Not just for faculty: Medical students excel at research

Annual student symposium awards first prize to a project examining neural stem cells

Anne Pinckard

Jason Liauw’s work supports the idea that a protein from neural stem cells helps to heal brain damage.

Ten years ago, Orange County high school student Jason Liauw, then 13, stood before a committee to request a fellowship grant for a research experiment he had designed to study whether genetic mutations in eyes could be linked to environmental factors.

The committee rejected his proposal, but the experience set Liauw, now a third-year medical student, on the path to earn first place May 17 in an annual competition with an array of medical student research projects.

"Research is like a roller coaster—there are a lot of risks to take," Liauw remarked. "But it becomes satisfying when you know what your endpoint is, and you realize why you are doing the research."

Liauw's research confirmed the identity of a specific protein thought responsible for improving recovery in brain tissue after a stroke, and the project impressed the judges in all the categories considered at the 23rd annual Stanford Medical Student Research Symposium. The criteria included significance of the research question, creativity, study design and presentation, said Patricia Cross, PhD, associate dean for medical student research and scholarship. Med students Winifred Adams and Bill Bragg won second place, while Anand Veeravagu and Jenny Wilson placed third.

The symposium is a chance for the medical students to present posters showing the results of their hard work, in some cases taking more than a year of investigation on their chosen topic. Over the last three years, the number of students who have earned one-year full-time research fellowships or the prestigious national Howard Hughes Medical Institute research fellowship has doubled, reflecting a substantial increase in student interest and the high quality of the research, Cross said.

This year students made 33 presentations, covering such topics as how women in Colombia perceive the threat of congenital toxoplasmosis, a parasite that can cause birth defects, and how bone growth may be suppressed by the particles commonly used in prosthetic limbs.

For the first time, students in the Practice of Medicine course also presented findings from their research projects on issues involving community advocacy and outreach, though they were not part of the competition. The mix of work on medical innovations and health-care system reforms stimulated a useful dialogue at the symposium between these two major means of improving health care.

Liauw's fascination with research began in middle school as he devoured issues of Science News. Even before he graduated high school, he participated in experiments on the molecular action of pain and fear memory at Washington University in St. Louis, where he then enrolled and completed his undergraduate work.

By the time Liauw entered medical school, he knew he wanted to pursue research in neurosurgery. He decided to take a year off from classes to investigate how stem cells could be used to help the brain heal after a stroke. He wanted to find the mechanism, what molecules were involved and how they worked to help the neurons recover. The question he proposed for his research project, funded by the Stanford Medical Scholars Endowment, was whether thrombospondin, a protein secreted by neural progenitor cells, or neural stem cells, could help neurons form new connections.

Under the mentorship of Gary Steinberg, MD, PhD, chair of neurosurgery; Ben Barres, MD, PhD, professor of neurobiology; and postdoctoral researchers Tonya Bliss, PhD, Cagla Eroglu, PhD, and Raphael Guzman, PhD, Liauw developed his hypothesis.

This experiment was the first that he designed himself and would see to completion. He had a year to get it right, and he'd aimed high by choosing a relatively unexplored subject, he said. He read all the papers on the topic he could find.

Researchers have known that transplanted neural progenitor cells, a type of stem cell, help improve recovery in a brain damaged by stroke. What's not clear is whether the progenitor cells turn into neurons themselves or secrete molecules such as thrombospondin, which elicit the healing response.

To test the theory, Liauw, working with Eroglu, placed mouse progenitor cells above cultured neurons. These progenitor cells would secrete thrombospondin. On another set of cultured neurons, they laid mutated progenitor cells unable to secrete thrombospondin.

Luck was on their side, and the preliminary experiments went smoothly, Liauw said. When it came time to look at the final results, he analyzed the stained cells without knowing which ones were which to avoid any bias. Sure enough, the neurons exposed to stem cells secreting thrombospondin formed significantly more connections than those exposed to the stem cells deficient in the molecule. The results suggest that thrombospondin may play an important role forming neural connections, though further research is needed.

"It was exciting to see that stem cells have that effect," Liauw said. The idea that his work could directly lead to a clinical therapy drives him to continue, he said. He plans to submit the results for publication in the next year or so.

"The benefit of the research is a personal one for the students," said Julie Parsonnet, MD, senior associate dean for medical education. "We want students to leave medical school more excited than when they come in—to have a chance to explore their personal interest and gain command over a way of thinking and creating knowledge."

Every year, the symposium poses a quandary for judges because of the excellence of the students' work, Parsonnet said. On May 17, the judges, also medical students, ran a half-hour over the allotted time before choosing Liauw. He accepted the award to quiet applause from the students that remained. He gave the $300 prize to his lab's social fund to thank the senior researchers for their guidance. They'll enjoy a happy hour together soon, he said.

Anne Pinckard is a science-writing intern in the Office of Communication & Public Affairs at the School of Medicine.