Medical Student Research Fellowship for Summer 2011
Mentor: Steven Vernino, M.D., Ph.D.
Room number: J3.118
Mail Code: 9036
Phone number: 214-648-8816
Project title: Long term prognosis of Autoimmune Autonomic Ganglionopathy
Human subjects IRB approved project number (where applicable): 092004-041
Animal subjects IRB approved project number (where applicable):
Project Type: patient-based research
Brief Description of Project:
The ganglionic (a3-type) AChR is found in the autonomic nervous system, specifically in sympathetic, parasympathetic, and enteric autonomic ganglia. Ganglionic AChR antibodies are found in patients with autoimmune autonomic ganglionopathy (AAG), and are believed to be the cause of AAG (similar to how antibodies against the nicotinic AChR cause myasthenia gravis). Patients with AAG present with autonomic failure, the clinical features of which include orthostatic hypotension, bladder dysfunction, anhidrosis, and gastrointestinal dysmotility. While autonomic failure can often be improved in patients with AAG following plasma exchange or immunomodulatory treatment, the long-term outcome of these patients is currently not well established. Recent reports have suggested patients with AAG may have increased susceptibility to certain kinds of cancers. This project aims to examine the potential link between AAG and other diseases, including cancer, by following up with the physicians of previously identified AAG patients to determine the patients' current health status and recent medical history since their initial presentation with AAG. In doing so, the student will gain experience with clinical research and help to establish what types of screenings might be beneficial or worthwhile to AAG patients in the long term.
Specific methods: About 40 patients with AAG have been identified over the past 10 years by Dr. Vernino and his colleagues. These patients consented to research studies to help characterize this disease and develop diagnostic tests. The student and mentor will develop a data acquisition form to collect follow-up data from these patients. Specifically, data on cancer diagnosis, progression or remission of symptoms, treatments and survival will be collected. The student will first contact these research patients by phone or mail to ensure consent for additional data collection and then collect this information from the patients and their treating physicians. After data collection, the student will compile and analyze the data to characterize the course of this recently recognized disease. It is expected that this study will lead to a peer reviewed publication. This project will require the student to have good personal and organizational skills.
Previous Research Activities or Publications with Medical Students:
Tajzoy E, Mukherjee S, Vernino S. Autonomic Ganglia Neuronal Density and Synaptic Structure in Chronic Experimental Autoimmune Autonomic Ganglionopathy. Arch Neurology. 2011. (in press)
Emil Tajzoy has worked in the lab for the past 2 summers, and two other manuscripts are in preparation