Yasuko Nagasaka sees a future where ambulances are equipped with tanks of a gas that, when inhaled during heart attacks, will dramatically cut the nearly 50 percent death rate.
In that future, the tanks would contain nitric oxide, found widely today everywhere from automobile exhaust pipes to the human body. Not to be confused with nitrous oxide — the familiar laughing gas of dental-surgery lore — nitric oxide is chemically simpler, with just one nitrogen atom, and very reactive. It lasts under a second in the body before it combines with other atoms, including the potentially harmful oxygen compounds that arise during a heart attack.
Nagasaka’s vision will take enormous amounts of hard work: She will need to conduct research as a principal investigator even as she takes on teaching duties and juggles responsibilities at home, where she is a single mother to two children, ages 11 and 7.
“It has been challenging for me to work as a researcher on a full-time basis, in a foreign country where there is no family or friends to help,” said Nagasaka, who came to Harvard-affiliated Massachusetts General Hospital (MGH) from Japan in 2005 and who is now an instructor in anesthesia at Harvard Medical School (HMS) and in MGH’s Department of Anesthesia and Critical Care. “My work requires a considerable amount of time being physically present in the laboratory.”
The crushing squeeze of work and family is a familiar one in the medical research field. Young faculty members not only have to prove themselves in the laboratory during these years, but also have to juggle teaching, patient care, grant-writing, publication, and family duties. In 1995, Harvard Medical School began a special fellowship program aimed at easing these difficult years, especially for women, who often bear a greater share of responsibilities at home.
The Eleanor and Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine awarded 81 fellowships of $25,000 to $50,000 this year to lend a hand to Nagasaka and to others like her.
The fellowships don’t convey the ability to be in two places at once, but they can be used to hire help — in the lab or at home — to ease the need to be so. They also can be used to opt out of clinical responsibilities to gain time for research or grant-writing, to help a new lab get its footing, or for other purposes.
Nagasaka, who received her M.D. and Ph.D. degrees from the Tokyo Women’s Medical College, will use the fellowship for her science, where the grant will help her begin to gain independence as a researcher at MGH.
If Nagasaka can fully unearth nitric oxide’s heart-helping effects, in coming years emergency workers might administer the gas to heart-attack sufferers, letting the compound traverse the lungs and travel to the heart. Once there, it would reduce the damage. However, the precise downstream effects of inhaled nitric oxide on the injured heart remain to be elucidated. Nagasaka will tackle this question with her laboratory team and the aid of a Shore fellowship.
There’s real reason to think this future could become a reality. Nagasaka is researching nitric oxide’s effects in a pioneering MGH lab that has made other strides with this gas. Headed by Warren Zapol, the Reginald Jenney Professor of Anaesthesia, and Kenneth Bloch, William Thomas Green Morton Professor of Anaesthesia, the lab has already documented the gas’ beneficial effect by selectively dilating the lung’s blood vessels and has developed life-saving treatments for hypoxic term infants, treatments that the Food and Drug Administration approved in 1999.
Though the gas is already used widely to help improve lung function, Nagasaka said that its short lifespan made people think it didn’t last long enough to penetrate into other organs. More recent research, however, showed that its benefits can extend to preserving the heart, intestines, and liver from injury.
Nagasaka’s work has begun to pay off. In 2008, she was the lead author on a paper that appeared as a featured article in the journal Anesthesiology showing that brief periods of nitric oxide inhalation by mice can protect against heart damage from the restriction of coronary artery blood flow and its subsequent resumption. The next step would be clinical trials.
“I believe the excitement of this scientific development will be fully justified if it produces a dramatic impact on clinical medicine,” Nagasaka said.
The Nov. 18 presentation and reception will be held at the Tosteson Medical Education Center Atrium, 260 Longwood Ave., Boston, from 4 to 6 p.m. The awards presentation (4:30 p.m.) will be held in the Carl E. Walter Amphitheater.
To download a pdf of the recipients.