Heather Ferris, M.D., Ph.D., Joins Joslin
Wednesday, March 06, 2013
Heather Ferris, M.D., PhD first joined Joslin in 2009 when she arrived on a BIDMC/Joslin endocrinology fellowship. After completing her fellowship in 2012, she began treating adult patients in November of that year. She became interested in diabetes care while studying internal medicine during her residency at the University of Pittsburgh Medical Center. After seeing patients with diabetes who were not well managed, she knew that she could work with them to get them under better control.
Dr. Ferris is now a research associate in the lab of C. Ronald Kahn, M.D., studying cholesterol metabolism in the brain. She continues to see adult patients at least one half day a week.
How did you become interested in studying cholesterol metabolism in the brain?
There are many complications in diabetes that do not have good treatment options for patients. The area that probably has the fewest treatment options available is problems with the neurological system. Dr. Kahn, who I work with, had recently shown that in mouse models of diabetes there is less cholesterol produced in the brain. Working with him I am trying to explore further how this might impact their cognition. This is an area that we can potentially manipulate in the future to prevent some of the neurologic complications in diabetes.
What type of research are you specifically conducting right now?
Right now, we have mouse models with disruptions in cholesterol regulation in the brain. We are trying to understand how those disruptions impact their cognition, behavior, and peripheral nerves.
What kind of diseases or conditions can occur if there are defects in cholesterol metabolism of the brain?
It is honestly not very well known yet because this is a brand new area of interest. It is not something that anyone has connected to diabetes in the past. The only examples that we have so far are very severe genetic diseases in pediatric patients. Those are often lethal because they are so profoundly disturbed in their metabolism. But there really isn’t a good place to put it in context yet.
Does diabetes only affect cholesterol levels in brain?
Diabetes affects cholesterol in the rest of the body in somewhat of a different way. Cholesterol does not cross the blood brain barrier, meaning that all of the cholesterol in the brain is produced there. The cholesterol in the rest of the body is made separately. As we all know, high cholesterol in the circulation throughout the body is bad because it clogs arteries. And in people with diabetes we often see high cholesterol in the circulation. In contrast to this, in our mouse models we see low cholesterol in the brain since it is completely independent from the high cholesterol circulating throughout the body.
Have there been any clinical implications in this research?
The biggest clinical implication of this research is that we use a lot of cholesterol lowering medication to treat our patients with diabetes to help prevent heart disease. There has recently been an FDA warning surrounding these medications because they can cause memory impairments and other neurologic problems. This raises the question: Do we need to consider being less aggressive in our treatment? Especially in younger patients who are at lower risk for cardiac disease, but whose brains need to continue to lay down cholesterol into their mid-20’s to fully develop.
Is there a link with cholesterol metabolism in the brain with both Type 1 and Type 2 diabetes?
Yes. We have seen that in both Type 1 and Type 2 models that there is deregulated cholesterol metabolism. In Type 1 diabetes there is a lack in insulin and in Type 2 diabetes insulin doesn’t function as well as it should. In both of these situations we see the same thing. This is an insulin dependent affect.
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