‘Bench to bedside’ research takes a unique form at the NC State College of Veterinary Medicine, where advancements bridging veterinary research and human health care can span ‘barn to bedside’ or ‘farm to table.’
‘A Dream Come True’
Members of the Class of 2025 had been dreaming for years of having a white coat with their names stitched on the chest.
And on April 13, that moment finally came for the nearly 100 students at the NC State College of Veterinary Medicine’s annual White Coat Ceremony. Students were presented with their white coats by a friend, family member or mentor who had played a pivotal role in their lives and education.
The ceremony marked a significant milestone for the Class of 2025, signaling the students’ transition from the threeyear pre-clinical portion of the Doctor of Veterinary Medicine program to the clinical phase, where they will work alongside veterinarians at the NC State Veterinary Hospital for the next year.
With crisp white coats draped over their shoulders, the students were ready and eager to begin the next chapter of their careers.
“I have loved the student part. I love learning and being in a classroom and learning new material, but I’m in this ‘put me in, coach’ moment, and I’m ready to get my hands dirty,” said Shanti Coleman, who received her white coat at the ceremony. “This feels like the start of the career I’ve been training so much for, and now the training part is over. I get to actually get my hands in there, get off the bench and really start doing it.”
RIGHT: Lindsey Shapiro DeLuigi receives her white coat from Dr. Elizabeth Rose, an assistant clinical professor at the NC State College of Veterinary Medicine. (John Joyner/NC State College of Veterinary Medicine)
One of the original missions on which this college was founded was to advance medicine through research. Today, slightly more than 40 years since we opened our doors, this mission still sits prominently in our new strategic plan.
We advance animal and human health by being curious and truly investigating and testing our current understanding of our medical practices. This means closely evaluating the 30,000-plus patients we see through the hospital every year and asking ourselves how we could diagnose, prevent or treat these patients better; watching the agricultural landscape for trends in herd management and outbreaks of disease and asking how we can prevent and manage population health better; and reflecting on each class of veterinary students and house officers we train and asking how we could teach more effectively and more meaningfully.
The impact of our discoveries will be determined by our ability to apply them, including the translation of fairly basic research into clinical settings.
In this issue of the Oath, we highlight the college’s dedication to discovery and the application of our discoveries to the advancement of medicine for animals and people.
Dr. Mike Sano, an engineer, has developed a new cancer therapy that uses electricity to destroy inoperable tumors. Drs. Glenn Cruse and Gustavo Machado have been recognized by the NC State chancellor as University Faculty Scholars for their leadership in research. Dr. Cruse studies the role of mast cells in allergic and inflammatory diseases in order to identify novel therapeutics. Dr. Machado has developed technology to track the spread of viruses from farm to farm and to help identify beneficial interventions to decrease spread.
The NC State CVM ophthalmology team performed a corneal transplant to help an equine athlete get back on the jumping circuit, and Dr. Natasha Olby’s gerontology work is leading to the development of a new Center for Healthy Aging.
Finally, we have a significant responsibility to develop and train the next generation of clinician-scientists who will make the discoveries of the future. In this issue, we’ve highlighted our new Veterinary Academic Leaders program, which was designed to inspire and train the next generation of translational scientists.
All of these are just a few examples of how we are working to make medicine better tomorrow than it is today — part of our mission from Day One of the NC State College of Veterinary Medicine. Kate
TOP: A new position at the Veterinary Hospital aims to enhance the experiences of clients and clinicians (Page 6).
MIDDLE: NC State alumna helps ruminants and protects our food (Page 34).
ABOVE: Open House drew thousands to the CVM in March (Page 36).
ON THE COVER
Dr. Ravi Kulkarni, assistant professor in our Department of Population Health and Pathobiology, conducts research at his lab bench.
FEATURES
16 NC State Helps Jumping Horse Stay the Course
Aided by cutting-edge growth factor research and ultrasound technology, NC State ophthalmologists successfully performed one of the largest equine corneal transplants ever reported.
20 Next Step for NC State’s Pioneering Geroscience Research Building on world-renowned leadership in researching the aging process, the NC State College of Veterinary Medicine is establishing a Center for Healthy Aging.
22 The Human Connection
Whether it’s at lab benches in the state-of-the-art Research Building, in modernized wards at the Veterinary Hospital or in the dynamic fields of the Teaching Animal Unit, our life-saving research extends across the human-animal bond.
30 Powering Breakthroughs
Dr. Mike Sano is harnessing the power of electricity to target and destroy inoperable cancer in a therapy that elim inated 80% of tumors in a recent clinical trial with horses.
STAFF PROFILE
College Welcomes New Head of Molecular Biomedical Sciences
By Burgetta Eplin Wheeler
Dr. Michele Battle, formerly a professor in the Department of Cell Biology, Neurobiology and Anatomy at the Medical College of Wisconsin, is the new leader of the NC State College of Veterinary Medicine’s Department of Molecular Biomedical Sciences.
“Dr. Battle has been recognized for her research, teaching and mentoring, as well as for her involvement with graduate student mentorship and encouraging diversity within the STEM fields,” said Dr. Kate Meurs, dean of the College of Veterinary Medicine. “Additionally, she’s internationally known for her research in gastrointestinal biology and disease. She is an outstanding addition to the college.”
Battle’s research lab focuses on studying how tissues develop, specifically the processes that govern how the linings
of the esophagus and stomach form, in an effort to better understand and treat esophageal and gastric cancers. She is particularly looking forward to mentoring a greater number of students and faculty members as a department head.
“I really have loved seeing my students move on and grow into their careers,” Battle said. “Now I’ll have an opportunity to mentor on a larger scale, from undergrads to faculty, so that was really appealing to me, to be able to bring my experience to the table and help develop the careers of students and help faculty move into the places they want to be.”
While at the Medical College of Wisconsin, Battle received the college’s Outstanding Graduate School Educator award several times. She also currently serves as the chair of the Cellular and Molecular Gastroenterology section of the American Gastroenterological Association.
“At NC State, there is a great deal of integration of researchers, clinicians and teachers fostering a collaborative environment that will give me opportunities to grow my program and to have a much more seamless integration with clinical researchers that wasn’t as easily available in a medical school,” Battle said.
The Department of Molecular Biomedical Sciences offers Ph.D. programs through the College of Veterinary Medicine and interdepartmental NC State graduate programs that include anesthesiology, clinical nutrition, pharmacology and radiology specialties.
Through the MBS department, students can concentrate on subjects such as immunology and infectious disease. The department boasts a large number of research programs that are making critical inroads in animal and human medicine, addressing biomedical, agricultural and biological issues.
“Dr. Battle has actually seen the benefits of comparative medicine and how it has helped in the study of gastrointestinal diseases,” Meurs said. “I know she is very excited to be a part of our program and to see how natural diseases in our animal patients can be used to advance human health.”
PRESS PLAY
Welcoming the Community
The NC State College of Veterinary Medicine’s mission to be a driving force in veterinary research, training and medical care was on full display in March when the college and hospitals opened their doors to the public for our annual Open House. The daylong event provided the community with behind-the-scenes tours of our veterinary hospitals, exhibits highlighting our cutting-edge research and access to our worldclass students and faculty.
Rodeo Royalty
As a dual-degree student in the NC State College of Veterinary Medicine’s DVM/Ph.D. program, Rachel Gagliardi is working hard in the classroom, research lab and clinic to earn prestigious academic titles. They’ll be impressive additions to another title she gained last year: Miss Rodeo North Carolina. The royal opportunity has allowed Gagliardi to mix her equine research with her passion for animal welfare to benefit the rodeo community.
The Role of Rehab
This spring, Dr. Carmella Britt and the rehabilitation team at the NC State Veterinary Hospital worked to get Cary Police dog Nitro moving after a knee surgery so that he could enjoy his retirement as a beloved family pet. Using a water treadmill, balance beams and ramps, the team provided Nitro with the best patientcentered care to help him return to good health.
RESEARCH CONNECTION
Innovative Immunity Approaches
An assistant professor in our Department of Population Health and Pathobiology, Dr. Ravi Kulkarni continuously works to improve gut health and develop alternatives to antibiotics in the poultry industry. He is currently developing a probiotic-based oral vaccine for clostridial dermatitis that can be more easily administered to large turkey populations.
Improving Human and Feline Heart Health
Dr. Ronald Li, an associate professor of emergency and critical care, knows the value of translational medicine and its importance in progressing benchtop research into clinical studies to provide patients with the highest quality of care. Dr. Li researches the interaction between neutrophils and platelets in cardiovascular diseases and other forms of inflammation and studies novel antiplatelet therapy to advance feline health.
STAFF PROFILE
New Veterinary Hospital Positions Aim to Enhance Patient, Clinician Experience
By Burgetta Eplin Wheeler
The NC State College of Veterinary Medicine has named Dr. Timo Prange, an associate clinical professor of equine surgery, as its executive veterinary medical officer.
In the newly created position, Prange will focus on adding efficiencies to the NC State Veterinary Hospital that will allow the facility to increase its caseload and enhance the clinical experience for both patients and staff members.
“In this role, Dr. Prange will help with clinical service interactions and communications and will work closely with
the house officer program focusing on mentoring and wellness,” says Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine. “We’re taking steps to make interacting with our hospital a smoother experience so that we can increase the caseload.”
Dr. Shelly Vaden, a professor of internal medicine, has been named the new associate veterinary medical officer and will focus on staff wellness initiatives.
The college created the veterinary medical officer positions to make it easier for the hospital to continue its excellent patient care as caseloads increase in the face of a national shortage of veterinarian educators and veterinary technicians.
“We wanted to make a larger role to facilitate the interactions between faculty and staff in the hospital in the best way as we continue to grow, and that can only help us better serve clients as well,” says Dr. Anthony Blikslager, associate dean and director of veterinary medical services. “Dr. Prange will be using his exceptional interpersonal skills to help us maximize efficiencies. He will be the point of contact for all faculty who work in the hospital and for the hospital administration as well as house officers.”
The NC State Veterinary Hospital generally has more than 100 house officers – medical residents or interns – training with nearly 90 faculty clinicians year-round. An important part of Prange’s new role will be to identify ways to enhance the interactions between house officers and faculty mentors as the trainees fill the crucial role of healer in a bustling veterinary hospital.
“I love the opportunity that I’ve been given to help the entire hospital community grow together as a team and to really see our values played out in our everyday workplace culture,” says Prange, who also chaired the hospital’s board from 2021 to 2023. “This is going to be work, but it’s also going to be exciting. I really enjoy solving problems together with other people.”
More than 30,000 patients are seen each year at the NC State College of Veterinary Medicine, which offers services in more than 30 specialty areas. As the caseload grows, Prange will manage a delicate balancing act.
For example, Blikslager points to the many services such as neurology, surgery or radiology that offer procedures requiring animals to be anesthetized. Any increase in caseloads has a cascading
effect on the anesthesia department.
“There’s not enough time or room or personnel to do everything everybody wants, no matter where you are,” Blikslager says. “And that’s really where Dr. Prange comes in. He gravitates toward getting in the middle of sometimes challenging interpersonal communications between all levels—staff, house officers and faculty— and trying to resolve it.”
Any metrics used to measure how the NC State Veterinary Hospital is doing will stem from how well the people working there are doing, Blikslager says. The creation of the executive veterinary medical officer position shows the college’s commitment to caring for its internal community, Blikslager says, and Prange is particularly well-suited to fill it.
“He is an extraordinarily genuine, direct, open, listening person,” says Blikslager, who as a professor of equine surgery has worked closely with Prange for years. “From what I’ve seen, the people he’s interacted with are exceptionally grateful for how he’s done that. It’s just a skill that doesn’t come along very often.”
Prange will continue to see equine surgery patients and conduct research into treating cancer and advancing equine health even while helping his colleagues excel.
“The CVM values are community, inclusivity, innovation and passion,” Prange says. “When you see them on a daily basis with the people that you work with, that is really awesome. If people feel like we have improved the situation by the efforts we’ve put in, that’s ultimately what it comes down to. We can make that happen.”
Dr. Timo Prange has been named executive veterinary medical officer at the NC State Veterinary Hospital. In the new position, Prange will work alongside clinicians to streamline and improve processes in the hospital.
Inspiring the Next Generation
The NC State College of Veterinary Medicine has launched a virtual program called VETS DEN to connect aspiring veterinary students across North Carolina with mentors in the field and admissions staff at the CVM. Monthly meetings are tailored toward current undergraduate and high school students to inspire more young people to pursue veterinary medicine.
Conducted over Zoom, VETS DEN gives North Carolina residents unprecedented access to information about admissions and pathways into veterinary medicine by introducing them to our veterinarians who are providing cutting-edge care at our veterinary hospitals.
Learn more about the program at cvm.ncsu.edu/vetsden.
$5.9 million
The money raised for the College of Veterinary Medicine during NC State’s sixth annual Day of Giving. Offering 530 donations to support the college, our community is investing in the ways we teach, research and provide clinical service. Thank you!
Students Visit Capitol Hill
Six NC State College of Veterinary Medicine students added conversing with congressional staffs to their impressive list of skills in February through the American Veterinary Medical Association’s Legislative Fly-In to Washington, D.C. Making the trip were Hannah Wubbenhorst, Lilly Smith, Jasmine Lapsley, Isla Farrow, Anna Jones and Malik Chennault.
Thomas S. Kenan III played an instrumental role in establishing a new endowed chair at the College of Veterinary Medicine.
$3 Million Kenan Gift Leads to Endowed Chair in Translational Medicine
By Burgetta Eplin Wheeler
With philanthropist and business leader Thomas S. Kenan III playing an instrumental part, the William R. Kenan Jr. Charitable Trust has given $3 million to the NC State College of Veterinary Medicine to establish an endowed chair in translational medicine.
“We recognize with enthusiasm that this chair will add to – and build upon – the university’s current strengths in infectious disease, regenerative medicine and rigorous academic work in interdisciplinary methods to understand, treat and prevent human and animal diseases,” representatives of the trust said.
The goal of creating the William R. Kenan Jr. Distinguished Chair in Translational Science and Medicine is to advance
human and animal health and welfare by applying the most current research techniques to complex medical problems.
“I’m just so incredibly grateful to Mr. Kenan and the William R. Kenan Jr. Charitable Trust for their long-term generosity to North Carolina State,” says Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine. “Mr. Kenan and Mr. Randall V. Terry Jr., another incredibly generous donor to the college, were classmates and friends at the Woodberry Forest School as young men. They have each made significant gifts to the college that helped enhance our missions of education, discovery and service.”
The NC State College of Veterinary Medicine is internationally known as a leader in comparative and translational medicine. Meurs describes translational medicine as taking discoveries made at the benchtop in a lab and using them ultimately to treat patients at the bedside in the clinic.
“Many of the complex medical problems in humans and animals require a basic scientific approach to truly making a major clinical impact in disease diagnosis, treatment and prevention,” Meurs says. “This position will allow us to hire a skilled scientist with benchtop science skills and a passion for using those skills to resolve complex clinical problems.”
Dr. Joshua Stern, associate dean of research, says he is thrilled with the complete flexibility that the Kenans’ gift has given the college to be open to what might be a novel hire for a College of Veterinary Medicine.
“We want a world leader in their area of medicine who is going to propel translational science at the CVM, so we haven’t pigeon-holed this position into any one discipline,” Stern says. “Anybody that’s doing great work out there, we want to talk about adding them to the CVM community.”
Meurs says the professor chosen for the role will work with colleagues to build an internationally recognized program focused on developing integrated research methodology that improves medical care.
For decades, Kenan, a former director of the NC Veterinary Medical Foundation and a member of the university’s W.J. Peele Lifetime Giving Society, and his family have been supporters of NC State. At the College of Veterinary Medicine, up to six students are selected each year to receive the William R. Kenan Jr. Memorial Scholarship.
“Mr. Kenan is truly visionary and for allowing us to have the latitude to select the best possible fit for our institution to move research and translational science forward,” Stern says. “That flexibility is an amazing gift that can propel research in incredible ways.”
AWARDS AND RECOGNITIONS
Cruse, Machado chosen as University Faculty Scholars for 2024
By Burgetta Eplin Wheeler
Two faculty members with outstanding research accomplishments at the NC State College of Veterinary Medicine were named University Faculty Scholars for 2024.
Dr. Glenn Cruse, a mast cell biologist in the Department of Molecular Biomedical Sciences, and Dr. Gustavo Machado, an infectious disease modeler in the Department of Population Health and Pathobiology, were among the NC State University faculty members chosen for the honor.
“We are so proud of Dr. Cruse and Dr. Machado and the work they do that truly represents our college’s goal for leading life-changing research,” said Dr. Kate Meurs, dean of the College of Veterinary Medicine. “They are both also exceptional mentors and leaders as well.”
Launched in 2012, the program recognizes outstanding academic achievements and teaching, service and scholarship contributions. Honorees carry the title through their NC State employment. Scholars are nominated by individual colleges and reviewed by senior faculty.
“Being honored as a University Faculty Scholar speaks volumes to not only the culture at NC State University, but also at the CVM specifically,” said Cruse, an associate professor of immunology. “Despite working in a field with a strong human focus, the collaborative culture at the CVM and the amazing faculty have opened my research to veterinary applications and enabled fantastic interdisciplinary collaborations.”
Cruse’s research focuses on mast cells that drive inflammatory processes in asthma, atopic dermatitis and allergic diseases. His lab also studies mast cell proliferation diseases, such as mastocytosis and mast cell leukemia, which are rare but often devastating.
Machado, an associate professor of transboundary disease epidemiology, said he is incredibly grateful to be recognized as a scholar because it means he and his team are doing problem-solving research.
Machado’s research focuses on food animal production epidemiology and developing novel disease-control strategies to reduce the burden of endemic and emerging diseases. His lab specializes in mathematical models that help control and eliminate livestock diseases. In 2019, Machado developed the Rapid Access Biosecurity App, which builds interpretable models to help industries and veterinarians make informed decisions on disease-control efforts.
“This award signifies that our efforts are making a meaningful impact in food animal production epidemiology, especially in enhancing our understanding of swine disease dissemination and the development of new control strategies to improve the health of swine farms in North Carolina and nationally,” Machado said. “I also see it as a reminder of the responsibility I have to continue striving for excellence and making positive contributions to our NC State community.”
Dr. Glenn Cruse
Dr. Gustavo Machado
Training Veterinary Professors of the Future
By Burgetta Eplin Wheeler
To expand the pipeline of veterinarians who train the healers of the future, the NC State College of Veterinary Medicine has created a Veterinary Academic Leaders Program that will help participants prepare for careers in academia.
The college chose an inaugural group of 10 first-year residents to become VAL program fellows during a time when national veterinarian shortages are creating critical needs.
According to data released by the AVMA, only about 6% of veterinarians in the United States are engaged in academic practice. Veterinary colleges throughout the world are struggling to fill academic positions needed to teach students and move veterinary research forward, said Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine. The challenges will be compounded by upcoming retirements and a large efflux of specialty trained veterinarians entering private specialty practice, she said.
Dr. Joshua Stern, associate dean for research and graduate studies, will lead the Veterinary Academic Leaders Program, which will include mentoring opportunities, research training and membership participation in the NC State College of Veterinary Medicine’s Academy of Educators.
“Over the course of what will be a three-year program, our VAL fellows will work hand in hand with leading academic veterinarians to develop a toolkit that prepares them to compete and succeed as faculty members and clinician scientists,” Stern said. “NC State is dedicated to continuing to develop a pipeline of veterinary academicians who will go on to lead the academy and train future generations of veterinarians across the globe.”
In the past two years, nearly a dozen colleges and universities have proposed adding veterinary medicine to their academic program offerings. Currently, there are 33 veterinary colleges in the United States, and all of them are recruiting for faculty positions.
“Who will be leading these program expansions and training veterinary students?” Stern said. “NC State hopes that the VAL fellowship program will help to answer this call.”
The diverse and talented NC State Veterinary Hospital residents who are the first Veterinary Academic Leaders fellows are Cody Atkinson, small animal internal medicine; Elisabeth Collins, ophthalmology; Lexi Fielding, large animal surgery; Maria Guzman, emergency and critical care; Siena Mitman, ruminant health management; Mickaël Pinto, dermatology; Leo Ragazzo, cardiology; Sarah Saylor, small animal surgery; Hayley S. Stratton, zoological medicine; and Kristy Williams, cardiology.
Mitman, who got her DVM at Tufts University in Massachusetts, came to the NC State College of Veterinary Medicine for an internship and accepted a three-year residency as well. Professors who understand her career goals in public health encouraged her to apply to be a VAL fellow, she said.
“My interest is staying in an academic setting where I can blend the clinical side of veterinary medicine with global health research and work in advocacy that blends all of it,” said Mitman, who also has a master’s in public health from the University of Minnesota. “It sounds like I would have a lot to learn from this program, and it’s a pretty cool opportunity for someone with my interests.”
Stern said NC State is making a big investment in the future of the profession. “We’re building a community of veterinary academic leaders through a combination of small group training opportunities, research funding and formal continuing education support,” he said.
Updated Veterinary Curriculum Launches
This Fall
By Katie Rice
The NC State College of Veterinary Medicine will debut the largest curricular rework in its history this fall, bringing a five-year collaborative endeavor among faculty, staff and clinicians to fruition.
The new curriculum will strengthen the training of tomorrow’s healers by restructuring the course system into focused themes, called “threads,” that better integrate material across years and species, encourage more professional development and provide time for focused clinical skills practice.
The transformation started in 2019 when Dr. Laura Nelson, associate dean and director of academic affairs, and Jesse Watson, director of curriculum and educator development, assembled a team of faculty, alumni and staff to form the Curricular Strategic Plan Steering Committee.
The committee was tasked with identifying what students should know upon graduating from the DVM program and how they master that information. During this process, the group consulted members of the veterinary community and organizations, including the American Association of Veterinary Medical Colleges and the
International Council for Veterinary Assessment, to evaluate what benchmarks they set for graduates.
The team found students needed to not only understand veterinary medicine across species but also develop professional dispositions, or behaviors and attitudes, that equip them for medical practice.
“It’s not just, ‘What do the students know and what can they do?,’ but, ‘Who are they as veterinarians?’” Watson says. “What kind of a professional are we hoping to inspire? These are not skills that are trainable in the same way. It’s more like gardening. You’ve got to figure out how to plant the seed and provide resources to help students grow in that direction.”
The next step was evaluating how well NC State prepared students to reach those benchmarks. In the fall of 2019, a separate Curricular Strategic Planning Committee began comparing the college’s existing curriculum to standards set by the American Veterinary Medical Association Council on Education, peer institutions and other professional organizations and then identifying how NC State could improve.
The committee members also
reviewed feedback from other students and staff, discovering that courses felt siloed with students having difficulty connecting what they learned in one course or year to another because the classes were organized by discipline and species.
Faculty members proposed about a dozen different models for the new curriculum structure that integrated these strengths and addressed the challenges. Dr. Katie Sheats, associate professor of equine primary care, was the creator of the selected model, which groups content from previous courses into themes that connect both what students are learning and how they are learning it.
The new curriculum’s five threads group the same core material from dozens of individual courses and disciplines into larger themes of Animal Health and Disease, Becoming a Professional, Exams & Interventions, Form & Function and Integrated Applications.
Each thread encompasses an essential knowledge basis and skill set for practicing veterinarians. Watson says this structure supports comparative medicine, or the ability to think across species, and aligns with the
PHOTO BY JOHN JOYNER/NC
American Association of Veterinary Medical Colleges’ competency-based veterinary education model.
In NC State’s curriculum, course material will be organized into a “spiral” format that encourages student learning and application.
“A spiral curriculum is a curriculum that is designed to, over time, revisit and build on learners’ previous knowledge and experience,” Sheats says. “The design allows educators and students to create more connections between different curricular content that can seem disparate to
the learner, but really isn’t once the learner becomes more advanced.”
Another curricular addition from Sheat’s model, the preceptorship encourages students to put their learning into practice. The program will be a four-week workplace-based experience for third-year students at an outside organization.
The new curriculum also aims to improve the overall student experience, including further supporting students’ mental health in a challenging program. College of Veterinary Medicine leaders began improving
the advising program by training additional faculty to be advisers and providing them with more mentorship tools, Nelson says.
Of course, this curricular evolution would have been impossible without the faculty who bring it to life in their classrooms. Professors and clinicians from across the college led the task from the beginning.
“This new curriculum really has an ‘NC State flavor,’” Nelson says. “It reflects the priorities, the culture and the clinical expertise we have here that is unique to our college.”
Congrats Class of 2024 to the
From starting classes in a global pandemic to supporting each other during their clinical year, the Class of 2024 forged unbreakable bonds with their colleagues and the campus they called “home.”
PATIENT PROFILE
Groundbreaking Corneal Transplant
NC State helps jumping horse stay the course through faculty-led innovations in ophthalmic surgery and treatment.
By Katie Rice
In a medical breakthrough, NC State ophthalmologists successfully completed one of the largest resections and corneal transplants ever reported in a horse, replacing about 60% of the show-jumping animal’s right cornea and then using a novel technique of introducing platelet-rich fibrin, or PRF, proteins onto her eye to encourage healing.
Dutch warmblood horse Myra, which Dr. Michelle Carnes and her husband bought in the Netherlands last fall, somehow injured her cornea while moving to the United States and introduced a fungus that would nearly cost her the eye. As Myra’s infection worsened, Carnes, a veterinary neurologist and neurosurgeon, consulted ophthalmologists across the East Coast and realized that the NC State Veterinary Hospital was Myra’s best chance at recovery.
“If anybody was going to be able to save Myra’s eye, it was the NC State team,” she says.
Before Myra arrived at NC State
in November, she was diagnosed with a treatment-resistant stromal abscess. As NC State veterinarians cared for the 6-year-old mare over nearly three months, they depended on advancements unique to the College of Veterinary Medicine, from the research exploring PRF use in veterinary ocular surgery to the ultra-high-frequency ultrasound ophthalmologists used to see her infection’s spread, to save the athlete’s vision.
A COMPLEX INJURY
Carnes and her husband fell in love with Myra’s sweet demeanor and sharp intelligence while searching for a Dutch show-jumping horse last year. They quickly purchased her and flew her into New York City’s John F. Kennedy International Airport on Sept. 22.
Myra spent over two weeks in two separate required quarantines, during which veterinarians noticed she was not opening her eye and initially treated her for blunt trauma. As soon as Myra’s
quarantine ended, Carnes had her seen at the University of Georgia’s Veterinary Teaching Hospital, which is closer to her farm in Tryon, North Carolina.
UGA veterinarians diagnosed her with a stromal abscess caused by a fungal infection deep within her cornea.
“That, as a horse owner, is a devastating diagnosis, because you know that condition can go south really, really fast,” Carnes says.
Myra responded to antifungal treatment at first, but a recheck showed the infection spreading. Georgia ophthalmologists said Myra would likely lose the eye, Carnes says.
A small animal ophthalmologist friend in Florida recommended that Carnes contact Dr. Brian Gilger, an NC State professor of ophthalmology and leading expert in equine ocular diseases.
Gilger and Dr. Michala Henriksen, an associate professor of ophthalmology with expertise in equine ocular fungal infections, promptly replied they would
take Myra’s case.
Myra arrived well after hours at NC State on Nov. 10, and the waiting ophthalmology team immediately started her treatment with an examination, a new ophthalmic catheter and an antifungal injection.
They then used an uncommon, specialized gadget called an ultra-high-frequency ultrasound to get a better look at the eye. NC State is one of few universities nationwide that have this advanced device, which lets ophthalmologists see deeper into the eye in more detail than traditional scans allow.
“This ultra-high-frequency ultrasound really transforms how we’re managing these horses’ eyes, because we can see so much better where the disease really is,” Gilger says. “It allows us to see through tissues that are white or opaque and examine underlying structures, something we cannot do with the usual ophthalmic instruments.”
The ultrasound showed surgical intervention was possible to save Myra’s eye, but the odds were daunting.
“Generally, if abscesses are greater than a centimeter in diameter, we know that there’s a very low chance of actually saving the eye, even after surgery,” Gilger says. “Myra’s measured about 1.4 to 1.6 centimeters.”
The team decided to first try antifungal and antiinflammatory treatment, including luliconazole, a medication whose use in horses Gilger researches. That regimen worked at first, and Myra was discharged to the Tryon farm for a week in late November.
Dr. Brian Gilger, a professor of ophthalmology, examines Myra’s right eye.
When recheck imaging later showed Myra’s abscess was resisting treatment and breaking into the anterior chamber of her eye, the team had to take the leap. Myra had a surgical resection and corneal transplant Dec. 8.
Ophthalmologists removed 60% of Myra’s cornea to excise the infected tissue and sutured in cryopreserved cornea from a deceased horse whose owner consented to donation. The donor cornea served as a scaffold for Myra’s eye to grow new tissue into the area, Gilger says.
They placed a conjunctival graft over the corneal graft to protect her eye from infection and encourage tissue regeneration and healing.
But their challenges weren’t over. Myra’s conjunctival graft unexpectedly detached within two weeks, revealing that her cornea had ulcerated underneath. The ulcer showed few signs of regrowing its protective epithelial layer on its own, and ophthalmologists decided to introduce growth factors to kick-start the tissue repair.
Platelet-rich fibrin is derived from the same proteins in the blood that produce clotting. It is increasingly being used in human medicine and dentistry for its regenerative properties, because it stimulates the formation of new connective tissues within surgical sites or injuries.
Henriksen has studied the clinical use of PRF in dogs with corneal ulcerations and found it helped their injuries heal quickly. She’s launching another clinical study evaluating its use in horses like Myra.
“It’s basically tissue glue with healing power,” Henriksen says. “And in Myra’s case, it led to a drastic improvement in her vascularization, or how her blood vessels were growing into the
graft, and boosted her scar tissue healing.”
Similar to how PRF research entered the veterinary world from human medicine, NC State ophthalmologists are conducting research into wound healing and fungal disease treatment in horses and small animals that can one day translate to human therapies.
For example, stromal abscesses caused by fungal infections are commonly diagnosed in humans living in hot, humid climates. Rising global temperatures are causing outbreaks in previously unaffected areas, and NC State ophthalmologists’ research into treatments like luliconazole for veterinary eye infections could promise results in human ophthalmology.
“Myra’s case really goes to show why we all work in an academic institution where you have access to novel and innovative procedures,” says Erin Barr, a registered clinical technician in ophthalmology and a Veterinary Hospital
Dr. Michala Henriksen separated platelet rich fibrin from Myra’s blood to produce an ointment with growth factor healing power to help new connective tissues form.
employee since 2006. “I’m just grateful to be a part of it.”
Seeing how these state-of-the-art treatments benefited Myra showed Nicole Himebaugh, a third-year ophthalmology resident, new ways to approach stubborn conditions.
“Making those day-to-day decisions, changing Myra’s treatment protocol depending on her needs and seeing how it was helping her added to my clinical background, which is always helpful,” Himebaugh says. “It was nice to see the progression, the treatment and the outcome.”
Going forward, Myra is expected to retain much of her central vision in her right eye but will not recover her hind vision, “like she has built-in blinkers,” Henriksen says. The scar tissue on her cornea may appear opaque, but Myra will be able to exercise and compete in jumping events just fine.
“As a person who is in the veterinary profession, I know how difficult it
can be sometimes and you get busy,” says Carnes, who practices in Florida. “But everybody on the ophthalmology service, the doctors, residents, students and the technicians, they were all absolutely lovely. And Myra keeping her eye is a testament not only to the expertise of the team, but the unmatched compassion and love they showed her.”
LOOKING AHEAD
Myra’s friendly attitude not only helped her tolerate extensive treatments but also charmed everyone who worked on her case. She would greet the ophthalmology team with neighs as they approached her stall and nudge their pockets searching for peppermints when they prepared her for grooming or walks.
Most patients are hospitalized for 7 to 10 days at the longest, Barr says. Myra’s 73-day stay, coupled with her cheeriness, led caregivers to form a close bond with her.
“When a horse reaches out to your heart like that, it’s really hard not to get attached,” Barr says. “Everybody’s invested, from the treatment technicians to the overnight staff and the people who cleaned her stall. From the ophthalmology team to the whole equine hospital team, it really was just an incredible group effort.”
Myra was cleared to go home at the end of January. The ophthalmology team threw her a small going-away party during her last week, complete with a carrot cake, and sent photos to Carnes.
“They continually went above and beyond with Myra’s care and their communication with me,” Carnes says. “All of their updates made it easier to be away from her. At that point, NC State knew her better than I did.”
Next Step for NC State’s Pioneering Geroscience Research: A Center for Healthy Aging
Building on its world-renownedleadership in researching the aging process, the NC State College of Veterinary Medicine is establishing a Center for Healthy Aging led by Dr. Natasha Olby, the Dr. Kady M. Gjessing and Rahna M. Davidson Distinguished Chair in Gerontology.
The center will bring NC State faculty members from multiple disciplines under the same umbrella to collaborate on four missions: innovative research, cutting-edge education, excellence in clinical practice and support for pet owners. Olby anticipates that the geroscience research will be translatable to human medicine and help us better understand aging in people.
“As we continue to break new ground in geriatric medicine, I work more and more with people across the school who are all quite passionate about aging as well,” says Olby, a professor of veterinary neurology and neurosurgery. “I thought it would be beneficial to capture our efforts together in this Center for Healthy Aging, which will allow us to articulate our goals, pull people together, maybe leverage funding and improve our call for adding more things to the student curriculum that will provide more opportunity for us to reach out to those catalysts.”
Dr. Margaret Gruen, associate
By Burgetta Eplin Wheeler
professor of behavioral medicine, and Drs. Katie McCool and Allison Kendall, both assistant professors of small animal internal medicine, will serve as the center’s executive committee.
Olby had been recognized primarily as a leading expert on canine spinal cord injury and intervertebral disc disease before she began blazing new trails in studying the aging process after she received NC State University’s largest endowed professorship in 2017.
A gift from Dr. Kady M. Gjessing, a 1994 NC State DVM graduate, and her philanthropic mother, Rahna M. Davidson, helped establish the chair in gerontology, the first of its kind at a U.S. veterinary school. With medical advances leading to longer animal lives, the family wanted to make it easier for the NC State College of Veterinary Medicine to concentrate on geriatric medicine and research.
“We’ve got a clean slate. This is something that will encompass all species and disciplines,” Gjessing said in announcing the chair in 2017. “What I’m hoping for is that research and work done here is also going to help the human population.”
As Olby began to dig into veterinary research on the neuro-aging process, she realized that there was very little longitudinal data about
what happens to the sensory, motor and cognitive systems in dogs as they age.
In 2018, she began a long-term project to develop ways to describe and measure the changes in cognition, mobility and vision in older dogs so that her team could potentially devise ways to intervene with treatments or preventative measures.
“These aging dogs suffer the consequences of debilitating age-related decline, so I started that study to really try to describe the changes and see if we could actually really quantify these changes in novel ways,” she says. “And we have done it with great success, being able to look at everything from sleep quality to postural stability to simple measures of gait speed, to new measures of smell.”
With ways to measure decline confirmed, Olby’s research now looks at the intersection between an aging nervous system and neurodegenerative diseases in dogs in ways that could serve as a model for evaluating cognitive decline progression in humans with Alzheimer’s disease. The hope is that the research ultimately leads to treatments in humans as well.
Being able to conduct research in dogs is particularly valuable because of their lifespans.
“The real benefit is that we can do very focused clinical trials on elderly
PHOTO BY JOHN
dogs – six months of life for an elderly dog is the equivalent of like three or four years of life in humans – so we can do a clinical trial on aging much more efficiently in dogs,” Olby says.
The new Center for Healthy Aging will accelerate Olby’s work by creating pathways of collaboration for all of the researchers, clinicians and other educators from across the NC State College of Veterinary Medicine whose work touches on the aging process. Members of every department are potential partners given that aging is a risk factor for myriad diseases and conditions, Olby says.
“Oncology has already been interested in our measures of frailty because one of the challenges that they get is an owner who comes in with a really old dog and says, ‘Well, what’s its lifespan? Should I treat it or shouldn’t I treat it?’” Olby says. “Right
“Six months of life for an elderly dog is the equivalent of three or four years of life in humans, so we can do a clinical trial on aging much more efficiently in dogs.”
— Dr. Natasha Olby
now, we don’t have a scientificallybased response to that question. If we can quantify their frailty, and then from that, predict how well they’ll respond to cancer treatment, wow. I anticipate we’ll have an enormous interface with oncology.”
Some of the long-term goals for the center include applying for grants to create fellowships in geroscience and to start a hospice service for pets.
NC State College of Veterinary Medicine has already introduced geriatric medicine into the curriculum so that its veterinary students and their
future patients can benefit from the work as well.
Since 2019, Olby has offered a selective in geriatric medicine, and it is always full. Selectives are fastpaced, intensely focused classes held during a mini-term after final exams that are kept small to offer individualized attention.
“The students loved it, and it’s really obvious that this is such an important educational piece of the puzzle for them because age is one of the biggest risk factors for many diseases,” Olby says. “They’ll see lots of older pets who are medically complicated, and education on how to approach them is important. It is also heartwarming to see how many students are really thoughtful and passionate about the care of aging pets.”
THE HUMAN CONNECTION
Whether it’s at lab benches in the state-of-the-art Research Building, in modernized wards at the Veterinary Hospital or in the dynamic fields of the Teaching Animal Unit, our life-saving research extends across the human-animal bond.
Identifying gene mutations linked to bladder cancers and investigating targeted treatments. Improving storage methods to keep intestines healthy for transplant and expand the donor pool. Studying cardiac genetics to develop therapies for cardiomyopathy.
This critical research may be happening at the NC State College of Veterinary Medicine, but it has a direct benefit on human health, too.
“We’re taking the fundamental knowledge that we learn through research and using our expertise and resources to impact human and animal health, whether that’s in a screening mechanism, a new therapeutic or a better diagnostic tool,” says Dr. Michele Battle, head of the college’s Department of Molecular Biomedical Sciences.
Whether conducted at lab benches in the state-of-the-art Research Building,
By Katie Rice
in modern wards at the Veterinary Hospital or in the dynamic fields of the Teaching Animal Unit, a majority of the research happening at the NC State College of Veterinary Medicine is applicable to human health.
“Translational medicine is a twoway street between what we do at the bench and what we see in the clinic,” Battle says. “Many diseases we see in people also occur naturally in animals, and comparative medicine allows us to identify commonalities in diseases across species and solve problems in both animal and human health.”
For instance, faculty and graduate students across the Department of Molecular Biomedical Sciences and the Department of Clinical Sciences – including Dr. Jorge Piedrahita, director of the Comparative Medicine Institute – found in 2023 that pig
intestinal epithelial stem cells are similar to those within the human intestine. This groundbreaking discovery means that, by studying colorectal cancer in pigs, researchers can better understand the disease in humans, too.
Located inside the Research Triangle, the NC State College of Veterinary Medicine is a neighbor to the nation’s preeminent human medical schools and major pharmaceutical and biotechnical developers, leading to unparalleled interdisciplinary collaborations on health care’s biggest needs.
From research with whole-body benefits to organ-specific investigations, the college makes a difference in the health of our animal and human communities every single day. Here’s a glimpse of the recent life-changing work conducted by our faculty and graduate students.
Helping Whole-Body Health
CANCER
Lung, bladder and colorectal cancers are among the most commonly diagnosed cancers in the United States, affecting approximately 474,000 Americans combined in 2023. Several College of Veterinary Medicine researchers have dedicated their careers to treating and one day potentially eradicating these and other types of cancers.
Dr. Ken Adler, a professor of cell biology, was the first researcher to identify the MARCKS protein’s role in lung cancer progression. Now, the cancer drug he developed to target the protein has shown encouraging results in halting the progression of advanced lung cancer in a phase 2 human clinical trial.
Studying cancer development in companion animals can give us valuable insight into human cancers because pets share our environments and are exposed to many of the same carcinogens.
Dr. Matthew Breen and Dr. Paul Hess understand this well. Breen, the Oscar J. Fletcher Distinguished Professor of Comparative Oncology Genetics, pinpointed novel genetic mutations linked to a subset of canine bladder cancers that could lead to targeted treatments in dogs and humans.
Hess, an associate professor of oncology and immunology, partnered with Dr. David Zaharoff, an associate professor of biomedical engineering at the NC State College of Engineering, to develop an immunotherapy treatment for latestage canine muscle-invasive bladder cancer that is currently in clinical trials at NC State. Their National Institutes of Health-funded research aims to find a treatment for the same type of cancer in humans, which has been considered incurable thus far.
“Immunotherapies that succeed in dogs are ‘fast-tracked’ into humans,” Hess says. “Veterinary oncology is in a sweet spot: We get to try to help our patients and people at the same time.”
INFECTIOUS DISEASE
Coronaviruses have been top-of-mind for scientists and the public over the past four years, and the veterinary research field is no exception.
Assistant virology professor Dr. Elisa Crisci found that a novel platelet-rich plasma biologic drug developed at NC State not only stalled the spread of a common porcine RNA virus in cells, but it also made human RNA viruses, including coronavirus, less infectious.
Using an in vitro approach, her team found that the antiviral treatment, called BIO-PLY™, reduced the viral load of porcine reproductive and respiratory syndrome virus, or PRSSV, and decreased the infectious viral particles spread in macrophages, a type of white blood cell. When tested on the human coronavirus and influenza
A virus, the drug had similar outbreak-fighting effects. Crisci’s lab is developing studies to evaluate the treatment in pig patients with viral respiratory infections and pneumonia.
A key step in stopping spread is understanding how a disease moves through communities. Infectious disease professor Dr. Cristina Lanzas models disease spread in animal and human populations, and she recently tracked the impact of vaccination on COVID-19 transmission in St. Louis. Her team found that higher vaccination rates led to fewer COVID
cases, adding to a body of research showing that higher vaccination rates make COVID more manageable.
NC State scientists are also advancing treatments for diseases that spread zoonotically.
Dr. Ed Breitschwerdt, a professor of medicine and infectious diseases, is considered the foremost expert on the Bartonella bacterial family. In 2023, his team discovered that Bartonella henselae, which causes cat scratch disease, could survive in fluids including blood, saline and cow’s milk for up to a week, demonstrating the bacteria’s previously undocumented ability to survive in external environments.
Bartonella infections can be serious or even life-threatening. Breitschwerdt’s lab is working with researchers from Duke Pharmacology and Tulane University to develop an antimicrobial treatment for bartonellosis that the group hopes will heal both animals and humans.
FOOD SAFETY
Good health begins with good nutrition, and College of Veterinary Medicine researchers work closely with the U.S. Department of Agriculture and the Food and Drug Administration to protect the nation’s food supply from veterinary medication residues, pesticides, environmental toxins and the types of foodborne pathogens that sicken over 48 million Americans every year.
Dr. Ronald Baynes, a director of the Food Animal Residue Avoidance Databank, says the 42-year-old organization co-led by NC State maintains the most comprehensive veterinary pharmacokinetic database nationwide that veterinarians can consult in real time to mitigate drug and chemical residues from animal-derived food.
Much of the databank’s information comes from live animal and pharmacokinetic modeling research to better understand how changes in animal health status and physiology can influence how long it takes an animal’s body to process medications or recover from chemical exposure. This work is conducted by NC State
scientists, including clinical veterinarian Dr. Danielle Mzyk, ruminant medicine associate professor Dr. Derek Foster and assistant professor Dr. Jennifer Halleran, along with a team of technical support staff and graduate students.
“When we publish and present our work, we’re sharing with the world that animal and human health are interconnected,” says Baynes, interim head of the Department of Population Health and Pathobiology.
Faculty within the department extensively study antimicrobial resistance, which can lead to the proliferation of disease-causing agents in our food, animals and environments. Dr. Sid Thakur, executive director of the university-wide Global One Health Academy, veterinary microbiology professor Dr. Megan Jacob and Global Health Program director Dr. Paula Cray are key partners with the Food and Drug Administration, leading grants within the organization’s National Antimicrobial Resistance Monitoring System and GenomeTrakr project, which helps identify drug-resistant pathogen strains across the globe.
In a recent project, the group tested for E. coli in meat sold at grocery stores statewide, found evidence of multidrug-resistant E. coli in a significant share of the meat tested and isolated an emerging E. coli strain in some samples. This research showed the need for additional studies on the origins of drug resistance and further monitoring of a new pathogen.
Earlier this year, a team including Thakur and Dr. Ben Callahan, an associate professor of microbiomes and complex microbial communities, developed a new computational technology to serotype, or classify, E. coli and Salmonella enterica by sequencing a single-marker gene. Their work is a key steppingstone in improving and expediting the detection of foodborne pathogens and avoiding illness outbreaks.
Boosting Body Systems
NERVOUS
The nervous system is the body’s control center and includes the brain, spinal cord and an extensive nerve network. College of Veterinary Medicine researchers work with it all.
Dr. Natasha Olby, the Dr. Kady M. Gjessing and Rahna M. Davidson Distinguished Chair in Gerontology, is deepening medicine’s understanding of human aging by studying the process in dogs. Her research has demonstrated that aging dogs and people share the same relationships between hearing loss, sleep disruption and dementia.
Olby’s comparative research also includes identifying similarities in gene mutations that cause neurodegenerative and muscle diseases in dogs and people. She helped uncover a gene mutation in canine degenerative myelopathy — a condition comparable to Lou Gehrig’s disease, or amyotrophic lateral sclerosis, in people — and is currently running clinical trials at NC State evaluating a targeted gene therapy for the condition.
Dr. Santosh Mishra, an associate professor of neuroscience, is also making headway in neurosensory research through his investigations of common chronic skin and joint conditions. Last year, Mishra identified the brain natriuretic peptide’s role in activating atopic dermatitis, also known as eczema. This finding suggests that blocking the peptide’s ability to bind to skin cell receptors could lead to future eczema therapeutics.
IMMUNE
The immune system directs the body’s response to bacteria, viruses and other pathogens and includes the thymus, spleen, lymph nodes, white blood cells and bone marrow. Such a complex system demands collaborative research.
Anaphylaxis is a potentially life-threatening severe allergic reaction that can sometimes occur idiopathically, without being triggered by a known allergen. Traditional immuno-
therapies to prevent recurrent anaphylaxis can be prolonged and ineffective, so associate immunology professor Dr. Glenn Cruse is testing the ability of a longer-term gene therapy treatment called KitStop to decrease anaphylaxis’ severity.
The new therapy depopulates mast cells, a kind of immune cell found in connective tissues that causes anaphylaxis. Cruse’s lab found KitStop decreased the duration and severity of anaphylaxis in a mouse model and proposed it could be an effective therapy for people who regularly experience anaphylaxis.
Our immune systems also respond to chemicals in our environment, including PFAS, or per- and polyfluoroalkyl substances. Dr. Jeff Yoder, a professor of innate immunology, and Dr. Katie Sheats, an associate professor of equine primary care, found that three common PFAS inhibited an immune process called the respiratory burst that kills pathogens and fights infection.
Their study is the first to link these PFAS, part of a family of “forever chemicals,” to suppressed function of neutrophils, a type of white blood cell. It also established new cellular screening tools that future researchers could use to identify chemicals with immune-inhibiting effects.
MUSCULOSKELETAL
College of Veterinary Medicine faculty are experts in the myriad conditions affecting the skeleton, muscles and connective tissues.
Dr. Duncan Lascelles, the Dr. J. McNeely and Lynne K. DuBose Distinguished Professor in Musculoskeletal Health, leads the field in cross-species pain research through his Comparative Pain Research and Education Centre and Translational Research in Pain program. His labs frequently partner with researchers college-wide and beyond to develop methods to measure and treat pain in different animal species.
Lascelles’ recent collaborations include a partnership with Duke University researchers investigating the ability of a localized adenosine solution to relieve pain and promote healing after bone injury. That study found that giving adenosine, a naturally occurring chemical in the body, to mice with tibial fractures reduced pain for these mice and improved their bone healing.
With further research, adenosine could replace nonsteroidal anti-inflammatory drugs and opioid analgesics, both of which can have significant side effects, to alleviate bone fracture pain in human orthopedic patients.
Dr. Lauren Schnabel, a professor of equine orthopedic surgery, conducts research that can also benefit other species with musculoskeletal injuries and diseases. Her work includes pioneering the use of equine mesenchymal stem cells from the bone marrow in therapies to treat tendon and ligament injuries in horses. The same treatment will likely promote healing in humans and dogs with Achilles and other tendon injuries.
CARDIOVASCULAR
Diastolic dysfunction, a common type of failure in the heart’s lower chambers, often occurs with age in humans and is more prevalent in women than in men. Rhesus macaques also develop the condition, but until recently, scientists did not know whether their disease patterns were similar.
Assistant clinical professor Dr. Yu Ueda found that a macaque’s age and exercise levels could predict its risk for
developing diastolic dysfunction and that female macaques showed increased risk. His research opens the door to further efforts to prevent and treat diastolic dysfunction and similar cardiovascular diseases in primates and humans.
Ueda’s co-author on the study is Dr. Josh Stern, associate dean of research. Stern’s lab consistently highlights the parallels between animal and human cardiac conditions, including hypertrophic cardiomyopathy.
Subvalvular aortic stenosis is another highly comparative condition. It is the most common congenital heart disease in dogs, and though rarer in human children, it produces a similar fibrous ridge under the aortic valve that obstructs blood flow from the heart’s left ventricle.
Stern’s analysis showed that treatment diverges between species as the disease progresses, with medications prescribed for canine treatment and surgery advised in human care. He noted that veterinary and human cardiologists should work together to find treatments to halt disease progression and identify a method to permanently remove the ridge. The Stern lab is currently leading a clinical trial for dogs with severe subvalvular aortic stenosis that Stern hopes will help children with the same condition.
RESPIRATORY
College of Veterinary Medicine researchers help animal and human communities breathe easy about health, especially when it comes to the lungs.
Dr. Yogesh Saini, a professor of pulmonary immunology, researches the respiratory tract, including the impact of environmental toxins on the lungs. Saini collaborated with researchers at the University of Texas at Tyler Health Science Center on work suggesting that a specific peptide, CSP7, could be an effective treatment for conditions including cigarette smoke-induced lung injury and chronic obstructive pulmonary disease, or COPD.
COPD is a leading cause of death in the U.S. and worldwide. Many current treatments reduce airway inflammation or manage COPD’s symptoms, but CSP7 may be able to reverse lung injury while improving the organ’s function, making it a more effective therapy. The research team is also furthering its preclinical testing of this peptide against allergic asthma.
Additionally, NC State scientists are looking to the lungs to improve drug delivery methods. Researchers from the College of Veterinary Medicine and College of Engineering collaboratively developed a tunable nebulization system to more effectively administer intrapulmonary drugs, which can work faster and at lower doses than medications given in other ways.
The team, including Cruse and former regenerative medicine professor Dr. Ke Cheng, found that the system, which allows patients to inhale medicine liquefied into a fine mist, was effective in mice and could be upscaled for larger species.
GASTROINTESTINAL
The College of Veterinary Medicine’s gastrointestinal experts are guiding the field in understanding and treating conditions of the stomach, intestines, gallbladder and related organs.
Clostridioides difficile, or C. diff, is a bacterium that causes nearly half a million infections in people in the U.S. each year. Infections can result in colonic inflammation with potentially life-threatening symptoms.
Dr. Casey Theriot, an associate professor of infectious disease, launched a study that discovered that certain bile salt hydrolase enzymes found in different Lactobacillus bacteria can restrict C. diff’s spread within the gut. Her team’s work reveals how altering the gut bile acid pool might be an effective treatment for patients with C. diff infection, avoiding antibiotics that can exacerbate the infection and treatments that can pose complications.
Intestinal malrotation, a congenital condition where parts of the intestine become twisted, occurs in approximately one out of every 500 births in the U.S. Its cause is unknown, but Dr. Nanette Nascone-Yoder is looking for answers.
Nascone-Yoder, a professor of developmental biology, worked on a study to identify potential environmental causes of the condition in frogs, finding that exposure to the herbicide atrazine was correlated to amphibian intestinal malrotation. It is unclear whether herbicides may also contribute to the condition in people, but her research suggests that the cellular processes disturbed by atrazine may also underlie human malrotation.
‘One Health’ At Home and Abroad
All of this work, combined with NC State’s exemplary research facilities, makes it no surprise that public health agencies, including the World Health Organization, rely on NC State veterinary faculty to help shape protocol. Locally, faculty also lead college- and university-wide consortiums, including the Global Health Program and Comparative Medicine Institute, to advance medical understanding using a One Health approach.
Sometimes, the veterinary college advances research simply by opening avenues of communication with human-focused scientists who are unaware of veterinary medicine breakthroughs, says Dr. Mike Nolan, interim head of the Department of Clinical Sciences.
“We help scientists in other departments, at other universities and in other health professions understand what the needs are in veterinary medicine, what we have to offer, where there are similarities and differences between human and animal health and how those can be leveraged,” he says.
These conversations have saved years and millions of dollars in research and development, Nolan says, through insight only a veterinary school can provide.
“We bring a lot of value to the region in that way,” he says.
The College of Veterinary Medicine’s renown as a prominent research institution helps recruit world-class faculty, staff and graduate students who develop new ideas that
advance human and animal health. And in return, these investigators — particularly student trainees — grow professionally and personally.
Even students who enter the college without research backgrounds can get involved in studies that improve animal and human health via initiatives like the Veterinary Scholars Program. The 10-week summer program lets first- and second-year students work on mentored research projects in faculty labs under the guidance of faculty, graduate students and lab technicians.
“Research is about bedside in the clinic, about the benchtop in a lab, about helping the community, but research is also in our classrooms,” Stern says.
Because veterinary medicine researchers are well-positioned to approach health questions from a holistic perspective, they have a deep understanding of the interplay among animal, human and environmental health and are critical to advancing this approach across the world.
“I got into veterinary medicine because I believe it’s always One Health,” Baynes says. “Animals and humans share the planet and need each other, and our researchers’ work gives the public a better understanding of that interchange while improving care across species. We’re leading the way to a healthier world.”
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LIFE-CHANGING RESEARCH
Powering Breakthroughs
Dr. Mike Sano is harnessing the power of electricity to target and destroy inoperable cancer in a therapy that eliminated 80% of tumors in a recent clinical trial with horses.
Electricity will soon be doing more in health care than just powering machines. With the research of Dr. Mike Sano and the bioelectricity lab at the NC State College of Veterinary Medicine, it could be the key ingredient in groundbreaking medical advancements from vaccines to cancer therapies.
“Everything in our body has an electric component,” Sano said. “We have a lot of signaling that happens through electricity, and there are a lot of bioelectric phenomena that are governed by electricity, especially on a small scale. It turns out that super interesting phenomena arise when you apply external fields to these already electrically reactive materials.”
In his search for a new cancer treatment for animals and humans, the associate professor is currently harnessing the power of electricity to target and destroy inoperable tumors. In recent clinical trials with client horses, the therapy eliminated 80% of tumors when used at the highest level.
“Technologies like this are so good that you don’t need to go through six months of chemotherapy and lose your hair and have your fingernails fall off,” Sano said. “The goal is to replace those really harsh therapies that have
By Brandon Bieltz
middling effectiveness with something that is much more effective and has fewer side effects.”
And that’s just one way bioelectricity could be changing health care.
HARNESSING BIOELECTRICITY
Sano’s vision for using electricity in medical treatments built slowly throughout his education. He studied electrical engineering and mathematics at the University of Buffalo as an undergraduate but was introduced to the capabilities of bioelectricity during his doctoral work at Virginia Tech.
“I was hooked immediately,” he said. “This combination of engineering, electronics and biology was fascinating.”
His doctoral research transitioned from studying bioprosthetics to using high-frequency electric fields to isolate and identify cancer cells in blood samples based on cells’ electric properties. As he worked to determine the maximum amount of electricity he could apply to isolate a cell for the diagnostic, Sano also learned at what point the electricity killed the cells he was trying to examine.
“I was really good at figuring out where that threshold was,” Sano said. “Through the process, I got a good
understanding of the biophysics of what was happening.”
His short — at a nanosecond-level — but powerful electrical pulses were making the molecules in cells move rapidly and farther apart, eventually causing the cell membrane to develop pores. Once pushed far enough, those holes in the cell membrane ruptured, killing the cell. Nanosecond pulses also allowed for more voltage to be applied to cells without creating so much heat that the electricity would damage other tissue, blood vessels or nerves nearby, making it a viable approach to use in living things.
His Ph.D. adviser was already working on using bioelectricity to treat cancer, and with the discovery of Sano’s faster, shorter electric pulses leading to cell death, a new approach to cancer therapy started to develop. The goal: create a simplified device that could treat tumors ranging in size from a quarter to a golf ball in what are typically inoperable locations of the body.
Sano continued developing the therapy as a postdoc at Stanford University and brought it with him in 2017 when he became an assistant professor in the NC State-UNC Joint Department of Biomedical Engineering.
Six years later, he joined the College of Veterinary Medicine to continue to develop the therapy — now called Integrated Time Nanosecond Pulse Irreversible Electroporation, or INSPIRE.
CHANGING HOW CANCER IS TREATED
Intent on translating the novel cancer therapy to a clinical setting, Sano immediately began looking for a veterinary partner in Raleigh and found Dr. Callie Fogle, a clinical professor at the CVM who works with horses at the Large Animal Hospital.
Fogle had experience with electrochemotherapy machines, which use principles similar to Sano’s INSPIRE but have one significant difference: The horse has to be anesthetized, or laid down, for the procedure.
“He was able to manipulate the electrical current in such a way that we could treat standing horses,” Fogle said. “With the electrochemotherapy machine, you could only treat anesthetized horses because the muscle contraction was very strong. To be able to provide that in a standing horse decreases the risk for the horse and the expense.”
Before an INSPIRE treatment, Sano and his team run a scan of a tumor through a computational model that determines where to place electrodes and how much voltage to use. The procedure, which delivers electrical pulses directly to the tumor, lasts between three and five minutes.
Sano and Fogle began a clinical trial using INSPIRE in 2022 to treat equine cancer patients with melanoma, examining how different voltages and speeds of the electrical pulses impacted tumors.
“The reason why INSPIRE is needed is because other therapies fall flat.”
— Mike Sano
The results were promising.
At the lowest setting of 1,000 volts, INSPIRE reduced tumor volumes by 11% to 15%; at 2,000 volts, tumor volumes shrunk by 84% to 88%. The treatment eliminated 80% of tumors when used at the highest level.
The results also showed that the therapy packs a powerful one-two punch for cancer treatment. When the electricity kills the tumor, enough biological information is left behind that the immune system will recognize and attack the disease if it occurs elsewhere.
“We’re not just killing the tumor, but we’re killing it in the right way for the immune system to come in and recognize the tumor as something dangerous and start to mount an attack against it,” Sano said. “By the time most tumors reach the size of a golf ball, they’ve started to metastasize. It’s not enough to just kill that tumor. You really need to help the body respond to that disease that is now spreading around the body.”
The treatment has already altered the landscape for clinical cancer treatment at the NC State Veterinary Hospital.
“INSPIRE has allowed us to perform more advanced tumor treatment
without a really large price tag or asking owners to ship halfway across the country to a facility that has a linear accelerator or radiation,” Fogle said. “It has already changed the way we treat tumors here, and I think we see horses from outside our normal referral radius because of this therapy.”
INSPIRE has now been used with more than 100 horses at NC State, and Sano has been able to work with other CVM veterinarians to expand clinical trials into dogs with liver and breast cancer — seeing more positive results there.
With promising signs, Sano said, INSPIRE could provide a new approach to treating cancer in humans when radiation and chemotherapy can’t hit the mark and surgery isn’t an option.
“We can burn it out, but if it’s near a blood vessel, like most tumors are, then you can’t burn it out. You could try and freeze it, but again, if it’s near a major blood vessel or a critical nerve, you can’t do that,” Sano said. “The reason why INSPIRE is needed is because other therapies fall flat.”
A NEW APPROACH TO VACCINES
While cranking up the power to kill a cell is the principle behind INSPIRE, Sano is also looking at how the same concept can be used — turned down a few notches — to push cell membranes to the brink without rupturing. Creating holes in the membrane that then reseal themselves may be the key to making DNA vaccines a reality.
Similar to the mRNA vaccines developed to address the COVID19 pandemic in 2020, DNA vaccines allow scientists to go from pathogen to a vaccine candidate rapidly. Unlike mRNA vaccines, which require constant
refrigeration, DNA vaccines are shelf stable. During the pandemic, cold storage became a critical obstacle in the supply chain of the new vaccine.
“You can take a DNA vaccine, put it in your backpack and march across the desert, no problem,” Sano said.
But the need for cold storage is by design: An mRNA vaccine causes the body to make a specific protein to protect it from a virus, but it degrades quickly to prevent the body from making too many proteins. DNA vaccines, though better for storage, won’t enter cells on their own. They need an extra jolt in the form of a nanosecond electrical pulse that opens cell membranes and allows the vaccine in.
“We need to give it a push, and the
way we do that is with electricity,” Sano said. “We use electric pulses that push the DNA into the cell to improve the efficacy of those vaccines. We just started working on it during the pandemic. We have shown it works in a dish, and now we’re trying to scale up.”
Eventually, that vaccination process could look as simple as a device, like a noncontact thermometer, delivering the vaccine and electric pulse simultaneously without the patient feeling anything. It would make current vaccinations more convenient and efficient and even open the door to even more impressive treatments.
“There’s a number of cancer vaccine candidates out there, and there’s also big agriculture applications — avian
Mike Sano works with INSPIRE therapy equipment in the bioelectricity lab of the Research Building.
flu, for example, things where you need to vaccinate really big populations, but you can’t do it in this clinical setting,” Sano said.
Sano said the ability to harness electricity into a health care tool in these ways has progressed rapidly over the last decade, and there are no signs of the work slowing down. It’s just a matter of getting the equipment from the lab bench to patients. It’s a task he is up for.
“I have a very clinically focused mentality,” he said. “My goal is to get these technologies into the clinic and to patients.”
ALUMNI PROFILE
From ‘Bench to Farm to Table,’ 3-Time Alumna Helps Ruminants and Protects Our Food
By Katie Rice
When food animal veterinarians nationwide have drug questions about their cows, pigs, chickens, goats or even their moose, they call Dr. Danielle Mzyk.
Mzyk is a clinical veterinarian with the Food Animal Residue Avoidance Databank, which is funded by the U.S. Department of Agriculture and co-led by the NC State College of Veterinary Medicine and four other universities. The partnership works to keep residues from medications given to animals and potential toxins from entering into the U.S. food supply.
“It’s the walking definition of ‘bench to farm to table,’” says Mzyk, a three-time alumna of NC State. “The decisions practitioners make on their farms could impact the hundreds of thousands of people who consume their products. FARAD’s role is the protection of public health.”
When Mzyk isn’t dispatched to a farm through her primary position with NC State’s ruminant field service, she’s often answering FARAD’s calls from vets in need and calculating withdrawal times, or how long it takes a medication to clear an animal’s system.
Her on-call weeks involve up to 120 calls from veterinarians nationwide seeking recommendations for extralabel drug use — using a medication in another species, for another condition or at a different dose than it has approval
for — or help addressing an animal’s pesticide exposure.
“Sometimes, I’m extrapolating data: ‘I don’t have cow data for this drug, but I have goat data,’” says Mzyk. “That’s why I fell in love with this in the first place — putting the pieces all together like a puzzle. I don’t know what the full picture looks like, but once I’ve got the edges outlined I can start filling them in.”
She has even contributed her own data to FARAD’s comprehensive drug database. A recent $30,000 grant from the American Veterinary Medical Foundation and the Veterinary Pharmacology Research Foundation will help Mzyk research potential new pain relief treatments in wool and hair sheep using the anti-inflammatory drug flunixin.
Mzyk makes long days of research and fieldwork look easy, but she says her career journey was far from smooth sailing. But with strong mentors, particularly FARAD director and pharmacology professor Dr. Ronald Baynes, Myzk was encouraged to persevere, achieve her goals and support students in similar positions.
‘SOMEBODY HAS ALWAYS LOOKED OUT FOR ME’
Math and chemistry always made sense to Chapel Hill native Mzyk growing up. She knew her career would involve problem-solving and animals, but she says mentorship is really what got her into veterinary medicine.
Mzyk started her education at Lees-McRae College in Banner Elk, North Carolina, where she scored a pharmacology internship at the U.S. Food and Drug Administration as a first-year student. That opportunity led to a fateful meeting with Baynes at a pharmacology conference.
“After discussing everything from pharmacokinetics to the game of cricket, Ronald Baynes handed me a business card and told me to contact him if he could ever be of any help on my path toward becoming a doctor of veterinary medicine,” Mzyk wrote in a student essay in 2018. “That business card was the key that unlocked my future career.”
Eager to study pharmacology with Baynes, Mzyk tried to transfer to NC State during her sophomore year and was rejected over a credit misunderstanding. Once that was resolved, Mzyk was NC State-bound by the end of her sophomore year.
In Raleigh, Mzyk tracked down Baynes and asked to join FARAD. She started working with pigs and rotated through various species, discovering a passion for ruminants and specifically goats.
Mzyk graduated with her bachelor’s in zoology in 2012. She was accepted into the College of Veterinary Medicine’s DVM program on her first try but was rejected from the dual-degree DVM/Ph.D. track. On Baynes’ advice, she gained more research experience as a DVM and was admitted to the Ph.D. program the following year.
“Somebody has always looked out for me and helped push me along,” Mzyk says. “In each of those rejections, it just was not the time for me to be in those programs. Each rejection led me to a path that got me eventually to where I needed to go.”
FROM MENTEE TO MENTOR
Mzyk earned her Ph.D. in pharmacology from NC State in 2018 and her food animal-focused DVM in 2019.
After four years in mixed animal practices in Erie, Pennsylvania, and Janesville, Wisconsin, Mzyk returned to the NC State College of Veterinary Medicine in 2023 to resume her pharmacokinetics research and work with her mentors again, this time as their colleague.
Mzyk enjoys balancing her time between the lab bench and the barn. She says her research background gives her a unique perspective among field veterinarians.
“Not many clinical vets have Ph.D.s in pharmacology,” Mzyk says. “So I’ll be out practicing with goats, and I’ll explain how these medications work and why it’s better to give them orally versus intramuscularly, and the owners are just like, ‘Where did you come from?!’”
Following in her mentors’ footsteps, Mzyk coaches students through conducting research at FARAD, practicing clinical skills by riding along with her field service crew and serving the community via veterinary mission trips with the Christian Veterinary Fellowship.
“Danielle has a natural talent for teaching students, whether undergraduate or graduate, and connecting with them,” says Baynes, the interim head of the Department of Population Health and Pathobiology.
She’s still continuing her education at NC State, too, by completing an alternate route residency for board certification through the American College of Veterinary Clinical Pharmacology.
“I’m exactly where I’m supposed to be, and I’m doing exactly what I wanted to do, but the path that got me here isn’t a straight line,” she says. “There are different ways to get where you want to go in this profession. You just sometimes have to take a different route and step out of your comfort zone.”
Stoking Veterinarian Dreams at Open House 2024
For high schooler Shelby Koenig of Maryland, Open House 2024 at the NC State College of Veterinary Medicine was everything she could have hoped for.
She and her parents traveled hours to the March 23 event to meet NC State’s experts in sports medicine and rehabilitation. The group’s demonstration of how a dog uses an underwater treadmill for rehab was just one of scores of experiences that thousands of visitors explored at the CVM throughout the day.
“I’ve always dreamed of becoming a veterinarian, and where I’m from, we don’t have a lot of places like this that are just open to people to come and see,” said Shelby, who realized she wanted to work specifically in rehab after her own recent physical therapy.
Throughout the day, community members of all ages toured through the halls of the college, hospitals and Research Building. They could check out the anatomy lab, try their hand at laparoscopic surgery or learn about the science of nerve firings at the “Unraveling the Puzzles Behind Ouch and Itch” stop.
Outside, visitors could meet with local animal rescue groups, check out a horse corral or try milking a cow, among other activities.
Also available at the event were seminars with NC State College of Veterinary Medicine admissions staff talking about the best paths to take to get into veterinary college and with students sharing a day in the life of a veterinary student.
BY JOHN JOYNER/NC
NC STATE VETERINARY MEDICINE
NC Veterinary Medical Foundation
1060 William Moore Drive, Raleigh, NC 27607
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The Oath is published by the NC State Veterinary Medicine Communications and Marketing office. Contact us at CVMCommunications@ncsu.edu
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“Being a donor to the College of Veterinary Medicine plays a crucial role in advancing veterinary medicine. Your support can help fund research projects, equipment and facilities that enhance the quality of care for animals and contribute to important discoveries in the field.”
— Ed Vinson, donor and member of the NC Veterinary Medical Foundation Board of Directors
