Children’s Hospital LA Awarded $2M for Precision Medicine Study

June 07, 2021 - Children’s Hospital Los Angeles received a three-year, $2 million grant from the state of California to conduct a precision medicine study screening children for adverse childhood experiences (ACEs). The grant was provided by the California Initiative to Advance Precision Medicine.

Adverse childhood experiences include abuse, neglect, racism, and witnessing economic hardships. These experiences can have negative psychological effects on children. The study will utilize precision medicine techniques to pinpoint biomarkers of early-life stress.

“Excessive adverse childhood experiences can cause toxic stress in children, and many studies have shown this may have lifelong consequences for health challenges, such as cardiovascular disease, obesity and mental illnesses," explained Pat Levitt, PhD, the study’s lead investigator and chief scientific officer, vice president and director of the Saban Research Institute, in a recent press release.

"To improve outcomes for these children, we need to identify those at greatest risk as early as possible, because early interventions promote the best outcomes."

Approximately 61 percent of surveyed adults reported experiencing one or more ACEs, with one in four reporting that they had experienced four or more ACEs, according to the Centers for Disease Control and Prevention (CDC) website.

The CDC estimates that 21 million depression cases and 1.9 million heart disease cases could have been avoided with better prevention of ACEs. In addition, ACEs have high social and economic costs, and tend to effect women and minority groups the most.

Despite the risk factors, the CDC points out that ACEs are entirely avoidable, and that “to prevent ACEs, we must understand and address the factors that put people at risk for or protect them from violence.”

The only way to screen for ACEs currently is to give a questionnaire to parents and guardians. However, this method may not be able to accurately assess babies and young children who are experiencing toxic stress.

With the grant, Children’s Hospital Los Angeles will use a questionnaire called the Pediatric ACEs Screening and Related Life Events Screener (PEARLS) along with a lab test that takes note of potential disturbances to mitochondria. By measuring mitochondrial allostatic load (MAL), researchers hope to identify “red flag warnings” for toxic stress in children as early as infancy.

"We believe this multipronged approach will improve our understanding of the mitochondrial stress associated with ACEs, and will ultimately lead to a cost-effective test that could be readily adopted by pediatricians across the state," said the study’s co-investigator Xiaowu Gai, PhD, director of bioinformatics at the Center for Personalized Medicine at Children’s Hospital Los Angeles, in the press release.

This study will mark the first use of MAL measurement in children. Oral swabs will be used to collect samples, and the PEARLS questionnaire will be filled out by mothers. The precision medicine approach will combine clinical tests, child development and mental health measures to determine risk levels.

The hospital plans on recruiting 300 mother-baby pairs to participate in the study. Screened participants who are deemed to be high-risk will be referred to the hospital’s behavioral health program. The project will begin in July 2021. The state of California awarded $9 million in grants to support ACE research, split among four institutions.

Precision medicine initiatives across the country are gaining both popularity and significant funding. The Prostate Cancer Foundation recently launched the Drew Foundation Precision Oncology Center of Excellence in California, enabling researchers to provide precision medicine treatments to Veterans diagnosed with prostate cancer.

Meanwhile, researchers say that precision medicine has the potential to be beneficial for COVID-19 treatment, but hurdles with taxonomy and subtype criteria are proving to be barriers to precision medicine’s success.