, NCCAM created a new collaborative program—the NCCAM Director's Fellowship—to promote the training of promising young CAM investigators by supporting their work in the intramural laboratories of senior scientists in other ICs. Ultimately, the fellows will serve as a bridge between their mentor's laboratory and NCCAM. The fellowship, says NCCAM Director Stephen Straus, "exemplifies our approach to promoting the integration of evidence-based CAM practices into conventional biomedicine."   It also provides an innovative means through which NCCAM can recruit and train the next generation of CAM researchers, he observes, noting that the program has gained wide support throughout NIH. That support has been rewarded, he observes, by the "excellence" of the program's inaugural awardees—Marni Silverman and Patrick McCue. The fellowship provides full research support for two years of clinical, translational, and/or laboratory research. It is funded by NCCAM in partnership with the Prince of Wales Foundation through the Foundation for the NIH. —Leikny Johnson

A Step Beyond Cancer Survival:
Comparing Tai Chi And Physical Exercise

In her second project, Silverman plans to explore changes in neuroimmune markers in cancer survivors practicing a mind-body intervention such as tai chi compared to physical exercise.

For this project, she is collaborating with NCCAM's Patrick Mansky, who is studying the efficacy of tai chi versus moderate exercise to reduce stress and improve metabolic parameters and physical and psychological well-being in adult cancer survivors.

The NCCAM Director's Fellowship served as the vehicle for the first collaborative contact between Mansky and Sternberg. Without that vehicle, Sternberg observes, this valuable exploration might have been viewed as a diversion of lab resources.

Patrick McCue	James Phang

Botanical Extracts and Cancer Prevention

McCue received his Ph.D. in molecular and cellular biology from the University of Massachusetts at Amherst and is currently at the Genome Research Facility at the NASA Ames Research Center, Moffett Field, Calif., where he is investigating herbal antioxidants as countermeasures for radiation injury.

In July, he will be joining the Laboratory of Comparative Carcinogenesis, NCI-FCRDC, where he will work with James Phang, who heads the Metabolism and Cancer Susceptibility Section.

When asked what attracted him to CAM research, McCue pointed to the "challenge of applying cutting-edge research techniques to the study of CAM modalities" and contributing to a science-based perspective that generates a better understanding of how such therapies work.

He plans to investigate the chemopreventive mechanisms of action of botanical extracts against cancer cells using a functional genomic approach.

The underlying hypothesis is that phenolic antioxidants in the extracts may promote apoptosis by modulating the link between the proline and pentose phosphate pathways.  

He will enlist high-throughput technologies, high-density DNA microarrays, computational biology, and bioinformatics in the investigation of this hypothesis.

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