FEATURE ARTICLE

Spotlight on the William L. Young Neuroscience Research Award – Interview with Dr. Umeshkumar Athiraman

Dr. Koerner
Ines Koerner, MD, PhD

By Ines Koerner, MD, PhD
Chair of Research Committee

Dr. Umeshkumar Athiraman is Assistant Professor of Anesthesiology at Washington University. In 2018, he received the William L. Young Neuroscience Research Award for his project investigating the effect of isoflurane conditioning on cognitive function following subarachnoid hemorrhage.

Dr. Athiraman
Dr. Umeshkumar Athiraman

Why did you choose a career in Neuroanesthesiology?
My interest in neuroscience commenced in the labs of Dr. Berde and Dr. Soriano at Boston Children’s Hospital and Harvard Medical School, while I was working on the toxicity of the anesthetic agents in the brain and spinal cord. Following my research work, I completed an anesthesia residency in India and pursued a neuroanesthesia fellowship at the University of Washington, where the clinical rotations and the projects I pursued allowed me to develop a more in depth understanding of ischemic brain injuries particularly, stroke. Due to my strong interest in neuroscience research, I had actually chosen to enter the field of neuroanesthesiology even before I started my anesthesiology residency.

What recommendations do you have for trainees who want to establish themselves as physician-scientists?
We need more physician-scientists in the field of neuroanesthesiology. Academic career in anesthesiology is a very rewarding and an exciting career, though it can be stressful sometimes. The path to success as a physician scientist is not a straight-line, there will be ups and downs during your career. As long as you understand those hurdles are temporary and continue your work with love and passion, you have a high chance of success. I would also like to point out that choosing the right lab and mentor is one of the critical aspects in your success as a physician-scientist.

What do you see as the most exciting current topic in Neuroanesthesiology? Currently, there are many interesting topics under investigation in the field of neuroanesthesiology. To name a few, 1) neural circuits in thermoregulation using optogenetics 2) reversal agents for general anesthetics 3) neurobiology of consciousness/unconsciousness 4) POCD and delirium 5) Anesthetic conditioning in neurovascular protection, etc.

Can you tell us about your research and how the Bill Young Award supported your success?
My research work is focused on anesthetic conditioning and neurovascular protection in the secondary brain injury after aneurysmal subarachnoid hemorrhage. Aneurysmal subarachnoid hemorrhage (SAH) is a devastating condition with extremely high morbidity and mortality. Apart from the initial hemorrhage severity, the secondary brain injury due to early brain injury (EBI) and delayed cerebral ischemia (DCI) are the major contributors to the SAH patient’s outcome.

Though many strategies to prevent EBI and DCI have been explored over the years, none have proven efficacious likely because of targeting an individual element of what is now known to be a multifactorial pathophysiological process. We apply a therapeutic strategy – conditioning – that leverages endogenous protective mechanisms to exert powerful and remarkably pleiotropic protective effects against injury to all major cell types of the central nervous system.

Our initial results from preclinical studies show that inhalational anesthetics conditioning provides robust protection against large artery vasospasm and short-term neurological deficits in a SAH endovascular perforation model in mice. Whether inhalational anesthetics provide long term protection against SAH-induced neurobehavioral deficits and the underlying mechanisms of anesthetic conditioning in the SAH-induced neurovascular protection have to be explored in the future.

We hope that our research will fill the existing critical knowledge gap on the role of anesthetics in the protection of the secondary elements of brain injury after subarachnoid hemorrhage. Our long-term goal is to translate a conditioning-based therapy for SAH to the clinic. We are deeply grateful to the SNACC and the Bill Young award which helped us to provide support to a research assistant in our lab.

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