Lauren Gallagher, MD, a fourth-year resident in the University of Colorado Department of Surgery, was recognized for her research by the American College of Surgeons Committee on Trauma in March, winning first place in the organization’s annual Resident and Fellow Trauma Paper Competition during its annual meeting in Chicago.
“This is one of the most prestigious resident paper competitions in all of surgery, and residents from the CU surgery trauma lab have had a nice string of finals appearances and wins over the past few years,” says Mitchell Cohen, MD, a principal investigator at the Trauma Research Center and Gallagher’s research mentor. “It is particularly outstanding that this work was co-mentored by myself and Dr. Lucy Kornblith at the University of California San Francisco. Lucy was in my lab as a T32 resident when I was at UCSF and now is a very successful funded scientist and clinician. To see things come full circle, where we can co-mentor the next generation in Lauren, is gratifying.”
Platelets’ secret payload
Gallagher’s paper, “Platelet Releasates Mitigate the Endotheliopathy of Trauma,” explores the role of blood platelets in preventing blood vessels from becoming leaky during trauma — a condition known as endotheliopathy.
“Platelets are classically known for their role in hemostasis and coagulopathy, but recently, they’ve been shown to have a huge influence on inflammatory pathways and endothelial stability and integrity,” Gallagher says. “Platelets carry around thousands of different active biomolecules in their granules, and whenever something stimulates these platelets, like a traumatic injury or a bacterial infection, it causes them to release all this cargo. That creates a microenvironment that contributes to mitigating permeability in the blood vessels that can cause morbidity and mortality.”
Lauren Gallagher, MD
Gallagher’s research involved collecting blood from injured and healthy patients to generate platelet releasates and plasma in parallel. Those were applied alone and together to endothelial cells — the cells that line the blood vessels — and permeability was measured. Gallagher and her team found that endothelial cells treated with trauma plasma alone had greater permeability, while those treated with platelet releasates had decreased permeability. When the two were mixed, the releasates mitigated the permeability caused by the trauma plasma.
“We were able to identify the unique anti-inflammatory pathways that were contributing to this phenomenon,” she says. “We are now looking to see how we might be able to use these releasates as a type of resuscitation method — using platelets from donors, stimulating their release, and trying to create a shelf-stable product we could give to patients. Right now, they are released in the local environment where the injury is happening in the body. It would be interesting to see if we could use them more systemically.”
Clinical applications
Gallagher can even envision keeping freeze-dried platelet releasates in stock on ambulances and mixing them with water to give to a patient to manage endotheliopathy before they even arrive at the hospital. It’s an aspect of her research she appreciates, she says — seeing its eventual application in a clinical setting.
“Sometimes, during the day-to-day grind of research, you think, ‘Am I actually doing anything?’ It’s very different than clinicals, where you can get positive feedback immediately,” she says. “It is pretty cool to identify something that hopefully we could use down the road.”
She’s glad the American College of Surgeons Committee on Trauma judges felt the same way, and that they saw enough potential in her research to award her the contest’s top prize.
“It was very shocking to me,” she says. “I wasn’t expecting to win at all. But it was very gratifying to see that this research is something people are interested in, and something that is worth pursuing. It’s incredible to be part of the trauma lab under the mentorship of Dr. Cohen. He’s an incredible surgical scientist, and that’s what I really aspire to be like.”
