The Silent Role of Biofilms in Chronic Disease › Forums › Biofilm Community › Expert Interviews › Dr. Garth Ehrlich – Microbiologist, Geneticist (Video & Interview Excerpt Available)
Tagged: allegheny-singer research institute, asri, bill costeron, garth ehrlich, hai, implant infection, molecular diagnostics, mrsa, post-op infection, post-operative infection
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The video interview is complete, the 11 minute distillation is below. See below for a profile on this scientist.
Garth D. Ehrlich, Ph.D.
Executive Director, Center for Genomic Sciences
Scientific, Governmental and Regional Affairs Liaison Officer
Allegheny-Singer Research Institute
Professor of Microbiology & Immunology
Professor and Vice Chairman, Dept. of Human Genetics
Drexel University College of Medicine
______________________________________________________“I have an atypical personality for a scientist,” matter-of-factly states Garth Ehrlich, Ph.D., executive director of ASRI’s Center for Genomic Sciences and a world-renowned geneticist. “I often look for unorthodox ways to solve a scientific problem, outside the confines of the field I happen to be working in at the time.”
A man who wears many hats microbiologist, geneticist, technologist, and even dairy farmer Dr. Ehrlich has been one of the most influential minds in the field of genomic sciences, helping to find answers to some of the most challenging medical dilemmas facing mankind. And through his steady, supportive leadership, Dr. Ehrlich has helped put the Allegheny-Singer Research Institute center stage in the rapidly-evolving field of biomedical research.
Everything Dr. Ehrlich has accomplished as a researcher is not only the result of his educational and vocational background, but also the culmination of his life experiences Dr. Ehrlich says he has been interested in the sciences ever since he was able to walk. Growing up on a dairy farm in Upper New York State, he quickly became fascinated with plants, animals and human development. At first, young Dr. Erlich wanted to be an archeologist, then a paleontologist. Finally, he decided upon a career in biology. In the mid 1970s, Dr. Ehrlich attended Alfred University in New York, where he earned a B.A. degree with a special emphasis on evolutionary biology and marine biology.
“At the time, I had almost no interest in genetics,” reflects Dr. Ehrlich. “I thought that geneticists were merely involved in counting fruit flies.”
But when he became a junior, Dr. Ehrlich’s impression of that field was to take a life-altering transformation. Molecular genetics was becoming a burgeoning field and was attracting many bright young scientific minds. (According to Dr. Ehrlich, molecular genetics is a mechanistic science: it provides explanations as to why things happen. Population genetics, on the other hand, is a descriptive science that simply catalogs observations.)
Dr. Ehrlich describes his first molecular genetics lecture (a new, required course at the time) as a “metanoic” experience. “When my professor explained the first known models of gene regulation, a path was suddenly opened to me and I abandoned all of my previous scientific pursuits to become a molecular geneticist,” he said.
In the late 1990s, Drs. Ehrlich and Post heard about a burgeoning research program that was being developed at Allegheny General Hospital, and they were recruited with the promise of Genomic able to build an entire new Department of Genomic Sciences. Dr. Ehrlich joined the Allegheny University of the Health Sciences (AUHS) in 1997, while Dr. Post accepted a position at AGI I the same year. Dr. Ehrlich became executive director and scientific director for AUHS’s (center for Genomic Sciences. Later, the entire Pittsburgh-based AUHS faculty was folded into ASRI.
Over the next several years, Drs. Ehrlich and Post built up a robust set of relationships with various governmental, regional and; academic institutions, which were formalized when Dr. Ehrlich was named ASRI’s liaison officer for Scientific, Governmental and Regional Affairs. He also holds professional titles in microbiology and immunology, otolaryngology, head and neck surgery, and human genetics at the Drexel University College of Medicine, and serves as all adjunct professor of biomedical engineering at Carnegie-Mellon University.
At ASRI, Dr. Ehrlich has been part of several groundbreaking studies, including: mapping a gene for severe pediatric gastroesophageal reflex (a condition that was not even thought to be genetic); establishing that chronic otitis media (middle-ear disease) and a host of other chronic inflammatory conditions are bacterial biofilm diseases; promulgating and proving the disturbed genome hypothesis; and developing the intelligent implant concept.
In recognition of his scientific achievements, Dr. Ehrlich has received more than $35 million in research support from the National Institutes of Health and other federal agencies that support research. He has also been all invited participant oil dozens of federal grant review panels; delivered more than 150 national and international talks at meetings, symposia, conferences and workshops around the world; served as all editorial board member for several peer-reviewed scientific journals; and has been a participant on numerous industrial research advisory boards.
Currently, Dr. Ehrlich is involved in several trend-setting research projects at ASRI. His most current research passion is using the tools of computational biology and metabolomics to help determine the function of thousands of uncharacterized genes.
“Now, when we sequence a bacteria even though we and others have done it thousands of times a large percentage of the genes are of unknown function. I want to build an informatics system and mate it with a robust phenotyping system to permit the statistical pathway-based determination of gene function, as opposed to having to go into the lab and shady each gene one at a time to determine its function,” said Dr. Ehrlich, who also is working on an ambitious goal to develop all intelligent implant all artificial joint that call self diagnose and self treat.
When he isn’t coming up with answers to some of the most perplexing medical mysteries, Dr. Ehrlich enjoys alpine skiing, mountain biking and racing his BMW.
Reflecting on his career, Dr. Ehrlich believes he has achieved success because he has always kept all open mind. “There are good scientists who can quote verbatim everything there is to know about a particular field, but I find that those people rarely make paradigm-shifting contributions to science. When YOU know too many details about a particular field, it starts to blind you from other possibilities. I try not to get caught up with having to know everything about a specific discipline. I do my best work fairly early in an area, when I’m not trapped into a particular way of thinking about it. And I am always looking for answers outside the box.”
Always searching for the next puzzle to solve, Dr. Ehrlich continues his passion for unraveling the mysteries of the double helix. Besides working on a full slate of his own research studies and training the geneticists of tomorrow, Dr. Ehrlich is spending considerable time expanding the Center of Genomic Sciences. “My goal is to build a world-class genomics program at Allegheny General Hospital,” he said. “While we need additional infrastructures and faculty to reach that level, we are making tremendous progress. With our abundance of talent at ASRI, I’m confident our researchers will be on the cutting edge of some of the most important discoveries that will be made in the field of genomic sciences.”
After graduating from Alfred University, Dr. Ehrlich started graduate school at the University of Chicago. Shortly after beginning his studies, Dr. Ehrlich boldly announced that he wanted to undertake a search for human retroviruses a group of pathogenic human and animal viruses that would later be linked with lethal diseases such as leukemia, AIDS and encephalitis. The reaction from his teachers and advisors stunned Dr. Ehrlich.
“The faculty laughed and said there was no such thing as a human retro virus,” said Dr. Ehrlich. “They told me not to make a fool of myself.”
Discouraged with the scientific establishment, Dr. Ehrlich left graduate school after only six months. He returned to Upper New York State, where he ran the family dairy farm for several years. Milking cows and growing crops such as corn, oats, wheat and alfalfa seemed like the furthest thing from examining test tubes in a prestigious, urban medical laboratory, but Dr. Ehrlich later realized that this experience would play a major role in shaping his development as a geneticist.
“I learned a lot about different applications of science and technology during that period,” said Dr. Ehrlich. “Dairy farmers have to be good in many things, such as agronomy, animal husbandry, breeding (genetics) and veterinary sciences, and have to be competent as mechanics, plumbers and electricians. They also have to understand banking, tax laws and basic economics. Farmers simply can’t afford to hire specialists for everything that needs to be done.”
Dr. Ehrlich said he also became a sort of cracker barrel geneticist during this time. “As a farmer, you have to make important decisions about which cows and bulls to breed. My father, brother and I put a lot of thought into matching positive traits with negative traits, in order to breed the best possible offspring. That experience rekindled my interest in genetics and gave me a different perspective of looking at things.”
Revitalized, Dr. Ehrlich moved to Maryland in 1980, where he was hired as a microbiologist for Bethesda Research Laboratories. There, he began his career by learning microbial strain construction techniques and applied them to the creation of bacteria that produced high concentrations of amino acids. A little over a year later, Dr. Ehrlich accepted a position as a research scientist with a newly formed Genetic Engineering Group within Bristol Myers’ Industrial Division in Syracuse, N.Y. During this time, he was involved with cloning the amidohydrolase gene from Fusarium oxysporum (a mold) the protein product that was used in bulk reaction for the creation of semisynthetic penicillins (one of the major products of Bristol Myers’ industrial division).
Dr. Ehrlich soon realized he would need a doctoral degree to further his career and started his Ph.D. studies in biology at Syracuse University while working for Bristol Myers. One of his mentors was Bernard Poiesz, M.D., the internationally-acclaimed scientist who had lust discovered the first human retro virus. After working on his degree part-time for two years, Dr. Ehrlich quit working in the industry to focus all his efforts on his degree. This period would prove to be a turning point in Dr. Ehrlich’s development as a researcher.
“AIDS was entering the spotlight and medical science was frantically searching for answers about how to treat this mysterious disease,” said Dr. Ehrlich, who was also working as a technical specialist for the SUNY Research Foundation in Syracuse, N.Y.
Following a post-doctoral fellowship in human retrovirology at the SUNY Health Science Center in Syracuse, Dr. Ehrlich worked at the same school: first as a research instructor, then as a research assistant professor. Dr. Ehrlich began to attract attention for his sharp analytical skills and his ability to devise ingenious technological tools to find scientific answers.
“Initially, I wasn’t that happy about this notoriety, since people were recognizing me as more of a technology guy, rather than a theoretical biologist,” said Dr. Ehrlich. “But later on, I realized that wasn’t such a bad thing, since technology completely changes how you think about your research.”
In 1990, Dr. Ehrlich was recruited to the University of Pittsburgh to establish one of the first clinical molecular diagnostic laboratories in the world. During his tenure at Pitt, Dr. Ehrlich held a number of academic and research positions at the University of Pittsburgh and began to establish himself as a leading expert in infectious disease studies and human genetics. He also met and formed a long-lasting collaboration and friendship with Christopher Post, M.D., Ph.D., another infectious disease researcher who would later become president and scientific director of the Allegheny-Singer Research Institute. Both men would soon map and clone one of the most important genes responsible for crania-facial abnormalities.
______________________________Taken from the color brochure, Allegheny-Singer Research Institute. These may be obtained by calling 412-359-3236.
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Excerpts from our on-camera interview are below. Minor edits were made for brevity and clarity.
__________________________________________________Arthroplasty Patient Foundation: Please tell us a bit about yourself any major developments here.
Dr. Garth Ehrlich: I serve as the Executive Director for the Center for Genomic Sciences and our primary mission is to understand how bacteria cause disease, specifically, how bacteria cause chronic disease. Weve been doing this type of research for nearly 20 years. We started at the University of Pittsburgh in 1990, and then moved to the Allegheny-Singer Research Institute in 1997.
I think that the major epiphanies, if you will, metanoic moments, that weve had scientifically was the recognition that chronic bacterial infections are usually caused by biofilms and one of the things that occurs during biofilm infections is continual gene rearrangements.
Arthroplasty Patient Foundation: Can you differentiate between an acute and chronic bacterial infection?
Dr. Garth Ehrlich: Acute bacterial infections and chronic bacterial infections are very different. Acute bacterial infections are caused by planktonic bacteria, that is, bacteria that are swimming freely, each bacteria is essentially a single-celled organism. Chronic infections, for the most part, are caused by bacterial biofilms, and a bacterial biofilm is, in essence, a multicellular organism, so that each individual bacterium within the biofilm is analogous to each individual cell in your body. And so they are actually functioning as a single, single organism, and its the adoption of the biofilm mode of growth that provides for, what we say, chronicity, or persistence.
And, so, when you get an acute infection anywhere in your body when you have a medical device implanted, there is a finite risk that some of those planktonic bacteria that are associated with acute infection will land on the implanted medical device. And, if they do, they can form a biofilm on that device, uh and then you end up with a chronic infection resulting from that. You can think of bacteria as having a life cycle, because, once the bacteria are on the device as a biofilm, theres always a certain percentage of the biofilm bacteria that are shed as planktonic bacteria, and we call these showers.
And so, when a shower of planktonic bacteria occurs, then that can cause an acute exacerbation. So you go from chronic to acute, chronic to acute. Now the acute, you can treat with antibiotics, so you can treat somebody, and youll stop the acute infection, but you wont get rid of the nidus, the mother biofilm, which keeps spewing them out over time. And so, thats why, if you hear about somebody who has something like a central line or something like that (e.g. a catheter) in their vein, and they become episodically febrile, (they have a fever) that means theyve had a planktonic shower. You treat the planktonic shower with antibiotics then it kills the planktonic bacteria, but the mother biofilm stays intact. So theyre no longer acutely ill, but they still have that chronic infection and that chronic infection will produce subsequent showers again. So the only way to actually stop that showering is to take that device out, pull the catheter out and start over again.
Arthroplasty Patient Foundation: Can you elaborate on this a bit more the bacterial infections process?
Dr. Garth Ehrlich: There are two different ways, basically, that a medical device inside someones body can become infected. The first way is actually associated with the procedure that put the device in, so that there was a break in sterility. Generally, we try to do surgery under sterile conditions, but its not perfect. And, so, at some low percentage, bacteria will be introduced into the wound site at the time of infection and these are called acute infections because it happens with the surgery. The second type is one where the infection occurs much, much later. It can occur years later, when somebody has what we call septic or bacteremic effect, where, for some reason theres bacteria in the bloodstream. So, perhaps you had a dental procedure or something like that; if you disrupt the biofilm bacteria you know, that are associated with gum disease, and its very easy for them to get into the blood. So, essentially you have a planktonic shower and then those planktonic bacteria if some of them land on the plates in somebodys spine or their artificial joint in their in their leg, then they can become infected. They can have their implant infected years after it was put in.
And those late-occurring infections are by no means are a result in a loss in sterility during the surgical process. So, basically, if somebody you know is out more than six months from the time of surgery before they have any symptoms, then its a fairly good guess that the infection occurred post-surgically, as opposed to intra-operatively.
Arthroplasty Patient Foundation: Are there any other things you wanted to mention that you feel as though patients should learn from you or from the Institute?
Dr. Garth Ehrlich: One of the things that I would recommend to any patient who is going to have any sort of procedure done, if they already have an implantable device anywhere in their body, is that, before the procedure is done, is that they prophylactically take antibiotics to prevent a planktonic shower to prevent what we call bacteremia — which is simply bacteria in the blood. .
So, whereas I dont think people should overdose with the antibiotics, if youre going to have a procedure and you already have some sort of prosthetic device, then I think its very wise to be treated prophylactically with antibiotics you have that procedure. Thats one thing you could really do to cut down the risk of developing a chronic biofilm infection. The other thing that Id like patients to know is that there is now a community of scientists which recognize that chronic infections are associated with biofilms.
And biofilms act profoundly differently than planktonic bacteria and it is only a matter of time before we do have effective therapies for biofilms. The analogy I would use is, when people first really understood the bacterial nature of disease in the middle of the 19th century, some of the work that was done by Louis Pasteur, Robert Koch and Paul Ehrlich. It took decades from the discovery of planktonic bacteria, really, to the development of the first antibiotics and nearly a century before the antibiotics became widely available in usage. So its only been within the past.
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Please see this link for an eleven-minute excerpt: http://www.youtube.com/watch?v=OK-6B2J-si0
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