Dr. Maya Mikami
Assistant Professor of Anesthesiology
Dr. Mikami’s previous experience in neuroscience research coupled with her clinical interest in neuroanesthesiology led to studies of the neural control of airway reactivity. Cough and bronchoconstriction are protective airway reflexes from inhaled noxious agents. However, during induction and emergence from general anesthesia, these reflexes can cause serious complications including laryngospasm or bronchospasm which may lead to hypoxemia and these events are more common in patients with reactive airway diseases. These airway events occur in part by neuronal modulation of airway tone. There remains an unmet clinical need for optimal control of perioperative bronchospasm and this deficit exists in part due to a lack of understanding of the mechanisms involved in pharmacologic modulation of airway tone.
By comparing remifentanil (opioid), lidocaine (local anesthetic) or dexmedetomidine (alpha 2 agonist) in airway contractile responses and acetylcholine releases, she found that dexmedetomidine reduced both cholinergic nerve stimulated airway smooth muscle contraction and the release of acetylcholine from parasympathetic nerves. These findings provide a plausible mechanism for the observed utility of dexmedetomidine in attenuating airway responses during airway instrumentation. Dr. Mikami also questioned the cellular mechanism(s) by which emerging classes of potential bronchodilators act on airway smooth muscle. Ligands for bitter taste receptors, GABAA receptors, TMEM16A antagonists, and flavonoids have all been shown to relax airway smooth muscle despite a seemingly paradoxical transient increase in intracellular calcium.
In collaboration with Dr. Steven An (Johns Hopkins University) who has a novel method for measuring single cell stiffness using magnetic twisting cytometry, she is demonstrating that calcium activation of the actin protein gelsolin, may be the mechanism by which calcium induces actin depolymerization and smooth muscle relaxation. A part of this actin binding protein gelsolin is now being studied ex vivo (airway luminal area measurement using precision cut lung slices) and in vivo (mouse respiratory mechanics measurement by FlexiVent) in order to be used as potential therapeutic option for bronchoconstrictive diseases. Using small animal model, Dr. Mikami is currently conducting a study which ultimately link chronic allergic lung inflammation and brain inflammation. Her study has the potential to connect lung research and neuroscience research.
For more information, please contact Dr. Mikami at email@example.com.
View a complete list of Dr. Mikami's publications.