Written by Erin Kreszl
Dr. Louis Kim, MD, is Professor and Vice Chairman of Neurological Surgery at the University of Washington, School of Medicine, and is chief of the neurological surgery service at Harborview Medical Center in Seattle. Louis and his team are the recipients of a 2019 TBF research grant. Recently, we had the chance to speak with him about his very promising research project.
What got you interested in brain aneurysm research?
There is a lot of mythology around aneurysms. People think that once an aneurysm is found, there’s a 1% chance of surviving it. But we know better – if you can find it, you have a chance to help, and that’s what draws me to these kinds of patients: they are high risk, and there are many emergencies, but there is a huge payback when you can intervene and improve the outcome. However, there is still much to be done to understand how to identify brain aneurysms and prevent rupture.
Tell us a little about your research project.
Ultimately, we are trying to determine the genetics that lead to aneurysm formation and see if there is a way to figure that out, based on molecular characteristics of the endometrial cells. This, of course, is basically the holy grail. If we can identify the determining characteristics and biopsy these cells, we can avoid surgery. Look at the trajectory of brain illnesses and treatments: In the past you had to have a brain operation to obtain the needed tissue for analysis. Now less invasive approaches have come into play, marking the cells and finding out what they are expressing, then comparing those with normal cells to see if we can find a mutation or some kind of genetic marker at the tissue level. This is something that has been done in cancer research but has never come into play in the brain aneurysm arena.
Our research is based on acquiring tissue during endovascular treatments as opposed to surgery, which has historically been the only way to get to the actual tissue needed for exploration and diagnosis. We now have the ability to get tissue from the endovascular approach, which is much less invasive, and the most common treatment approach for aneurysms. It’s not a brand new technique, but we have taken it to a brand new level in proving that we can do the sequencing from this tissue, taking a low volume of genetic material and analyzing it. We can then figure out which are high and low risk aneurysms based on the morphology of the cells. This approach has never been employed before, and this grant provides the seed money to get it off the ground.
What would be the advantage of your approach?
We need to get to the point of detecting brain aneurysm factors in the bloodstream. RNA has the direct relationship between the gene and the utilization of that gene in that particular cell. So, doing the RNA sequencing right from the cells is more efficient and more cost effective. It’s basically a shortcut to the end goal – identifying what causes brain aneurysms.
One of the goals of The Bee Foundation is not only to fund research, but to build a body of expertise and foster scientific careers. Does this come into play in your research project?
Absolutely. In our case, the grant project will be an investment in our full neurological research team at the University of Washington. In particular, this grant enables us to support Chris Young, M.D., Ph.D., a fifth-year resident on the team and Rhodes Scholar, who will be working alongside the team during the research project. We’re very proud of Chris, and excited about his next career steps which entail a fellowship at Johns Hopkins after this grant is complete.
What is your hope for the future of brain aneurysm treatment?
Well, obviously, we need more education. But we also need to find a better screening tool.
What I would love to see is a cost-effective way to screen for brain aneurysms without an MRI or MRA which, at their current costs, would bankrupt the country! Japan, for instance, screens everyone after the age of 50, but their health system is staggering under the costs.
I guess my favorite line about my professional goal is that I would like to put myself out of business! If we can find a non-invasive and cost-effective approach to identifying brain aneurysms and stopping them from developing, that would be a vision well worth the work and effort.
We look forward to seeing Dr. Kim at the Honey Bash Gala on October 5th. Join us to learn more about this ground-breaking research!