This article originally appeared in the July 2015 issue of the ASA Newsletter.
It is 92,960,000 miles away and the most powerful source of energy and life on Earth. For more than 4.5 billion years, until the invention of the incandescent light bulb in the 1800s, the sun was our only source of light, and human behavior revolved around the light-dark pattern it set. Manufactured light altered human dependence on the day-night cycles of the sun and, perhaps an unintended consequence, affected circadian sleep-wake cycles.
Research in the 1970s showed that the circadian rhythm not only regulates sleep-wake cycles but also has a molecular mechanism that influences individual cells and organ systems. Several decades later, there is substantial biomedical research that correlates disrupted circadian rhythms with health problems such as sleep disorders, metabolic syndrome and obesity, diabetes, and cardiovascular and other clinical diseases. Research has also shown that patients in the ICU suffer from sleep deprivation and disturbances, in addition to critical illnesses, that contribute to dysfunctional circadian rhythms.
Although we know long-term circadian disturbances affect human health and lead to clinical disease and disorder, we do not yet know the clinical consequences of short-term circadian disturbances that occur during surgery and anesthesia.1 Tobias Eckle, M.D., Ph.D., and his research team are examining the potential consequences and solutions by studying how intense light could be used as a novel therapy to prevent or treat ischemic myocardial tissue injury in surgical patients.
“Perioperative myocardial infarction is a major contributor to mortality in surgical patients,” Dr. Eckle says. “Observations that myocardial ischemia could be worse after longer periods without daylight pointed us toward intense light as therapeutic strategy in perioperative myocardial ischemia. In fact, a light-dependent circadian rhythm protein was found as a molecular basis for intense light elicited cardio-protection.”
Dr. Eckle is Associate Professor of Anesthesiology, Cardiology and Cell Biology in the Department of Anesthesiology at the University of Colorado, Denver. He recently received an NIH R01 from the National Heart, Blood and Lung Institute for his study “Intense Light Therapy for Perioperative Cardio-Protection.”
“By using murine studies on tissue specificity, drug-based therapy and metabolism in vivo in combination with human studies, we hope to establish intense light therapy in surgical patients to prevent or treat myocardial infarction,” he says.
Dr. Eckle has been studying myocardial infarction since his days as a post-doc. “I started my research by looking at the special phenomenon of the protective effect of ischemic preconditioning of an organ,” he says. “My research group has done pioneering work on the underlying molecular mechanism of ischemic preconditioning of the heart and finally was able to answer long-lasting research questions in this field.” The findings contributed substantially to the development of new drugs to treat heart attacks.
His early research also led to significant grant funding that has enabled his group to create new-found knowledge and clinical recommendations to help restore circadian function in ICU and surgical patients. In 2008, he received a Mentored Research Training Grant – Basic Science from FAER for his study “Myocardial Ischemic Preconditioning through Hypoxia Inducible Factor (HIF)-1alpha.” Immediately after his FAER grant, Dr. Eckle received a career development grant, an NIH K08, from the National Heart, Blood and Lung Institute and now continues to be an NIH-funded anesthesiologist with his R01.
Dr. Eckle’s research has been published in PlosBiolog, Nature Medicine and most recently in Anesthesiology. He says his FAER grant allowed him to pursue the research that led to the discoveries he has made to date and enabled him to receive his NIH grants.
“As an anesthesiologist in research, I am extremely thankful to FAER and the ASA for providing an outstanding platform such as the MRTG [Mentored Research Training Grant] that allows young anesthesiologists to pursue a career as a physician scientist,” he says. “Without the generous support by FAER and the ASA, it would have been extremely difficult to become an independent NIH-R01 funded scientist.”