University of Nevada professor awarded NIH RO1 grant for study of control of motility in internal anal sphincter

Kathleen Keef, Ph.D., professor of physiology and cell biology at the University of Nevada School of Medicine, has been awarded a four-year, $1.2 million grant from the National Institute of Health to study the control of motility in the internal anal sphincter.

This is Keef's second major NIH RO1 grant in the last 10 years for research with significant implications for fecal incontinence.

Approximately five percent of the general community and 15 percent of adults over the age of 50 suffer from fecal incontinence. This disorder greatly reduces the quality of life for millions of Americans and can lead to depression, anxiety, social isolation, loss of employment, and institutionalization.

The combined financial burden for treating fecal and urinary incontinence in the United States exceeds $26 billion per year. However, even in 2010, fecal incontinence remains the "unspoken affliction" rarely discussed by patients and under reported to physicians. In spite of both financial and quality of life issues our understandings of the causes underlying this disorder, as well as our ability to prevent or treat this disorder, remain poor.

Keef's grant investigates the internal anal sphincter (IAS), a specialized ring of muscle located at the end of the gastrointestinal tract that plays a central role in maintaining fecal continence. In spite of its clear clinical relevance, the IAS is the least studied muscle in the gastrointestinal tract.

For the past 10 years, Keef has established herself as a leading expert on how contraction of this muscle (i.e., "motility") is controlled. Her newly funded grant seeks to further explore this issue by focusing on several unique properties of the IAS including differences in the structural design of this muscle, differences in the types of cells that participate in the control of muscle contraction and differences in the mechanisms by which nerves regulate contraction of this muscle. Such information is critical for an improved understanding of the unique functional role of this muscle. It is also fundamental for devising new strategies to help prevent, diagnose and treat problems associated with IAS dysfunction; circumstances that can lead to fecal incontinence as well as to other disorders arising from defects in IAS motility.