Blood, Sweat and Smears - Episode Summary
Podcast Title: Blood, Sweat and Smears - A Machaon Diagnostics Podcast
Host: Dr. Brad Lewis, Machaon Diagnostics
Guest: Dr. Tony Cybulski, Assistant Professor of Pediatrics, Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's
Episode: 5 Questions with Dr. Tony Cybulski
Release Date: March 28, 2025
Introduction
The episode features Dr. Brad Lewis and senior director Bjorn Stromses engaging in a "5 Questions" segment with Dr. Tony Cybulski. The conversation delves into Dr. Cybulski's experiences, insights, and perspectives within the fields of thrombosis, hemostasis, bone marrow transplantation, and immune deficiencies.
1. The Best Thing About Dr. Cybulski’s Work
Timestamp: [01:03 - 05:15]
Dr. Cybulski highlights the unique blend of being a physician scientist, dedicating approximately 80% of his time to research and 20% to clinical duties. He emphasizes the importance of human interaction in his role, especially in establishing trust with patients who may not be familiar with him.
Notable Quote:
“At the core of it, in this field, that's so important. And like when I think about the most memorable, important moments when I've been on service and taking care of patients, it's really about things like that.”—Dr. Tony Cybulski [02:30]
He shares a poignant experience with a non-English speaking family where his presence provided hope during a critical time, underscoring the significance of building relationships beyond medical expertise.
Additionally, Dr. Cybulski discusses the "bench to bedside" paradigm. He recounts how casual conversations with colleagues led to the identification of biomarkers for graft rejection, culminating in a funded clinical trial. This underscores his passion for translating research findings into tangible patient outcomes.
Notable Quote:
“We came up with a couple biomarkers that we would do a little pilot study for to see if, you know, maybe these things can help us predict these graft rejections earlier and let us actually do something about it.”—Dr. Tony Cybulski [04:50]
2. Utilizing CXCL9 in Transplant Patients
Timestamp: [05:35 - 07:49]
When discussing the application of CXCL9, Dr. Cybulski explains its multifaceted role in transplant medicine beyond diagnosing hemophagocytic lymphohistiocytosis (HLH). At Cincinnati Children's, CXCL9 is employed as a biomarker for patients with multiple risk factors for graft rejection, monitored at various stages of the transplant process.
He elaborates on ongoing research, including an active R01 project investigating the role of interferon in thrombotic microangiopathy (TMA). The research suggests that interferon pathway activation may perpetuate complement activation, presenting potential targets for interferon-directed therapies.
In the consultative setting, CXCL9 assists in diagnosing complex cases where traditional methods fall short, enabling Dr. Cybulski and his team to identify underlying diseases or therapeutic targets that can improve patient outcomes.
Notable Quote:
“There's something about being able to do that, I think that's just, it's awesome. It's why I think a lot of us get into this field.”—Dr. Tony Cybulski [05:15]
3. Communicating with Pediatric BMT Patients and Families
Timestamp: [07:49 - 10:21]
Dr. Cybulski addresses the delicate balance required in ensuring that pediatric bone marrow transplant (BMT) patients and their families understand their medical situations. He emphasizes the dual focus on both the patient and the family, recognizing that each requires a tailored communication approach.
He cautions against underestimating the intelligence and understanding of both children and their families. Recognizing when families choose not to discuss severe prognoses is crucial, and it's important to respect their coping mechanisms without making assumptions about their comprehension.
Dr. Cybulski collaborates closely with the palliative care team to navigate these conversations, ensuring that discussions are appropriate for the patient's age and cognitive level. This interdisciplinary approach helps in effectively conveying complex medical information while maintaining empathy and support.
Notable Quote:
“You don't have to come in there and say those things every day. And that's where I think the balance is.”—Dr. Tony Cybulski [09:00]
4. The Future of Gene Therapy: Hopeful Cures on the Horizon
Timestamp: [10:35 - 12:44]
Looking ahead, Dr. Cybulski expresses optimism about the advancements in gene therapy and its potential to cure debilitating diseases within the next decade. He identifies several diseases where gene therapy could make a significant impact:
-
Sickle Cell Disease: Dr. Cybulski is particularly enthusiastic about the progress in treating sickle cell disease through gene therapy. He envisions making these treatments accessible in low-resource settings, where the disease is most prevalent.
-
Fanconi Anemia: He highlights Fanconi anemia as a complex disease where bone marrow transplantation extends life but doesn't eliminate the risk of other severe complications like solid tumors or liver disease. Gene therapy could provide a more comprehensive cure.
-
Epidermolysis Bullosa: Dr. Cybulski references this devastating skin disorder, noting its severe impact on patients’ quality of life. Successful gene therapy could transform outcomes for those affected.
Notable Quote:
“When you think of just an absolutely terrible disease for the child living with it every single minute of their life, dealing with that, that's one that I think if gene therapy could be successful there, which I know there are some studies, that would—that is just an awful disease.”—Dr. Tony Cybulski [12:00]
5. Choosing a Complement or Coagulation Factor for a Tattoo
Timestamp: [12:59 - 14:22]
In a lighter segment, Dr. Cybulski is asked which factor from the complement or coagulation cascade he would choose to get tattooed. After considering various options, he settles on C3 Convertase, citing its pivotal role in the complement system.
He appreciates how C3 Convertase integrates inputs from three different pathways, acting as a central coordinator within the cascade. This role mirrors his view of it as a "leader" within the system, making it a meaningful and intellectually satisfying choice for a tattoo.
Notable Quote:
“You could look at some of the regulatory factors and think about it as, you know, you're regulating things. Or C1Q is an initiator. Are you an initiator person? But what I'm going to land on, and I never would have guessed this is C3 Convertase.”—Dr. Tony Cybulski [13:30]
Bonus Question: Personal Recommendation
Timestamp: [14:33 - 15:58]
For the bonus question, Dr. Cybulski shares his newfound passion for vinyl records. He discusses how acquiring a record player has transformed his evenings, offering a relaxing and immersive musical experience. He appreciates the requirement to listen to entire tracks without skipping, which has introduced him to a broader range of music genres and artists.
Dr. Cybulski also mentions enjoying this hobby with his wife, adding a personal touch to the recommendation. This activity not only diversifies his musical tastes but also provides a mindful break from his professional responsibilities.
Notable Quote:
“There's just something so awesome and relaxing about sitting there next to the spinner, the turntable. And you have to listen to every song.”—Dr. Tony Cybulski [15:00]
Conclusion
The episode offers a comprehensive look into Dr. Tony Cybulski’s professional journey, his dedication to patient care and research, and his visionary perspective on the future of gene therapy. His insights into clinical practices, particularly in pediatric bone marrow transplantation, provide valuable knowledge for clinicians and listeners interested in thrombosis, hemostasis, and rare diseases. The personal anecdotes and recommendations further humanize the discussion, making it both informative and engaging.
Stay Connected:
To learn more about Machaon Diagnostics and stay updated with future episodes, follow them on Twitter @matriondx and visit their website at macheondiagnostics.com.