Miller School Orthopaedic Researchers Shine Bright at Vail Summit
Article Summary
- Miller School of Medicine orthopaedic researchers have a long working relationship with the Steadman Philippon Research Institute and shared their regenerative medicine, orthopaedics and cancer research at the Vail Scientific Summit.
- Dr. Thomas Best, the Miller School’s vice chair of research in orthopaedics, spoke about personalized medicine for osteoarthritis at the summit.
- Dr. Joshua Hare spoke about modifying exosomes to treat pain and inflammation for osteoarthritis.
Hosted by the Steadman Philippon Research Institute (SPRI), the Vail Scientific Summit offers a unique opportunity for researchers and clinicians to discuss regenerative medicine, orthopaedics, cancer and other areas.
The University of Miami Miller School of Medicine and SPRI have a long history together. The organization’s managing partner, Marc Philippon, M.D., conducted his residency at UM and has maintained those ties ever since.
SPRI held its ninth annual meeting in August. Miller School researchers discussed their work, gathered information and looked to develop new partnerships. Thomas Best, M.D., Ph.D., professor and vice chair of research in the Department of Orthopaedics at the Miller School, was one of the featured speakers, discussing personalized medicine in osteoarthritis care.
“Quite often, we don’t look hard enough at the molecular mechanisms that are driving a patient’s disease,” said Dr. Best. “We should be trying to define each specific patient’s clinical phenotype and match to molecular endotype disease pathway to determine which treatments will work best.”
Dr. Best is collaborating on this work with Anthony Griswold, Ph.D., associate professor in the Dr. John T. Macdonald Foundation Department of Human Genetics at the Miller School. Dr. Griswold was also at the conference, presenting how deep learning can help distinguish different forms of osteoarthritis.
Drs. Best and Griswold are using data from the National Institute of Arthritis and Musculoskeletal and Skin Diseases’ Osteoarthritis Initiative (OAI), a decades-long effort to follow arthritis patients and learn more about the disease. Using machine learning, the team has identified four distinct phenotypes based on patient data. They have applied this model to more than 750 of Dr. Best’s patients and found similar results.
“Ultimately, we want to take a patient’s clinical data and determine if their molecular signatures from synovial fluid and plasma can inform care,” said Dr. Best. “It’s using precision medicine to define specific treatments.”
Overcoming Resistant Cancers
While SPRI started as a regenerative medicine conference, it has evolved to cover many other areas, including cancer. Francis Hornicek, Jr., M.D. Ph.D., professor and chair of the Department of Orthopaedics, specializes in ortho-oncology and presented his team’s efforts to understand why cancer stem cells resist chemotherapy.
“When somebody fails cancer treatment, it’s usually because the cancer cells have evaded chemotherapy,” said Dr. Hornicek. “We’re looking at many ways to make the chemo more effective, including CRISPR-Cas gene editing, small molecule drugs and immunotherapies. We are also collaborating with the Department of Engineering to pursue nanotechnology.”
Nanotechnology could be a promising way to improve drug delivery. Multifunctional nanoparticles could package chemotherapy, RNA, imaging agents or other beneficial payloads to make these agents more effective and possibly reduce side effects.
AI and Orthopaedics
The close connections between the Miller School and SPRI were well-represented at the meeting. Michael Rizzo, M.D., a former Miller School orthopaedic surgery resident and SPRI fellow, discussed using AI image recognition to predict patient outcomes after hip replacements.
Joshua Hare, M.D., chief science officer and senior associate Dean for Experimental and Cellular Therapeutics as well as a professor of cardiology, biomedical engineering and molecular and cellular pharmocology at the Miller School, presented on cell-based therapies to treat age-associated frailty and neurocognitive disorders. Dimitrious Kouroupis, Ph.D., assistant professor of orthopaedics, spoke about modifying extracellular vesicles (exosomes) to treat pain and inflammation for osteoarthritis applications.
Exosomes are attracting a lot of attention. These tiny delivery mechanisms carry DNA, RNA, proteins and other molecules through the body to facilitate intercellular communication. In a sense, they are nature’s own nanoparticles. The Miller School, SPRI and other institutions are collaborating on efforts to understand and potentially harness exosomes to carry more targeted payloads.
“Exosomes have become a hot topic, and they could possibly be deployed to transport therapeutic molecules to, say, a degenerative meniscus tear,” said Dr. Best. “Instead of coming in and getting a surgery where we take out part of the meniscus, we might actually transport cell-based therapies to ideally preserve tissues, such as articular cartilage and meniscus, that innately have poor healing capabilities.”
Tags: Department of Orthopaedics, Dr. Francis Hornicek, Dr. Joshua Hare, Dr. Thomas Best, orthopaedic oncology, Orthopaedic surgery