Biomedical Scientists at Osteopathic Medical Schools A Critical Resource for Osteopathic Research Fred Downey, PhD

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1 Biomedical Scientists at Osteopathic Medical Schools A Critical Resource for Osteopathic Research Fred Downey, PhD Regents Professor, Department of Integrative Physiology University of North Texas Health Science Center at Fort Worth

2 Outline Models of Collaborative Research - Clinical and Basic Science Success Stories Suggestions for Future Success in Osteopathic Research

3 AOA Research Conference 1999 San Francisco, California

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5 There s more than coffee at the coffee bar.

6 + = Clinical Faculty Basic Science Faculty Success in Osteopathic Research

7 AOA Research Conference 1999 San Francisco, California

8 Elroy Cantrell, DO, PhD TCOM 1984 Emergency Medicine Device for Mechanical Cardiac Resuscitation Setty S, Bian X, Hart BJ, Williams AG, Downey HF, Cantrell ET. Simultaneous abdominal and chest compressions improve carotid blood flow, and aortic pressure during CPR in swine. J.A.O.A. 99: C22, 1999.

9 Glendal Dow, DO TCOM 1984 Family Practice Load-Sensitive Drive for an Artificial Heart U S Patent Pending

10 Marty Knott, DO, PhD Scott Stoll, DO, PhD Knott, M., J. D. Tune, S. Stoll, and H. F. Downey. Lymphatic pump treatments increase thoracic duct flow. J. A. O. A. 105: , Recipient of 2006 George W. Northup, DO, Medical Writing Award

11 Lymphatic Pump Treatments Increase Thoracic Duct Flow Effect of Abdominal Lymphatic Pump on Lymph Flow n=5 Knott et al.,. A. O. A. 105: , 2005.

12 Treadmill Exercise Increases Thoracic Duct Flow n=4 Knott et al., J. A. O. A. 105: , 2005.

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14 Research Grant (Sugar for the Coffee with Cream) U19AT004141, National Institutes of Health, National Center for Complementary and Alternative Medicine, 09/01/04 08/31/10 Mechanisms of Manual Medicine, Michael L. Smith, PhD, Principal Investigator

15 Mechanisms of Manual Medicine PROJECT 1: "Fibroblast Strain Modeling: Evidence Base for Manual Therapy Effectiveness Paul R. Standley, PhD PROJECT 2: "OMT-Enhanced Fluid and Leukocyte Flux in Lymphatics H. Fred Downey, PhD PROJECT 3: "Somatic Dysfunction: Mechanisms of Sympathoexcitation Michael L. Smith, PhD CORE B: Manual Medicine Core Scott T. Stoll, DO, PhD

16 Effects of Lymphatic Pump Treatment Before and After Extracellular Space Expansion (ECE) Lymph Flow (ml/min) * * * * * Before ECE After ECE * P < 0.05 vs. Before ECE P < 0.05 vs. Respective Baseline n = 8 * * * * Time (min) Downey HF, Durgam P, Williams AG Jr, Rajmane A, King HH, Stoll ST Lymph Res Biol 6:3-13, 2008

17 Effects of Lymphatic Pump Treatment on 8-min Integrated Lymph Flow Integrated Thoracic Duct Flow (ml) min Baseline 8 min LPT Incremental Increase Produced by 8 min LPT * P < 0.05, vs. Respective Baseline Condition P < 0.01, vs. Respective Before ECE Condition n = 8 * * 0 Before ECE After ECE Downey HF, Durgam P, Williams AG Jr, Rajmane A, King HH, Stoll ST Lymph Res Biol 6:3-13, 2008

18 Edema in Conscious Dogs Produced by Constriction of the Inferior Vena Cava Before IVC Constriction After IVC Constriction

19 Lymphatic Pump Treatment Increases Thoracic Duct Lymph Flow in Conscious Dogs with Abdominal Edema Prajapati P, Shah P, King HH, Williams AG Jr, Desai P, Downey HF., Lymph. Res. Biol., 8:149-54, 2010.

20 Lymphatic Pump Treatment Increases Thoracic Duct Flow in Conscious Dogs with Abdominal Edema * * P<0.05 vs. Respective Baseline * Prajapati P, Shah P, King HH, Williams AG Jr, Desai P, Downey HF., Lymph. Res. Biol., 8:149-54, 2010.

21 Lymph Flow in the Thoracic Duct During Exercise 9 mph 3 mph Desai, P., Lymph. Res. Biol., 8: , 2010.

22 Lymph Flow in the Thoracic Duct During Graded Exercise Desai, P., Lymph. Res. Biol., 8: , 2010.

23 Hollis King, DO Professor Osteopathic Manipulative Medicine Osteopathic Research Center Lisa Hodge, PhD Associate Professor Immunology and Molecular Biology Osteopathic Research Center

24 Abdominal Lymphatic Pump Treatment (LPT) Increases Flow in the Thoracic Duct of Conscious Dogs and also Increases Number of Leukocytes Leukocyte flux x 10 6 cells/min Thus, leukocyte flux from lymph to blood is greatly increased * P < 0.01 n = 8 * P<0.01 n=8 0 Baseline LPT Hodge LM, King HH, Williams AG Jr, Reder SJ, Belavadi T, Simecka JW, Stoll ST, Downey HF Lymph. Res. Biol. 5: , 2007.

25 Research Grant (Sugar for the Coffee with Cream) R01AT Mechanisms of Lymphatic Pump-Enhancement of Immune Function, National Institutes of Health, National Center for Complementary and Alternative Medicine, 01/01/ /31/2012. Lisa Hodge, PhD, Principal Investigator H. Fred Downey, PhD, Collaborating Investigator

26 AOA Research Grants (Sugar for the Coffee with Cream) AOA Lymphatic Pump Manipulation: Effects on Lower Respiratory Tract Infection and Immunity, American Osteopathic Association, 9/1/06-8/31/08 AOA The Effects of Lymphatic Pump Manipulation on Tumor Development and Metastasis, American Osteopathic Association. 9/1/08-8/31/10 AOA The Effect of Lymphatic Pump Treatment on the Clearance of Influenza and Influenza Complicated by Bacterial Pneumonia, American Osteopathic Association, 9/1/10-8/31/12 Lisa M. Hodge, PhD, Principal Investigator Hollis H. King, DO, Collaborating Investigator H. Fred Downey, PhD, Collaborating Investigator

27 Abdominal LPT Increases Flux of Immune Cells in Thoracic Duct Lymph Pre-LPT LPT Post-LPT Neutrophils 0.27 ± ± ± 0.01 Monocytes 0.34 ± ± ± 0.10 Lymphocytes ± ± ± 2.30 CD4 + T cells 3.25 ± ± ± 1.90 CD8 + T cells 1.24 ± ± ± 0.76 IgA + B cells 0.65 ± ± ± 0.21 IgG + B cells 1.06 ± ± ± 0.18 Data are means 10 6 immune cells/min ± SE from six experiments. Hodge LM, Bearden MK, Schander A, Huff JB, Williams A Jr, King HH, Downey HF. Lymphat Res Biol

28 Lymphatic Pump Treatment Mobilizes Inflammatory Mediators into Lymphatic Circulation Schander A, Downey HF, and Hodge LM. Exp. Biol. Med. 237:58-63, 2012.

29 Lymphatic Pump Treatment Mobilizes Leukocytes from Gut- Associated Lymphoid Tissue into Mesenteric Lymph Hodge LM, Bearden MK, Schander A, Huff JB, Williams A Jr, King HH, Downey HF. Lymphat Res Biol

30 Lymphatic Pump Treatment Augments Lymphatic Flux of Leukocytes in Rats Huff JB, Schander A, Downey HF, Hodge LM. Lymphat Res Biol, 2010.

31 Lymphatic Pump Treatments Reduces Streptococcus Pneumoniae Colony Forming Units in Rats with Acute Pneumonia **P < 0.01 compared to control and sham. N = 10 rats per group. Hodge LM. Int J Osteopath Med, 2012.

32 Research Grant (Sugar for the Coffee with Cream) , Cranial Osteopathy and Cerebral Tissue Oxygenation, American Osteopathic Association, 09/01/ /31/2010. Xiangrong Shi, PhD, Principal Investigator Scott T. Stoll, DO, PhD, Collaborating Investigator Russell G. Gamber, DO, Collaborating Investigator H. Fred Downey, PhD, Collaborating Investigator

33 Shi X, Rehrer S, Prajapati P, Stoll ST, Gamber RG, Downey HF. Effect of cranial osteopathic manipulative medicine on cerebral tissue oxygenation. J Am Osteopath Assoc. 111:660-6,2011. Recipient of 2012 George W. Northup, DO, Medical Writing Award.

34 Effect of Cranial Osteopathic Manipulative Medicine on Cerebral Tissue Oxygenation Shi X, Rehrer S, Prajapati P, Stoll ST, Gamber RG, Downey HF. J Am Osteopath Assoc, 2011.

35 Normalized Low-Frequency and High-Frequency Power of R-R Interval Variability Showed that Augmentation and Suppression Techniques Increase Parasympathetic Tone and Decrease Sympathetic Tone Shi X, Rehrer S, Prajapati P, Stoll ST, Gamber RG, Downey HF. J Am Osteopath Assoc, 2011.

36 + = Clinical Faculty Basic Science Faculty Success in Osteopathic Research Clinical Insight and Skills Access to Patients Inspiration $$$$ Mechanistic Insight New Technology Time and Motivation Grantsmanship New Knowledge Validation of Osteopathic Principles and Procedures Grants and Publications

37 Suggestions for Future Success in Osteopathic Research

38 Communicate Appreciate Collaborate

39 Pet PhD Species: Pet PhD Habitat: Osteopathic Clinical Departments Visibility: Low Productivity: Low Lifespan: Short

40 Collaborate with Basic Science Faculty for Clinically Relevant Osteopathic Research They are ready, willing, and able!

41 Empower the Students and Faculty Clinical Departments Clinical Conferences Research Conferences Professional Visits Seminars Laboratory Rotations DO-PhD Programs Basic Science Departments

42 Share the Wealth Talent, Instrumentation, Patients, Staff, Funds Clinical Departments + Research Success Basic Science Departments

43 To Success In Osteopathic Research! The Best Is Yet To Come!!!! Thank You!