Dr. Berger Receives Prestigious K76 Award

Miles Berger, MD, PhDThe National Institutes of Health has awarded Duke Anesthesiology’s Miles Berger, MD, PhD, and his team of investigators a Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76); a five-year, $1,195,505 grant for their project, titled “Neuro-inflammation in Postoperative Cognitive Dysfunction: CSF and fMRI Studies.”

According to the project description, each year, more than 16 million older Americans undergo anesthesia and surgery, and up to 40 percent of these patients develop postoperative cognitive dysfunction (POCD), a syndrome of postoperative thinking and memory deficits. Although distinct from delirium, POCD (like delirium) is associated with decreased quality of life, long term cognitive decline, early retirement, increased mortality, and a possible increased risk for developing dementia, such as Alzheimer’s disease. Strategies are needed to prevent POCD, but first, we need to understand what causes it. A dominant theory holds that brain inflammation causes POCD, but little work has directly tested this theory in humans. Dr. Berger and his team’s preliminary data strongly suggests that there is significant postoperative neuro-inflammation in older adults who develop POCD.

In this K76 award, the team of investigators will prospectively obtain pre and postoperative cognitive testing, fMRI imaging and CSF samples in 200 surgical patients over the age of 65. This will allow them to evaluate the role of specific neuro-inflammatory processes in POCD, its underlying brain connectivity changes, and postoperative changes in cerebrospinal fluid (CSF) Alzheimer’s disease (AD) biomarkers, such as the microtubule-associated protein tau. This project will advance understanding of neuro-inflammatory processes in POCD and clarify the potential link(s) between these processes and postoperative changes in AD pathology, in line with the National Institute of Aging’s mission to understand aging and fight cognitive decline due to AD.

The K76 is a mentored career development award; Dr. Berger’s mentoring team includes Drs. Joseph Mathew (chairman of Duke Anesthesiology) and Harvey Cohen (director of the Duke Center for the Study of Aging and Human Development ), as well as Drs. Roberto Cabeza (from the Duke Center for Cognitive Neuroscience), Kent Weinhold (vice chair for research of Duke Surgery), and Heather Whitson (deputy director of the Duke Center for the Study of Aging and Human Development). Co-investigators and collaborators include Drs. Niccolò Terrando (Duke Anesthesiology), Jeffrey Browndyke (Duke Psychiatry & Behavioral Sciences) and David Murdoch (Duke Medicine).

During this K76 grant period, Dr. Berger, an assistant professor of anesthesiology, will also complete an individually-tailored MS degree in translational research that will include training in immunology methods, fMRI imaging, cognitive neuroscience, geroscience, and physician leadership. This career development plan will provide him with transdisciplinary skills to pursue his longer term goal of improving postoperative cognitive function for the more than 16 million older Americans who have anesthesia and surgery each year.

Chris KeithDr. Berger Receives Prestigious K76 Award
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Dr. Zhang Wins Poster Award at Inaugural Pain Meeting

Dr. Zhang with is award winning poster.

Dr. Zhang with is award winning poster.

Duke Anesthesiology’s Xin Zhang, MD, PhD, received an award for “Outstanding Poster” at the first Translational Pain Research Symposium, held on June 21 – 23 at Duke Kunshan University in China. His poster is titled, “Activation of peripheral β2 and β3ARs leads to increased nociceptor activity.”

Zhang and Nackley China June 2017

Zhang and Nackley China June 2017

As noted in the abstract, Dr. Zhang’s research shows that i) COMT inhibition leads to pain sensitivity, in line with increased ERK phosphorylation in DRG neurons and strengthened nociceptor activity in response to noxious stimuli, ii) COMT-dependent increases in pain sensitivity and nociceptor activity are driven by peripheral β2- and β3ARs, and iii) treatments targeted towards peripheral β2- and β3ARs and downstream effectors may prove useful in the management of functional pain syndromes. The team of investigators includes Duke Anesthesiology’s Andrea Nackley, PhD, Seungtae Kim, MD, PhD, and Sandra O’Buckley.

Dr. Zhang is a postdoctoral fellow with The Nackley Lab, part of Duke Anesthesiology’s Center for Translational Pain Medicine which is dedicated to unraveling the causes of painful conditions to better improve patient care. The Translational Pain Research Symposium was held on the new state-of-the-art campus of Duke Kunshan University. The goals of the conference were to present recent advances in basic science research of pain mechanisms, introduce cutting-edge techniques in pain research, and bridge the gap between basic research and clinical applications.

Chris KeithDr. Zhang Wins Poster Award at Inaugural Pain Meeting
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Neuroscientists Awarded School of Medicine Voucher

The Duke University School of Medicine has awarded an $8,000 voucher to Duke Anesthesiology’s Niccolò Terrando, PhD, and Zhiquan Zhang, PhD, for their project, titled “Preventing Memory Dysfunction after Surgery with a Novel Pro-Resolving Peptide from Annexin-A1.”

Major surgery, including cardiac and orthopedic, often causes neurological complications such as delirium and postoperative cognitive dysfunction. According to the project investigators, there are currently no safe and effective therapies to prevent or limit these complications in patients. Dr. Zhang previously developed a bioactive peptide (ANXA1sp) derived from the N-terminal domain of the human protein Annexin-A1 (ANXA1), a critical molecule involved in the resolution of inflammation. Ongoing studies with this peptide are revealing promising effects in protecting the brain against excessive neuroinflammation after surgery, which is becoming a key contributor to memory deficit.

This voucher, in collaboration with the Mouse Behavioral and Neuroendocrine Shared Core, will help Drs. Zhang and Terrando validate the effects of this peptide on cognitive, as well as higher order memory tasks, in their models of cognitive dysfunction after major surgery. Given the impact of neuroinflammation on memory function across many different neurological disorders, this therapy could provide fundamental knowledge to direct future studies and therapy development for numerous conditions such as Alzheimer’s disease and other dementias.

Dr. Terrando is an assistant professor in anesthesiology, a collaborator with Duke Anesthesiology’s Center for Translational Pain Medicine and the director of the Neuroinflammation and Cognitive Outcomes Laboratory which studies the mechanisms underlying postoperative neurocognitive disorders with a strong focus on neuroinflammation, innate immunity and behavior. Dr. Zhang is an assistant professor in anesthesiology and a member of Dr. Terrando’s lab.

Chris KeithNeuroscientists Awarded School of Medicine Voucher
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Dr. Jordt Named Co-Chair of Terrorism & Inhalation Disasters Section

Sven-Eric Jordt, PhDThe American Thoracic Society (ATS) elected Duke Anesthesiology’s Sven-Eric Jordt, PhD, as the co-chair of its Section on Terrorism and Inhalation Disasters (TID) on May 23 at the society’s annual meeting.

TID brings together ATS members with interests in mechanisms and treatment approaches for chemically-induced inhalation injuries and their health effects, epidemiology of inhalation injuries, identification and control of inhalation threats associated with terrorism, industrial accidents, infectious diseases and environmental disasters, preparedness and first responder networks. Dr. Jordt will support the section’s mission by coordinating section proposals, official society publications and outreach efforts.

An ATS report calling for an increase in research efforts to develop new therapeutics for chemical inhalation injury was published in the June 1, 2017 issue of the Annals of the American Thoracic Society, titled “An Official American Thoracic Society Workshop Report: Chemical Inhalational Disasters. Biology of Lung Injury, Development of Novel Therapeutics, and Medical Preparedness.”

Dr. Jordt is an associate professor of anesthesiology, faculty of Duke Anesthesiology’s Center for Translational Pain Medicine, and the director of the Chemical Sensing, Pain and Inflammation Research Laboratory which focuses on the mechanisms that enable humans and animals to sense touch, pain and irritation.

Chris KeithDr. Jordt Named Co-Chair of Terrorism & Inhalation Disasters Section
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Dr. Swaminathan Elected Vice President of ASE

Madhav Swaminathan, MD, FASE, FAHAOn June 4, Duke Anesthesiology’s Madhav Swaminathan, MD, MMCi, became the first anesthesiologist to be appointed as vice president of the American Society of Echocardiography (ASE) in the organization’s 42-year history.

“It is humbling to be accepted by the society into a key leadership role that will eventually lead to the presidency of the largest and most influential voice in echocardiography in the world,” says Dr. Swaminathan. “It represents recognition of years of hard work by many giants in the field who have made it possible for an anesthesiologist to be in this position.”

In his new role as vice president on ASE’s Board of Directors, Dr. Swaminathan says he hopes to continue some of the work that they have been doing in the society – expanding its global presence in echocardiography and reaching out to non-traditional users of cardiovascular ultrasound, such as critical care medicine practitioners, through educational initiatives. He believes these efforts will continue to foster innovation in echocardiography and explore novel ways in which diagnostic cardiovascular ultrasound can add value to population health.

According to Dr. Swaminathan, Duke Anesthesiology has been a leader in the field of perioperative echocardiography since its inception. “My appointment to the leadership of the ASE is unprecedented and reflects years of hard work by leaders in our specialty,” adds Dr. Swaminathan. “Many in our institution, including Drs. Joseph Mathew, Jonathan Mark, and Mark Newman of Duke Anesthesiology, and Joseph Kisslo and Pamela Douglas of Duke Medicine, both past ASE presidents, have been instrumental in this effort.”

Dr. Swaminathan has assumed roles on several ASE committees, most recently as chairman of the Membership Committee and chairman of the Council on Perioperative Echocardiography. He has also served on the Industry Relations Committee, Education Committee, and as co-chairman and chairman of the Perioperative Echocardiography track for ASE’s Scientific Sessions from 2011-2015. Notably, he was the first anesthesiologist selected to deliver the prestigious Feigenbaum Lecture at ASE’s Scientific Sessions in 2015.

Dr. Swaminathan is a professor of anesthesiology, the clinical director of the Cardiothoracic Anesthesiology Division, and co-director of Perioperative Optimization. His research focuses on elucidating mechanisms of, and risk factors for, perioperative acute kidney injury in patients undergoing heart surgery with emphasis on the role of early recovery of kidney function. He is also involved in research exploring the role of transesophageal echocardiography in outcomes after cardiac surgery.

Chris KeithDr. Swaminathan Elected Vice President of ASE
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Dr. Kwatra Awarded Funding for Glioblastoma Study

Madan M. Kwatra, PhDGenzada Pharmaceuticals has awarded Dr. Madan Kwatra a two-year, $763,200 grant, titled “Evaluation of novel anti-cancer agents, either alone or in combination, for activity against glioblastoma subtypes: a personalized medicine approach.”

Genzada specializes in pharmaceuticals derived from plants. Their lead compounds have shown activity in preclinical models of several cancers. These agents will be tested against glioblastoma because they have the ability to penetrate the blood brain barrier and represent a natural, alternative therapy against glioblastoma. The compounds will be tested against GBMs of multiple molecular subtypes allowing for a personalized and targeted approach to treating this deadly disease.

Dr. Kwatra is an associate professor in anesthesiology and the director of the Molecular Pharmacology Laboratory at Duke Anesthesiology, which focuses on understanding the role of G protein-coupled receptors in human diseases.

Chris KeithDr. Kwatra Awarded Funding for Glioblastoma Study
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