Rudin Prize Awarded for Outstanding Glaucoma Research

NEW YORK CITY, Aug. 14 -- The New York Academy of Medicine has awarded the 2002 Lewis Rudin Glaucoma Prize to two trailblazing ophthalmology researchers who have discovered a molecular mechanism behind glaucoma, the world's leading cause of irreversible blindness. The awardees who will share the prestigious $50,000 prize are: Joel S. Schuman, M.D., professor and vice chairman of ophthalmology at the New England Eye Center at Tufts New England Medical Center, Tufts University School of Medicine in Boston; and M. Elizabeth Fini, Ph.D., Professor and Co-Director of Research at the Bascom Palmer Eye Institute, University of Miami School of Medicine.

Schuman and Fini are being honored for their March 2001 research paper in the journal Nature Medicine in which they identify the first-ever molecular marker for human glaucoma. They examined normal and glaucoma-stricken eyes from cadavers and found that a certain molecule - "ELAM-1" -- was detectable only in the ailing eyes. Nan Wang and Shravan K. Chintala were also authors on the winning research paper.

In an article accompanying the research, Stanislav Tomarev of the National Eye Institute hailed the discovery as a critical step toward improving future detection and treatment of this eye disease. Glaucoma begins with no symptoms and surreptitiously steals a person's vision. It affects more than three million adults in the United States and 17 million worldwide. As many as half of those with early-stage glaucoma do not realize they have it, making early detection a vital tool.

"We found there was a fundamental molecular difference between people who have glaucoma and people who don't," said Schuman, who is also director of the Glaucoma and Cataract Service at the New England Eye Center, and interim director of research there. "If we can use this finding to develop a diagnostic test, it may allow us to identify people who have glaucoma, better than we can now." Fini and Schuman are now conducting several follow-up studies into treatments for glaucoma, including an investigation into whether glaucoma patients have genetic abnormalities that might lead to overexpression of ELAM-1.

The Academy awards the Rudin Prize for the most significant glaucoma research work published in the prior year. The award was established in 1995 and is funded by the May and Samuel Rudin Family Foundation, Inc. Rudin Prize recipients are chosen by a Selection Committee chaired by David H. Abramson, M.D., clinical professor of ophthalmology at The New York Presbyterian Hospital.

Many cases of glaucoma occur because the eye's optic nerve is damaged by an improper buildup of "aqueous humor" fluid in the eyes. Under normal conditions, this fluid circulates between the front and back chambers of the eye, nourishing the lens and corneal cells. It then drains through the "trabecular meshwork" tissue and flows out into the "Schlemm's canal." When these two parts don't function properly, drainage is impaired and pressure builds up on the optic nerve. The researchers found that the ELAM-1 molecule (short for "endothelial leukocyte-adhesion molecule-1) was overexpressed in these two parts of glaucoma-stricken eyes. They also found that the ELAM-1 protein was consistently present in cell lines derived from the trabecular meshwork tissue of glaucomatous eyes, but not present in the same tissue from normal eyes. Combined, the findings identify ELAM-1 as the first true molecular tag for glaucoma.

Interestingly, Schuman and Fini also discovered that ELAM-1 is actually part of a stress response that protects cells and tissues in the eyes' outflow pathways. They postulate that this protective response leads to eye tissue damage if it continues on a chronic basis. That tissue damage leads to pressure build-up that is characteristic of glaucoma. The researchers are now toiling to understand the dynamics of this helpful-to-harmful change, in the hopes of devising a way to reverse it.

"It's a fundamentally new way of thinking about glaucoma and outflow, that there are these changes to the cell that happen in the trabecular meshwork," Fini said. "We want to understand what the meaning of this change is. Characterizing the change could provide us with potential new targets for drug therapy."

This research was deemed so significant that it was published as the cover article in Nature Medicine. An abstract of the paper was printed in the journal Nature - something reserved for only the most significant research findings. Schuman's laboratory collected data over a 10-year period, and new insight into the data's meaning developed when he teamed up with Fini and they combined their different perspectives. Fini was Professor and Director of Research at the New England Eye Center at Tufts when the paper was published.

"It's a great feeling when you've worked all these years and suddenly everything comes together and your colleagues recognize it as significant," Fini said, in describing her delight over winning the Rudin Prize. "It's very exciting for us because it opens up all of this new potential for diagnostics and treatments, and could ultimately lead to a cure."

The New York Academy of Medicine is a non-profit organization founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations.

Media Coverage:

• Miami Herald

• Florida Sun-Sentinel (in MS-Word format)

Posted on August 15, 2002

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Andrew J. Martin
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The New York Academy of Medicine
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amartin@nyam.org

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