Smita Pathak (smita.pathak@gmail.com)

Lab PI: Gabriel Silva
Undergraduate Institution: UC Berkeley
Med-into-Grad clinical training area: Neurodegeneration/ Ophthalmology
Main clinical mentors:  Igor Kosak, MD PhD

Quote:  “Overall my HHMI experience was valuable not only in terms of the clinical perspective gained but also in terms of the collaborations developed with doctors working on similar scientific problems in need of research tools to solve them.”

Rational for Med-into-Grad training:  My thesis research involves quantum dot labeling of proteins implicated in central nervous system injury and disease.  These quantum dots elucidate mechanisms unidentifiable using conventional fluorescent microscopy.  I wanted to work on a clinical project pertaining to my research interests and this program allowed me contact with doctors who gave me the avenue to pursue these studies.

Medical training and identification of medically-relevant research issues: I started the Med into Grad program by shadowing Dr. Igor Kozak in the Department of Opthalmology. I saw patients with age-related macular degeneration and scarring in the retina.  I examined patients pre and post-surgery and saw the need for improvements in decreasing scar tissue formation.  I was allowed to add numbing eye drops for patients as part of their initial exam prep routine and followed Dr. Kozak as he examined different patients pre and post-surgery. Many of the complications and difficulties of ocular diseases became readily apparent and the direction of my research (nervous system injury and disease) became more clinical. 
In particular, studying glial scarring in retinal tissue became a particular interest of mine because of the lack of treatment targets in this area.  The mechanism of glial cell communication is poorly understood and when glial cells become reactive, it is difficult to control.  The scarring propagates unchecked if not treated.

Research collaborations:
A collaboration was developed and is ongoing in the study of choroidal neovascularization and reactive gliosis in the retina.  Dr. Linguen Chen and Dr. William Freeman both provided insights and clinical expertise to help develop these project ideas.
I was able to apply quantum dot labeling of glial scarring to quantify and correlate this disease process with choroidal neovascularization.   This project was developed with Dr. Lingyun Cheng who performed the laser induced scarring of the choroid (in our rabbit model). 
Another ongoing collaboration that was developed involves tracking of drug targets using quantum dots both in vitro and in vivo.  This project will elucidate mechanisms of drug binding for efficacy studies. 

Long term impact:  This training provided direction for my research.  While I had the tools and interest in using nanotechnology for labeling proteins, I did not have the clinical applications for my research. 

Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs: Current therapeutics for AMD and CNV are very invasive and traumatic for the patient.  Surgery and laser treatments cause more scarring in the eye.  Different drug targets are necessary to help develop compounds that will decrease the scarring in retinal tissue.  Quantum dot labeling can elucidate some of these targets.  Efforts are also ongoing to use QDots to track drugs as they travel through different areas of ocular tissue.

Diagnostic & Therapeutic collaborations:
While my research was purely on the basic science side, potential diagnostic and therapeutic collaborations could be made with drug development labs.

Student-specific experiences:
Working with patients was very rewarding because I saw that the applications of my research would help people see well into their later years.

Advice for new trainees--Autumn preparatory quarter:
Think in advance about ideas you want to develop for collaboration.  If you have specific tools that you work on in the lab, think about how these will apply in the clinical setting.  On your rotation, it will be easy to offer these up if you have already thought in advance of the specific applications.

Advice for new trainees—Winter clinical training quarter:
Most patients think that you are also a doctor because you are wearing a lab coat.  This was difficult when they started asking personal questions or questions related to their ailments, so talk to your mentor about this in advance in terms of how to respond.

Take home perspective on Med-into-Grad at UCSD: Overall my HHMI experience was valuable not only in terms of the clinical perspective gained but also in terms of the collaborations developed with doctors working on similar scientific problems in need of research tools to solve them.  I would recommend this program to anyone hoping to gain a clinical perspective of their research or looking for a clinical collaboration.  I found the doctors very open to new research ideas.