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Research advancements could lessen scleroderma complications  by Megan Fink Public Relations The ultimate weapon for scleroderma treatment would be “a silver bullet” that specifically targets problem cells and their signals stopping the over-production of collagen. With the accelerated pace of learning at MUSC, physicians will soon be using these specialized agents as safer and more effective means of therapy.     For 26 years, Richard M. Silver, M.D., has provided clinical care and led research efforts in the Division of Rheumatology at MUSC to find that silver bullet, a veritable Holy Grail in medicine. The Medical University is the largest scleroderma center in the Southeast and a major player internationally. Scleroderma patients from around the country come to Charleston for treatment and hope.   Last month Silver joined physicians and researchers from across the globe at the Prof. E. Carwile LeRoy Memorial International Workshop on Scleroderma held in Tokyo, Japan. The late physician LeRoy was the founding chief of the Division of Rheumatology and Immunology at MUSC before accepting the chair position for the Department of Microbiology and Immunology. Silver credited LeRoy with establishing the institution’s distinguished area of research.   “To know that scleroderma research will thrive because of him, but without him, is perhaps his greatest legacy,” Silver said.   Scleroderma literally means hard skin. The hallmark of the condition is the overproduction of collagen. Scleroderma primarily affects the skin, but the systemic version often affects other vital organs, especially in adult patients. It’s an autoimmune process that signals the overproduction of collagen, and MUSC faculty members are analyzing how the immune system and fibroblast are regulated.   One of the latest developments in suppressing the overactive immune system of scleroderma patients is cyclophosphamide, which is a chemo-therapy agent that also is being used to halt scleroderma of the lung. Though Silver and MUSC colleagues began working with cyclophosphamide in the early 1990s, more recent studies have confirmed its benefit to the improvement of lung function and other aspects of this chronic disease. The pivotal trial was published in the New England Journal of Medicine in 2006.   Other research avenues being explored include stem cell therapy. MUSCs Alan Brown, M.D., is a co-investigator in the Scleroderma: Cyclophosphamide or Transplantation (SCOT) study. The SCOT study, which is funded by the National Institutes of Health, compares cyclophosphamide treatment to that of bone marrow transplant. The recruitment of patients continues for this study, which is based at Duke University.    Almost 20 years ago, Duke referred patient Amy Parrish to Silver and MUSC for treatment of her complex case of scleroderma. Parrish, who remains in Silver’s care, now heads the Scleroderma Foundation’s South Carolina Chapter and is active in research fundraising.   “When I was first diagnosed, there wasn’t much information available,” said Parrish. “There’s hope now. There’s no cure, but there are medications. Research is available to discover the cause and get a cure.”   In addition to boosting funds for research, the Scleroderma Foundation raises awareness about the disease. June is National Scleroderma Awareness Month and in recognition, organized walks are taking place across the nation to do just that. “Stepping Out to Cure Scleroderma” takes place June 16 at the South Carolina Botanical Gardens at Clemson University. The nature walk starts at 10 a.m., and participants can even bring their leashed dogs. Silver will be a guest speaker sharing his expertise with patients and their families.     Friday, June 15, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.