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Masonic Medical Research Laboratory
By: Dr. Charles Antzelevitch and Ronald P. Kamp
Bro. and Dr. Charles Antzelevitch is the Executive Director of the Masonic Medical Research Laboratory in Utica, NY and Bro. Ronald P. Kamp is the Director of Development and Communications at the Lab.
-Editor
Can you imagine a world without penicillin, or polio vaccine, without drugs to combat heart disease, high blood pressure or other diseases that plague humanity? If not for medical research that would be the world we would face. Society owes a great debt to the men and women we call scientists; especially those who conduct basic research. Basic scientists have an innate passion to understand the mysteries of life as well as a unique ability to see what no human has seen before. In most cases, only in retrospect does society begin to comprehend the fruits of their collective labors.
The Masonic Medical Research Laboratory
(MMRL), a 501 (c) (3) not-for-profit corporation sponsored by Freemasonry, has made the study of cardiac arrhythmias, ischemic heart disease, and sudden cardiac arrest its primary focus. You may not be aware that cardiac arrhythmias or irregular heartbeats claim more lives than any other mechanism of heart disease or that MMRL scientists are credited with either discovering or unraveling the mechanism of the majority of known cardiac arrhythmias. As a result of our scientific achievements, the practice of medicine has been revolutionized and mortality from heart disease has been greatly reduced. The MMRL' s scientific record has earned it international prominence as one of the leading research centers in the fight against heart disease in the world.
The ability to understand the electrocardiogram (ECG) is critical in the diagnosis of a heart attack; as critical as the treatment of the disease. Electrical instability of the heart can lead to cardiac arrhythmias during a heart attack and can be the immediate cause of death during or after a heart attack. Since 1958, the MMRL has contributed knowledge towards the development of a number of drugs and devices such as the pacemaker, implantable cardioverter defibrillator (ICD), and automatic external defibrillator (AED) to prevent sudden death. AEDs have proven so effective that they can be found in most airplanes, malls, public buildings, schools and even private homes.
We are often asked what represents the most important discovery at the MMRL to date. Without a doubt, it was our discovery of a unique sub-population of cardiac cells, that we named M cells in 1990. M cells were found to possess electrical properties different from other cells in the heart and were also found to respond differently to a wide variety of drugs. This particular discovery was a defining moment in science and medicine that revolutionized the world of cardiology and continues today to have a far-reaching impact. Prior to this breakthrough, the heart was thought to be a homogeneous organ, and drugs were believed to exert similar effects on all cells that make up the muscular walls of the heart. This discovery of the M cells showed that heterogeneity existed within the cells of the heart.
MMRL scientists have gone on to uncover the cellular basis for the J wave and T wave of the electrocardiogram (ECG), thus providing cardiologists a more accurate means to diagnose cardiac disease. The MMRL continues its pioneering research in defining the differences that exist in the electrical and mechanical behavior of cells that make up the heart.
Sudden Cardiac Death (SCD) is a widespread health problem with several known inherited causes and predispositions. Inherited SCD generally occurs in healthy individuals who do not have other conventional cardiac risk factors. With the recent completion of our new molecular genetics and molecular biology wing, the Masonic Medical Research Laboratory has assembled one of the most complete teams of investigators anywhere in the world to tackle the problems of cardiac arrhythmias and sudden cardiac death. The MMRL is currently one of a handful of medical research centers worldwide capable of studying the genetic causes of the lethal cardiac arrhythmias responsible for sudden cardiac death in young adults, children and infants.
Using molecular biology and molecular genetic techniques our scientists have unraveled the basis for a number of inherited diseases including three forms of sudden cardiac death: the Long QT, Short QT and Brugada syndromes. One such study provided the first definitive data linking genetic mutations of the Long QT syndrome to Sudden Infant Death syndrome or (SIOS). This ground- breaking study was so important that it was published in the July 2000 issue of the world renowned clinical journal, The New England Journal of Medicine. Once again, this is solid testimony to the high caliber and high regard given to the life-saving research emanating from the Masonic Medical Research Laboratory.
Assuming a leadership role is not unfamiliar to the MMRL. The Brugada syndrome, first described as a new clinical entity by Drs. Pedro and Josep Brugada in 1992, is a form of sudden cardiac death that tragically takes the lives of young adults. It is an inherited syndrome (arrhythmia) that can lead to life-threatening ventricular tachycardia and fibrillation. Ventricular tachycardia causes the heart to beat at an extremely high rate and ventricular fibrillation occurs when the electrical activity in the ventricles of the heart goes into disarray and the heart beats chaotically. In both cases, the main pumping chambers of the heart become very inefficient.
Available data suggests that 4% to 12% of unexpected sudden deaths, and approximately 20% of sudden death in patients with an "apparently normal" heart can be attributed to the Brugada syndrome. Recent discoveries of genetic abnormalities linked to this syndrome by our scientists point to it being a primary electrical disease. Identifying the genetic defects that cause or predispose to the development of the syndrome is an important stepping-stone to the development of new treatments and ultimately a cure.
The New York Times featured the MMRL's pioneering work to conquer the Brugada syndrome and how it saved the life of Brian Nelson of Seattle, Washington on the front page of the Science section of the February 10, 2004 issue. This is just one life-saving incident that we know of, but it happens more often than any of us can imagine. The article went on to say that the MMRL is considered to be the leading center for the study of the Brugada syndrome in the United States.
Last year our scientists succeeded in identifying the gene responsible for a relatively new clinical entity responsible for sudden death in infants, children and young adults. Over the past three years, in reports co-authored by colleagues from throughout the world, we and others reported a new clinical entity known as the Short QT syndrome. Members of these families display a very short QT interval on their electrocardiogram (ECG) and suffer from life-threatening abnormal rhythms of the heart.
After several months of intensive search for the genetic mutations, our scientists discovered a gene mutation responsible for this deadly syndrome. Our studies identified an important gain of function in the activity of a potassium channel in the heart. In a recent study published in Circulation, we developed an experimental model of the Short QT syndrome which mirrors the electrocardiographic and arrhythmic manifestations of the syndrome. Studies involving expression of the mutant gene in specialized cell lines helped us identify a drug (quinidine) to correct the genetically-induced electrical malfunction. Using this information, our clinical colleagues determined that quinidine is indeed effective in reversing the ECG defect in patients with the Short QT syndrome. Thus, starting and ending with the patient in the clinic, MMRL scientists have brought the research full circle by delving into the cause of disease at the genetic level, its root basis.
Among the many syndromes associated with abnormal rhythm of the heart is the Long QT syndrome (LQTS). Like other arrhythmic diseases, LQTS is an abnormality of the heart's electrical system caused by defects in heart muscle cell structures known as ion channels. These electrical defects predispose affected individuals to a very fast heart rhythm called Torsade de Pointes, which can lead to sudden loss of consciousness (syncope) and sudden cardiac death.
The LQT syndrome's name derives from its distinctive electrocardiographic (ECG) signature, which usually takes the form of an unusually long interval between the beginning of Q wave and end of T wave. The QT interval is a measure of the time it takes the heart to return to "normal" after activating to pump blood to the rest of the body. The syndrome can be inherited or acquired. The acquired form of the disease is often caused by drugs used to treat arrhythmias, depression, migraine, and schizophrenia. The MMRL has remained at the cutting edge in the generation of new knowledge relative to the identification of drugs that may prove to be pro-arrhythmic and life threatening.
In a recent issue of Circulation, the leading clinical journal of the American Heart Association, we presented a new experimental model of a syndrome that causes sudden death in children when they exercise. The syndrome is generally known as Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). This syndrome is caused by gene mutations that affect the handling of calcium in cardiac cells. Our experimental model provided new insight into the cause of arrhythmias attending this syndrome and particularly the cause of sudden death, which proved to be different from that generally presumed. New treatment strategies suggested on the basis of these findings will be pursued.
We all desire to present a positive and humanitarian view of Masonry to our membership and the public. Disease, my Brothers, can not discern race, creed, color, religion, Masonic affiliation or Grand Jurisdiction. The importance and value of medical research is very real and relevant to every human being.
The MMRL' s internationally prominent research facility has brought Masonry many accolades over the years as well as a deep sense of pride in the Laboratory's mission by those in our fraternity who know of our existence. Our continuing challenge is to bring our message and solid record of scientific achievement to the grass roots level of Masonry across North America and the world. We would welcome the opportunity to expand our base of support and communication via e-mail. We encourage you to visit our website at www.mmrl.edu and complete the e-mail form to assist us in keeping you informed. We will notify you via e-mail of new postings to our website regarding press releases, current medical stories, availability of new brochures and our newsletter.
All information will be kept confidential and will not be shared or sold to any group or organization. You may, of course, request to have your name removed at anytime. The MMRL respects your time and appreciates your support and will not inundate your inbox with trivial and unnecessary e-mails. Copies of our VHS or DVD presentation or literature may also be requested via e-mail. PDF versions of our scientific studies, MMRL Update and other literature are also available online at www.mmrl.edu.
Help us spread the word about our life-saving research. We welcome the opportunity to tell our story to a much wider audience. Help us raise awareness about inherited sudden death syndromes such as the Long QT syndrome, Short QT syndrome, Brugada syndrome and Sudden Infant Death Syndrome. Increased awareness may help to identify those at risk. Thousands, perhaps millions, of lives of young adults, children and babies could be saved around the world if physicians and potential victims or their parents only knew the symptoms.
As we look to the future, it is up to each of us to envision our fraternity not only as it is, but what it can become. Biomedical research is a key force for change in the world today, with important economic and social implications that will affect future generations. We believe that the Masonic Medical Research Laboratory can and should help lead the way. As we prepare to celebrate our 50th anniversary as a leading research institution, the MMRL has embarked on a Campaign for Discovery. There has never been a more exciting time for all Masons to support and invest in medical research because we are on the threshold of a new era of discoveries that will change the face of medicine as we know it. You have read what we have accomplished. We aspire to do more! Our ability to forge new frontiers in the fight against heart disease is in direct proportion to the resources that are made available. State-of-the-art medical research requires technical sophistication and sizeable resources. Recruitment of high caliber scientists continues to be a high priority. Our physical plant requires systematic updating and investment in state-of-the-art scientific equipment. We would welcome multi-grand jurisdiction support. We are grateful beyond words for the enthusiastic support we currently receive from the Grand Lodges of New York, Florida and Alaska.
When someone asks you how Freemasonry can make a difference in today's world, please think of medical research and the Masonic Medical Research Laboratory! We invite you to join our growing family of friends.
To make a tax-deductible donation to the Masonic Medical Research Laboratory's Campaign for Discovery call our donation hotline at 1-888- 888-6675 or go to www.mmrl.edu click on support and make a donation using your credit card (MasterCard and VISA only) at our secure website. You can also help ensure the health of future generations by including the Masonic Medical Research Laboratory in your will or contacting the Development Office at 1-888-888-6675 if you are interested in learning about our unique Named Gift Opportunities. Such gifts provide a legacy that will withstand the test of time, fulfill your wishes and attest to everything that you hold dear. Through your charity, we can build a healthier tomorrow for all of us.
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