Volunteering for a reading program at a children’s hospital led to a career change for Amy Lightner, M.D. As a Stanford University undergraduate, she met a cardiac surgeon who turned her interest to medicine.
“I got to see how medicine and surgical intervention could change a child’s life forever,” says Dr. Lightner. “The research, in parallel, changed lives of thousands, and this combination of clinical practice and translational research was inspiring.”
Today Dr. Lightner is a Mayo Clinic colorectal surgeon, practicing minimally invasive surgical approaches and researching regenerative cellular therapies for some of the most difficult complications of inflammatory bowel disease (IBD). She is recognized as an emerging leader for her achievements in improving surgical outcomes for patients.
Dr. Lightner completed her general surgery residency and two years of full-time research studying stem cell biology in a liver regeneration and immunology laboratory. While she found liver transplantation fascinating, it was while she was finishing her clinical training she turned her focus to IBD and a career in colorectal surgery. IBD is an umbrella term used to describe disorders that involve chronic inflammation of the digestive tract, including ulcerative colitis and Crohn's disease.
“I would see young patients suffering from chronic bowl disease coming to terms with suffering for the rest of their lives without a known cure,” says Dr. Lightner. “Surgery treated the symptoms but not the disease, and I thought we could do so much better than the current treatment options — we needed to find out how to treat the underlying disease.”
Dr. Lightner immersed herself in a Mayo Clinic fellowship for complex clinical care and stem cell research to treat perianal Crohn’s disease. It was during this time she started to see a connection to stem cells and the therapy for IBD. “This was the time that regenerative medicine was taking off at Mayo and becoming an institutional priority,” says Dr. Lightner. “The timing was perfect.”
For patients with ulcerative colitis, a proctocolectomy, or removal of the colon and rectum, is often a last resort. After a proctocolectomy, a J-pouch surgery is performed to create an internal pouch, eliminating the need for a permanent ostomy bag. However, in about 10 to 15 percent of patients the pouch will fail and they will need a permanent ostomy.
Dr. Lightner offers these patients an alternative. She is among a small group of surgeons across the country that is skilled at pouch reconstruction – giving patients a chance at an ostomy-free life.
While an innovative physician who is an expert at reconstructive pouch surgery, Dr. Lightner wants to see fewer IBD surgeries. She is currently researching innovative cellular, non-surgical therapies.
“Regenerative medicine with novel cellular and acellular therapies is the future of medicine,” says Dr. Lightner. “I want to change the way we think of treating IBD to focus on repair derived from our own cells.”
After seeing initial success in treating Crohn’s fistulas with adipose or bone marrow derived mesenchymal stem cells from healthy donors, Dr. Lightner is initiating a Phase 1 trial to explore a novel regenerative acellular therapy. The trial will be the first of its kind in perianal fistula, which affects approximately 25 percent of people with Crohn’s disease.
Translation into Practice Platforms
Dr. Lightner is the enterprise medical director for the Translation into Practice Platforms (TIPPs) for the Center for Regenerative Medicine. The platform accelerates regenerative medicine clinical trials and advancements into clinical practice. Teams provide help with protocol design and writing, and support in communicating with the U.S. Food and Drug Administration.
Dr. Lightner’s research space is best described as a regenerative medicine surgical lab. This all-encompassing lab is working on optimizing regenerative products like extracellular vesicles and engineered mesenchymal stem cells. The work in the lab can be applied to other disease states, allowing these products to cross disciplines. The goal is to bring multiple investigators together, and find novel regenerative therapies for the treatment of multiple diseases.