Wednesday, 19 April 2017
Usha Lee McFarling : This tech was meant to explore space. Can it also solve the mysteries of breast cancer?
By Usha Lee McFarling @ushamcfarling
April 18, 2017
A CAÑADA FLINTRIDGE, Calif. — For decades, scientists here at NASA’s Jet Propulsion Laboratory have sent spacecraft deep into the solar system. Now, they’re exploring another mysterious terrain: the human breast.
The lab’s primary mission, of course, is to dream up and create robotic spacecraft to look for water on Mars or peer below the dense clouds that shroud Jupiter. But in recent years, top scientists here have realized that JPL’s powerful technology for exploring the cosmos might also help solve daunting medical questions here on Earth.
“It’s very simple. If JPL has a bunch of technology — to get to the moon, to look for life on Europa — and that has any benefit for medicine and health, then we have a responsibility to share that benefit with the public,” said Leon Alkalai, a veteran technologist at JPL who has been involved in several space missions and now manages the lab’s office of strategic planning.
One of lab’s first medical breakthroughs came in the area of breast cancer.
Dr. Susan Love, a well-known surgeon and advocate for breast cancer research, was trying to understand the microbiome of breast ducts — the channels under the skin that carry milk to the nipple. (The breast was one of the organs left out of the federally funded Human Microbiome Project, she notes.) Since almost all breast cancers originate in the ducts, Love has been keen to map them and to determine if they harbor any infectious agents that may play a role in breast cancer.
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But Love’s analysis kept running into trouble; her team found far more microbes than they anticipated. It turns out, she said, that the antiseptic being used to clean the volunteers’ skin was filled with dead microbes, which posed no risk to them but made analysis tough.
“It was hard to figure out what were the important bacteria versus what was just noise and contamination,” Love said.
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Scientists here have developed a host of techniques to analyze very tiny concentrations of microorganisms. These tools are exquisitely sensitive because they are used for planetary protection — to ensure that NASA spacecraft carry as little earthly bacteria as possible so they don’t contaminate distant worlds.
In a fortuitous coincidence, one of the scientists immersed in planetary protection at JPL, Parag Vaishampayan, had spent his postdoctoral training in Berkeley studying how a mother shares her microbiome with her infant, possibly through breastfeeding. While many biologists have long assumed the breast and ducts to be sterile, Vaishampayan knew otherwise.
“When Dr. Love presented her work, I said, ‘That’s fantastic. Of course there’s microbacteria in the breast. And we can help analyze it,’’’ he said.
Vaishampayan was thrilled to return to his academic roots: “When I came to NASA,” he said, “I never thought I would work on microbiome — ever.”
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The team analyzed breast ductal fluid from 23 healthy women and 25 women with a history of breast cancer, using advanced sequencing techniques to determine the microbial fauna. They established that breast duct fluid does indeed have a distinct microbiome, and that the populations of microbes in healthy patients appear to differ from those with cancer history.
What does that mean? It’s still not clear: It may be that a microbe they found only in healthy women is somehow protective against breast cancer. But it also could simply be that radiation and chemotherapy wiped out that particular microbe in women who’d been treated for cancer.
Either way, the differences are intriguing enough that Love and her collaborator, UCLA’s Dr. Delphine Lee, are planning a larger, follow-up study. Vaishampayan plans to work with them. He sees real potential for clinical gains: “These are not sci-fi objectives,” he said.
Indeed, there is mounting evidence that changes in the microbiome may play a role in both the development of breast cancer and how aggressively it spreads. Altering the microbiome may one day even be a therapeutic option for patients, according to Nick Chia, a microbiome researcher at the Mayo Clinic.
NASA breast duct map
JPL scientists are using tech developed to map complex topology on other planets to help create maps of human breast ducts.
Mapping foreign terrain — inside the breast
Love has also tapped JPL for help updating maps of the breast ductal system, which has been little studied since some basic dissection work was conducted by master English anatomist Sir Astley Paston Cooper — back in 1840. She hopes the new maps could lead to more precise cancer surgeries.
“We know nothing about the anatomy,” said Love, who now serves as chief visionary officer for the nonprofit Dr. Susan Love Research Foundation in Encino, Calif. “That’s why we cut out big chunks.”
The Love Foundation has tried to use regular 3-D medical ultrasound to capture images of the ducts in healthy, lactating women. But they’re still very hard to trace.
That’s where JPL comes in: Detailed radar mapping of complex and foreign topography is second nature to the planetary scientists.
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For Love, who considers the human breast about as unexplored as the surface of Mars, the collaboration with the lab is a natural fit. “This is really discovery research. We have no idea what we’re going to find,” Love said. “We’re like JPL. We just want to go and see what’s out there.”
Love credits her connection with JPL to Charlayne Fliege. A senior executive at at the lab, Fliege also belongs to Love’s “Army of Women” — healthy women who volunteer their time and bodies to participate in breast cancer research. As Fliege lay on a table getting poked and prodded during one research session, Love talked about the vital need to learn more about the breast.
“She’s so passionate,” Fliege said. “I said, ‘Susan, you sound just like a scientist who’s exploring Mars. Seriously, you should talk to the people at JPL.’”
So Love did.
Before the work could start, Alkalai had to convince his superiors at JPL to devote at least a few resources to medical questions on Earth. “It’s not an easy thing to sell,” he said. “JPL is very busy.”
In search of ‘truly tough’ questions
But when Alkalai held an exploratory meeting, he was shocked to draw a full house of 60 JPL staffers, many of whom were already working on medical projects on the side or as volunteers.
So he set up the Medical Engineering Forum, a virtual department at JPL that brings together scientists and engineers keen to work on medical projects. It brings in external researchers to talk about their work — and offers small amounts of seed money for JPL scientists to team up with them.
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It’s still early days for the forum, but JPL employees are already working on a number of collaborations, including working with neurosurgeons to develop smarter materials for use in spinal surgery. Also on the table: better imaging technology to guide surgeons more precisely.
JPL’s tech, after all, includes “exquisite detectors to image galaxies,” Alkalai said. “They can also image the human brain for cancer surgery.”
Outside experts who want to work with the lab can submit “challenge problems.” But Alkalai warns it’s highly competitive. The forum looks for problems with high medical relevance — and research protocols that make full use of JPL’s unique sets of skills.
“We’re hard to get,” he said. “What we’re looking for is truly tough problems.”
The new initiative has a side benefit as well. It’s building community across JPL.
Scientists always attend the lectures and colloquia held here. But when the topic is medical, the rooms fill with new faces: administrators and secretarial staff rarely seen at scientific talks. “If they’re talking about cancer, it doesn’t matter what degree you have,” said Alkalai. “It cuts across every demographic.”
Usha Lee McFarling can be reached at email@example.com
Follow Usha Lee on Twitter @ushamcfarling
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