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CARES Foundation Awards Research Grant to NIH

CARES Foundation is excited to announce that it has awarded the NIH Clinical Center a $62,500 research grant to support ongoing research in CAH.  The researcher, Dr. Deborah Merke, will be the primary beneficiary of this grant.  A pediatric endocrinologist at the National Institutes of Health (NIH) Clinical Center, she is completing studies of a new treatment regimen for children with classic CAH, comparing  the conventional treatment (hydrocortisone and Florinef®) with an experimental regimen of reduced hydrocortisone, Florinef, flutamide (an anti-androgen), and letrozole (an estrogen inhibitor). The preliminary results are very promising.

For the past 11 years, Dr. Merke has specialized in deepening our understanding of congenital adrenal hyperplasia and testing the effectiveness of new CAH treatments in human volunteers. Historically, CAH has been considered a disease of the adrenal cortex, in which an enzyme deficiency leads to cortisol and aldosterone deficiency and androgen excess.  Over the past few years, however, her lab has defined additional endocrine problems in CAH, such as epinephrine (adrenaline) deficiency and insulin resistance.   

Dr. Merke has also further explored the psychological aspects of abnormalities of adrenal function.   She discovered that CAH patients have smaller amygdala volumes.  The amygdala is the part of the brain that regulates emotion.  Over the next few years, she plans to: 1) further explore the clinical implications of reduced amygdala size and the psychological aspects of altered adrenal function; 2) expand our understanding of the clinical implications of epinephrine deficiency; and 3) test new treatments aimed at treating the insulin resistance characteristic of many patients with CAH.  She also plans to start a new protocol using metformin, a diabetes drug, to treat CAH patients.

The grant from CARES will be used to hire a Nurse Practitioner to support this research. "Additional clinical personnel will be invaluable in allowing us to see more patients," says Dr. Merke. "Thanks to the generosity of CARES and its supporters, we will now be able to begin new testing programs and add new patients to our clinical trials."

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