September 20, 2024 • 17 mins
In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., interviews Shannon Strader, D.O., a resident in cellular therapy at Mayo Clinic in Rochester, Minnesota, to discuss trailblazing new connections in medicine.
Timestamps:
0:00 Intro
00:56 Can you share your story with our listeners of how you connected the dots between physical medicine and rehab (PM&R) and cellular therapy?
04:54 What’s been those challenges and joys of working in the lab medicine world now?
08:38 You’re talking about your creativity, is that something that you’ve been able to tap into throughout your life during PM&R training, etc.?
10:24 What’s been your experience for the level of knowledge of cellular therapy in the physical medicine and rehab world? Is this something that people are aware of?
13:35 In what ways can laboratory professionals reach out and relationships with clinical colleagues?
15:31 What does the future of PM&R look like with cellular therapies in the toolbox?
17:13 Outro
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
(bright upbeat music)
(00:05):
- This is "Lab Medicine Rounds,"
a curated podcast for physicians,
laboratory professionals, and students.
I'm your host, Justin Kreuter,
a Transfusion Medicine Pathologist
and Assistant Professorof Laboratory Medicine
and Pathology at Mayo Clinic.
Today, we're roundingwith Dr. Shannon Strader,
a fellow in cellular therapy
at Mayo Clinic here inRochester, Minnesota,
(00:28):
talking about trailblazingnew connections in medicine.
Thanks for joining us today, Dr. Strader.
- Thank you so much for having me on.
- So we're talking about trailblazing
and we're talking about connections.
I introduced you as ourcellular therapy fellow.
What I didn't put in the introduction
is that you completedyour residency training
(00:49):
in physical medicine and rehabilitation.
Maybe to kick off this podcast,
can you kind of share yourstory with our listeners
of how you connected the dotsbetween physical medicine
and rehab and cellular therapy?
- That's just a wonderful question.
So I think to start, I'llstart by describing PM&R,
(01:11):
and then what a physiatristor PM&R doctor does.
To make it more complicated, in PM&R,
we have so many differentnames that we call ourselves,
but physical medicinerehabilitation is a specialty
dedicated solely to maximizingfunctional abilities
and quality of life for those
with any type ofneurological or MSK disorder.
(01:34):
So we care for a widerange of individuals.
Sometimes we callourselves the zebra finder,
but we do focus on stroke,spinal cord injury, brain injury,
cerebral palsy, spinabifida, muscular dystrophy,
amputee medicine, and thensports and pain medicine.
(01:54):
Because PM&R is fairly newand a unique specialty,
I often get the question onhow I even found the specialty
in interviews for PM&R,
whether it's attending interviewor residency interview,
that's a common, common question,
and I always say it has allto do with my twin sister.
(02:17):
My twin sister passed fromcomplications of cerebral palsy.
And so I truly don'tremember a time in my life
where I wasn't exposedto both the positive
and negatives of medicine.
And so I became aphysiatrist or PM&R doctor
because of my twin sister.
However, connecting thedots to cell therapy,
(02:38):
there's so much unmet needin treating these patients.
There's not a lot of options,
and oftentimes, the proceduresand medications we can offer
are just maybe a temporary solution
with a lot of side effects.
So this led me to being very interested
in novel cell therapeutics.
(03:01):
Down my path, as I grew up
and in high school and in college,
I found Dr. James Thompson.
He is the father of stem cells.
He derived the first embryonic stem cell,
and then later createdinduced pluripotent stem cells
alongside Dr. Yamanaka.
And so I emailed him when Iwas in high school saying,
(03:21):
"Thank you for your work,"
and he offered a job as anundergrad researcher at the time.
And so I'm forever thankful for that.
And working in his lab,
I just developed even more passion
for discovering innovationand novel cell therapeutics.
(03:43):
And so I did have toput that kind of passion
of cellular therapy and stem cell research
on the back burner
as I completed medicalschool and residency,
there's so much I needed tolearn clinically, of course.
And then during my training,it was during the pandemic,
so we were just trying not to drown
in clinical work at the time.
(04:04):
So now I'm very thankful
to be in my cell therapy fellowships
where I can connect all my dots together,
including PM&R and cell therapy.
I would say that I guess thecommon conception is that,
or common thought is that cell therapy
relates mostly to oncology.
(04:25):
And I think that's true,
especially for the focus onCAR-T therapies currently,
there's a lot of promise there
and so many new discoveries in that arena.
But I do think celltherapy was made as a home
to innovate procedures and therapeutics
for patients that don'totherwise have any options.
(04:48):
And so as a PM&R physician,
I think I fit perfectly in that realm.
- I really appreciateyou kind of highlighting
that aspect that you'recoming at cellular therapy.
Yeah, so even coming at cellular therapy
in really a new way,
you know, there certainly are some people
(05:09):
that might be interested,
but a lot of focus hasbeen on that neoplastic
or oncology background, as you say.
And so I really appreciate
that you're kind ofbringing it into a new area.
What's been those challenges and joys
(05:29):
of kind of working in thelab medicine world now?
You've been a couple monthsinto your fellowship,
and it also sounds like youhave some prior lab experience,
but this might be the first time actually
in terms of clinicallyworking in the laboratory.
How have you found it?
- Well, I think it's so fascinating.
(05:50):
It's so stimulating.
Every day, there's just a new adventure
and the possibilities are endless.
There's a lot of hope inthis arena, which I love.
It's been wonderful to learnhow to create cellular products
from both a diagnostic standpoint
and a therapeutic standpoint.
And then, I guess the dreamgoal is to biomanufacture
(06:14):
and make it on a scalable level
so that all facilitiesand clinician scientists
could use such a product.
Interesting, I feel thatI can be more creative
while I'm in this fellowshipand in laboratory medicine,
even though laboratory medicine
is much more black and white
(06:35):
than I'd say a clinicor inpatient setting,
there's a lot more gray.
I do feel like there's somuch more time to be able
to think about how you're going to analyze
a certain product or procedure.
And so it's very interestingto see the different ways
(06:56):
of thinking and approaching solutions
versus clinic and lab medicine.
The challenge I would say iseducating the clinical world
on what's actually beingperformed in the lab
and the innovation that is changing
the potential futuretreatments and pathways.
I think we do, asclinicians, get so tied up
(07:17):
in kind of the dailypressures, rightly so,
of taking care of patients in front of us
and also providing the standard of care
that we have at this moment.
And then also thepressures of documentation,
getting orders into the pharmacy,
and talking with insurance companies.
(07:39):
So we kind of sometimes aren't able
to use that creative part of our brain,
and think what could potentially we change
in the standard of care
and the processes that are happening.
And then another challenge I'm learning
is biomanufacturing aproduct can be very difficult
and have its challenges in itself,
(08:00):
but that's the ultimate goal.
So everybody in potentially the world
has easy access to these products.
- Something you saidearlier in your answer,
you're talking about kind ofthings being black and white
in laboratory medicine,
that's something that I find interesting,
'cause we often talk, wesometimes get residents applying,
(08:23):
and when you talk to 'em aboutwhy they chose pathology,
they a lot of times, willtalk about appreciating
that it's black and white.
And what's funny is, forpracticing pathologists,
I think most of us would sort of say,
"Oh, there is so much gray."
- So much gray. I can imagine.- You know.
- Totally, yeah.
- Like, yes, we put itin this diagnostic box,
(08:45):
but you know, these casescould be challenging.
But to your point though,
where I certainly will concede the point
when you're talking aboutmanufacturing a process,
or, sorry, not a process,
when you're manufacturing a product,
you know, that often does have a lot more
of that black and white contrast
(09:08):
because of the manufacturing requirements.
- Exactly, like, allthe regulatory processes
being very strict withthe standard of practice
and your SOPs are so vital in that.
- When you're talkingabout your creativity,
(09:30):
is that something that you'vebeen able to kind of tap into
throughout your life?
Is that something that as you were doing
your physical medicinerehabilitation training,
like, because of your kindof strengths in that area,
you were able to kinda continue
to think about cellular therapies,
(09:51):
as opposed to, I think,for a lot of people,
as you're saying, you get busy with things
and people probably just think about,
"Okay, let me go and start working,
"hang up my shingles as as a physiatrist."
- 100%, yeah.
I think it also, it startedwith my twin, especially,
(10:11):
is wanting to have more options,
have more answers, and there just wasn't.
And then unfortunately, 20 years plus,
and fast forward in my residency,
I realized a lot of things haven't changed
in the standard of care,
and that made me very frustrated.
And so as much as I wouldgo throughout my day-to-day
(10:35):
and offer potentialtreatments or procedures
that are considered the standardof care and what we do have
to provide to the patientpopulation I was working with,
there is still that big partof myself that was like,
"Ugh, I hate this.
"I want to provide more, Iwant there to be more options."
(10:56):
I want there at leastto be clinical trials
that I'm aware of
that's going on that Icould direct my patients to.
And so I think I've never lost that,
I guess, creative thought process,
but definitely had to putthat on the back burner
to focus on what I can do in that day
(11:19):
while that patient waspotentially hurting or suffering
or needing a different kind of direction
of medication and treatment.
- What's been your experiencefor the level of knowledge
of cellular therapiesin the physical medicine
and rehab world?
Is this something thatpeople are aware of,
(11:41):
but are thinking about it like, well,
that's cancer treatment,
or like, is it something like, you know,
how could this constructhelp us in physical medicine?
What's that like? What'syour experience been?
- Yeah, it's veryinteresting you say that,
because I do think there'skind of a clouded version
(12:02):
of what cell therapy even is.
But in PM&R, we use orthobiologicsdaily for our patients.
And that's probably aconversation in itself
of what that even entails,
but you could say that isa cell therapy version,
because you are takingcells from a patient
and essentially injectingit back into the patient.
(12:26):
I do think there needsto be a lot more studies
on orthobiologics and a lotmore regulatory processes,
which also is why I wantedto complete this fellowship
so that I could bring back thatknowledge to the PM&R world
and say, "Hey guys, I thinkwe can do this better."
But also, I thinkbecause PM&R is, I guess,
(12:50):
more focused on calling it orthobiologics,
they don't even considerit a type of cell therapy.
And I think the education insaying that this is a cell,
that these are cells that we are injecting
and understanding them better
is probably gonna helpour field a lot more.
I will say, as far aslike, MSC type cells,
(13:14):
that has been-- When you say MSC,
I'm sorry to interrupt, but-- Yeah.
- What does that mean for our listeners?
- Oh, yeah, mesenchymal orstromal cells or stem cells,
there's a debate on whetheryou should call them stromal
or stem cells,
but they're finding more andmore these types of cells
(13:37):
help with anti-inflammatory mechanisms,
help with potentiallyproteins and growth factors
and signaling for certain cells
to help with injury or disease.
And so the MSCs in PM&Rworld have been used for,
(13:57):
I think over a decade nowin certain clinical trials.
There's some promise there still,
but I think that has been challenging
to translate it as a standard of care
of treatment for our patients.
But that has been a constantconversation, I think,
(14:17):
in the PM&R world.
- You know, I'm alwayslooking for the tagline
for this podcast, is, you know,
encouraging people to continueto connect lab medicine
in the clinical practice.
And you know, I'm kind ofstruck by, as I hear you,
as you've connected thesedots, how, you know,
really, it's beendisparate expertise, right?
(14:39):
We have some people that areexpert in cellular therapies,
we have some people that are expert
in physical medicine rehabilitation.
And because those are twodifferent knowledge sets,
like, the physiatrists don'teven know what's possible,
necessarily, on the cell therapy side.
Cell therapy peopleprobably don't even know
there's a maybe a clinical need
or an application.- Oh, for sure. Yeah.
- And so this connection,thinking about this connection,
(15:03):
knowing that, you know,
you're somebody whoenjoys laboratory medicine
and working in these areas now,
but you've certainly haveworked in the clinical practice
for a number of years.
Everyone's super busy.
What ways can, you know,laboratory professionals reach out
and build relationshipswith clinical colleagues?
(15:23):
A lot of times when I have clinicians on,
I kind of tell them they shoulddefinitely pick up the phone
and call the lab.
How can lab reach out tothe clinical colleagues?
- Well, I think you're doinga wonderful job, first off,
by creating and leading this podcast.
I think social media,for better or for worse,
(15:44):
is kind of the future for young trainees
to learn in a lot of different ways.
And so using social media tools,
I definitely think help and will help,
continue to help closethat communication gap.
I do think laboratory professionals
are kind of the unicorns of medicine.
(16:05):
You guys have the 360view of what's going on
and streamlining processesto even get to a patient.
And most of what you guys are developing
as far as products to be usedfor patients are lifesaving.
And so you guys kinda have this overview
of both clinically and what'sgoing on in the laboratory,
(16:26):
which I think is so vitalto promote to the clinicians
that may not trulyunderstand what's going on
in that world.
I do feel like when somebody is talking
about bone marrowtransplant or CAR-T therapy,
which is the most commontypes of cell therapies
that I think are beingdiscussed out in the world,
(16:47):
they think more aboutadministrating it to the patient
and potentially curingor treating that patient,
which is very exciting,
but personally, I think the coolest part
is actually creating the product itself,
which is what you guys do and perform.
And then without creating that product,
there'd be absolutelyno treatment or option.
And so getting the wordout about that is, I think,
(17:10):
just as is importantas as these treatments
and the patients benefiting from them.
- Wow, that's a perfectlead-in to my final question,
which is, now you're talking
about getting these products out.
What does the future of PM&R look like
with cellular therapies in the toolbox?
(17:31):
- Yeah, well, I hope I canrecruit some other PM&R docs
to be excited about cell therapy
and want to be educatedand understand it more.
But there are thousands ofboth cell and gene therapies
being produced in clinicaltrials at this time,
and over half are not forcancer-related disorders
(17:53):
at this time,
most of which are MSK or neuro-related.
And so I think thatthe next biggest hurdle
is addressing these treatments
that are coming in the pipeline
for education and trainingin residencies and fellows,
and who takes ownershipof that as a clinician
(18:14):
and understanding these.
And then my dream is for PM&R
to combine forces withneurology and cellular therapy
to create more of a holistic approach
in streamlining these novel therapeutics.
I don't think we can do this alone
or isolated from each other.
I think these therapies are very complex
(18:35):
and they require a lot ofdifferent expertise and education.
And so I hope that we allkind of get together as a team
in our expertise.
But my personal goal is toinvestigate cellular products
related to abnormal muscular pathology
for both diagnostic andtherapeutic reasons.
(18:57):
Most recently, I've become veryobsessed with nanoparticles
and nanomedicine for delivery of therapy.
So we'll see if I canmake something happen
in these next couple years.
- We've been roundingwith Dr. Shannon Strader,
talking about creating newconnections in medicine.
Thanks for taking the timeto talk about this with us.
(19:18):
- Thank you so much for havingme, I really appreciate it.
- And to all of our listeners,
thank you for joining us today.
We invite you to share your thoughts
and suggestions via emailto mcleducation@mayo.edu.
If you've enjoyed thispodcast, please subscribe,
and until our next rounds together,
we encourage you to continueto connect lab medicine
in the clinical practice througheducational conversations.
(19:42):
(bright upbeat music)
(bright upbeat music)
(00:05):
- This is "Lab Medicine Rounds,"
a curated podcast for physicians,
laboratory professionals, and students.
I'm your host, Justin Kreuter,
a Transfusion Medicine Pathologist
and Assistant Professorof Laboratory Medicine
and Pathology at Mayo Clinic.
Today, we're roundingwith Dr. Shannon Strader,
a fellow in cellular therapy
at Mayo Clinic here inRochester, Minnesota,
(00:28):
talking about trailblazingnew connections in medicine.
Thanks for joining us today, Dr. Strader.
- Thank you so much for having me on.
- So we're talking about trailblazing
and we're talking about connections.
I introduced you as ourcellular therapy fellow.
What I didn't put in the introduction
is that you completedyour residency training
(00:49):
in physical medicine and rehabilitation.
Maybe to kick off this podcast,
can you kind of share yourstory with our listeners
of how you connected the dotsbetween physical medicine
and rehab and cellular therapy?
- That's just a wonderful question.
So I think to start, I'llstart by describing PM&R,
(01:11):
and then what a physiatristor PM&R doctor does.
To make it more complicated, in PM&R,
we have so many differentnames that we call ourselves,
but physical medicinerehabilitation is a specialty
dedicated solely to maximizingfunctional abilities
and quality of life for those
with any type ofneurological or MSK disorder.
(01:34):
So we care for a widerange of individuals.
Sometimes we callourselves the zebra finder,
but we do focus on stroke,spinal cord injury, brain injury,
cerebral palsy, spinabifida, muscular dystrophy,
amputee medicine, and thensports and pain medicine.
(01:54):
Because PM&R is fairly newand a unique specialty,
I often get the question onhow I even found the specialty
in interviews for PM&R,
whether it's attending interviewor residency interview,
that's a common, common question,
and I always say it has allto do with my twin sister.
(02:17):
My twin sister passed fromcomplications of cerebral palsy.
And so I truly don'tremember a time in my life
where I wasn't exposedto both the positive
and negatives of medicine.
And so I became aphysiatrist or PM&R doctor
because of my twin sister.
However, connecting thedots to cell therapy,
(02:38):
there's so much unmet needin treating these patients.
There's not a lot of options,
and oftentimes, the proceduresand medications we can offer
are just maybe a temporary solution
with a lot of side effects.
So this led me to being very interested
in novel cell therapeutics.
(03:01):
Down my path, as I grew up
and in high school and in college,
I found Dr. James Thompson.
He is the father of stem cells.
He derived the first embryonic stem cell,
and then later createdinduced pluripotent stem cells
alongside Dr. Yamanaka.
And so I emailed him when Iwas in high school saying,
(03:21):
"Thank you for your work,"
and he offered a job as anundergrad researcher at the time.
And so I'm forever thankful for that.
And working in his lab,
I just developed even more passion
for discovering innovationand novel cell therapeutics.
(03:43):
And so I did have toput that kind of passion
of cellular therapy and stem cell research
on the back burner
as I completed medicalschool and residency,
there's so much I needed tolearn clinically, of course.
And then during my training,it was during the pandemic,
so we were just trying not to drown
in clinical work at the time.
(04:04):
So now I'm very thankful
to be in my cell therapy fellowships
where I can connect all my dots together,
including PM&R and cell therapy.
I would say that I guess thecommon conception is that,
or common thought is that cell therapy
relates mostly to oncology.
(04:25):
And I think that's true,
especially for the focus onCAR-T therapies currently,
there's a lot of promise there
and so many new discoveries in that arena.
But I do think celltherapy was made as a home
to innovate procedures and therapeutics
for patients that don'totherwise have any options.
(04:48):
And so as a PM&R physician,
I think I fit perfectly in that realm.
- I really appreciateyou kind of highlighting
that aspect that you'recoming at cellular therapy.
Yeah, so even coming at cellular therapy
in really a new way,
you know, there certainly are some people
(05:09):
that might be interested,
but a lot of focus hasbeen on that neoplastic
or oncology background, as you say.
And so I really appreciate
that you're kind ofbringing it into a new area.
What's been those challenges and joys
(05:29):
of kind of working in thelab medicine world now?
You've been a couple monthsinto your fellowship,
and it also sounds like youhave some prior lab experience,
but this might be the first time actually
in terms of clinicallyworking in the laboratory.
How have you found it?
- Well, I think it's so fascinating.
(05:50):
It's so stimulating.
Every day, there's just a new adventure
and the possibilities are endless.
There's a lot of hope inthis arena, which I love.
It's been wonderful to learnhow to create cellular products
from both a diagnostic standpoint
and a therapeutic standpoint.
And then, I guess the dreamgoal is to biomanufacture
(06:14):
and make it on a scalable level
so that all facilitiesand clinician scientists
could use such a product.
Interesting, I feel thatI can be more creative
while I'm in this fellowshipand in laboratory medicine,
even though laboratory medicine
is much more black and white
(06:35):
than I'd say a clinicor inpatient setting,
there's a lot more gray.
I do feel like there's somuch more time to be able
to think about how you're going to analyze
a certain product or procedure.
And so it's very interestingto see the different ways
(06:56):
of thinking and approaching solutions
versus clinic and lab medicine.
The challenge I would say iseducating the clinical world
on what's actually beingperformed in the lab
and the innovation that is changing
the potential futuretreatments and pathways.
I think we do, asclinicians, get so tied up
(07:17):
in kind of the dailypressures, rightly so,
of taking care of patients in front of us
and also providing the standard of care
that we have at this moment.
And then also thepressures of documentation,
getting orders into the pharmacy,
and talking with insurance companies.
(07:39):
So we kind of sometimes aren't able
to use that creative part of our brain,
and think what could potentially we change
in the standard of care
and the processes that are happening.
And then another challenge I'm learning
is biomanufacturing aproduct can be very difficult
and have its challenges in itself,
(08:00):
but that's the ultimate goal.
So everybody in potentially the world
has easy access to these products.
- Something you saidearlier in your answer,
you're talking about kind ofthings being black and white
in laboratory medicine,
that's something that I find interesting,
'cause we often talk, wesometimes get residents applying,
(08:23):
and when you talk to 'em aboutwhy they chose pathology,
they a lot of times, willtalk about appreciating
that it's black and white.
And what's funny is, forpracticing pathologists,
I think most of us would sort of say,
"Oh, there is so much gray."
- So much gray. I can imagine.- You know.
- Totally, yeah.
- Like, yes, we put itin this diagnostic box,
(08:45):
but you know, these casescould be challenging.
But to your point though,
where I certainly will concede the point
when you're talking aboutmanufacturing a process,
or, sorry, not a process,
when you're manufacturing a product,
you know, that often does have a lot more
of that black and white contrast
(09:08):
because of the manufacturing requirements.
- Exactly, like, allthe regulatory processes
being very strict withthe standard of practice
and your SOPs are so vital in that.
- When you're talkingabout your creativity,
(09:30):
is that something that you'vebeen able to kind of tap into
throughout your life?
Is that something that as you were doing
your physical medicinerehabilitation training,
like, because of your kindof strengths in that area,
you were able to kinda continue
to think about cellular therapies,
(09:51):
as opposed to, I think,for a lot of people,
as you're saying, you get busy with things
and people probably just think about,
"Okay, let me go and start working,
"hang up my shingles as as a physiatrist."
- 100%, yeah.
I think it also, it startedwith my twin, especially,
(10:11):
is wanting to have more options,
have more answers, and there just wasn't.
And then unfortunately, 20 years plus,
and fast forward in my residency,
I realized a lot of things haven't changed
in the standard of care,
and that made me very frustrated.
And so as much as I wouldgo throughout my day-to-day
(10:35):
and offer potentialtreatments or procedures
that are considered the standardof care and what we do have
to provide to the patientpopulation I was working with,
there is still that big partof myself that was like,
"Ugh, I hate this.
"I want to provide more, Iwant there to be more options."
(10:56):
I want there at leastto be clinical trials
that I'm aware of
that's going on that Icould direct my patients to.
And so I think I've never lost that,
I guess, creative thought process,
but definitely had to putthat on the back burner
to focus on what I can do in that day
(11:19):
while that patient waspotentially hurting or suffering
or needing a different kind of direction
of medication and treatment.
- What's been your experiencefor the level of knowledge
of cellular therapiesin the physical medicine
and rehab world?
Is this something thatpeople are aware of,
(11:41):
but are thinking about it like, well,
that's cancer treatment,
or like, is it something like, you know,
how could this constructhelp us in physical medicine?
What's that like? What'syour experience been?
- Yeah, it's veryinteresting you say that,
because I do think there'skind of a clouded version
(12:02):
of what cell therapy even is.
But in PM&R, we use orthobiologicsdaily for our patients.
And that's probably aconversation in itself
of what that even entails,
but you could say that isa cell therapy version,
because you are takingcells from a patient
and essentially injectingit back into the patient.
(12:26):
I do think there needsto be a lot more studies
on orthobiologics and a lotmore regulatory processes,
which also is why I wantedto complete this fellowship
so that I could bring back thatknowledge to the PM&R world
and say, "Hey guys, I thinkwe can do this better."
But also, I thinkbecause PM&R is, I guess,
(12:50):
more focused on calling it orthobiologics,
they don't even considerit a type of cell therapy.
And I think the education insaying that this is a cell,
that these are cells that we are injecting
and understanding them better
is probably gonna helpour field a lot more.
I will say, as far aslike, MSC type cells,
(13:14):
that has been-- When you say MSC,
I'm sorry to interrupt, but-- Yeah.
- What does that mean for our listeners?
- Oh, yeah, mesenchymal orstromal cells or stem cells,
there's a debate on whetheryou should call them stromal
or stem cells,
but they're finding more andmore these types of cells
(13:37):
help with anti-inflammatory mechanisms,
help with potentiallyproteins and growth factors
and signaling for certain cells
to help with injury or disease.
And so the MSCs in PM&Rworld have been used for,
(13:57):
I think over a decade nowin certain clinical trials.
There's some promise there still,
but I think that has been challenging
to translate it as a standard of care
of treatment for our patients.
But that has been a constantconversation, I think,
(14:17):
in the PM&R world.
- You know, I'm alwayslooking for the tagline
for this podcast, is, you know,
encouraging people to continueto connect lab medicine
in the clinical practice.
And you know, I'm kind ofstruck by, as I hear you,
as you've connected thesedots, how, you know,
really, it's beendisparate expertise, right?
(14:39):
We have some people that areexpert in cellular therapies,
we have some people that are expert
in physical medicine rehabilitation.
And because those are twodifferent knowledge sets,
like, the physiatrists don'teven know what's possible,
necessarily, on the cell therapy side.
Cell therapy peopleprobably don't even know
there's a maybe a clinical need
or an application.- Oh, for sure. Yeah.
- And so this connection,thinking about this connection,
(15:03):
knowing that, you know,
you're somebody whoenjoys laboratory medicine
and working in these areas now,
but you've certainly haveworked in the clinical practice
for a number of years.
Everyone's super busy.
What ways can, you know,laboratory professionals reach out
and build relationshipswith clinical colleagues?
(15:23):
A lot of times when I have clinicians on,
I kind of tell them they shoulddefinitely pick up the phone
and call the lab.
How can lab reach out tothe clinical colleagues?
- Well, I think you're doinga wonderful job, first off,
by creating and leading this podcast.
I think social media,for better or for worse,
(15:44):
is kind of the future for young trainees
to learn in a lot of different ways.
And so using social media tools,
I definitely think help and will help,
continue to help closethat communication gap.
I do think laboratory professionals
are kind of the unicorns of medicine.
(16:05):
You guys have the 360view of what's going on
and streamlining processesto even get to a patient.
And most of what you guys are developing
as far as products to be usedfor patients are lifesaving.
And so you guys kinda have this overview
of both clinically and what'sgoing on in the laboratory,
(16:26):
which I think is so vitalto promote to the clinicians
that may not trulyunderstand what's going on
in that world.
I do feel like when somebody is talking
about bone marrowtransplant or CAR-T therapy,
which is the most commontypes of cell therapies
that I think are beingdiscussed out in the world,
(16:47):
they think more aboutadministrating it to the patient
and potentially curingor treating that patient,
which is very exciting,
but personally, I think the coolest part
is actually creating the product itself,
which is what you guys do and perform.
And then without creating that product,
there'd be absolutelyno treatment or option.
And so getting the wordout about that is, I think,
(17:10):
just as is importantas as these treatments
and the patients benefiting from them.
- Wow, that's a perfectlead-in to my final question,
which is, now you're talking
about getting these products out.
What does the future of PM&R look like
with cellular therapies in the toolbox?
(17:31):
- Yeah, well, I hope I canrecruit some other PM&R docs
to be excited about cell therapy
and want to be educatedand understand it more.
But there are thousands ofboth cell and gene therapies
being produced in clinicaltrials at this time,
and over half are not forcancer-related disorders
(17:53):
at this time,
most of which are MSK or neuro-related.
And so I think thatthe next biggest hurdle
is addressing these treatments
that are coming in the pipeline
for education and trainingin residencies and fellows,
and who takes ownershipof that as a clinician
(18:14):
and understanding these.
And then my dream is for PM&R
to combine forces withneurology and cellular therapy
to create more of a holistic approach
in streamlining these novel therapeutics.
I don't think we can do this alone
or isolated from each other.
I think these therapies are very complex
(18:35):
and they require a lot ofdifferent expertise and education.
And so I hope that we allkind of get together as a team
in our expertise.
But my personal goal is toinvestigate cellular products
related to abnormal muscular pathology
for both diagnostic andtherapeutic reasons.
(18:57):
Most recently, I've become veryobsessed with nanoparticles
and nanomedicine for delivery of therapy.
So we'll see if I canmake something happen
in these next couple years.
- We've been roundingwith Dr. Shannon Strader,
talking about creating newconnections in medicine.
Thanks for taking the timeto talk about this with us.
(19:18):
- Thank you so much for havingme, I really appreciate it.
- And to all of our listeners,
thank you for joining us today.
We invite you to share your thoughts
and suggestions via emailto mcleducation@mayo.edu.
If you've enjoyed thispodcast, please subscribe,
and until our next rounds together,
we encourage you to continueto connect lab medicine
in the clinical practice througheducational conversations.
(19:42):
(bright upbeat music)
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