This week began as normal for me attending brain cutting on Monday and looking at histology slides with Dr. Lavi. I'm learning a lot about how surgical pathology operates to diagnose disease. Histology has been especially interesting to me and I'm really beginning to be able to tell different types of tissues apart from each other and note several of the characteristics used to differentiate cancers from one another. However, after Monday of this week Dr. Lavi left to go on vacation and I came down with a head cold which I decided I shouldn't continue in the ICUs with. Instead, I chose to focus down on my research project with Dr. Cesarman and try to make some progress.
As I've previously written about, my project will focus on creating new detection methods for Kaposi's Sarcoma Associated Herpes Virus, which eventually will be designed in such a way they can be run in resource limited communities with very little infrastructure. KSHV is a disease which causes cancer in already immuno-compromised patients, and is considered an AIDS defining illness. Identifying lesions caused by KSHV and not other diseases is important because some limited treatment exists to deal with KS which would be ineffective on other conditions. Currently, diagnosis requires biopsies to be taken and antibody staining to be performed to make a complete diagnosis (regular H&E can mostly confirm the presence of KSHV, but only antibody staining is absolute). Specifically, antibodies specific to a protein called latency-associated nuclear antigen, or LANA, are stained and exposed to the samples. If the antibody stain is found in high concentrations in the nucleus of the cell, where LANA is mostly present, a positive diagnosis can be made.
Here I'll try to develop a more molecular approach to KSHV diagnosis in which fixing histology slides would not be necessary. As I've previously mentioned, a sizable amount of work has been published on how nanoparticles can be caused to aggregate in the presence of specific DNA or other biomolecules and change the optical properties of the suspension. Last week I had incorrectly identified a section of DNA in the virus which could be used with such techniques, which I corrected this week. I've designed the oligonucleotides which would be required for the detection of KSHV and am just waiting for our laboratory technician to return so I can place the order.
Overall this week has been more successful in terms of my research project than clinical exposure. With my mentor out of town I had less of a chance to observe clinicians at work and more time to sit down and design a reasonable set of experiments to run over the next few weeks. Next week I hope to increase the amount of time I spend on clinical activities and place the order for the oligonucleotides I have designed.