Other complex childhood problems
Fifty years ago, the diseases that threatened children and challenged
scientists typically had isolated causes such as viral or bacterial infections.
According to Xiaobin Wang, MD, MPH, ScD, today's health challenges such as
preterm birth, asthma, obesity, diabetes, cancer and emotional and behavioral
disabilities have broader and more complex origins.
"Unlike tetanus, polio and measles, which we now can control" she says,
"today we confront disorders that have multiple causes including environmental
and genetic factors." These problems require a new model for treatment and
prevention. As the new director of the Mary Ann and J. Milburn Smith Child
Health Research Program at Children's Memorial Research Center, Wang is excited
about the opportunity to work with investigators from multiple disciplines to
address the most challenging child health problems.
Wang's own research focuses on the interactions between genes and
environment, and their effects on reproductive outcomes. "More than one in ten
U.S. babies comes into the world either too early or too small," says Wang.
"Both preterm and low-weight births are associated with high death rate in
infants and high risk illness in children." In 1988, with funding from the March
of Dimes and the National Institutes of Health (NIH), Wang and her team at
Boston Medical Center began recruiting mothers and their newborns for a
comprehensive study of the genetic and social-environmental factors that
contribute to preterm births and low birth weight. With over 2,500 mother-infant
pairs already enrolled, it is one of the largest studies of this kind in the
country. At Children's Memorial, Wang will continue to recruit research
subjects.
Wang, a molecular epidemiologist, also has extensively examined the link
between genetic factors, maternal cigarette smoking and infant birth weight. She
recently published her results in the Journal of the American Medical
Association. While the dangers of smoking during pregnancy are fairly common
knowledge, Wang points out that there are vast differences in a person's
capacity to avoid the negative effects. "This capacity is largely determined by
genes." Her study found that women who smoked and had two gene variants (CYP1A1
and GSTT1) had a markedly increased risk of having a baby with low birth weight
than women who smoked and did not have these genetic variants.
Wang says the smoking-gene interaction study is just the beginning. "With a
multidisciplinary team of investigators and our expertise in clinical medicine,
epidemiology, molecular genetics, biostatistics and bioinformatics, we have a
great potential to better understand the causes of preterm births and low birth
weight, and to improve clinical practice and public health interventions."
[Note: This article appeared in the Spring 2004 issue of Carousel, the
magazine of Children's Memorial Hospital.]