The Department of Otolaryngology—Head and Neck Surgery at Indiana University School of Medicine has grown significantly over the past three years with the addition of 14 new physicians and scientists, nearly doubling the number of department faculty since 2019.
Vijay Ramakrishnan, MD, professor of otolaryngology—head and neck surgery, is the newest faculty member to join the department. Ramakrishnan, a clinician-scientist, comes to IU School of Medicine after spending over a decade at the University of Colorado School of Medicine.
A fellowship-trained Rhinology and Endoscopic Skull Base surgeon, Ramakrishnan said he was drawn to IU School of Medicine and the Department of Otolaryngology because of its culture.
“Working in academic medicine has always been challenging, but it is particularly challenging in the modern era,” Ramakrishnan said. “There are frequently many conflicting priorities, but the shared vision of the department, school and affiliated institutions really spoke to me. I felt like they defined a clear path to achieve ambitious and innovative goals and are willing to do what it takes to get there.”
Ramakrishnan is the second rhinologist in a few months to join the department; Satyan Sreenath, MD, assistant professor of clinical otolaryngology—head and neck surgery, started at IU School of Medicine in fall 2021. Rhinologists treat patients with chronic nose, sinus and breathing conditions, such as chronic rhinosinusitis and nasal polyps, nasal obstruction, sinonasal tumors, and perform endoscopic approaches to the skull base and orbit.
In addition to clinical care, Ramakrishnan’s role as a clinician-scientist lends itself toward advancing basic science and clinical research in his laboratory at IU School of Medicine. His clinical research centers on understanding patient outcomes from chronic rhinosinusitis and using these insights to choose appropriate personalized treatment plans for patients that maximize the chances for success.
Ramakrishnan, who has consecutively received funding from the National Institute on Deafness and Other Communication Disorders, part of the National Institutes of Health, over the past several years, said his basic science interests have stemmed from these clinical findings.
For example, Ramakrishnan is investigating the role of the microbiome—the collection of microorganisms, such as bacteria, fungi and viruses, that live within the human body—and particular pathogens in respiratory diseases to understand how a person’s immune defenses function in response to microbial or environmental exposures.
A multi-year project that Ramakrishnan collaborated on at the University of Colorado was recently published in Oncogene. The study demonstrated that the microbiome has the potential to contribute to carcinogenesis—the formation of cancer cells—in head and neck cancer.
“We observed ‘dysbiosis’ in human saliva specimens from patients with cancer of the upper aerodigestive tract, where loss of the healthy homeostatic balance could be implicated in the disease process,” Ramakrishnan said. “We then showed accelerated tumor progression after antibiotic depletion of microbiota in a mouse model of head and neck cancer, and that microbial transfer from cancer bearing mice to a germ-free orthotopic mouse model also accelerated tumor progression. Most striking is the finding that a single bacteria (Lactobacillus) was implicated in this process through its actions on the aryl hydrocarbon receptor pathway.”
Ramakrishnan said this work is unique in that it shows individual bacteria, such as lactobacilli, can regulate tissue processes involved in carcinogenesis. It also suggests that targeting these specific bacteria could potentially influence cancer treatment outcomes in addition to serving as a simple disease biomarker.