Profiles in Student-Led Research

Third-year MD student

Research: Criscitiello entered medical school with an interest in research. He majored in cellular biology and minored in neurology at College of the Holy Cross, worked for two years as a medical scribe and later worked at Dana-Farber Cancer Institute assisting with leukemia research.

At Wake Forest University School of Medicine, he has worked with Eric Marrotte, DO, PhD, assistant professor of neurology, as his faculty adviser on research focused on acute traumatic spinal cord injuries. Criscitiello’s work has involved assessing the effectiveness of a hydrogel injected into cells to promote regenerative growth. When the spine is damaged and scars form, the cells within the spinal cord can’t traverse the damaged tissue, which limits the effectiveness of stem cells in promoting cellular recovery in the spinal cord. The research, which was tested using an animal model, hypothesized that changing the injury microenvironment could prevent scar formation and promote recovery.

Criscitiello says: “You learn about debilitating diseases, disorders and injuries to the spinal cord where people who have been in car accidents and are paralyzed from the waist or the neck down, and they have poor quality of life after that. They never really regain much in terms of their functioning. We sought to design an injectable therapy that can allow the spinal cord to regenerate following trauma, which has never been done before.

“Not only can we say this hydrogel has potential for treating acute spinal cord injuries in patients following traumatic accidents, but also for demyelinating diseases like multiple sclerosis, transverse myelitis and neuromyelitis optica. All of these diseases have pretty poor therapeutic options for patients.

“I think what this project has emphasized for me is that research is absolutely essential to improve patient care and disease outcomes, especially for diseases for which there are poor treatments.

“Dr. Marrotte is fantastic. He has a dream job where he gets to see patients in the ICU and has a lab where he designs novel therapies. I’m not sure what I want to do long term, but it’s fascinating that you can have this dynamic role as a clinician and a researcher. It’s something I’m keeping an open mind about.”

Marrotte says: “Our research is dedicated to pioneering therapeutic approaches targeted at mitigating spinal cord injuries, primarily aimed at improving motor function. During his Summer Research Fellowship, Joseph concentrated on investigating the mechanisms underlying therapeutic effects on spinal cord tissue, using techniques such as immunostaining, microscopy and image analysis. He adeptly led the implementation of new software for analyzing histological data of injured spinal cord tissue, with a focus on neurogenesis, angiogenesis and re-myelination. He subsequently trained fellow laboratory members in the use of this software for tissue analysis.”

Third-year PhD candidate, Cancer Biology

Research: Working in the lab of David Soto-Pantoja, PhD ’08, associate professor of surgery and cancer biology, Tsai’s research focuses on understanding interactions between brain tumor cells and the tumor immune microenvironment to develop new treatments for primary and metastatic brain tumors. A particular focus includes enhancing tumor immune responses by manipulating metabolism related to breast cancer that metastasizes to the brain and on glioblastoma. Soto-Pantoja says Tsai leads all aspects of these projects in his lab.

Tsai says: “The most fascinating thing about studying brain tumors is the unique structure and immune environment within the brain. There are a couple of different cancer types that occur in the brain, including primary and metastatic tumors, and they all encounter the same issue during treatment, which is the immune suppression environment. Due to the protective brain structure and its critical function, it is difficult for the chemotherapy to reach without harming the brain function. This challenge makes it much more interesting to develop a new treatment option by utilizing the body’s — especially the brain’s — immune system.

“I also have learned so many new experimental methods to study cancer immunotherapy during my research here. The training at Dr. Soto-Pantoja’s lab regarding this project provides me the opportunity to obtain more powerful techniques for my future development.”

Soto-Pantoja says: “Terry is very disciplined. He is always thinking about next steps, about what may be coming in the future, how cancer cells may react, because they often will find some way to bypass a drug's effect. He is always studying the literature to learn what new tricks are in the pocket of the cancer cell, so you can then find a mechanism to target. He is very hard working, always here and super meticulous about the quality of the models he uses. The main thing, though, is that he is always willing to help others. Professors in his other classes tell me about how he helps other students and how mature he is. He wants to lead research that helps the community and helps cancer patients.

“I know he will be a leader no matter where he ends up, and I will be very surprised if he does not have his own lab in the future, leading research in neuro-oncology. It is not a matter of me giving him a project. He has steered our research in this area of neuro-oncology. He has led our lab on this path that has resulted in grants, manuscripts and establishing ourselves in this area.”

All second-year PA students

From left to right: Olga Correa, Jesseca Garcia, Lucia Gurrola and M. Tiye Young.

Research: A capstone research project is required of all Wake Forest University School of Medicine PA students, and this group worked together on a project of personal importance to each of them: cervical cancer disparities among racial and ethnic minorities. Robert L. Wooten, MS, PA-C ’81, was the group’s faculty sponsor.

Correa says: “Having this opportunity to do a research project was eye-opening. It was an opportunity to dive deeper into a topic that is not always covered in our didactic year. Growing up in a Hispanic family, I experienced firsthand the disparities that are present in medicine, especially when English is not your first language. For me, it was important to research a topic that could help bring awareness to these communities and help providers tackle some of the disparities they face.

“It was very helpful to have a team full of passionate and hard-working women. We were all able to divide the work equally and come together as a team to discuss and complete the project.”

Garcia says: “Before starting our research, I knew that there were many disparities seen in Black and Hispanic women from personal and familial experiences. However, regarding cervical cancer, I did not fully understand how vast and severe the impacts were. This research heightened my awareness and illuminated actionable strategies to address these disparities, providing a framework to ground my future practice.

“Research can allow us to become better providers as it gives us insight into so many aspects of medicine. It may allow us to make an appropriate decision about which medicine to choose, based on recent studies. It may give us the groundwork to understand social determinants of health, ultimately helping providers make sound recommendations to patients.”

Gurrola says: “I think it is necessary for all PA students to have exposure to research. Reading through various research articles, extracting information and understanding the significance of different findings is invaluable for a student and future clinician. Medicine would not be what it is without research, and it is important we recognize that.

“We chose to perform our research on Black and Hispanic women because that is how we identify ourselves. We’ve experienced the disparities firsthand and wanted to bring light to a topic that is often overlooked. Knowing that we were bringing awareness to the issue is what motivated us and made it all worth it.”

Young says: “Having been diagnosed with cervical cancer myself and enduring multiple surgeries and hospital visits before the age of 29, I have learned that it could have been prevented through communication and patient education. Medical mistrust, lack of communication and resources play a huge role in Hispanic women having the highest incidence of cervical cancer and Black women having the highest mortality rate. It’s important to acknowledge the facts concerning the data and understand our role in contributing to the solution.

“We know through research that Hispanic and Black women have felt unheard and misinformed so it’s an amazing feeling to know we can improve this for the next generation of women as future medical providers.”

Wooten says: “I commend the students for the work they did on this research project. They chose to shine a light on a health disparity that affects Black and Hispanic women. The students were passionate about this topic and eager to see how they could make a positive difference. Performing this research was insightful and helped to develop skills that will be beneficial in their medical careers.”

First-year MS student

Research: Serkiz became interested in research during his senior year at Wofford College, where he majored in biology, and came to Wake Forest University School of Medicine planning to pursue both master’s and doctoral degrees. He expects to complete master’s classes by late summer and begin work on his thesis.

His research project is on glaucoma, a retinal degenerative disorder that is commonly associated with elevated intraocular pressure. The work for his Master’s thesis examines the therapeutic efficacy of a novel neuroprotective agent in a mouse model of glaucoma. He is working with faculty mentor Rebecca Sappington, PhD, associate professor of biochemistry, co-director of the Translational Eye and Vision Research Center and director of the Ocular Biorepository Core Resource at the School of Medicine. They are looking at how cytotoxicity, specifically glutamates, may contribute to the disease. The project is a collaborative effort between Sappington’s lab and that of Dr. Marco Feligioni at the European Brain Research Institute, who developed the drug. The study is funded by the BrightFocus Foundation.

Serkiz says: “We are doing a drug study in mice, where we are essentially blocking the NMDA receptor to try to dampen some of that cytotoxic insult to the eye and seeing if that can be another potential way we can treat this disease because historically trying to lower intraocular pressure is one way that you can mitigate that degeneration but it hasn’t been very successful.

“Coming to Wake Forest, I didn’t know exactly what sort of research I wanted to do. I was very interested in metabolomics and genetics, and I didn’t know all that much about the eye. But through this experience, I have gained a greater appreciation for how intricate the organ is and how it can give you insights to what’s going on in the brain as well.

“What I have liked most about the lab is getting to learn all these cool techniques. You learn so much in undergrad about conceptualizing and knowing where the optic nerve is and what it does. Going in and seeing it in person and working with some of these structures gives you a deeper level of understanding and a greater appreciation for the organ itself.

“I’m not sure if academic research is the path I ultimately want to take, but I think using research to some degree is going to play a role in whatever career path I choose. There is a lot of great research being done, but I don’t necessarily think it always gets applied in the right ways clinically. I’d like to help make the gap between those two a little smaller.”

Sappington says: “This study seeks to develop this therapeutic for targeting of excitotoxicity mechanisms in the degeneration of the optic nerve in glaucoma. Every aspect of this project is new to Jack, which can be a daunting proposition for any student. Jack rises to the challenge every day by tackling each new concept and technique with curiosity, enthusiasm and determination. He has a tremendously bright future ahead of him!”