The effects of obstructive sleep apnea on respiration muscle systems

. 10 MIN READ

Making the Rounds

The effects of obstructive sleep apnea on respiration muscle systems

Dec 1, 2023

In this episode of Making the Rounds, Srujith Medharamelta, a second-year medical student at Chicago College of Osteopathic Medicine, Midwestern University, talks about his research submission for this year's AMA Research Challenge. His poster is titled: “Effects of Obesity on the Neuromuscular Junction of Genioglossus Muscle and Other Associated Muscles of Respiration.”

Learn more about the AMA Research Challenge.

Speakers

  • Srujith Medharametla, second-year medical student, Chicago College of Osteopathic Medicine, Midwestern University
  • Brendan Murphy, senior news writer, American Medical Association

Host

  • Todd Unger, chief experience officer, American Medical Association

Listen on the go to the full episode on Apple Podcasts, Spotify or anywhere podcasts are available.

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Unger: Welcome to Making the Rounds, a podcast by the American Medical Association. Today’s interview features one of the finalists for the AMA Research Challenge, which is the largest national research event of its kind. Join us for the main event in February where the five finalists will present their research and compete for a ten-thousand-dollar grand prize, sponsored by Laurel Road. For the full details, visit ama-assn.org/finals. Here’s AMA Senior News Writer, Brendan Murphy.

Murphy: Hello and welcome to Making the Rounds, a podcast by the American Medical Association. I'm Brendan Murphy, senior news writer at the AMA. Today we're kicking off a special series where we'll feature each of the five AMA Research Challenge finalists right here on Making the Rounds. The AMA Research Challenge is the largest national multi-specialty medical research conference for medical students, residents, fellows and international medical graduates to showcase and present their research.

Our top research projects were showcased in October at a semifinal round, and our five finalists will present their research to an elite panel of judges on February 6, 2024. Visit ama-assn.org/finals to learn more. Today I have with me Srujith Medharamelta, a second-year medical student at Chicago College of Osteopathic Medicine, Midwestern University. How are you doing today, Srujith?

Medharametla: I'm doing great, Brendan. How are you?

Murphy: I'm doing well. Thank you so much for coming on our show to talk about your submission to the Research Challenge, which is titled, “Effects of Obesity on the Neuromuscular Junction of Genealogosis, Muscle, and Other Associated Muscles of Respiration.” Let's get started. Srujith, can you tell us a little bit about this topic, why it appealed to you and how you got involved in the Research Challenge?

Medharametla: Yeah, when I was a first-year medical student, our college, obviously, encourages us to do research. And so, I was looking around for some research projects to join, and I came across this physiology research project. And for me, I think physiology is a cool field of science where it appeals to me because you haveIt is the understanding of the mechanisms of what's going on in the human body, and it helps us understand the effects. And that's what appealed me to some physiology research, and this in particular, on neuromuscular junctions. That was pretty cool, because just trying to understand, it's this junction between the nerve and the muscle, and even though it's this small junction, it has implications in the nerve and in the muscle.

And for me, it was just, that was appealing to me to understand that. And so, I reached out to my professor, who's my principal investigator now, Dr. Isabel Martinez-Pena, and she led me into this, into her lab, and we got started on this project. And it's been very fruitful so far. It's ... for us, we're just investigating the effects of obesity-induced obstructive sleep apnea on the neuromuscular junctions of mice that we have in the lab. So far, we're looking at some of the respiration muscles, the genioglossus muscle in the tongue and some of the other muscles of respiration. That's what I got to present at the semi-finals and that's what I'll be presenting at the finals.

Murphy: So, what were some of the challenges you encountered in doing this research?

Medharametla: Some of the challenges in the research, it's mostly the lab stuff. Sometimes once we wanted to tag ‘acetylcholine esterases’ in the junction, and so we brought in this fasciculant toxin from, we bought that and we were trying to get that going but then it just didn't work in the lab and sometimes those things happen. Some of the other things are like confocal microscope, getting the training done to visualize these synapses and sometimes you may not get the right ones and that's pretty, those are some of the challenges that we usually encounter and but we try to work through them. We try to approach the question from different angles if one angle is not possible just so we have all the bases covered around the question.

Murphy: So it turns out things might not always go according to plan.

Medharametla: No, no, not always, no. We have to adapt.

Murphy: Adaptability is a good nugget for medical students and residents who are conducting research. What other advice do you have on conducting research as a medical student?

Medharametla: As a medical student, I think we're not, obviously, experts in research. So it's just trying to learn how to do research, how to approach a question, how to have your controls, how to approach a topic from various aspects. And for me, I've been learning a lot from my PI, Dr. Isabel. We call her Dr. Isabel. And just that.

It's a lifelong learning process. Medicine is lifelong learning and so research, getting involved in research is just that. So that's the advice I would give them. Embrace the research that you're doing. Try to learn how to do research, how to get your feet wet in research and that will help us once we're residents or once we're attendings to conduct our own research. And that's the advice I'd give them.

Murphy: You mentioned Dr. Isabel, and also just kind of that as a medical student, you may not be as well-versed in research methods and just the finer points of conducting it. What role did mentors play in this project? And for medical students who are listening, what makes a good research mentor?

Medharametla: For me, I think Dr. Isabel, obviously, she's been a great encouragement to us, to me and my colleagues in Research Garrett. She is the one who, it's pretty fascinating, our dynamics. She helps us understand research because sometimes I don't think about an angle, or we don't think about an angle. And then she comes in and she's like, “Hey, you've ... we gotta do this testing as well. We've gotta look at the neuromuscular junctions in this aspect, or I'm gonna take this to Northwestern University to do something to conduct more, such as electron microscopy studies,” or things like that. And I think she is very encouraging, very accommodating and answers all the questions I have, and also challenges us with new questions. And I think that's what a great mentor is.

Murphy: What are the next steps in this work?

Medharametla: The next steps for us in this project are to first confirm and validate or reproduce some of the data we have and increase the sample size on some of the data before we go on to publish and also to look at some of the other aspects of research. For example, we have the sexual dimorphism topic within our research where we're seeing effects in male mice, but not effects in female mice. And we think it's due to some reasons, female hormones or estrogen in these mice. And we just want to explore that topic further. And also, by looking at something called lipid wraps, which are clusters on the cell membrane that have acetylcholine receptors, which we're testing, and also estrogen receptors that could clue us into the physiology of why we're seeing this dimorphism between males and females. And also, we would like to look at the satellite cell markers in skeletal muscle that can help us understand why we're seeing central nuclei in skeletal muscle, which is very unusual. So just some of the topics we want to explore further before we try to submit for publication.

Murphy: How will this research impact your career trajectory? Could it impact your specialty choice perhaps? Would you pursue something like obesity medicine or sleep medicine?

Medharametla: Yeah, it is very fascinating for me. It has been very fruitful doing this research and I'm trying to look at internal medicine as a specialty, and so I think, obesity is something almost all physicians have to deal with. I used to work as a medical assistant at an orthopedic clinic before medical school and BMI was something we looked at before a person was a surgery candidate for a total knee or a total hip.

And so, obesity is something almost all physicians will have to deal with. And I think understanding more of these effects of obesity, these minute effects could help us in our practice. And so, as an internal medicine doctor in the future, I would have to look at these cases of obesity and just having more background on sleep apnea. as well or obesity and it'll just help me be a better physician too.

Murphy: What else should our listeners know about your journey in medicine?

Medharametla: I am a second-year medical student right now, so I do have two more years to go. And then obviously, as I said, I'm looking at internal medicine and then maybe a specialty after that, maybe something like cardiology as of now. But obviously that can change adaptability again, changing to see what fits my personality, what fits my desire as a physician. And I think just trying to go into that specialty. I love research too, so I would love to continue doing research as a resident and as an attending physician. It would be something very cool to have throughout my career.

Murphy: Well, I think this is the fun question, Srujith. Let's say you win the $10,000 grand prize in the AMA Research Challenge. What would you do with the prize money?

Medharametla: That's a lot of money. I would share part of it with one of my colleagues who has worked as much as I have in this project, Geert Borger. And then the rest will probably be at, looking at, we're looking at probably our expensive tuition in medical school or my expenses as we go along in medical school. So that's probably what I'll be doing with that money, if I win that.

Murphy: Well, we wish you the best of luck. Thank you for sharing your research with our listeners. And we all look forward to watching you compete in the finals on February 6. This has been Making the Rounds. I'm AMA Senior News Writer, Brendan Murphy. Thanks for listening.

Unger: Don’t forget to tune in to the AMA Research Challenge finals on February 6. Get the details at ama-assn.org/finals. Subscribe to Making the Rounds today.


Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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