Beaker to bedside

University of Houston researchers on why bridging the gap between academia and clinicians is key

There's a growing need for physician-scientists who can see from both sides of the table. Miguel Tovar/University of Houston

Physician-scientists are a group of specialized researchers at the intersection of medicine and technology. Earning both medical degrees and Ph.D.s, they offer a perspective beyond the scope of clinical practice.

Three such researchers discussed how they make the connections between discovery and patient care.

Why a dual education matters

Shaun Xiaoliu Zhang, director of the Center for Nuclear Receptors and Cell Signaling at the University of Houston and M.D. Anderson professor of biology and biochemistry, knows exactly what the clinical demands are.

"I can see from the M.D. perspective, but at the same time I have a Ph.D. — I know how to design research properly," he says. "In the clinic, you're faced with reality that a patient is struggling but you don't have the tools to treat those patients. If you engage in research you can create a tool."

Zhang says clinicians know the need but may struggle to design a solution. A Ph.D., on the other hand, may only know basic research.

Renowned hormone researcher Jan-Åke Gustafsson, Robert A. Welch professor of biology and biochemistry and founding director of the Center for Nuclear Receptors and Cell Signaling, agrees.

"The dual education makes it possible for you to see which diseases are in need of more research, drugs and so on," he says.

Physician-scientists are the driving force behind many advances of modern medicine.

"The way I look at it is, practicing medicine is relatively easy but coming up with the next diagnostic device or the next treatment for a disease is way more difficult, way more challenging," says Chandra Mohan, Hugh Roy and Lillie Cranz Cullen Endowed professor of biomedical engineering at UH.

"You see patients with certain diseases, and you know there's a dire need for better diagnostics, earlier treatment, earlier diagnosis with fewer side effects," he says.

While researchers spend time primarily in the laboratory and clinical practitioners interact with patients, they both want to make an impact.

"We have made some discoveries which have led to the development of new drugs and better understanding of certain diseases," says Gustafsson. "There's a great satisfaction that it may help people to get healthy."

Traditional research brings value to a university

The synergy of this dual education makes these investigators valuable not only to academia, but also to medical science.

"I can't imagine doing translational research without medical training," Zhang says. "If you have this part without the other, you don't know where to go. With medical training, you know exactly which direction to go."

Mohan echos that assessment.

"When you start doing research there are so many questions you can answer," he says. "Sometimes there are questions which are just too basic. They're too far removed from how it will impact a patient's life. So what are the most important questions? I think questions that really make a difference in the patient's life are the most important."

Zhang notes that the National Institutes of Health has switched its funding philosophy — once focused on basic science, it now is more interested in translational research, with a direct relationship to patient health.

As physician-scientists, these "translators" of medical research are able to bridge the chasm.

Amr Elnashai, vice president/vice chancellor of research and technology transfer at UH, says physician-scientists play an important role.

"The increasing importance of deploying technology in medicine renders it essential for a progressive research university to hire medical Ph.D. holders who are in an ideal position to bridge the gap between engineering and science on the one hand, and the broad field of medicine on the other," he says.

Research groups that bring both fields together not only have a much higher probability of impacting lives by adopting the latest technology in medical applications, he adds, but they also give interdisciplinary teams greater access to specific funding pursue such solutions.

In that sense, says Elnashai, medical Ph.D. researchers play an important part of the future research university.

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This article originally appeared on the University of Houston's The Big Idea.

Nitiya Spearman is the internal communications coordinator for the UH Division of Research.

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Building Houston

 
 

This UH engineer is hoping to make his mark on cancer detection. Photo via UH.edu

Early stage cancer is hard to detect, mostly because traditional diagnostic imaging cannot detect tumors smaller than a certain size. One Houston innovator is looking to change that.

Wei-Chuan Shih, professor of electrical and computer engineering at the University of Houston's Cullen College of Engineering, recently published his findings in IEEE Sensors journal. According to a news release from UH, the cells around cancer tumors are small — ~30-150nm in diameter — and complex, and the precise detection of these exosome-carried biomarkers with molecular specificity has been elusive, until now.

"This work demonstrates, for the first time, that the strong synergy of arrayed radiative coupling and substrate undercut can enable high-performance biosensing in the visible light spectrum where high-quality, low-cost silicon detectors are readily available for point-of-care application," says Shih in the release. "The result is a remarkable sensitivity improvement, with a refractive index sensitivity increase from 207 nm/RIU to 578 nm/RIU."

Wei-Chuan Shih is a professor of electrical and computer engineering at the University of Houston's Cullen College of Engineering. Photo via UH.edu

What Shih has done is essentially restored the electric field around nanodisks, providing accessibility to an otherwise buried enhanced electric field. Nanodisks are antibody-functionalized artificial nanostructures which help capture exosomes with molecular specificity.

"We report radiatively coupled arrayed gold nanodisks on invisible substrate (AGNIS) as a label-free (no need for fluorescent labels), cost-effective, and high-performance platform for molecularly specific exosome biosensing. The AGNIS substrate has been fabricated by wafer-scale nanosphere lithography without the need for costly lithography," says Shih in the release.

This process speeds up screening of the surface proteins of exosomes for diagnostics and biomarker discovery. Current exosome profiling — which relies primarily on DNA sequencing technology, fluorescent techniques such as flow cytometry, or enzyme-linked immunosorbent assay (ELISA) — is labor-intensive and costly. Shih's goal is to amplify the signal by developing the label-free technique, lowering the cost and making diagnosis easier and equitable.

"By decorating the gold nanodisks surface with different antibodies (e.g., CD9, CD63, and CD81), label-free exosome profiling has shown increased expression of all three surface proteins in cancer-derived exosomes," said Shih. "The sensitivity for detecting exosomes is within 112-600 (exosomes/μL), which would be sufficient in many clinical applications."

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