Waiting for Knowledge Translation: The Unfulfilled Promises of PNI and Ischemic Conditioning
Wednesday, May 16, 2018
4:00 PM-5:30 PM
Waiting for Knowledge Translation: The Unfulfilled Promises of Psychoneuroimmunology (PNI) and Ischemic Conditioning
Kenneth Frumkin, PhD, MD, FACEP
Educator, Researcher, Emergency Medicine Physician
A fundamental challenge for the biomedical sciences lies in fulfilling the mission of knowledge translation. This discussion presents two areas needing further investigation. Together, they encompass over 70 years of combined study and thousands of publications, yet realization of their life-saving and life-changing potential still waits for practical translation.
As early as 1975, researchers exposed rats to the combination of a unique taste (saccharin solution) and the chemotherapy agent cyclophosphamide. Later, exposure to the saccharin solution alone suppressed T-cell function and antibody formation in the same fashion as the cyclophosphamide, representing behavioral conditioning of the immune response. Beneficial antibody production has been enhanced via similar paradigms. Broader application of such conditioning principles has the potential to mitigate drug side effects and cost, while enriching diverse areas of investigation including cancer chemotherapy, pharmacology and immunology. Recognizing that the placebo effect is an example of such conditioning can greatly expand the role of that phenomenon in treatment.
In a 1986 experiment, dogs were subjected to a series of brief coronary artery occlusions. Compared to subjects without prior interruptions of flow, the dogs undergoing this “ischemic conditioning” had a 75% reduction in the size of the infarct created when the same artery was fully obstructed. Ischemic conditioning refers to the ability of brief episodes of controlled hypoperfusion around the time of an acute ischemic event to protect a target organ from reperfusion injury. Subsequent literature over 30 years and 9000+ publications demonstrates that interventions as simple and safe as repetitively inflating a blood pressure cuff can reduce the size and long-term morbidity of heart attacks and strokes. The same methods proposed for heart and brain ischemia are waiting to be applied to any organ system faced with the cellular insults associated with reperfusion. Potential applications are limited only by the imagination, and include mitigating vascular cognitive impairment and other diseases of ageing, moderating traumatic brain injury, treating sepsis, and augmenting the myriad beneficial effects of exercise.
After earning his PhD in physiological psychology from McGill University, Dr. Frumkin served in the U. S. Army’s Biomedical Laboratories, at Edgewood Arsenal, MD. Doctoral and post-doctoral work focused on the psychophysiological mechanisms underlying evolutionary drives, learning, and addiction. Following graduation from Hahnemann Medical College, Dr. Frumkin returned to the military to complete his internship and emergency medicine residency. He subsequently became Chairman of the Emergency Department at Madigan Army Medical Center and the US Army Surgeon General’s Consultant in Emergency Medicine.
Following his military service, Dr. Frumkin practiced emergency medicine in community hospitals, holding both administrative and clinical and positions. He returned to academic practice and military medicine in 2008 at the emergency medicine residency, Naval Medical Center, Portsmouth, Virginia.
Dr. Frumkin has published clinical and basic science research, reviews, editorials and textbook chapters. He serves as a reviewer for four leading emergency medicine journals, has been member and chairman of Institutional Review Boards, and an examiner for the American Board of Emergency Medicine. Academic appointments were at Eastern Virginia Medical School and the Uniformed Services University of the Health Sciences. He is Board‐certified in emergency medicine, a member of the Eastern Psychological Association and the Pennsylvania Psychological Association, a Life Fellow in the American College of Emergency Physicians, and an Emeritus Member of the Society for Academic Emergency Medicine.