11 months ago

2016 Fall/Winter Highlights of Hope

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RESEARCH THE BEST OF BOTH WORLDS: MEET VARI'S PHYSICIAN-SCIENTISTS What is the best part of being a physicianscientist? Q Lena Brundin, M.D., Ph.D. Associate Professor, Center for Neurodegenerative Science, Van Andel Research Institute; Collaborating Researcher, Pine Rest Christian Mental Health Services Patrick Grohar, M.D., Ph.D. Associate Professor, Center for Cancer and Cell Biology, Van Andel Research Institute; Pediatric Oncologist, Spectrum Health Helen DeVos Children’s Hospital Stefan Jovinge, M.D., Ph.D. Professor, Center for Epigenetics, Van Andel Research Institute; Director, DeVos Cardiovascular Research Program (a joint effort between VARI and Spectrum Health); Medical Director of Research, Frederik Meijer Heart & Vascular Institute, Spectrum Health Matthew Steensma, M.D. Assistant Professor, Center for Cancer and Cell Biology, Van Andel Research Institute; Orthopedic Surgeon, Spectrum Health MS: There are many wonderful aspects of being a physician-scientist, as well as unique challenges. What I really like about physician-scientist work is the ability to see the "entire picture," from bedside to bench and back. In my opinion, it's the best way to develop a comprehensive understanding of a complex disease like sarcoma. When you do translational research as a clinician, you acquire a deep understanding of the genetics or molecular biology of disease. It's a great reminder of the invisible battle going on inside of a patient. It can also be incredibly frustrating because it takes a lot of time to implement promising research findings, or your project simply fails. These frustrations are inherent to all medical research, but as a physicianscientist you always want to see the impact of your research. In many ways, our success is defined by how we improve the lives of our patients through research. The job is very motivating, not only for myself but also for our lab members, who really appreciate the context of their work. SJ: In my case as a critical care cardiologist, I see very sick patients, sometimes in a hopeless condition. To be part of the cutting edge to generate new technologies and treatments gives me a lot of inspiration and energy to move things forward. LB: The best part is that I am able to do true translational research. I observe symptoms in patients that generate ideas and hypotheses that I then can test directly in my own laboratory. It is very fulfilling to be able to work like that. It is great to work with the full spectrum of research—to enroll patients in our clinical studies working directly with several hospitals in Grand Rapids; to evaluate the patient’s symptoms; collect blood and tissue samples; and then work on these samples in my own laboratory, put together the results, and finally interpret them, often together with our skilled biostatisticians at VARI. PG: Being a physician-scientist is the best of both worlds. I enjoy working directly with patients and making a 2 | VAN ANDEL INSTITUTE HIGHLIGHTS OF HOPE

difference in their care, while also using the tools available to me as a scientist to investigate questions that arise in the clinic. Although the approaches may be different, they’re completely complementary and they have the same goal—to help patients fight these devastating cancers. Q How does your clinical experience inform your research? How does your research inform your clinical work? MS: Practicing medicine allows you to identify gaps in care that only research can fill. Conducting research on a disease that you frequently see in the clinic gives you a platform to apply your research findings toward the betterment of your patients. SJ: My clinical experience gives me inspiration to drive my mission and leads to ideas either from direct experience or from the results we retrieve from our clinical research. Our basic research inspires me as a clinician by knowing the possibilities— it opens my eyes to see opportunities to find new treatments for patients. In the lab, we see future treatments, which is very inspirational. LB: As a researcher, I don’t think anything can be more motivating than personally meeting the patients who you are trying to find a cure for. Preclinical researchers also reach out to and meet with patients, but as a clinical researcher, you are lucky enough to get that motivation on a daily basis. My research has established that many patients with depression and suicidal ideation have high levels of inflammation in the blood. Now I am trying to spread that knowledge back to the clinic. It is important because inflammation in these patients could potentially be treated, and the patients might benefit from this in terms of fewer symptoms of depression, according to our hypothesis. I am writing reviews and clinical guidelines on this topic, informing the clinical community of the risk of psychiatric symptoms during inflammatory conditions. I am also planning treatment studies together with hospitals in Grand Rapids in the near future, where we hope to treat depressive patients with anti-inflammatory agents to reduce their symptoms. PG: The lab and the clinic are two sides of the same coin. Ultimately, everything we do in the lab is focused on finding better ways to help patients. At the same time, our experiences working directly with patients in the clinic give us important insight that we can then investigate in the lab. On a more personal level, working with patients is a strong motivator to identify the problems and the shortcomings in current therapeutic approaches and to try to solve these problems through our research. The reverse is also true—the lab gives us the tools to develop new treatment strategies and bring them to patients in a scientifically rigorous way. BREAKING DOWN THE WALLS BETWEEN THE LAB AND CLINIC Van Andel Institute Graduate School Pediatric Hematology/Oncology Fellowship-Ph.D. Program As a physician working with children at Spectrum Health Helen DeVos Children's Hospital, pediatric oncology fellow Dr. Aditi Bagchi discovered she sometimes has more questions than answers. “We often treat children who are critically ill,” Bagchi said. “It’s very difficult to have to explain to their parents that we have limited knowledge about their disease. I wanted to be able to answer the unknown questions and also help develop improved treatments for children with lifethreatening illnesses. Getting involved with basic and translational research provides that opportunity.” The Pediatric Hematology/Oncology Fellowship-Ph.D. program at Van Andel Institute Graduate School offers physicians the opportunity to earn a Ph.D. while continuing to practice medicine. Unlike the traditional physician-scientist degree track, which requires two years of medical school, four years of a Ph.D. program, and then an additional two years of medical school, the Institute’s fellowship program provides a less linear approach to a doctoral degree. “We have designed my doctoral program around my specialization in pediatric oncology,” Bagchi said. “The program is especially meaningful because of its relevance to the children I treat. I more deeply understand the molecular basis and mechanisms of disease, which will help me break down the walls between the lab and the clinic.” Balancing the program’s demanding requirements while working as a full-time physician is not easy, but the rewards are life-changing, both for Bagchi and the children she treats. “My life’s goal is to minimize the existing gap between bench and bedside; I believe the education and training I am getting DR. ADITI BAGCHI through this dual program will help me design more scientifically accurate clinical trials that will impact ailing children across the globe,” Bagchi said. “The Institute’s fellowship program is innovative. Its impact on my ability to help my patients is incredible.” For information on Van Andel Institute Graduate School visit VAN ANDEL INSTITUTE HIGHLIGHTS OF HOPE | 3

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