Luke P. Brewster, MD, PhD, MA, RVT
Division of Vascular Surgery
Department of Surgery
Emory University School of Medicine
I am a young vascular surgeon-scientist identifying and testing the mechanisms that lead to arterial stiffness. Arterial stiffness initiates and escalates the progression of atherosclerosis throughout the arterial tree, but is particularly prevalent in the peripheral arteries. As a vascular surgeon I see and treat the effects of peripheral arterial disease (PAD) on this patient population. Unfortunately little is known of the root causes of arterial stiffness or the signaling mechanisms involved in this unfavorable remodeling process. In coordination with my mentorship team, including Hanjoong Jo and Bob Taylor, I have been awarded a Clinician Scientist Career Development Grant to identify a role for disturbed flow in arterial stiffness and identified putative signaling pathways involved in this process. Under the direction of an excellent mentorship team and in an unparalleled environment for endothelial cell mechanobiology, this proposal will identify and test the role of the mechanosensitive matricellular protein, thrombospondin-1, in stiffened arterial remodeling. This work has broad scientific application to the understanding of PAD and will provide me with the resource of protected time and structured mentorship to collect important preliminary data and publication record to establish a career as a translational surgeon-scientist with expertise integrating endothelial cell signaling with fluid shear stress and the solid mechanics of stiffened matrices. Most importantly positive results can be rapidly translated to clinical trial to improve the arterial health and prevent atherosclerosis in PAD patients.
Dr. Brewster's PhD work involved the development and characterization of designer growth factors that could sterically bind to sites of vascular injury as they maintained a regenerative effect on the surrounding tissue, while his MA focused on evaluating the patient perspective towards autonomy after severe burn injury and liver transplantation. He is a registered vascular technician with an interest in utilization of ultrasound technologies to limit radiation exposure to patients; has experience with the creation and validation of a number of surgery educational modules for the evaluation of trainee interpersonal, communication and technical skills; and has published the first surveys and evaluations of the exposure of surgical residents to clinical ethics scenarios and their subsequent understanding of these constructs. His practice is focused on general vascular surgery with a clinical research interest in the use of ultrasound to diagnose and treat vascular disease, the patient and surgeon perspective in surgical decision-making, selection and outcomes of carotid artery stenosis therapy, and optimal therapy for limb salvage. His translational research involves the characterization of the blood vessel wall's deformity in diseased states and how this impacts both surgical and endovascular therapies. The goal of this work is to better refine therapies for application to diseased arterial conditions. In 2012, the American Heart Association awarded a National Center Research Program (NCRP) Innovative Research Grant to Dr. Brewster, which will support his project to improve the angiogenic capacity of adipose-tissue derived mesenchymal stem cells for the purpose of saving ischemic limbs. The study will involve the culturing of cells harvested from ischemic limbs that required amputation.