in Neuroscience at MUSC: An Overview
Guest: Dr. Peter Kalivas - Neurosciences/Neuroscience Research
Host: Dr. Linda Austin – Psychiatry
Austin: I’m Dr. Linda Austin. I’m interviewing Dr. Peter Kalivas who is
Director of Neurosciences here at the Medical University of South Carolina. Welcome, Dr. Kalivas. First, just to clarify something that can be
kind of confusing to understand, at MUSC, we have a Department of Neurosciences
that encompasses physicians and researchers from a variety of disciplines. Can you describe those disciplines and who
the players are in the department?
Kalivas: Actually it’s a very new
idea. I think it might be the only
situation where we’ve created this kind of academic structure in the
nation. Basically, about four or five
years ago, we merged a basic research department, which previously was called
the Department of Physiology and Neuroscience, and that was my department, with
Neurology and Neurosurgery, which were two clinical departments. And the goal there was primarily to enhance
the ability to perform translational research.
So, up until that time, the research going on in Neurosurgery and
Neurology was entirely clinical and, of course, the research in my Basic
Science department was entirely basic.
this merger, we’ve been able to direct resources in a very targeted way to
enhance translational research. This has
occurred in a number of areas that are relevant, of course, to
Neurosciences. The strongest areas are
addiction, Alzheimer’s disease, movement disorders, epilepsy, and stroke.
Austin: So, just to clarify terms that
are very familiar to you but may not be so familiar to somebody who’s never
been in an academic health center before, you talked about clinical research
and basic research as well as translational research, can you explain what
those three different terms refer to?
Kalivas: Sure. There’s a little bit of an open
interpretation on translational. You can
ask 10 different scientists, or researchers, and they’ll give you 10 related
but somewhat distinct answers to translational.
So, bear in mind that I’m giving you my own interpretation.
basic research would be, for example, if I took a neuron out of a brain, put it
into a dish and then looked and saw how when I activated that neuron which
channels opened up on the membrane and I quantified the amount of ions that
were passing across the membrane. The
question I’m asking is, how does the membrane work and how does the membrane
regulate the activity of the neuron? One
can think of clinical relevance but, basically, that researcher is not very
interested, per se, in curing a disease.
They’re actually interested in how this neuron works, and that’s their
other side, a purely clinical study would be, for example, running a clinical
trial. So, there’s a new compound that’s
been developed, it might be good for treating stroke, so somebody sets up a
trial where they take two groups of individuals, one gets the placebo, one gets
the drug, or one gets a standard of care and another one gets a novel form of
care, they run these patients through and they look at outcomes and see if the
drug worked or not. So, that would be,
in my mind, a purely clinical study.
Another example that goes on in our department would be trying new tools
for neurosurgery, new ways to get into the brain, new ways to move tissue
around, new ways to cauterize tissue.
Things like that would also be clinical research.
in my mind, ranges between animals and people.
On the animal side, it would be having an animal model. So, lets say that this channel that the first
person I spoke about, the basic scientist, let’s say that this channel shows up
in a human genomic screen as something that might be involved in epilepsy,
okay? So, somebody would take an animal
model of epilepsy and mutate, let’s say, this channel in the animal model to
mimic what may be happening in the epileptic.
And, in the animal model, if it produced epilepsy or something similar
to what you see in the human, that would be a strong indication that somehow
this channel was important in human research.
that information, somebody might have known, well, you know, there’s a snail
toxin that’s been used for years to inhibit that channel. Maybe we should try to develop a compound
that would be useable in human beings that would inhibit that channel, and that
might be good for epilepsy. So then they
would get together with chemists and come up with analogs, screen them in the
animals, find the one that worked the best with the least toxicity, ultimately
move that into people and run a clinical trial.
So, that kind of translational research, in my mind, starts with the
animal model, taking something that, perhaps, the basic researcher wasn’t even
thinking of, epilepsy, when they made the discovery, and take something that’s
been observed in patients, whether it’s a behavioral symptom or a gene that’s
been altered in a certain subpopulation of people, take those two pieces of
information and move them into research setting, in animal models and human
Austin: Now, clearly, our Department of
Neurosciences was developed in order to bring together a lot of different kinds
of doctors and researchers who otherwise might not cross paths often enough to
figure out those kinds of interconnections.
How do you, as the director and as the, I believe you’re the founder of
the department, correct?
Kalivas: Yeah, along with Sunil Patel,
who’s my partner in crime as a neurosurgeon.
Austin: How do the two of you go about
fostering communication, dialogue, interaction,
between those disparate players?
Kalivas: I’ll tell you, it’s been a
learning experience for both of us. We,
basically, grew up in completely separate cultures, the training, everything,
is very isolated in every academic institution.
To some extent, the meeting ground was neurology. There are good animal models for neurology,
and that’s really where we started. For
example, one first step was to take Neurology Grand Rounds, we started
inviting, once a month, internationally recognized figures in translational
research, in neurology, people who’d actually done it, taken animal models and
converted it into a treatment for a human disorder.
is required to attend these, from graduate students to residents, to
physicians, to scientists. And the idea
is for people to start communicating and, in fact, it has happened. We also separate luncheons that are built
around our own research. There used to
be one that was more clinical research, one that was basic. Those have now been merged. We have a luncheon once a month where people
sit down and present their own research to the faculty at large. And, through this, ideas are born, as well as
communicating or collaborating between clinical and basic researchers. What it’s been most useful for is a younger
investigator, a younger faculty member, to present some of their ideas or some
of their preliminary data. And it’s
exciting to watch the senior basic scientists and the senior clinical scientists
come together and help guide that person.
And often, that direction is translational.
the hope is to change the culture. And
as we all know, cultural change is slow and best initiated with younger people
who are just getting started in the field.
Older people, you know, they can help, but they often already have their
careers set and in forward motion. It’s
more difficult for them to change.
Austin: Dr. Kalivas, I want to talk with
you about training opportunities, but let’s save that for another podcast.
Austin: Thank you so much.
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