Posts (30)

2 days ago · Regenerating muscles after cancer surgery

Advancements in microsurgery are making it possible to harness the body’s healing power to regenerate muscle strength after some cancer surgeries, particularly surgery to remove soft tissue sarcoma. Mayo Clinic orthopedic oncologists are teaming with plastic surgeons in a procedure they’ve coined “oncoregeneration.” They are seeking to perfect this procedure in which large muscle is transferred to close a surgical wound and then coaxed to function like the muscle lost to cancer. This oncoregenarative surgery combines free muscle transfers with pain management and lymphatic reconstruction with a goal of restoring function, while preventing damaged nerves and lymph nodes that can cause pain and swelling.

Matthew Houdek, M.D.

“Quality of life after surgery is one of the biggest reason we started doing this surgery. Sarcoma patients were functional, but would get tired easily, mainly because they are relying on other muscle groups to restore the function that they once had. Sometimes being just OK after cancer surgery isn’t good enough,” says Matthew Houdek, M.D., an orthopedic oncologist at Mayo Clinic. “With this functional transfer, we are attempting to restore form and function of the muscle, so patients can get back to the lifestyle they once had.”

Every year there are more than 13,000 new cases of soft tissue sarcoma diagnosed in America, and 5,000 people will die from it, according to the American Cancer Society. Just a few decades ago, the only way to treat it was through limb amputation. In more recent years, cancer could be controlled by removing only the tumor, but patients often suffered severe limitations in mobility due to swelling, pain and loss of muscle. 

The procedure at Mayo Clinic is a free flap surgery done under a microscope with high precision tools smaller than the tip of a pen. These micro tools protect blood vessels, small nerves and small lymphatic vessels that can be less than 1 millimeter in diameter, so they can be transferred to the site of the tumor resection. Much like a plug placed in an electrical outlet, nerves and blood vessels from the healthy muscle are connected to the nerves and blood supply where the cancer was removed. That triggers a regeneration in which the transferred muscle may function like the one that had been removed.

Steven Moran, M.D.

“Advancements in microsurgical technique have made what we can repair and what we can restore much better.We now have the abilities to reconstruct and manage nerves in such a way that we minimize the chances of developing chronic phantom pain. We are also able to reconstruct the lymphatic channels to avoid painful fluid buildup and swelling that can limit mobility, also known as lymphedema. That’s a major improvement  for patients,” says Steven Moran, M.D., of the Mayo Clinic Division of Plastic and Reconstructive Surgery.

Regenerative Medicine Minnesota, a statewide bipartisan initiative to advance regenerative medicine research, education and practice, has awarded Dr. Moran and his team a grant to further examine the regenerative capacity of muscle. The research will explore opportunities for new regenerative therapeutics to restore muscle volume and muscle function after surgery or traumatic injury.

Like extra innings in a baseball game

For Mark Merila, oncoregenerative surgery was like the bonus of playing extra innings. The 48-year-old former professional baseball player and coach for the San Diego Padres defeated a rare brain tumor in the early 2000’s through chemotherapy and radiation. He transitioned to a job as a baseball scout for the Padres and despite having right side paralysis from the brain tumor, he enjoyed an active lifestyle. Then in 2018, a lump developed in his good leg that turned out to be an aggressive soft tissue sarcoma. Dr. Houdek had to remove two-thirds of Merila’s left quadriceps to get rid of all the cancer.

Facing the prognosis of life in a wheelchair or walking with a brace, Merila opted for the free flap surgery. Together Dr. Houdek and Dr. Moran transferred a portion of Merila’s latissimus dorsi (back and shoulder muscle) to Merila’s quadriceps, where it now functions like a normal thigh muscle.

Mark Merila

“You’ve heard the saying that a cat has nine lives. I feel like I’ve had nine-and-a-half lives. I’ve defeated cancer twice before the age of 50. I am very happy for the opportunity to have this surgery which has restored my ability to walk and, most importantly, to drive a car again,” says Merila. “This surgery has given me a new chance to go back to work and return to my normal activities, although at a slower pace.”

While transfers of smaller muscle groups in the upper body are more commonly performed, Mayo Clinic is one of the first to successfully perform functional free flap surgeries in larger muscles in the lower body.

“It takes expertise in lymphatic reconstruction, nerve reconstruction and muscle reconstruction. To find that in one medical institution is unique. The incredible teamwork at Mayo Clinic is what makes this possible,” says Dr. Moran.

“This is a huge step forward for our patients. We have some people who have gotten back to running, biking, jumping and nearly everything they want to do,” says Dr. Houdek.

The team at Mayo Clinic aspires to apply the oncoregenerative surgery to more types of large muscle transfers. As for Mark Merila, he hopes that with additional physical therapy, he will one day be able to get back to all his normal activities, including playing golf.

Mayo Clinic Center for Regenerative Medicine supports the work of physicians and scientist to advance the body’s ability to restore form and function toward a pre-disease state.
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Thu, Aug 6 8:30am · "Rock star" baby hitting her milestones after fetal surgery to correct spina bifida

The first peak at her baby during the 20 week ultrasound turned from excitement to concern for Hetty Mollert.

Tyler, Hetty and Madelyn Mollert
Summer 2019

“It was taking longer than I expected. I thought they were just being super in-depth about everything,” said Mollert, a first time mother-to-be from Madison, Wis. “Then we learned the devastating news. The ultrasound showed our baby had an opening in her spine. They believed she had spina bifida.”

The ultrasound revealed the baby had myelomeningocele, the most common and serious form of spina bifida. It’s a condition in which membranes and spinal nerves push through the opening in the spine, forming a sac and exposing tissues and nerves. This made Mollert’s baby prone to life-threatening infections and severe disabilities. The discovery launched Hetty and her husband, Tyler, on an emotional decision making roller coaster.

“I cried every night. Of all of the choices, termination of the pregnancy was not an option for us. That left us with two alternatives. We could have surgery while she was still in the womb to close the spine or we could do nothing and have surgery after she was born,” says Mollert.

The Mollert baby also had Chiari malformation, a neurological disorder related to spina bifida that pushes the brain down through the base of the skull. That condition may lead to a buildup of fluid on the brain known as hydrocephalus, which can damage the brain. Oftentimes, infants with hydrocephalus require a shunt after birth to drain the fluid.

The Mollerts did their research, and then weighed the risks and benefits. Fetal surgery would increase possibilities of preterm delivery, ruptured uterus, or death of the baby in rare cases. But, surgery after birth meant longer exposure of spinal cord nerves to amniotic fluid. That could cause more severe disabilities, including bowel and bladder disorders, mobility problems, paralysis and cognitive delays.
Approximately 1 in every 4,000 babies, or 1,645 infants every year, are born in the United States with myelomeningocele, according to the Centers for Disease Control and Prevention.

“At first we were not going to do the fetal surgery because of the risks,” says Hetty Mollert.  “However, I realized that all the things I listed as cons to fetal surgery were related to my own concerns and all the pros were in favor of the baby. We chose fetal surgery, because we believed it offered the best chance of reversing the brain malformation. We thought that might improve her chances of someday being able to walk.”

Rodrigo Ruano, M.D., Ph.D., fetal surgeon and chair of Mayo Clinic Division of Maternal Fetal Medicine and Edward Ahn, M.D., pediatric neurosurgeon, performed fetal surgery to close the spine at 25 weeks of gestation. Dr. Ruano theorized that closing the spine would decrease the fluid on the brain and that the body’s amazing ability to heal might take over and regenerate the developing brain. An MRI examination six weeks later while the baby was still in the womb found that Chiari malformation had been restored after fetal surgery. 

Rodrigo Ruano, M.D., Ph.D.

“We discovered the main benefit of this procedure is not only to close the spine, but the most important thing is to improve the brain structure and the brain anatomy,” says Dr. Ruano. “Our study shows we can regenerate the brain structure so that it comes back to better development.”

She’s a rock star

Mollert was able to travel back to her hometown hospital and physician in Madison for her baby’s birth. Her daughter, Madelyn, was delivered via caesarian section at 37 weeks of gestation on January 11, 2019.

“From that point on, it was like a normal baby delivered in a normal pregnancy. The closure on her back looked fantastic. She did not need a shunt to release fluid from the brain. We went home after three days.  There was no stay in the neonatal intensive care unit,” says Mrs. Mollert. “Our physicians said Madelyn was a rock star.”

Madelyn has been hitting all developmental milestones.  At 13 months of age, she began standing on her own. Now, she is able to walk with assistance. That gives her parents confidence that she will one day be able to walk. But there are still some unknowns. Will she need leg braces to support her steps? Or, will she need a walker?  Also yet to be answered is whether fetal surgery improved chances of normal bladder and bowel function. That may not be known until she starts potty training. Indications so far are that her bladder health is on the right track.

“We just want to bask in the moment and enjoy how perfect she is now. We don’t want to worry about what might or might not happen years from now.”

Hetty Mollert believes her daughter is progressing better than if she’d had spine closure surgery after birth.  She’s healthy enough to go to daycare “and loves it,” says her mother, who works in human resources for a retail company. 

Madelyn Mollert is one of three consecutive spina bifida patients that Dr. Ruano studied to determine that surgery to close the spine before birth restored brain structure better than surgery after delivery. Dr. Ruano’s research is published in Mayo Clinic Proceedings.

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Read the news release

Thu, Jul 30 8:30am · Spotlighting 2020 graduates of Mayo Clinic College of Medicine and Science

Integrating new discoveries into patient care requires a workforce equipped to deliver the latest innovations. That’s why training the workforce of the future is a key objective of the Education Shield at Mayo Clinic—an objective the Mayo Clinic Center for Regenerative Medicine is committed to advancing.

Every year, Mayo Clinic’s College of Medicine and Science advances new graduates to their next levels of research and/or medical practice to address the unmet needs of patients. From accelerating new ways to treat macular degeneration to discovering the latest immunotherapies that harness the body’s ability to heal, graduates of Mayo Clinic’s medical schools seek to apply the advanced diagnostics and novel therapeutics.

Sinibaldo Romero Arocha

Sinibaldo Romero Arocha

As a teenager in Venezuela, Sinibaldo Rafael Romero Arocha’s intrigue with American medical documentaries and television dramas inspired his career in biomedical research and regenerative medicine. His academic quests eventually led to the Regenerative Science Training Program (RSTP) in the Mayo Clinic Graduate School of Biomedical Sciences where he was one of the first graduates of the post-baccalaureate program.

“Many of the breakthrough discoveries I learned about in Venezuela happened at Mayo Clinic. I knew that if I wanted to be part of the next generation of scientists, this is where I should do my training,” says Romero Arocha. “Mayo Clinic was a fantastic training ground that helped prepare me for an M.D./Ph.D. program, which I will now be pursuing.”

While in RSTP, Romero Arocha trained in the cardiac regeneration research lab of mentors Andre Terzic, M.D., Ph.D., director of the Mayo Clinic Center for Regenerative Medicine, and Atta Behfar, M.D., Ph.D., deputy director for translation in the Center for Regenerative Medicine.

“We (trainees) were interested in trying to enhance therapies Dr. Behfar and Dr. Terzic had previously developed. My role was to help graduate students optimize the therapies to reduce cost of using the new technologies we were developing in the research lab,” says Romero Arocha.

During his time at Mayo Clinic, Romero Arocha had the opportunity to participate in the Regenerative Medicine and Surgery course, one of the first patient-focused regenerative sciences and surgery training programs in the country.  In addition, he was a leader in the Initiative for Maximizing Student Development program aimed at increasing the number of researchers from underrepresented socioeconomic backgrounds.

The mix of experiences he garnered through RSTP at Mayo proved to be a fertile training ground. He was accepted into the highly competitive, elite Oxford University-National Institutes of Health fellowship program which he will complete with the M.D./Ph.D. program at the University of Minnesota following his Mayo 2020 graduation from RSTP. He credits the rich training he received through RSTP with helping compete for and earn this prestigious fellowship. Romero Arocha will spend two years in medical school at the University of Minnesota, four years in the graduate fellowship program at the National Institutes of Health and two more years in medical school.

“RSTP exposed me to a lot of things that not every post baccalaureate has access to, such as a deep exposure to translational science and clinical trials. During my fellowship, I will be able to take my research training to the next level through exposure to groundbreaking research in many fields. It is such a huge honor,” he says.

Romero Arocha’s short term goal is to further research into ways stem cell therapy could improve treatment of macular degeneration. Still undecided about his long term clinical practice, he is interested in pursuing regenerative medicine and stem cell biology. Ultimately, he hopes to bring to his practice the vision of Mayo Clinic: the needs of the patient come first.

Rosalie Sterner, M.D., Ph.D.

While completing the Mayo Clinic Medical Sciences Training Program (MSTP), Rosalie Sterner, M.D., Ph.D., played a critical role in developing education for fellow trainees in the nascent fields of immunotherapy and regenerative sciences. One of the challenges of training the next generation of physician-scientists is delivering new curriculum for subject matter that is dynamic and evolving. Dr. Sterner helped build coursework for the Regenerative T Cell Immunology in the Treatment of Cancer course, which offers graduate level credit through the Mayo Clinic Graduate School of Biomedical Sciences; selective credit through the Mayo Clinic Alix School of Medicine, and continuing medical education through a 2020 Updates in Chimeric Antigen Receptor (CAR)-T Cell Therapy course.

Rosalie Sterner, M.D., Ph.D.

“Immunology is readily applicable and highly important to understanding and potentially treating most disease. Gaining a better understanding of the immune system and gaining a better functional control of the immune system is critical in helping the body to better heal itself.” says Dr. Sterner.

As the student course director since 2017, Dr. Sterner worked for three years with faculty course director Saad Kenderian, M.B., Ch.B. and Karen Hedin, Ph.D., the-then Mayo Clinic Department of Immunology Graduate Program Director; Mayo Clinic Center for Regenerative Medicine Associate Director of Education and Sterner’s Ph.D. mentor through the Department of Immunology. Together, they refined the course every year. The continuing medical education (CME) course 2020 “Updates in CAR-T Cell Therapy” was one such avenue of growth. Dr. Sterner serves as a course director for this CME course along with hematology faculty Dr. Kenderian and Yi Lin, M.D., Ph.D.  Dr. Sterner was able to apply for and secure a Regenerative Medicine Minnesota multi-year grant to fund the course.

In 2020, she and the faculty had to quickly adapt to the social distancing guidelines of the COVID-19 pandemic and deliver the course online. Despite the last minute change, attendance among both physicians and students was strong. Dr. Sterner believes the team effort between the support staff, speakers, attendees, course directors, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic Department of Immunology, Mayo Clinic Center for Regenerative Medicine, Mayo Clinic Regenerative Sciences Training Program, Mayo Clinic Alix School of Medicine, Mayo Clinic School of Continuous Professional Development speakers and Mayo Clinic Education Technology Center were critical to the course’s success.

Having graduated from the Mayo Clinic Medical Scientist Training Program (MSTP) in May of 2020, Dr. Sterner is now a resident in the highly competitive Mayo Clinic combined Joint General Surgery and Cardiothoracic Surgery Residency Program. Her goal is to become a cardiothoracic surgeon at an academic medical institution where she would have a research program of her own.

“From transplant to tumor immunology to many disease processes in between, immunology plays a critical role in cardiothoracic disease processes and potential development of treatments. These principles can potentially be applied to improving treatments of cardiothoracic diseases, and I plan to conduct research in these areas.”

The Iowa native looks forward to a career in medicine in which she can pursue her interests in research and education while helping people.

Somaira Nowsheen, M.D., Ph.D.

Growing up in Bangladesh as the daughter of two physicians, Somaira Nowsheen, M.D., Ph.D., knew she had a love for medical practice. However, she wanted to explore interests in research before committing to a career as a physician-scientist. After several years as a research technologist in various labs in the United States, Dr. Nowsheen enrolled in Mayo Clinic’s Medical Sciences Training Program (MSTP) in 2012.

Somaira Nowsheen, M.D., Ph.D.

“The unparalleled clinical training, the outstanding research opportunities and all in a collaborative supportive environment were some of the factors that attracted me to Mayo Clinic,” says Dr. Nowsheen.

Her background in research positioned her strongly to excel at Mayo Clinic, where she contributed to some 40 publications during the course of her M.D.-Ph.D. training program.  Among her many accomplishments, Nowsheen was named the recipient of the first Mayo Clinic M.D.-Ph.D. Program Director Achievement Award for outstanding research. The award is based on research achievements during the course of the Mayo Clinic Medical Scientist Training Program, which for Dr. Nowsheen included:

  • The Laura J. Siegel Breast Cancer Fellowship Award for “Regulation of BRCA1 and DNA double strand break repair”
  • The Vera Langan and Kieckhefer M.D.-Ph.D. Fellowships
  • The Agnes Hansen Award from the Xi Chapter of Graduate Women in Science 
  • Identification of the protein L3MBTL2 as a previously unrecognized component of the cell’s DNA damage response machinery, a result reported in a first-author paper in Nature Cell Biology
  • Three first-author papers describing the risk of cardiac toxicity after Herceptin treatment for breast cancer.

“I could not have asked for a better training program than the one I had at Mayo Clinic. I think the unique environment where medicine and research blends so seamlessly have helped make discoveries and innovation possible. For instance, for my Ph.D. thesis project, I collaborated with hematologists to access patient samples to validate my basic science research findings,” says Dr. Nowsheen.

A 2020 graduate of Mayo’s MSTP, Dr. Nowsheen will be doing her residency in dermatology at the University of California San Diego Medical Center after a transitional year at Gunderson Lutheran Medical Foundation.

“Dermatology is a field that encompasses medicine, infectious disease, immunology, and oncology. It offers a rich balance between clinical practice, translational research in cancer therapeutics, and teaching next-generation physicians,” she says.

Dr. Nowsheen looks forward to taking an individualized medicine approach to her research and practice to enhance therapeutic value of each patient’s treatments.

Besides Dr. Nowsheen, Dr. Sterner and Sinibaldo Rafael Romero Arocha, the other 2020 graduates across the five schools within the Mayo Clinic College of Medicine and Science undoubtedly have compelling stories of grit and achievement of their own to share. Mayo Clinic is committed to help propel their careers forward in order to cure, connect and transform medicine for generations to come.

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Thu, Jul 23 8:30am · Expanding CAR T-cell therapy

The first time Hong Qin, M.D., Ph.D., saw images of how chimeric antigen receptor (CAR) T-cell therapy obliterated a tumor, he was captivated and inspired by this revolutionary treatment. As the new director of Regenerative Immunotherapies at Mayo Clinic in Florida, Dr. Qin and his team will play a pivotal role in accelerating the latest CAR T-cell and other regenerative immunotherapy discoveries from bench to bedside to address unmet patient needs.

Dr. Qin’s team will work with the Mayo Clinic Departments of Hematology and Medical Oncology, the Center for Regenerative Medicine and the Cancer Center in developing first-in-class CAR T-cell products, procedures and treatments. The goal is to position Mayo Clinic at the forefront of expanding regenerative immunotherapy options to more types of cancers and potentially neurological and autoimmune disorders.

Hong Qin, M.D., Ph.D.

“When I was in medical school, I was taught that blood cancer was incurable. But with CAR T-cell therapy treatment, a significant number of patients with B-acute lymphoblastic leukemias can survive long term without the tumor coming back.  Such therapeutic benefits are unparalleled, and may go beyond traditional chemotherapy or radio therapy,” says Dr. Qin. “I believe that CAR T and regenerative immunotherapies in general will open a new era for Mayo Clinic to treat cancer patients.”

Immunotherapies unleash the body’s defense mechanisms to fight bacteria, viruses and diseases, including cancer. CAR T-cell therapy seeks to harness the power of the immune system by genetically modifying cells, equipping them to go on search and destroy missions to kill cancer. These engineered cells act like a living drug continually working within the body to cure disease.

The key hurdles to bringing CAR T-cell therapy to more patients are cost and access. It’s expensive and there are long waits for clinical trials.  Mayo Clinic is addressing those hurdles through the CAR T Translational Research Program that Dr. Qin leads.

New laboratory space will be made available in Florida for discovery science with the scope of attracting researchers with innovative ideas for developing new regenerative immunotherapy products unique to Mayo Clinic. For example, could scientists identify CAR T therapies with fewer side effects that are easier on patients? Could investigators discover ways to apply CAR T-cell therapy to solid tumors, providing new treatment options for many more types of cancer?

Mayo Clinic is one of only a few medical research centers that have made significant investments in facilities where clinical grade biotherapies can be manufactured on site. The new Discover & Innovation Building on the Florida campus will deploy current Good Manufacturing Practices (cGMP) facilities where new patient-ready immunotherapies can be manufactured under strict sterile quality control measures that meet Food and Drug Administration guidelines. That could eventually increase patient access to CAR T and other regenerative immunotherapies through clinical trials and lower the cost through in-house supply.

“With the cGMP facility we can help move new discoveries toward an initial clinical trial in order to perform critical first-in-man evaluation,” says Dr. Qin. “This platform is so important, because it empowers us to readily translate discoveries to the patient.”

The ultimate goal is to deliver the newly developed clinical grade immunotherapies to the medical practice to provide new hope and healing for patients.

Background in cancer research

Dr. Qin joined Mayo Clinic in June from City of Hope cancer research and treatment center in California, where he researched novel CAR T-therapies that are now in phase I clinical trials.

Dr. Qin holds a medical degree from the Shanghai Second Medical University in China and a Ph.D. in Anatomy and Cell Biology from The University of Western Ontario in Canada. He has completed post-doctoral training and early career development as a junior faculty at the National Cancer Institute of the National Institutes of Health and the University of Texas M.D. Anderson Cancer Center. Dr. Qin holds seven patents related to antibodies and CAR-T therapies. 

“It is so important to translate emerging discoveries to the patient bedside, which can provide hope to cancer patients who have exhausted all other therapeutic options,” says Dr. Qin. “The team work at Mayo Clinic is so critical to having this mission accomplished.”

For Mayo Clinic, mission accomplished might mean robust research and development that delivers new cellular therapies providing new cures that so far have eluded patients.

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Wed, Jul 8 8:30am · Using stem cells to find causes and treatments to prevent sudden cardiac death

Mystified by the need for defibrillation to save a 10-year-old from drowning, Michael Ackerman, M.D., Ph.D., vowed to dig for answers. That pivotal case during a Mayo Clinic pediatric cardiology residency was the catalyst for Dr. Ackerman’s career in genetic sleuthing of inherited sudden cardiac death syndromes. With help from the Center for Regenerative Medicine Biotrust, Dr. Ackerman’s team reprograms cell lines to zero in on precise causes and possible treatments for genetic heart disorders that increase the risk of sudden cardiac death. His research and practice focus on inherited conditions like long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT) and Brugada syndrome (BrS) along with heart muscle diseases such as hypertrophic cardiomyopathy (HCM).

Michael Ackerman, M.D., Ph.D.

“Working with the Center for Regenerative Medicine has opened up a whole new investigative arm to our lab. It is bench to bedside research. We take cells from a blood sample from my patients and then reprogram those cells to become cardiac cells. This research effort has been a powerful tool in gene discovery to prove beyond a shadow of a doubt when a monogenetic variant is indeed the cause of a sudden cardiac death syndrome,” says Dr. Ackerman.

Reprogramming cells to identify disease-causing mutations

Reprogramming a patient’s cells is like a step back in time to when the cells were initially forming in the mother’s womb. At that time, cells were dividing and could become any type of cell or tissue in the body. Reprogrammed cells, known as induced pluripotent stem cells, can be redirected to become new heart cells. Dr. Ackerman’s team uses these patient-specific cell lines to create a ‘disease in a dish’ model and investigate whether genetic mutations are causing the patient’s genetic heart disease such as long QT syndrome. 

“Once we think we’ve found the root cause of disease, we then go to the patient’s cell line. We ask, ‘does it show in the dish, in that patient’s re-engineered heart cells, a prolonged QT cellular phenotype?’  If it does, then we edit out and correct that variant of interest and at the cellular level test whether the abnormality disappears,” says Dr. Ackerman.

Dr. Ackerman’s team then introduces that genetic variant into normal, healthy cells. If those cells produce a long QT phenotype, they have proof that exact genetic variant is the cause.

Using this disease in a dish model and other genetic sleuthing strategies, Dr. Ackerman’s team has discovered six of the 17 known genes that cause long QT syndrome. And, they have recently described two entirely new syndromes. One is triadin knockout syndrome, a heart arrhythmia that could lead to cardiac arrest in children during exercise. The second is an autosomal recessive genetic mechanism for calcium release channel deficiency syndrome, prevalent within Amish communities. That key discovery solved the mystery of why so many Amish children were dying suddenly during ordinary childhood play. The disease in a dish model is also useful for discovering new therapies. After creating the patient’s disease in a dish, Dr. Ackerman’s team tests potential new drug compounds to see if they could be effective.   

“We are developing a new gene therapy for the most common genetic subtype of long QT syndrome. With this model, the gene therapy vector is essentially curing the diseased long QT phenotype in the dish,” says Dr. Ackerman.

Almost quit research

Dr. Ackerman began medical and graduate school at Mayo Clinic in 1988, where he worked in a research lab next to then fellow trainee, Andre Terzic, M.D., Ph.D., who now is director of Mayo Clinic Center for Regenerative Medicine. Initially not seeing the relevance to patient care, Dr. Ackerman finished his Ph.D. and left research vowing to “never, ever return.” True to his mentor’s predictions that “you’ll be back, Mike,” Dr. Ackerman felt the pull back to research to address unmet medical needs of his patients. He joined Mayo Clinic’s faculty in 2000 as one of the first genetic cardiologists with a goal of establishing a practice for patients at risk of sudden cardiac death from genetic heart diseases. Dr. Ackerman now directs the Mayo Clinic Windland Smith Rice Genetic Heart Rhythm Clinic and the Mayo Clinic Windland Smith Rice Sudden Death Genomics Laboratory

Dr. Ackerman’s return to research has provided many answers for patients, with over 600 peer-reviewed publications that have occurred since that time 23 years ago when Dr. Ackerman and his team first solved that 10-year-old boy’s near fatal drowning. It was a mutation in the gene causing type 1 long QT syndrome.

Dr. Ackerman is one of the innovators the Center for Regenerative Medicine collaborates with as it seeks to be a global leader and trusted destination for regenerative care driven by research and education.

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Thu, Jun 25 8:30am · Mayo Clinic to offer advanced degree in regenerative sciences

Mayo Clinic is launching one of the first-ever doctoral programs in regenerative sciences designed to prepare future physicians and/or scientists for an emerging area of health care. The new track in the Mayo Clinic Graduate School of Biomedical Sciences will encompass the full spectrum of regenerative science and medicine from discovery to translation and application. Isobel Scarisbrick, Ph.D., the newly named program director for the Regenerative Sciences program in the Center for Regenerative Medicine, sees this as an important milestone in advancing the practice.

Isobel Scarisbrick, Ph.D.

“This comprehensive track within the Graduate School of Biomedical Sciences will prepare students for a new era of medical sciences focused on rebuilding and restoring health.  It underscores Mayo Clinic as the premier and most trusted destination for regenerative sciences education and ultimately regenerative health care,” says Dr. Scarisbrick.

Regenerative medicine shifts the focus from treating disease to restoring health. It is expected to account for 10% of all clinical care within the next decade. To prepare scientists to help meet these needs, Mayo Clinic will launch the new doctoral Graduate Education Track. Taught by a regenerative medicine expert, the curriculum will embrace a training paradigm that includes fundamental cellular and molecular science principles and transdisciplinary education in regulatory issues, quality control, bio-business and entrepreneurial pathways, data science, medical sciences, ethics and emerging technologies.

“We will be able to offer students a cross disciplinary experience in the laboratory and a hands-on approach of translating to the clinic. That’s what makes this so unique,” says Dr. Scarisbrick. “There isn’t going to be one solution for a given problem.  We will equip students with the knowledge to be able to draw on those fundamental science principles and then integrate them into the complexities of discovering and implementing a regenerative solution.”

The new track is the culmination of years of work and the vision of Mayo Clinic to forge a new path in regenerative education. The training will be available to graduate students, medical residents and other health care professionals on all Mayo Clinic campuses.

Fredric Meyer, M.D.

“Regenerative sciences could play a role in healing most, if not all, diseases. Regenerative medicine should be integrated into the teachings of each organ system. An understanding of regenerative sciences will open a plethora of new treatment possibilities,” says Fredric Meyer, M.D., executive dean, Mayo Clinic College of Medicine and Science.

Sharing enthusiasm for learning

Dr. Scarisbrick brings to her new role experience in neuroregeneration research. She directs the Neural Repair Laboratory within the department of Physical Medicine and Rehabilitation where she investigates ways to harness the body’s ability to repair and regenerate the central nervous system.

“We are starting to understand how the nervous system works. We are excited in my lab to discover these principles and try to engage them in disease or injury models to repair and restore function,” says Dr. Scarisbrick. “To be involved in educating others in regenerative sciences and to transfer this enthusiasm and knowledge to next generation scientists is very exciting.”

The regenerative sciences track will complement the broader work Mayo Clinic is leading in educating the workforce of the future. For example, every year Mayo Clinic offers a week-long Regenerative Medicine and Surgery Course. This past year, 88% of the students who attended that selective said they would apply what they learned to their practice. Mayo Clinic is also spearheading an effort to include regenerative sciences training for all medical students in Minnesota by the year 2025.

The first students will be admitted to the new regenerative sciences doctoral track in the Mayo Clinic School of Biomedical Sciences in the fall of 2021.

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Thu, Jun 18 8:30am · Stem cells in space: interstellar research to improve regenerative therapies

Mayo Clinic research is reaching to the cosmos for answers on how to overcome hurdles in engineering human stem cells. Mesenchymal stem cells are adult stem cells with potential to unleash the body’s ability to heal diseased tissues and organs. However, growing or culturing stem cells in the laboratory is a slow process, and sometimes cells lose potency in the transfer from the body to the culture dish.

In his quest to improve manufacturing of stem cells for regenerative therapies, Abba Zubair, M.D., Ph.D., a leader in the Center for Regenerative Medicine, had stem cells from the research laboratory at Mayo Clinic in Florida flown on an interstellar trip to the International Space Station. His research team seeks to understand whether culturing stem cells in microgravity could improve function and accessibility. Dr. Zubair’s study, published in Nature Partner Journals Microgravity, finds stem cells grown in weightlessness are safe and feasible for applications to human disease.

Abba Zubair, M.D., Ph.D.

“In this study, we have established the identity, purity, viability and sterility of growing mesenchymal stem cells for human application at the International Space Station compared to ground controls,” says Dr. Zubair, who is senior author on the study. “The use of standard two- dimensional tissue culture flasks on Earth is an unnatural condition for cell growth. Therefore, culturing stem cells aboard the International Space Station under a weightlessness environment may provide a more natural three-dimensional environment for stem cell expansion and organ development.”

The demand for stem cells is growing as regenerative science explores new applications for restoring health. Physician-scientists are investigating the use of stem cell therapy for diverse conditions including spinal cord injury, diabetes, Parkinson’s disease, Alzheimer’s disease, heart disease, burns and even cancer.

The Research

Mesenchymal stem cells were rocketed to the International Space Station in a special device for transportation and culture. Astronauts imaged the cells every 24 to 48 hours and harvested them at seven and 14 days. When the cells returned to Earth, Dr. Zubair’s team compared them to cells grown in a laboratory in Florida. The research found that cells grown in a weightless environment in space had improved function over those grown on earth.  And, microgravity had a more significant effect on improving cell function than it did on speeding the process of growing the cells.

“We found that weightlessness had significant impact on the mesenchymal stem cell capacity to secrete cytokines and growth factors. They appeared to be more potent in terms of immunosuppressive capacity compared to their identical ground control,” says Dr. Zubair.

One concern about culturing cells in microgravity is whether it could trigger the emergence of cancerous cells. Significantly, chromosomal, DNA damage and tumorigencity testing showed no evidence of malignant transformation of cells cultured space.  Therefore, Dr. Zubair’s team concludes that it is feasible and safe to grow mesenchymal stem cells aboard the International Space Station for potential future clinical applications. Additional research will be needed to verify the findings.

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Thu, Jun 11 8:30am · Preparing the regenerative medicine leaders of the future

With the click of a mouse, medical students opened a window into the healthcare of the future. The 2020 Mayo Clinic Regenerative Medicine and Surgery Course, a foundation for transformative change, moved online this year due to social distancing guidelines around COVID-19.  Regenerative medicine is a shift from treating disease to restoring health. The week-long patient-centric regenerative medicine-intensive course is designed to prepare the next generation of physicians and scientists to apply emerging regenerative approaches to the practice.

Fredric Meyer, M.D.

“Mayo Clinic puts a high priority on regenerative sciences as an investment in the health care of the future. It represents a new paradigm in healthcare. It is vital that students take a regenerative lens toward treating diseases,” says Fredric Meyer, M.D., executive dean, Mayo Clinic College of Medicine and Science. “Beyond regenerative curricula dedicated to medical students, Mayo is one of the first academic medical institutions to establish master’s and doctoral programs in regenerate sciences.”

Traditionally delivered in-person at Mayo Clinic in Rochester, the course was quickly converted to an online, digital format. Online modules included a virtual human laboratory session featuring demonstrations of stem cell therapies, simulated regenerative telemedicine patient consults, live-broadcast video tours of clinical grade manufacturing facilities for regenerative products, patient interactions, career panels and group discussions.

Saranya Wyles, M.D., Ph.D.

“The online learning platform catalyzed a global community of next-generation learners.  Group learning was further facilitated by online information sharing, allowing students to post questions, review journal articles and engage with the virtual community,” says Saranya Wyles, M.D., Ph.D., course director.

Amanda Terlap is a Ph.D. student in the Mayo Clinic Graduate School of Biomedical Sciences whose thesis is focused on viral infections. She enrolled in the course to get a full overview of regenerative medicine from both patient and clinician perspectives.

Amanda Terlap

“I now have a better understanding of just how powerful regenerative medicine can be and the extraordinary impact it can have on patients. I have learned about potential opportunities that can evolve my research. I believe that regenerative medicine is the foundation in which cures will be made. It is inspiring,” she says.

Valerie Melson is a first year medical student who is leaning toward specializing in obstetrics and gynecology. She had heard about the diverse points of regenerative procedures involving stem cells, but also sees regenerative medicine as an area of practice that could bring breakthrough cures to patients. She was eager to learn from the experts.

Valerie Melson

“My belief is that regenerative medicine and the novel ways it tries to address problems is the future of medicine. The course gave me tangible ways in which physicians identified shortcomings in the treatment strategies and then used regenerative medicine to help rectify those shortcomings. It definitely reaffirmed that what I had been imagining for my career is in fact possible,” she says.

With a strong interest in neurodegenerative diseases and aging, Ayumi Sakamoto is leaning toward specializing in geriatric medicine. The course confirmed her desire to become a physician and piqued her interest in further exploring regenerative medicine in the context of neurodegeneration.

Ayumi Sakamota

“Learning about the various cutting-edge techniques and procedures in regenerative medicine gave me a valuable insight into the future of patient care. Hearing about the tremendously positive patient experiences with regenerative treatments has inspired me to continue learning more about the field and motivates me to become a physician who is able to utilize these therapies for my future patients,” she says.

The Mayo Clinic Regenerative Medicine and Surgery Course is a collaboration between the Center for Regenerative Medicine and the Mayo Clinic College of Medicine and Science. Open to students at Mayo Clinic and beyond, this year’s course included students from University College of London, University of Belgrade and the National Institutes of Health Alliance for Regenerative Rehabilitation Research & Training, which included students from Oxford University and Creighton University.

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