Contact: Sheila Hotchkin

The original discovery of the toxin produced by Mycoplasma pneumonia was made by Joel B. Baseman, Ph.D., (pictured) chairman of microbiology and immunology, and T.R. Kannan, Ph.D., assistant professor of microbiology.
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SAN ANTONIO (Oct. 26, 2010) — Not long ago, microbiologists at The University of Texas Health Science Center at San Antonio solved a longstanding medical mystery: A common pathogen, Mycoplasma pneumonia, was known to be involved in disease pathways throughout the body, but no one knew how it worked. Then the microbiologists discovered a toxin produced by M. pneumonia and began unraveling its secrets.

Now the microbiologists have teamed up with surgeons to study how M. pneumonia affects patients in intensive care units (ICUs).

A $190,000 grant from the National Trauma Institute (NTI) is allowing Health Science Center researchers to take their study into ICUs around the country, where they will try to determine how frequently M. pneumonia infection occurs among patients on ventilators and how it impacts their outcomes.

The study is an example of translational — or “bench-to-bedside” — research, where scientists and clinicians work together to make sure discoveries quickly emerge from laboratories to benefit patients. At the same time, clinicians’ observations can spark new areas of inquiry in laboratories.

Joel B. Baseman, Ph.D., the study’s principal investigator and chairman of microbiology and immunology at the UT Health Science Center, calls the collaboration “a terrific marriage between the clinical and basic science disciplines.”

The study was one of seven funded this year by the nonprofit NTI, which is committed to supporting translational research projects whose results may affect the practice of medicine in the near term. The NTI’s goal is to reduce death and disability resulting from traumatic injuries.

Toxin originally discovered by Dr. Joel Baseman
The discovery of a toxin produced by M. pneumonia, made in Dr. Baseman’s lab and first described in a 2006 publication, laid the groundwork for the current research. Dr. Baseman links the toxin to a range of acute and chronic airway diseases and puts it in the same category as toxins produced by the bacteria that cause pertussis, diphtheria and cholera.

Moving the study into the intensive care unit began as a collaboration between Joel B. Baseman, Ph.D., and Stephen M. Cohn, M.D., FACS, (pictured) professor of surgery at the UT Health Science Center.

The discovery was made by a team led by Dr. Baseman and T.R. Kannan, Ph.D., assistant professor of microbiology. Afterward, Dr. Baseman’s lab began taking the research in a number of new directions.

Collaboration began in San Antonio
The ICU study resulted from conversations between Dr. Baseman and Stephen M. Cohn, M.D., FACS, professor of surgery at the Health Science Center. They discussed whether M. pneumonia might be present in trauma patients, particularly in ICUs, and whether it might amplify their health problems.

“For many years we have been searching for a good explanation for why certain patients do extremely well in the ICU on ventilators, while others have an indolent process that ultimately leads to disability and death,” Dr. Cohn said.

Once the partnership between the departments of Microbiology and Surgery formed, Mark Muir, M.D., a surgical resident about to embark on a two-year research fellowship, took on the project. After training with Dr. Baseman’s team, in July 2008 Dr. Muir began the painstaking work of collecting samples from the ICU at University Hospital.

When a patient on a ventilator in the ICU underwent a bronchoscopy — a procedure that involves inserting an instrument into airways to examine them or take samples — the ICU team would take an extra sample and call Dr. Muir. With the consent of the patient’s family, Dr. Muir would take that sample and a blood sample back to the lab for processing.

Researchers were able to enroll several dozen patients in the study, and a significant number of those tested positive for M. pneumonia. Detailed results will be published in an upcoming issue of the journal CHEST.

New funding expands the study to other states
The pilot project data were compelling enough to attract the grant from the NTI, which allows researchers to expand the study to ICUs in other states. The researchers have already brought two ICUs, in Los Angeles and Boston, on board, and they’re in discussions with others. The expanded study seeks to validate the percentage of ICU patients on ventilators who carry M. pneumonia and better establish whether and when the pathogen causes disease in this population.

Dr. Muir, who has completed his research fellowship, will continue to play a role in the study, but surgical resident Ashwini Kumar, M.D., has stepped up to take the lead.

Funding for Dr. Baseman’s original work on M. pneumonia and for the ICU pilot project came from a center grant from the National Institutes of Health and from the Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation.

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The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 3 percent of all institutions worldwide receiving National Institutes of Health (NIH) funding. Research and other sponsored program activity totaled a record $259 million in fiscal year 2009. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced approximately 26,000 graduates. The $739 million operating budget supports eight campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.