Osteoimmunology and Fracture Healing
Diane Nam is studying the effects of the immune system
on fracture healing. Immunodeficient mice that lack T
and B cells have significant alterations in the normal
fracture healing pathway - inflammation followed by
proliferation and remodeling. Immunodeficient mice,
like immunodeficient humans, may fail to heal - developing
partial or non-unions. This interesting area of
osteoimmunology has important implications for fracture
healing for all human patients, as five to ten percent
of human fractures fail to heal satisfactorily. Cytokines
associated with T cell function are altered in human
patients with osteoporosis, diabetes, or those with
immunodeficiency induced by chemotherapy, smoking,
AIDS or trauma. "If we can use the immune response to
improve the outcome in these patients, we may even be
able to accelerate or guarantee union in normal patients.
Immune modulators, which might be dietary supplements,
T cell activators, or other pharmaceuticals may
accelerate healing in normal patients as well as rescue,
or strengthen those who are immunodeficient. Immune
dysfunction is frequently observed after traumatic injury.
Sunnybrook offers many opportunities to translate
research findings into the clinical milieu."
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Diane's clinical work is focused primarily on elective
reconstructive surgery of the upper extremity and
general orthopaedic trauma. Working with her colleagues
Terry Axelrod and Robin Richards, she sees a
great variety of upper extremity pathology. Diane has
75% protected time for research and 25% dedicated
time for clinical work. In addition, she teaches medical
students and residents. She took all of her training from
medical school through fellowship at the University of
Toronto. As a fellow with Terry Axelrod, she studied
upper limb surgery. Her clinical work is performed at
both Sunnybrook and at the Holland Orthopaedic and
Arthritic Hospital. Her mentors during training include
Nizar Mahomed who "sparked the orthopaedic interest
during clerkship", Ben Alman for basic science training,
and Terry Axelrod, who supervised her fellowship in
upper extremity surgery. She was interested in research
before entering medical school, earning a masters degree
in pharmacology. Her father was an architect in Korea
and her mother an accountant. Her parents and brother
Rob, featured elsewhere in this issue, have been great
supporters in her life and career. As a busy mother, she
has little time now for music and the arts, though she is
classically trained to play the violin. Diane is married to
Mark, an attorney. They have two children, Emma, age
5, Ava, age 1. The children are frequently at their Uncle
Rob and Aunt Yuna's house a stone's throw away, playing
with their cousins Matthew and Amy or enjoying their
uncle's gourmet barbecue cooking.
M.M.
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