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Dr. Vivian Lee

Dr. Lee Leads Ocular Pathology Research

By Melissa Homsher

Scheie Vision Winter 2015

Ocular surface disease is a leading cause of vision loss worldwide.  A variety of diseases comprises this category, such as corneal ulcers, trachoma, and conjunctival diseases, but vision loss ultimately results from opacification of the ocular surface.  Once vision loss from ocular surface disease occurs, there are few options other than surgery to correct it.   
In many cases, vision loss from ocular surface diseases originates from superficial wounds, which later develop into deeper wounds that scar.  Dr. Vivian Lee, Assistant Professor of Ophthalmology at UPenn, seeks to develop treatments that enhance the healing of superficial wounds, which recover without opacification. 

As an ophthalmologist and ocular pathologist, Dr. Lee investigates pathophysiologic mechanisms of diseases.  On a daily basis, she treats patients with severe ocular surface disease.  Despite aggressive treatment, many develop vision loss due to the resulting opacification.  Dr. Lee joined the Seykora laboratory in the Department of Dermatology at UPenn to understand molecular pathways that can be targeted to enhance ocular surface wound healing. 

Dr. Lee examines the significance of the Src-family kinases (SFKs) and a Src-activating and signal molecule (Srcasm) in corneal epithelial wound healing. SFKs are a family of proteins involved in critical cellular functions, including cell proliferation and migration. Srcasm is a novel, negative regulator of SFK activity. The Seykora laboratory has conducted extensive research that shows SFKs and Srcasm regulate cutaneous wound healing.  Dr. Lee is hoping to expand that knowledge of SFKs and Srcasm in cutaneous epithelial biology to corneal epithelial biology. 

“If we can understand a specific pathway that regulates epithelial wound healing,” explained Dr. Lee, “then we can develop potential therapies that can enhance wound healing and prevent the development of severe wounds that lead to vision loss.”

Preliminary results have been promising.  Using corneal epithelial cells from mice models that express various levels of Fyn, a member of the SFK family, and Srcasm, Dr. Lee has shown that corneal wound healing can be modulated by varying the SFK: Srcasm ratio in an in vitro model of corneal wound healing. 

“We can make corneal epithelial wounds heal faster in this model by increasing SFK activity or by decreasing Srcasm levels,” Dr. Lee said. “This is a really promising finding.”

Developing a treatment from this finding would be monumental for third-world countries in particular: “In areas with limited access to healthcare, surgical expertise, and resources, something easy like a drop to treat early corneal damage could be a game changer. Vision loss negatively affects quality of life, and an inexpensive preventative strategy could really make a profound impact on someone’s life.” 

Dr. Lee believes that the key to future research is to make connections across disciplines.  Her collaboration with Dr. Seykora in the Department of Dermatology has led to numerous cross pollination of ideas and techniques between the two departments. In addition, her clinical expertise in ophthalmology and ocular pathology combined with her basic science research has helped her bridge numerous aspects of a disease.  By integrating these disciplines and understanding how they interact, tangible results can be obtained. 

“All of us understand how important it is to correlate clinical findings with our understanding of cellular and molecular pathways and to identify interventions or therapies that would benefit our patients the most,” said Dr. Lee explained.  “At places like Scheie Eye Institute and University of Pennsylvania, we can accomplish that and really create the future of medicine.” 

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