UNMC physician studying pediatric shunt infections with $960,000 NIH grant

Gwenn Skar, MD, an assistant professor of pediatric infectious diseases at the University of Nebraska Medical Center, has received a $960,660 grant from the National Institutes of Health (NIH) to study shunt infections in children.
Shunts are placed when children experience hydrocephalus, a buildup of cerebrospinal fluid in the brain that affects more than 1 million Americans. It typically occurs in childhood, but is a lifelong condition — and requires the constant draining of the fluid with a shunt. 
In fact, shunt placement is the most common pediatric neurosurgical procedure, said Dr. Skar, who also practices at Children’s Hospital & Medical Center.
The shunts can become infected, requiring further surgeries and resulting in additional complications, including neurologic consequences. Children with shunt infections are at increased risk of seizures and of having trouble in school. Studies have linked an increasing numbers of infections with decreased verbal and performance IQ scores. 
Dr. Skar's lab has found preliminary evidence that the body's immune system may be contributing to the problem. The immune system kicks into gear in response to the infection. But it keeps working longer than it should, and its activity goes from helpful to harmful. 
"We think very specific immune molecules destroy connections between neural cells," Dr. Skar said. "If that's true, we can take advantage of therapeutics that already exist. And we can work to find other therapeutics to ultimately stop brain damage during these infections." 
The five-year NIH grant also is a K08, or mentored clinical scientist research career development award. "One of the more unique things about this type of grant," Dr. Skar said, "is a large portion of its purpose is to help MDs become better scientists.
"This has been my goal for many years now. I was inspired by a previous physician-scientist in the peds infectious diseases department here. I worked with her as a resident and fellow." 
While it is her experience with patients that drives her passion for solving shunt infections, Dr. Skar also sees the big picture: "Seeing the connection between patients, the need to better understand their conditions and improve treatments is what drew me to research," she said. 
She will work with Anna Dunaevsky, PhD, and Tammy Kielian, PhD, who will serve as mentors on her journey from clinician to clinician-scientist. 
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