The Rogosin Institute conducts basic scientific research to benefit all areas of our work.  It is important to give new understanding and make discoveries that can ultimately lead to new therapies for our patients.  Some of the basic research in kidney disease research, lipid research and diabetes research being conducted at Rogosin is described below.

Carolyn Diehl Molecular Biology Laboratory

Rogosin is developing a Molecular Biology Laboratory to determine whether modern molecular tools will be useful for routine care in all areas of treatment at Rogosin.  The laboratory will focus on three areas initially.  

The first is utilizing a cardiovascular disease DNA (SNP) array biochip capable of detecting 27 different polymorphisms that are known to cause atherosclerosis.  The initial work will focus on the validation of these new assays in studies performed at the Comprehensive Lipid Control Center.  One of the patient populations to be targeted is comprised of individuals who have normal lipid profiles but have documented coronary artery disease.  We may for the first time, be able to explain the cause of this disease using the biochip.  Currently this biochip is only available for research purposes.  It is hoped that a genetic test with good predictive value of who would be susceptible to coronary artery disease could be extremely helpful in determining the best care for these individuals.   

The second area involves pharmacogenomics or “personalized medicine”.  Patients will be genotyped in an attempt to determine their ability to metabolize drugs with the goal of being able to tailor prescriptions that will be better tolerated with fewer side effects.  We will look at patients taking lipid lowering drugs (statins) in the CLCC and transplant patients who often take multiple drugs to prevent losing their transplanted organs.  The most common statins and immunosuppressive drugs are metabolized by the CYP pathway (cytochrome P450).  Drugs that are cleared by one CYP enzyme may often act as inhibitors or inducers for other CYP enzymes.  Therefore, patients taking more than one drug may take one drug that causes toxicity with another drug through this mechanism.  The laboratory already has the instrument needed to develop blood tests to detect mutations in this pathway.  The tests will allow us to classify metablizers as poor, intermediate, extensive or ultra-rapid metabolizers.  Poor metabolizers may develop serious side effects, and extensive or ultra-rapid metabolizers may be insufficiently treated.  Further, the scientific literature has shown that a genotype screen can detect 90% of poor metabolizers at risk for overdoses.  We hope that this test will allow Rogosin physicians to tailor a patient’s prescription for statins and other medications to reduce side effects and will ultimately lead to better patient compliance.

The third area involves detection of coagulation mutations in a group of dialysis patients that tend to clot their access frequently.  Patients will be genotyped for coagulation mutations and anticoagulation therapy can be modified in patients expressing one of the mutations.