Evelin Szabó and Inez Bosnyák, sixth-year students at the Medical School in Pécs, did a one-month research internship in the summer at the Mayo Clinic in Rochester, one of the USA’s and the world’s leading medical institutions. Professor Dóra Reglődi, Head of the Department of Anatomy and Vice-Dean for Science, played an essential role in creating the opportunity and selecting the students. We talked about the background, the establishment of the collaboration, the experiences of the two young students, the benefits and advantages of the research internship, and the possibilities for further networking.
Written by Rita Schweier
Dr. Dóra Reglődi listed the background as follows: “In 2019, four of us from the Medical School visited the USA, led by the dean. We aimed to establish collaborations with the world’s leading universities. We already had Hungarian contacts at the Mayo Clinic, Professors Éva Morava and Tamás Kozicz, with whom we had had an excellent relationship before but had no bilateral professional agreement. First, we moved forward in the field of education, with my colleague Dr. Balázs Gaszner and I teaching anatomy at the Mayo for a week each. The coronavirus epidemic somewhat interrupted the process, but after it subsided, we appointed Dr. Éva Morava as a professor, and Dr. Tamás Kozicz became a visiting professor at the Department of Anatomy. The next step was to send the students abroad, which was preceded by a very long administrative process.”
As she said, Dr. Éva Morava has a robust research background besides working as a geneticist and clinician, while Dr. Tamás Kozicz works mainly as a researcher. They both run labs, which is how the two students were able to travel there. They were selected from a pool of six fifth-year MD-PhD students, the most outstanding fifth-year students who had already published scientific papers. Dr. Dóra Reglődi added that their aim was also to ensure that the knowledge acquired by the students would remain at the Medical School for a period, at least for the duration of their PhDs.
Evelin Szabó joined Dr. Tamás Kozicz’s research group, and Ivett Bosnyák joined Dr. Éva Morava’s research group. The Mayo Clinic accepted them as research trainees. Inez arrived in Rochester a week late due to visa difficulties, but it did not hinder her research internship.
“I could not believe that I had been chosen at first; I only realized it when I had my first online conversation with the professors abroad. My supervisors and family thought it was a great opportunity; everyone was happy,” said Evelin Szabó, deeply moved.
Evelin has been a TDK student at the Institute of Physiology for three years; her supervisors are Professor Dóra Zelena and senior lecturer Dr. Anita Péliné Kovács. They work on preclinical models of psychiatric diseases. Evelin is involved in two projects: one of them is examining the role of prolactin-releasing peptide (neuropeptide) on a rat depression model, and the other one is examining the metabolic aspects of post-traumatic stress disorder on a mouse model. As she said, Dr. Dóra Zelena and Dr. Tamás Kozicz had already worked together in a previous research collaboration, so they were keen to find a topic for her that could also be utilized here at home: the study of mitochondrial function in psychiatric and genetic diseases.
Evelin learned the mitochondrial measurements used at the Mayo: the measurement of mitochondrial respiratory chain complexes and citrate synthase enzyme activity, as well as the use of the SoNar intracellular sensor. The samples examined were connective tissue cells from patients’ skin biopsies, of which she performed the cell culture. As she had not worked with cell cultures at the Institute of Physiology, this opened up new perspectives for her. She said that the mitochondrial measurement techniques learned abroad can be integrated into research projects here; the conditions are given.
“Psychiatric disorders are very individual; we often do not understand their exact background and pathomechanisms, which is why animal experiments are important because we can influence the symptoms of a particular disorder by using certain substances. Hopefully, there will be clinical benefits at the end of our research, and in the long term, we may even be able to develop medicines,” she said, explaining her motivation.
Inez Bosnyák started working as a demonstrator after her final exam in anatomy, and later, she became a TDK student at the Department of Anatomy. Since September of the previous academic year, she has continued her research as an MD-PhD student under the supervision of Dr. Dóra Reglődi full professor, Dr. Alexandra Váczy senior lecturer, and Dr. Tamás Atlasz associate professor. Her main research topic is developing an optimal ischemic optic neuropathy mouse model; she also examines the potential beneficial effects of a plant hormone in retinal hypoxia and the protective role of PAC1R in various ocular inflammatory diseases. Dr. Éva Morava’s research group, which she joined, examines the pathomechanisms of cardiac manifestations of certain glycosylation disorders and tests potential therapeutic agents.
She explained that typically, sugar molecules are attached to proteins so they can function properly, but people with congenital disorders of glycosylation (CDGs) cannot correctly attach these sugars or sugar chains. Because glycosylation occurs in all cells and tissues, a child or adult with CDG may have symptoms in many parts of their body, including the brain, nerves, muscles, liver, or immune system. Members of the research team abroad use cells from patients’ skin biopsies to perform various measurements of the levels of highly glycosylated proteins and conduct multiple genetic tests.
She was fascinated that cells from skin biopsies were reprogrammed as stem cells and then differentiated into beating myocardium cells. In this type of disease, complementary therapy relieves all symptoms except those affecting the heart. The method can be used to test new therapeutic options. Inez also learned several laboratory techniques she can use here at home. She had the opportunity to gain insight into the care of patients with CDG as well, attending specialist visits several times.
Their case studies will also lead to first-authored papers, expected early next year.
In her paper, Inez deals with the case of a little girl with ALG1-CDG. As she said, the girl had muscle weakness, epilepsy, vision and hearing impairment as well. Since these glycosylation phenomena are often associated with ophthalmological consequences, she has also explored this in depth in connection with her original research topic, if only because it is an understudied area. Cells from the child’s skin biopsy were also subjected to various laboratory techniques because the most commonly used diagnostic method failed to detect the disease in her, even though she had very severe symptoms.
Evelin is also processing the case of a little girl with a rare genetic disease, congenital hypophosphatemia. Although this genetic variant tends to cause a very severe pathology, the symptoms are mild, both in terms of hearing impairment and motor retardation, the cause of which they do not yet know. She explained there are no significant differences in the development of children with this condition in the first few months, but they usually have an episode of low blood sugar and liver failure in the first year, which generally leads to them ending up in emergency departments. Those with severe symptoms lose the skills they have acquired by the age of two and need care for the rest of their lives.
They both emphasized that the Mayo Clinic has very well-equipped laboratories, but everything that can be done there can also be accomplished here at home. They said the clinic building, which is more than three stories high, is like a museum or a shopping mall because shops and cafés are below the ground floor between the clinical departments. In their free time, they could visit Rochester, walk around the beautiful lake ten minutes from their accommodation, and see the main attractions of Minneapolis as well.
“Dr. Éva Morava and Dr. Tamás Kozicz will continue to welcome our students for research internships at the Mayo Clinic, and the leadership of the Medical School will also support their stay. An educational collaboration has also been established with Harvard University, Dr. Krisztina Fischer has become a visiting professor at the Medical School in Pécs, and several educational development courses have been launched with her assistance. The new chairman of the Committee on International Affairs, Dr. Gábor Horváth, also plans to implement a wide range of programs for students, and he would like to build on the experiences gained so far so that there will be more opportunities for them” - Dr. Dóra Reglődi summarized the plans.
Photo:
Dávid VERÉBI