SleepTalker February 2022

Dr. Nada Named Medical Director of the Acute Pain Service

Tong J (TJ) Gan, MD, MBA, MHS, FRCA

   I am pleased to announce that Dr. Eman Nada has been named the Medical Director of the Acute Pain Service, effective February 1, 2022. This will be in addition to her role as the Division Chief of Regional Anesthesia. As most of you know, Dr. Nada joined our department last June. Eman earned a Doctorate of Anesthesia and Intensive Care from Alexandria University, Egypt. She completed a residency in anesthesiology at the University of Arkansas for Medical Sciences, Little Rock, Arkansas. In addition, she completed a fellowship in regional anesthesia and acute pain, and a fellowship in neuroanesthesia, both at the Cleveland Clinic Foundation. Eman is board-certified in anesthesiology. Most recently, Dr. Nada was a member of the faculty at the University of Massachusetts, in the department of Anesthesia and Perioperative Medicine.

   Over the years, Dr. Nada’s active teaching of residents has earned her several awards, including the University of Arkansas for Medical Sciences’ Marc Wise Award for improving resident well-being, and the Original Research Award from the Midwest Resident Anesthesia Meeting. Eman has published numerous peer-reviewed manuscripts and co-edited a book on regional anesthesia and pain management. She has also co-authored book chapters in Problem Based Learning Discussions in Neuroanesthesia and Neurocritical Care and Anesthesiology: A Problem-Based Learning Approach. Eman is a reviewer for the Clinical Journal of Pain, Journal of Neurosurgical Anesthesiology, Open Anesthesiology Journal, and PLOS One.

   Please join me in welcoming Dr. Nada to her new role.

James P. Dilger, PhD

   Igor Izrailtyan, MD, FACC has been promoted to Clinical Professor of Anesthesiology. Dr. Izrailtyan has been an Attending in our department and a member of the Cardiothoracic Anesthesiology Division since 2005.

   Igor received his MD from the Russian State Medical University, Moscow, Russia. He continued there to pursue a PhD in Physiology but departed the Soviet Union before defending his thesis. He moved to the Department of Cardiovascular Medicine and Surgery, Drexel University (MCP Hahnemann), Philadelphia, PA. There, he was a Research Associate where he studied microvascular-interstitial interactions in regulating coronary blood flow and cardiac mechanics and energetics. He was promoted to Research Assistant Professor and was a PI, Coordinator and co-Investigator in several clinical projects including “Risk Stratification of Myocardial Rejection Using Nonlinear Measures of Heart Rate Variability in Transplant Patients.” In 2000, he decided that his calling was medical practice, so he did a transitional residency year at Mercy Catholic Medical Center in Darby, PA. He was then accepted into our department's Residency Program 2001-2004. Igor followed this with a Fellowship in Cardiothoracic Anesthesiology and Critical Care at Duke University. He returned to Stony Brook to become an Assistant Professor and was promoted to Associate Professor in 2012.

   Dr. Izrailtyan serves our department as the Director of Perioperative Echocardiography. In this capacity, he directs transesophageal (TEE) imaging, electronic reporting, and QA. He represents us as a Senator in the Medical School Senate and works on the Admissions Committee. He gives monthly lectures to Residents rotating through Cardiac Anesthesia and teaches TEE imaging to non-cardiac Anesthesia Residents and Attendings.

   Igor's has diverse research interests. He has 25 peer-reviewed publications on topics such as heart rate variability, using photospectrometry to detect changes in blood volume, oxygenation and intracellular calcium, cocaine in the nonhuman primate fetal brain, and safety hazards with implanted electronic devices. He has authored over 100 presentations at scientific and medical meetings.

   Congratulations on your well-deserved promotion, Igor!

James P. Dilger, PhD

   The Stony Brook University Pain and Analgesia Research Center (SPARC) has just published its first manuscript! SPARC director, Dr. Shao-Jun Tang joined our department in July 2021 and established the Center. Their first paper "A neuron-to-astrocyte Wnt5a signal governs astrogliosis during HIV-associated pain pathogenesis" was published in Brain last month. The first author of the paper is postdoctoral associate Dr. Xin Liu and the co-authors are Dr. Tang's colleagues at the University of Texas Medical Branch, Galveston, TX and Southern Illinois University, Carbondale, IL. Congratulations to the SPARC team!!

gp120. By David S. Goodsell and the RCSB PDB
CC BY 3.0, Link

   The glycoprotein gp120 is expressed on the surface of the HIV envelope. High levels of gp120 are detected post-mortem in the spinal horn of only those HIV patients who developed pain. Wnt-5A, a signalling protein expressed mainly by neurons, is also upregulated in pain-positive HIV patients. Wnt-5A is implicated in causing pain by inducing prolonged astrogliosis. Although reactive astrocytes play a protective role after a moderate injury, prolonged astrogliosis is thought to cause damage in a number of neurological disorders. The goal of this study was to determine whether the pathway Wnt-5A pathway might link gp120 to HIV pain. This was done by producing Wnt-5A conditional knock-out mice.

   The investigators used a combination of genetic, pharmacological, behavioral, protein analysis, immunofluorescence, and patch clamp techniques. They found that conditional knock-out of either Wnt-5A in neurons or its receptor in astrocytes abolished gp-120 astrogliosis. Moreover, the knock-out animals did not get experience gp-120- induced hyperalgesia as measured both behaviorally and electrophysiologically. The results of the study indicate several attractive targets to treat HIV-associated pain.

• Liu X, Bae C, Gelman BB, Chung JM, Tang SJ. A neuron-to-astrocyte Wnt5a signal governs astrogliosis during HIV-associated pain pathogenesis. Brain. 2022 Jan 18
• Jin Z, Zhang W, Liu H, Ding A, Lin Y, Wu SX, Lin J. Potential Therapeutic Application of Local Anesthetics in Cancer Treatment. Recent Pat Anticancer Drug Discov. 2022 Jan 19

James P. Dilger, PhD