TODAY news - April 29, 2004

In Southeast Asia, tobacco advertisements cast shadows as they encourage individuals to buy their deadly products.

Unfortunately, most people in this area of the world do not know that cigarette smoking is harmful to their bodies, so they continue with their addiction. That is why LLU School of Public Health is helping to prevent tobacco-caused illnesses and death in Cambodia and Lao People's Democratic Republic (PDR).

More than a year has gone by since the SPH tobacco research team received its $1 million grant from the National Institutes of Health. The grant is being disbursed throughout a five-year period, and the first year has been deemed a success.

"Our first year of planning is now complete," states Linda Hyder Ferry, MD, MPH, associate professor, department of health promotion, and principal investigator for the project, "and has resulted in a successful first training session with 16 students who will become our newest group of off-campus students at SPH."

The research team is conducting a 28-unit certificate program, Global Tobacco Control Methods, in Phnom Pehn, Cambodia, with classroom sessions every six months. Students are health professionals who work in positions of influence in Southeast Asian countries. Once the students graduate from the five-year program, they will educate people in their own countries about the harmful effects of tobacco.

"Because of the students' positions working in the Ministry of Health," explains Dr. Ferry, "their full-time jobs in the ministry will equip them with the knowledge, background, and skills needed to develop tobacco control programs for their respective countries."

In the first year, the research team has developed interpersonal relationships with key people--government officials and students. They also have the commitment of the World Health Organization and the Ministry of Health to help SPH fulfill their goals with the Adventist Development Relief Agency (ADRA).

The most recent trip to Phnom Phen, Cambodia, was March 15 to 26, 2004. The team taught courses on principles of health behavior and epidemiology of developing countries. "The epidemiology course helped train these students to be tobacco researchers, so they can conduct their own studies," explains Pramil Singh, DrPH, assistant professor of epidemiology and biostatistics, School of Public Health and School of Medicine.

Because no accurate research has been conducted regarding tobacco among Cambodians and Laotians, the students will design their own survey to gain accurate information about the health issue.

The long-term impact of this five-year project will be to: assist people who will want to quit smoking; stop people from starting to smoke; create laws for preventing second-hand smoke; and develop second-hand smoke laws to protect non-smokers of the adverse health effects.

"This grant is a unique opportunity for Loma Linda University to train Cambodian and Laotian health professionals in tobacco control and research methods," states Emmanuel Rudatsikira, MD, MPH, assistant professor, international health, SPH. "The impact of this program is expected to last for a long time since the graduates will be in a position to train others, conduct research, and write grants for future funding."

The research team members are: Linda Hyder Ferry, MD, MPH, principal investigator; Jakaran Job, MD, DrPH; Floyd Petersen, MPH; Emmanuel Rudatsikira, MD, MPH; Pramil Singh, DrPH; Daravuth Yel, MD, Cambodia co-investigator; and Maniphanh Vongphosy, MD, MSc, Lao co-investigator.

Students and professors of the Global Tobacco Control Methods certificate program stand in front of the National Institute of Public Health building in Phnom Pehn, Cambodia, where the courses are taught.

Floyd Petersen, MPH, assistant professor, epidemiology and biostatistics, SPH, finds out what it is like to be a cyclo driver as he drives one of his students around. Cyclos are a common form of transportation in Cambodia. The World Health Organization and Ministry of Health in Cambodia had 35 cyclos made with a stop smoking message on the wheel like the one pictured above.

Breast cancer kills more than 40,000 women in the United States every year--making it the second leading cause of death in the nation for women. The School of Public Health has a chance to help decrease that death rate. The Susan G. Komen Breast Cancer Foundation granted SPH $250,000 for a two-year study titled "Protein profiling for the identification of serum biomarkers for early detection and prevention of breast cancer in African American women."

Because African American women have an increased incidence of breast cancer deaths compared with white women, SPH will conduct a study to understand the role of genetic and environmental factors in breast cancer among African American women. In the team's preliminary study that included 94 percent African American women, breast cancer was 18 percent among women who consumed pesticide DDT contaminated fish. Several studies suggest that DDT can mimic estrogens, the group of hormones that increase breast cancer risk.

"The purpose of this study is to utilize proteomics technology," states Padma Uppala, PhD, assistant professor, environmental and occupational health, SPH, and principal investigator for the study, "to identify biomarkers for early detection of breast cancer by comparing the serum protein profiles of breast cancer patients with sera from healthy controls."

Proteomics is a new field that includes the systematic study of patterns of proteins expressed in living organisms. Proteomics can be used to identify proteins that cause problems and removing or replacing them could help cure or prevent cancer. According to the research team, a comparison of proteins in normal cells or early stage breast cancer, which has a high cure rate with late stage breast cancer with high death rate, will allow identification of potential biomarkers that can detect breast cancer earlier and keep it from progressing.

"This technology could be used to quickly identify early stage cancer patients by testing the blood and matching it with drugs tailored specifically for the patient," says Dr. Uppala. "Early detection will help the prevention of the high mortality rates of breast cancer among African American women. In addition, blood protein patterns might ultimately be applied in medical screening for the diagnosis of breast cancer."

The research team members in addition to Dr. Uppala are: Larry Beeson, DrPH, epidemiologist, department of epidemiology and biostatistics, SPH; John Morgan, DrPH, epidemiologist, department of epidemiology, SPH; Guru Uppala, MS, biostatistician, department of epidemiology and biostatistics, SPH; Carlos Garberoglio, MD, chief of surgical oncology, LLUMC; Sharon Lum, MD, specialist in diseases of the breast, LLUMC; and Helen Kim, PhD, director of 2-D proteomics lab, University of Alabama at Birmingham.

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Revised June 3, 2004
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