Making the Rounds
The use of nerve cells to improve CHD post-surgery neurological deficits
Jan 11, 2024
Featured topic and speakers
In this episode of Making the Rounds, Alice Chen, medical student at George Washington University School of Medicine and Health Sciences talks about her research submission for the AMA Research Challenge, “Effect of Mesenchymal Stromal Cell Delivery Through Cardiopulmonary Bypass in a Piglet Model.” View her poster (PDF).
Learn more about the AMA Research Challenge.
Speakers
- Alice Chen, medical student, George Washington University School of Medicine
- 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.
Transcript
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 writer at the AMA. Today's episode is the last, but certainly not the least, in our series featuring each of the AMA Research Challenge finalists. If you missed the other episodes, I encourage you to go back and give them a listen. Our top five research projects will compete in the final event on February 6. Today I'm joined by Alice Chen. Alice is pursuing a research year between her third and fourth years of medical school at George Washington University School of Medicine and Health Sciences. Welcome, Alice. We're very excited to have you.
Chen: Hi, thank you so much for having me.
Murphy: Your submission to the AMA Research Challenge is entitled, “Effect of Mesenchymal-Stromal Cell Delivery Through Cardiopulmonary Bypass in a Piglet Model.” Tell us a little bit about this topic, why it appealed to you and how you got involved in the AMA Research Challenge.
Chen: Sure. So, what really appealed to me about this topic of the sort of use of nerve cells to help treat congenital heart disease is that it involves a really multidisciplinary approach to clinical care in both the fields of cardiology and neurology, specifically looking into how the functioning of the heart is involved with the brain. So, to give some context of why this topic is important, prior to the early 1980s, it was pretty uncommon for children with these complex heart diseases to survive into later childhood. But over the past few decades, deaths from CHD has significantly decreased and it's become a lot more manageable with new surgical procedures. But even though fewer patients are dying from surgery, more are presenting with neurological impairments depending on the severity of the disease, which can range from mild, such as just a hole in the heart, to severe, having a lot of missing or poorly formed parts of the heart. So, I think this study and a lot of similar studies in the past are really revolutionary in showing that you know, even with increased severity of CHD, there's increased frequency of neurological deficits, which suggests this correlation directly between the functioning of the heart and the brain and revealing what we can do to help decrease those negative effects from heart disease in children.
And I got involved in the Research Challenge by, you know, seeking out, in seeking out these opportunities, talking to a lot of mentors. I think GW and Children's National are very research heavy institutions. So, they really emphasize the importance of conducting research and showcasing a lot of this research on a national level. So, because I was exposed to that and I really held on to the opportunity of being able to show this research at a national level, I decided to take that chance.
Murphy: So certainly, this is an important topic. What were some of the challenges you encountered in doing this research?
Chen: I think a big part of this research relied on analysis using a software program called iMRS. And that can be pretty difficult and technical to use for first timers especially. It requires users to be very precise in measuring lengths of what we call branch processes in these cells and then also the number of branch points from the nucleus in the nerve cells. So, it definitely took several weeks to analyze and perfect an entire cohort of subjects completely accurately.
I think other challenges just have to do with the inherent limitations of our study. Some limitations to our data just have to do with our sample size being pretty small, which could have accounted for maybe a higher standard error in some cases, which doesn't accurately represent the entire population as a whole. Another limitation could be that acute studies only assess the acute effects of our mesenchymal-stromal cell treatment.
So since it only looked at the effects about three hours post-surgery, it's possible that these acute reactions of the MSCs that we were looking at may be altered according to different conditions such as temperature and duration.
Murphy: What advice would you offer to medical students who are conducting research on a project like this?
Chen: I think while this project and this topic is very important to the field of medicine, a lot of the jargon and scientific terminology can seem really foreign for someone who has limited background knowledge in this type of research. So my advice to medical students interested in a project like this that's very technical, very … has a lot of background information that you need to brush up on is just to read and absorb as much knowledge as you can every day so that when it comes time to present your research, you really have a grasp on the topic and can talk about it with ease and confidence. I think research is that much more fulfilling when you can take initiative to learn and educate yourself and just truly master what you've dedicated so much of your valuable time doing.
Murphy: What role did mentors play in your research and what, in your opinion, makes a good research mentor?
Chen: I think going off of what I was talking about just now with learning a lot, I think at the same time, you have mentors who are there to teach and answer all of your burning questions. I think a good mentor should really encourage clear and open communication at all times. They should be able to explain complex concepts, provide constructive feedback and sort of maintain that open line of communication with their mentees. I also think mutual adaptability is super important too in this mentor-mentee relationship. Just like every mentor is unique, every mentee is unique and a good mentor adapts your mentoring style to suit the individual needs and preferences of each mentee. So, I think adaptability would be something that I realized during that time that I was doing research came to be super valuable.
Murphy: What do you see as the next steps in this work?
Chen: So, this project was significant in showing the differences between our two comparison groups. We had a cardiopulmonary bypass group and then one with the actual nerve cell treatment with the MSCs. So those showed differences in the level of inflammation, which points to potential long-term benefits of this MSC delivery. But even though there were differences among those treatment groups, there weren't really any differences within the specific regions of the brain cortex. So, for future studies, I think it would be worth looking into the effects on different parts of the brain and the white matter as well. Also examining the dose effect of MSC delivery by comparing what we used, a standard dose versus a higher dose of MSCs, I think should be tested to optimize MSC treatment for children with CHD.
Murphy: How will this research impact your career trajectory? Certainly, we could see this applying to a number of medical specialties. They can be pediatric. They could just be general. Do you see this affecting that?
Chen: Yeah, absolutely. As I'm sure many medical students can relate to, I spent a lot of my first and second years at medical school considering different specialties and working on a journey, trying to figure out which one I was best suited to pursue. And this research experience contributed a lot to that journey. During the time that I spent conducting this research, I had the opportunity to shadow my mentor, Dr. Kei Kobayashi, who's a cardiothoracic surgeon at Children's National Hospital in D.C.
And for a lot of that time, he performed surgeries on some of our test subjects. So, I always thought the intricacies of surgery were super fascinating. That was really my first experience being exposed to surgery. So, for some time, I did consider working in that field, cardiothoracic surgery, cardiology as well. But right now, I am pursuing a research year in a different field. So, I think while I have decided to pursue different paths, I really do feel that the early exposure to cardiology, neurology surgery was crucial to shaping my early med school journey and allowing me the chance to learn about different paths.
Murphy: And it's all a process of self-discovery.
Chen: Exactly.
Murphy: Many people come into med school with one idea of what they're gonna do, and they leave with another.
Chen: Yep.
Murphy: What else should our listeners know about your journey in medicine?
Chen: Well, just like what you said about, you know, learning about different fields and being on that exploration, I think my journey in medicine wasn't linear and it really shouldn't be. We're sort of thrown into this completely new world with so much to learn and explore and much of my journey was embracing that exploration. So, I think as I enter my fourth year, I'm just really excited for my medical school journey to sort of culminate into a very meaningful final year ahead where I dedicate a lot of that time to pursuing what I meant to spend the rest of my life doing.
Murphy: Well, that is very exciting. And this is our most exciting question, I think. Let's say you win the $10,000 prize. What would you do with the money?
Chen: I would definitely use some of it to fund the rest of my medical school education, but also some of the expenses for some international research endeavors. I had this secondary interest in global health, so I hopefully will plan to seek out some opportunities during my fourth year and beyond, where I can provide medical care and underserved research and hopefully use some of that prize money to fund these experiences as well. I also want to try to give back as much as I can to my family and my community. Since they really just provided me with all the resources and the foundation to get me to this point
Murphy: Well, Alice, thank you for joining us today.
Chen: Thank you so much for having me.
Murphy: This has been the last of our series on the AMA Research Challenge. But the main event is yet to come. Don't miss Alice and the other finalists competing on February 6. For more information on that, visit ama-assn.org/finals. And you can also find that link in the description of this podcast. 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.
