Dr. Sean Monaghan was recently named vice chair of research for the Department of Surgery at Brown University’s Warren Alpert Medical School. He is a board-certified trauma/critical care surgeon at Brown Surgical Associates and an associate professor at the medical school.
Monaghan has been conducting National Institutes of Health-funded research into RNA biology and its role in sepsis. He and his colleagues hope to expand this work to investigate sepsis and other pathogens such as E. coli and Staphylococcus aureus after trauma, cancer, transplants or major operations.
PBN: What are your primary goals for your new role?
MONAGHAN: My overarching goal is to enhance the research performed by the Department of Surgery at Brown University. The department currently receives about $6 million in NIH funding. I hope to continue this funding and grow with the recruitment of new faculty. Many surgeons perform clinical research with residents and medical students. I hope to provide them with better resources for things like regulatory documents for the IRB [institutional review board] and biostatistics.
Bringing the newest technologies and treatments to care for our patients is done with increased industry-sponsored research and through innovation. Innovation is a focus in the state, as seen by the newly created R.I. Life Science Hub and I am part of a working group for innovation at Brown Health. I will work with these two entities and others – NEMIC [New England Medical Innovation Center], Brown Technology Innovations – to help create a group of surgeons working on the next great improvement in health care.
PBN: What trends have you found in your research into connections between RNA biology and sepsis? How do you hope to expand this work?
MONAGHAN: There are two main trends we are studying from the RNA sequencing work in sepsis. When looking at RNA from the humans with sepsis, we see the process called RNA splicing – where part of RNA are removed and the remaining are stitched together – occurs differently when a patient is sick.
We also look at the RNA in the blood that comes from the bacteria causing the infection. The RNA from the bacteria that we identify will be expanded into a clinical test to diagnose those infections sooner and will eventually use the QIAcuity Dx.
PBN: How does the QIAcuity Dx work?
MONAGHAN: This machine is a digital PCR [polymerase chain reaction] machine. As many will recall, some COVID tests were PCR and detected whether or not you had COVID. Now with QIAcuity Dx, instead of a single yes/no result like in the past, this machine allows you to get 26,000 yes/no results from a single sample.
While initial work with digital PCR is for cancer, we plan to use it to diagnose sepsis-causing infections. We predict the number of yes/no results in each sample will trend with the severity of the illness, helping clinicians decide if they need to go to the intensive care unit, the hospital floor, or can go home. This machine is also produced to be used for in vitro diagnostics, so once appropriate work is done in the research laboratory, it could be transitioned to the clinical laboratory.
PBN: How does the technology improve patient outcomes?
MONAGHAN: Combined with the RNA work, where we identify RNA from the pathogens, we will make PCR tests to faster identify the infection using the QIAcuity Dx. We will also be able to quickly identify if the bacteria is resistant, enabling us to change the antibiotics when needed.
When a patient has sepsis and their blood pressure is low as a result, the wrong antibiotics increase mortality 7% per hour. Current diagnostic tests for infections can take days. With this technology, we hope to have answers in four hours and quickly give the correct antibiotics and improve outcomes.
PBN: What does it mean to have led the first team behind getting the first QIAcuity Dx machine installed in North America?
MONAGHAN: Being the first team in North America with access to this cutting-edge technology demonstrates the importance of innovation at Brown Surgical Associates and Brown Health. The research we have done on RNA in sepsis has led to the development of a new way to diagnose infections. This machine, purchased with a National Institutes of Health grant, will enable us to apply those discoveries in the clinical setting, where they can help improve patient outcomes.
With the QIAcuity Dx, we can do the next level of testing to ensure it meets all the standards needed for use with patients. I look forward to the day when a patient I am caring for in the ICU [intensive care unit] can get the correct antibiotics sooner because we know the pathogen and if there is any resistance to other medications.
Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.
