Dr. Kang-Mieler's Retinal Vascular Research Laboratory Brings Hope for the Visually Impaired
Blindness and visual impairment affects 3.3 million Americans age 40 and over; that is one in 28 Americans. According to the National Eye Institute, this figure is projected to reach 5.5 million by the year 2020. Blindness is not a life threatening disease; however, it reduces one's quality of life. Dr. Jennifer J. Kang-Mieler's research is committed to developing clinical diagnostic tools and investigate disease process and treatment options for a number of blinding diseases such as Diabetic Retinopathy (DR) and Age-related Macular Degeneration (AMD).
Since coming to IIT five years ago, in addition to teaching in the BME Department as an assistant professor, Dr. Kang-Mieler and her team have focused on studying retinal cellular function and retinal blood flow in various diseases. For example, one of the projects involves an in-depth study of thrombosis, the formation of blood clots affecting retinal arteries and veins, and its effect on different retinal cell types and on retinal blood flow using both experimental rat arterial occlusion models and quantitative/computational models.
Her team is also investigating Diabetic Retinopathy (DR), a major cause of blindness in diabetic patients. Almost 50% of diabetic patients will eventually develop some degree of DR. Clinical detection of DR involves loss of capillary perfusion or when new vessel leakage is detected by fluorescein angiography. Unfortunately, according to Dr. Kang-Mieler, during the many years between the initial diagnosis of diabetes and the clinical detection of DR, significant and irreversible changes in the retinal vasculature silently develop. Because of that, it is important to focus on preventative efforts during the early stages, before any anatomical changes or clinically detectable pathology occurs. A major challenge is to develop a technique that is sensitive enough to detect these small early changes in vasculature.
Dr. Kang-Mieler and her team seek to understand the hemodynamic changes in the early phase of DR and to develop accurate blood flow measurement techniques, which will aid in the detection and prevention of DR. A previous study conducted in animal models indicated that there is a change in retinal flow before any anatomical changes are observed. An incomplete understanding of blood flow exists, however, mainly due to the many different measuring and evaluating techniques currently in use. Dr. Kang-Mieler is proposing to use a scanning laser ophthalmoscope (SLO) as a new tool for detecting retinal hemodynamic changes in the early stages of DR. The technique involves tracking fluorescent particles such as FITC- red blood cells or microspheres to measure blood velocity in the eye. Her team is investigating the changes detected by the SLO technique in a streptozotocin-induced rat DR model. As a complimentary study, her team also investigates the retinal cellular functional changes associated with DR using a non-invasive electroretinogram (ERG) recording technique.
Another area of research is the investigation of photoreceptors. Currently over 1.8 million Americans age 40 and older are affected by Age-related Macular Degeneration (AMD) and an additional 7.3 million people are at substantial risk for vision loss from AMD. Sadly, there is no effective treatment. The goal of Dr. Kang-Mieler's team is to investigate a new way to treat AMD by replacing the degenerating cells. Her team is investigating the optimal conditions and surface to culture healthy photoreceptors (light sensing cells that are first affected by the disease). The biggest challenge is maintaining the functional and structural characteristics of in vivo cells in vitro. The research team is exploring various surface modification and cell culturing techniques to address this goal. The long-term goal is to implant cultured photoreceptor cells into an in vivo system and investigate the efficacy of the therapy to rescue or replace the degenerated photoreceptors.
Why retinal vascular research and biomedical engineering?
Dr. Kang-Mieler completed all her undergraduate and graduate work at Northwestern University, earning her bachelor's degree in Mathematics, a master's degree in Applied Mathematics and her Ph.D. in Biomedical Engineering. "It was while I was doing doctoral research with Dr. Robert Linsenmeier that I became interested in working to answer questions related to retinal diseases," says Dr. Kang-Mieler.
"The quality of life for people with diseases of the eye and blindness is greatly affected. Think of all the things you take for granted as a sighted person: to see colors, to read music, to drive, to travel unimpaired. Thinking about those things inspired me to pursue this area of research in my professional life."
"Biomedical engineering doesn't cure the diseases. We're engineers working with doctors and other scientists to design processes, techniques and clinical tools to help doctors diagnose and treat retinal diseases earlier and more effectively."
Why IIT? The Department of Biomedical Engineering (BME) at IIT is a just a few years old but Dr. Kang-Mieler has been integral to its class design and growth as a research center since nearly the beginning. "While considering opportunities to teach and further my research professionally, I met Dr. Vincent Turitto, director of the Pritzker Institute and now also BME Chair, and was impressed that he and I shared the same vision for building a BME department at IIT," says Dr. Kang-Mieler. "He has a commitment to make this department the best biomedical engineering department and research facility in the country." Given the opportunity, Dr. Kang-Mieler decided she wanted to be part of that journey.
Starting a new biomedical engineering department provides an opportunity to modify a traditional engineering curriculum into one that would be appropriate for a multi-disciplinary biomedical engineering education. Because of the diversity in biomedical engineering, the major challenge in course design is to determine which areas of specialization are appropriate for biomedical engineers. The BME has used this opportunity to focus on three areas of study: Cell and Tissue Engineering, Neural Engineering and Medical Imaging.
Curriculum Development for BME To deliver the knowledge and skills necessary for these fields, Dr. Kang-Mieler was assigned the task of designing the BME 315 Instrumentation and Measurement Laboratory class. Traditionally, an instrumentation laboratory class focuses on transducers and electrical instruments, similar to an electrical engineering laboratory class. While this traditional instrumentation class is important for all engineers, BME students need to be exposed to biological-based measurements.
Dr. Kang-Mieler taught the first BME 315 class, which was offered to students during Fall 2004. Students work in teams of three with a specific role assigned to each student on a rotating basis. The specific role assignments help facilitate a collaborative work environment which enhances the students' ability to learn and to help prepare them for working with people from a wide variety of backgrounds and disciplines in post-graduate fields.
To the lay person, the instruments and measuring techniques involved in the class sound densely technical but the concepts that the students learn involve everyday ideas. For example, experimental Modules in BME 315 include:
- Measurements in Physiology which entails digital remixing of heart signals
- Microscopy and Imaging Analysis: use high-tech, cutting edge computer imaging techniques to determine whose blood carries the most metal
- Computed Tomograph: make your own CT-scan machine to amaze your friends
- Gel electrophoresis: investigate unknown DNA just like the popular crime scene shows
- Spectrophotometry: determine how Atkin's friendly bovine serum Biorheology: is blood really thicker than water? How can you tell?
Students are exposed to a broad range of techniques and the processes involved in investigating a problem, which will be beneficial in subsequent laboratory classes.
In what is thought of as a male-dominated field, Dr. Kang-Mieler is a fine example of just how far women have come in being accepted as peers in the biomedical engineering research space. In actuality, BME has become one of the more popular majors for females with approximately 50% of the IIT students being women.
Biomedical engineering holds enormous opportunities for all the bright young students coming into the field--both men and women. "We have an increasing number of young women following BME coursework at IIT," she says "and all of our faculty work hard to mentor all students coming into this exciting and important area of study."
When she is not teaching or mentoring her students through various research projects, Dr. Kang-Mieler frequently attends conferences and symposia�sharing progress and insights about her retinal vascular investigations.
She is a member of the Association for Research in Vision and Ophthalmology, a member of the Biomedical Engineering Society, a member of the International Society for Clinical Electrophysiology of Vision and a member of the American Society for Engineering Education.
Her research findings have been published in numerous publications devoted to vision and neuroscience. She has presented at more than dozen meetings of the Association Research in Vision and Ophthalmology and other related organizations.