Summer 2004
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Clinical Applications Abound with Bone-Formation Research
THE THOUGHT OF excessive cell proliferation usually conjures the
frightening specter of cancer, but the process can actually be manipulated for a
patient’s benefit, according to a Medical College of Georgia alumnus.
Dr. Nader Elbokle, who earned a Ph.D. in the Department of Oral Biology and Maxillofacial Pathology this spring, left his native country, Egypt, six years ago to study how to spur bone growth. After completing clinical work at Emory University in Atlanta, he transferred to MCG to work in the lab of Dr. Mohamed Sharawy, professor of oral biology and maxillofacial pathology. He returned to Egypt Feb. 29 to begin applying what he has learned.
“I wanted to be able to return to Egypt and give something back,” said Dr. Elbokle. “There, I think I can make a real difference.”
In Dr. Sharawy’s lab, he built on the relatively recent discovery that new bone growth results when a surgically fractured bone is stretched.
“When you look at it under a microscope, it looks like cancer,” he said of the process of excessive cell proliferation at the fracture site of stretched bone. As he delved into the cellular process involved, he discovered that cells multiply dramatically when the two sides of the fractured bone are stretched, or distracted. The proliferation is particularly excessive when the stretching begins, slowing dramatically midway through the tension.
“During the tension phase, marrow cells and other types of cells are upregulated,” he said. “The tension effect is a stimulus to form new bone. We also see calcification and mineralization taking place, then stopping when the tension stops.”
As the bone grows, muscles and tendons adapt and grow accordingly, Dr. Elbokle said. The result? “This has great clinical application in correcting disfigurement of craniofacial congenital anomalies,” said his mentor, Dr. Sharaway. The method has treated countless children worldwide with abnormally small jaws. The defect not only causes emotional distress because of the aesthetic abnormality but can impede vital functions such as breathing and eating, he said.
Bone growth also helps patients who have lost facial bone due to cancer or trauma. Other potential beneficiaries are sleep apnea patients who can breathe easier with surgically elongated jaws.
The process begins when an oral surgeon cuts the bone intended for elongation and inserts a stretching device. After waiting several days for a callous to develop at the fracture site, the oral surgeon stretches the bone approximately one millimeter a day until the desired length is achieved. The device is then removed and orthodontists are called in, if necessary, to match the patient’s bite with his new bone structure.
“It’s actually not painful at all except the first couple of days after surgery,” Dr. Elbokle said. “The main complication is potential scar formation.”
Once the new bone is in place, it grows at approximately the same rate as the existing bone. This is good news for all but patients who are congenitally primed for abnormal bone growth and generally require multiple surgeries throughout childhood.
“But this surgery absolutely changes their lives,” said Dr. Sharawy. “They go from being horribly deformed to looking absolutely normal. It’s amazing.”
Dr. Elbokle is one of 24 international students that Dr. Sharawy has mentored at MCG in the past two decades. In addition to working with MCG students like Dr. Elbokle, he also mentors students in MCG’s Joint Supervision Program, providing research experience for students earning a degree at a foreign university.
“The program greatly enhances the level of care the students are able to offer in their home countries,” said Dr. Sharawy. “This is a wonderful opportunity to form international friendships and create ambassadors for the United States when these students return home.”
Dr. Vaught Receives Distinguished Alumnus Award
THE SCHOOL OF Graduate Studies Alumni Association has presented its 2004 Distinguished Alumnus Award to Dr. Jim Vaught, special assistant for biological resources at the National Cancer Institute Division of Cancer Epidemiology and Genetics.
Dr. Vaught earned a bachelor’s degree in chemistry from the University of Georgia and a doctorate in biochemistry from MCG in 1977. From 1976-78, he was a National Institutes of Health postdoctoral fellow at Roswell Park Memorial Institute, for which he received the National Research Service Award. In 2001, he received the NIH Merit Award.
He is a member of the American Association for Cancer Research and the American Society for Pharmacology and Experimental Therapeutics. He is a past president of the International Society for Biological and Environmental Repositories.
Student Fielding New Discoveries in Retina
MARK FIELDS IS helping unlock the mysteries of a virus that annually strikes
over 500,000 Americans. His studies of the herpes simplex virus, and how it
travels through the central nervous system, could someday help save the sight of
thousands.
“One of the ways the herpes virus presents itself is through a disorder called acute retinal necrosis, an inflammation and deterioration of the retina. Over time, that leads to blindness,” said the Medical College of Georgia graduate student who is researching how the immune system deals with viral infection in the retina and the central nervous system.
Under the tutelage of Dr. Sally Atherton, chair of the MCG Department of Cellular Biology and Anatomy, Mark is using a mouse model to track how a cytokine called TNF Alpha fights herpes viral infection. “Inside the mouse model, we can mimic the infection in humans,” he said. “Cytokines are proteins which regulate the intensity and duration of immune responses. TNF Alpha, a cytokine known to play a role in apoptosis (cell death), is expressed in mice fighting infection in the eye. TNF Alpha recruits other cells in the immune system to join it in the fight.”
Their research is aimed at defining the virus’ pathways through the central nervous system, to explain why some herpes-positive people suffer retinal deterioration and others don’t.
“There are millions of people who are herpes-positive, but a very small fraction will get this and we don’t really know why,” said Dr. Atherton. “The virus becomes latent in a number of sites. It reactivates and somehow ends up in the retina. Our lab is working to find out where the virus is and what route it takes to get into the retina.”
By genetically manipulating the herpes virus, Mark and Dr. Atherton are creating a recombinant virus that expresses TNF Alpha, and then will use it in the mouse model. The process could lead to cytokine-based therapy, and a more universal impact on treating herpes viral infections than current anti-viral drugs, Mark explained. “Cytokine-based therapies tend to keep the virus at a latent-based point longer, and this can help reduce the damage to the optic nerve,” said Mark, whose work in the field was recently honored with a National Institutes of Health fellowship.
The award, based on a student’s qualifications and research plans, the school’s training environment and the mentor’s laboratory, will assist with Mark’s salary, supplies and travel to present his research over the next four years. The application process was “very tedious and mind-blowing,” Mark said, but one that taught him a great deal.
“I had to submit a grant proposal just as a primary investigator in a lab would,” he said. “It meant laying out every detail of my research plan, including experiment designs. It was very rewarding and humbling at the same time. You have to be very open to making corrections and adjustments.
“It was a great lesson in patience, and I’ve learned patience is essential in this field. It’s not like clinical medicine where, in many cases, it’s possible to make a diagnosis within a day or so of seeing a patient. In research, you may not get the results you expect in a day. You may not get the result you expect in a month. Then there comes a day where you get the results you were seeking and it makes it all worthwhile.”
An Augusta native, Mark began thinking about a career in research during his junior year at Covenant College in Lookout Mountain, Ga. He came home to attend MCG’s six-week Summer Educational Enrichment Program and returned to college with a new direction.
“I was kind of leaning toward science, but I wasn’t exactly sure I wanted to do it for a career,” he said. “I applied to SEEP because I knew it would help me decide if I wanted to pursue it any further. It was a great experience. We took classes in neuroanatomy and scientific writing and spent time in clinics and labs. It definitely helped me decide that I wanted to pursue science and attend MCG.”
“Mark is a great ambassador for our graduate program,” said Dr. Atherton, his Ph.D. mentor and previous boss. “He worked in my lab for six or seven months before he entered graduate school. He’s evolving into an independent investigator, which is what a graduate student should be doing.”
Noting that a mutual respect is essential for a successful mentoring relationship, Dr. Atherton said, “There’s a certain chemistry needed between a student and mentor. I may have the most interesting lab in the world, but if the chemistry between student and mentor is not right, it won’t be a successful learning experience. Mentoring a student is probably one of the most rewarding things you can do. It’s fun to see [students] mature, think on their own and solve problems. There’s a lot of work involved, but it is well worth it.”
2004-05 School of Graduate Studies Alumni Association Officers
- Dr. Dave Welter (’70), Augusta, Ga.--President
- Dr. Jill Lewis (’89), Augusta, Ga.--President-Elect
- Dr. Elizabeth Kenimer Leibach (’76), Augusta, Ga.--Past President
- Steve Harrison, Augusta, Ga.--Secretary/Treasurer
- Mary Chambers (’88), Augusta, Ga.--General Director
- Charles “Rick” Hall (’94), Augusta, Ga.--General Director
- Dr. Wanda Mundy (’77), Augusta, Ga.--General Director
- Dr. Geraldine Rinker (’64), Augusta, Ga.--General Director
- Rebecca Rule (’98), Augusta, Ga.--General Director
- Dr. Art Taft (’98), Augusta, Ga.--General Director
- Bill Jackson (’96), Augusta, Ga.--General Director
- Dr. Laryssa McCloud (’98), Augusta, Ga.--General Director
- Dr. Diane Turnbull (’87), Augusta, Ga.--General Director
- Dr. Gene Cannady (’98), Augusta, Ga.--Nominating Committee Member
- Dr. Jill Lewis (’89), Augusta, Ga.--Nominating Committee Member
- Dr. Ken Roper (’69), Augusta, Ga.--Nominating Committee Member
- Dr. Carol Lapp (’85), Augusta, Ga.--Nominating Committee Member
- Dr. Gretchen Caughman, Ex Officio--Associate Dean, School of Graduate Studies
- Dr. Matthew Kluger, Ex Officio--Dean, School of Graduate Studies
Students Honored by American Physiological Society
FIVE STUDENTS IN the Medical College of Georgia School of Graduate Studies are among 36 international recipients of the American Physiological Society’s Caroline tum Suden/Francis Hellebrandt Professional Opportunity Awards for 2004.
The award provided funds for physiology students to attend and participate fully in the society’s Experimental Biology Meeting, April 17-21 in Washington, D.C. MCG students awarded are Ahmed A. Elmarakby, Elizabeth D. Loomis, Christine S. Rigsby, Jennifer M. Sasser and Anita D. Smith. Each received $500 and complimentary registration to the Experimental Biology Meeting. They also presented an abstract to meeting participants.
“This award really helps enhance the career of these young people by calling international attention to their work,” said Dr. David Pollock, associate professor in the MCG School of Graduate Studies and a member of the APS’s Renal Section Executive Committee. “It also provides a lot of encouragement to the students by letting them know that what they are doing is important. The award encompasses all areas of physiological research and its review panel thinks what these students are doing is significant and worthy of note; this is an award based on the quality of their science, not on their personality or who interviewed well.”
To be considered for the award, graduate students or postdoctoral fellows must be first author of an abstract submitted to the society and the abstract sponsor must be a society member. A nonprofit organization devoted to fostering education, scientific research and dissemination of information in the physiological sciences, the society has over 10,500 members, most of whom have doctoral degrees in physiology, medicine or other health professions.
“It’s an amazing accomplishment and a testament to the strength of our graduate program that five of these students were from MCG,” said Dr. Gretchen Caughman, associate dean of the School of Graduate Studies. “No other institution on the recipients list had as many winners.”