Amosy Ephreim M'Koma, M.D., Ph.D., MS
Research Assistant Professor of Surgery, Colon and Rectal Surgery
Vanderbilt University, Depart General Surgery
Colon and Rectal Surgery, D-5248 Medical Center North
Nashville, TN 37231-2543
Dr. M'Koma is Research Assistant Professor of Surgery, Colon and Rectal Surgery in the Division of General Surgery at Vanderbilt University Medical Center. Dr. M'Koma received medical training initiated and completed his M.D. degree at Kharkov Medical Institute in Kharkov, Ukraine in 1984.
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Dr. M'Koma is Research Assistant Professor of Surgery, Colon and Rectal Surgery in the Division of General Surgery at Vanderbilt University Medical Center. Dr. M'Koma received medical training initiated and completed his M.D. degree at Kharkov Medical Institute in Kharkov, Ukraine in 1984. Dr. M'Koma did his postgraduate and surgical residency program at the Karolinska University Hospital in Stockholm, Sweden. He was Board Certified in General Surgery (The Swedish Board of Health and Welfare). Dr. M'Koma pursued a Licentiate of Medical Science degree (1999) and a Ph.D (2001) in Surgery from the Karolinska Institute.
Dr. M'Koma came to the United States to further pursue academic endeavors. He was able to work at the Mayo Clinic in Rochester, Minnesota as a Research Trainee where he interacted with some of the leaders in the field of Colon and Rectal Surgery. The interactions with investigators at the Mayo clinic provided additional insight into the development of his research career. He interacted with some of the leading physicians in the areas of inflammatory bowel disease (IBD) and received guidance and advice on the research activities that had the potential to significantly impact the understanding and treatment of the disease. His research efforts during this time related to an in depth study of the scientific and clinical background of inflammatory colitis and it maladies.
Dr. M'Koma research interest is focused on the pathophysiology of inflammatory bowel diseases (IBD) more focused on diagnostic methodologies and surgical management of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The research is gravitated to gastrointestinal disease, specifically relating to the restorative physiology of intestinal continuity after operations for IBD, specifically, restorative proctocolectomy (RPC). The research efforts are directed towards developing strategic methodologies based on MALDI-mass spectrometry, proteomics and recombinant single-chain antibody to identify peptides that can provide discriminatory diagnostic tool for inflammatory colitis.
- 1978-1984: Graduate: Kharkov Medical Institute, Kharkov, Ukraine.
- 1984 : Doctor Of Medicine Degree (M.D.) (Medicine), Kharkov Medical Institute, Ukraine. Vrach award, Reg. No. 778, ID. No. 087757
- 1985-1990: Post-Graduate & SURGICAL RESIDENCY: Karolinska University Hospital - Huddinge, Stockholm, Sweden.
- 1990: Board Certification: General Surgery. The Swedish Board of Health and Welfare [Socialstyrelsen] and Karolinska Institutet, Sweden.
- 1999: Licentiate Medical Science Degree (Med.lic) (Surgery). Karolinska Institutet, Stockholm, Sweden. Thesis title: Observations on Biochemical Data in Connection with Restorative Proctocolectomy [An analysis with specific reference to lipoproteins and gastric acids]. ISBN-91-7349-009-1.
- 2001: Doctor Of Philosophy (Ph.D) (Surgery). Karolinska Institutet, Stockholm, Sweden. Thesis title: Observations on Essential Biochemical Data Profile in Connection with Restorative Proctocolectomy in Humans. Vitamin B12 and fat absorption cited. ISBN-91-7349-007-5.
- 2004-2007: Postdoctoral Fellow: Cancer Biology. Vanderbilt University Medical Center, Nashville, TN, USA
One of the greatest advances in colorectal surgery over the past three decades has been the development of restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) for patients suffering from ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The development and refinement of pelvic pouch surgery now allows the entire excision of a diseased colon while maintaining transanal fecal continence. The success of RPC is largely dependent on careful patient selection combined with meticulous surgical technique. RPC is now the criterion surgical procedure, for patients with IBD. When this procedure first became the standard of care little was known about the metabolic consequences of the operation. We began several prospective studies investigating surgical complications, function of the pouches, consequences of pouch inflammation (pouchitis), new trends for ileal reservoir construction and health related quality of life (QoL) issues. We also developed several laboratory tests to detect possible metabolic effects of RPC (see publications). The patient's QoL and satisfaction are high and functional outcome is excellent, even after 20 years of functional pouches. The critical challenge we still face is the means to establish a correct diagnosis in IBD. An accurate diagnosis prior to initiating medical therapy or performing colectomy is of paramount importance in terms of evidenced personalized medical therapy, surgical intervention and prognosis, as well as delineation of IBD by non-invasive, easier, accurate and faster screening.
The research is focused on understanding the pathophysiology of IBD, particularly on diagnostic methodologies and surgical management of UC, specifically relating to the physiology of RPC or IPAA. The current research efforts are directed towards developing strategic methodologies based on matrix-assisted laser desorption-ionization-mass spectrometry (MALDI MS), proteomics and recombinant single-chain antibodies to identify peptides that can provide discriminatory diagnostic tools for inflammatory colitis.
Patients with IBD are susceptible to long-term complications from the disease and medications prescribed. The available cure may require surgical removal of the entire colon; however there are complications such as pouchitis/ cufittis, dysplasia, stricture and/ or fistulae. Why these complications affect patients with IBD after RPC differently has not been studied. There are no known preoperative predictor(s) of these complications. The ability to predict these outcomes can allow for prophylactic measures and prevention of pathologic outcomes. Thus our future studies would need to include further elucidation/ verification of the recombinant antibodies in larger patient study cohorts in order to understand the associated biomarker(s) that will be used in future endeavors to help:
-Clarify any proteomic differences of dysplasia within colitides.
-Predict future direction of indeterminate colitis (IC) into UC or CC.
-Predict CC/UC pts that are likely to develop colitis-associated colon or/and rectal cancer.
-Predict which patients with CC are likely to develop stricture or fistulae.
-Predict which patients with UC are likely to develop pouchitis or/ and cufittis following RPC.
Clinical Research Description
The treatment options for UC and CC differ significantly. Therefore the accurate diagnosis of IBD is of paramount importance in terms of personalized medical treatment, surgical intervention and prognosis. The distinction between UC and CC cannot be differentiated in 15% of IBD patients due to the fact that the pathological features of UC and CC often overlap. As a result, the CC patients undergo RPC surgery for definitive UC and subsequently are found to develop Crohn's diseases in the pouch. This is critical because the higher complication and functional failure rates (up to 60%) often necessitates excision of the pouch resulting in a permanent end ileostomy, a complication of which both patients and doctors would like to avoid. Additionally, failure to recognize characteristic signs of CC such as granulomas and transmural inflammation often leads to errors in pathological interpretation of IBD. Another 15% cannot definitively be categorized as UC or CC. This condition is labeled as "indeterminate colitis" (IC). About 90% of patients diagnosed with IC undergo emergency surgery for fulminate colitis, contrasting with only 30% of patients in whom UC or CC are more confidently diagnose. We aim to try to identify molecular features that distinguish UC from CC. We hypothesize that, the proteomic pattern candidates that permit distinguishing UC and CC may allow predicting IC patients into UC or CC. The early accurate distinction of the pathology of IC could alleviate the discomfort in the significantly growing pediatric population. Our goal is to initiating a successful research program in the area of colorectal surgery and establishes a feasibility of identifying a panel of novel molecular signatures in IBD. The research is also focused to further pursue the understanding of the biopathophysiologic mechanisms of the identified discriminatory molecules by examining the mucosal immune response in IBD.
- Joan C. Smith, Michael W. Schaeffer, Billy R. Ballard, Duane T. Smoot, Alan J. Herline, Samuel E. Adunyah, Amosy E. M'Koma Adenocarcinomas after Prophylactic Surgery for Familial Adenomatous Polyposis. Journal of Cancer Ther, 4(1), 260-270, 2013.
- M'Koma AE Inflammatory Bowel Disease: An Expanding Global Health Problem. Clinical Medicine Insight: Gastroenterology, (6), 33-47, 2013.
- Seeley EH, Washington MK, Caprioli RM, M'Koma AE Proteomic Patterns of Colonic Mucosal and Submucosal Tissues Delineates Crohn's Colitis and Ulcerative Colitis. Proteomics Clin Appl, 7(7-8), 541-549, 2013.
- M'Koma AE, Herline AJ, Adunyah SE Subsequent Adenomas of Ileal Pouch and Anorectal Segment After Prophylactic Surgery for Familial Adenomatous Polyposis. World Journal of Colorectal Surgery, 3(2), Article 1, 2013.
- Um JW, M'Koma AE Dysplasie und Adenokarzinome im Ileum-Pouch nach restaurativer Proktokolektomie wegen Colitis ulcerosa. Coloproctology, 33(5), 273-282, 2011.
- M'Koma AE, Moses HL, Adunyah SE Inflammatory bowel disease-associated colorectal cancer: proctocolectomy and mucosectomy do not necessarily eliminate pouch-related cancer incidences. Int J Colorectal Dis, 26(5), 533-552, 2011.
- Um JW, M'Koma AE Pouch-related dysplasia and adenocarcinoma following restorative proctocolectomy for ulcerative colitis.. Tech Coloproctol, 15(1), 7-16, 2011.
- M'Koma AE, Seeley EH, Washington MK, Schwartz DA, Muldoon RL, Herline AJ, Wise PE, Caplioli RM. Proteomic Profiling of Mucosal and Submucosal Colonic Tissues Yields Protein Signatures that Differentiate the Inflammatory Colitides. Inflamm Bowel Dis, 17(4), 875-883, 2011.
- Amosy M'Koma Biochemical Laboratory Data Following Restorative Proctocolectomy: Observations on Essential Biochemical Data Profile in Connection with Restorative Proctocolectomy in Humans. Book, ISBN 978-3-8383-2057-1(P Lambert Academic Publishing), 1-140, 2010.
- M'Koma AE, Wise PE, Schwartz DA, Muldoon RL, Herline AJ. Prevalence and Outcome of Anemia after Restorative Proctocolectomy. Clinical Literature Review.. Dis Colon Rectum, 52(4), 726-736, 2009.
- Blum DL, Koyama T, M'Koma AE, Iturregui JM, Martinez-Ferrer M, Uwamariya C, Smith Jr JA, Clark PE, Bhowmick NE Chemokine markers predict biochemical recurrence of prostate cancer following prostatectomy. Clin Cancer Res, 14(23), 7790-7, 2008.
- M'Koma, AE, Blum, DL, Norris, JL, Koyama, T, Billheimer, D, Motley, S, Ghiassi, M, Ferdowsi, N, Bhowmick, I, Chang, SS, Fowke, JH, Caprioli, RM, Bhowmick, NA Detection of pre-neoplastic and neoplastic prostate disease by MALDI profiling of urine. Biochem Biophys Res Commun, 353(3), 829-34, 2007.
- M'Koma, AE, Wise, PE, Muldoon, RL, Schwartz, DA, Washington, MK, Herline, AJ Evolution of the restorative proctocolectomy and its effects on gastrointestinal hormones. Int J Colorectal Dis, 22(10), 1143-63, 2007.
- M'Koma, AE, Longo, WE Postoperative liver enzyme abnormalities are related to staged restorative proctocolectomy. Int J Colorectal Dis, 22(3), 283-8, 2007.
- M'Koma, AE Serum biochemical evaluation of patients with functional pouches ten to 20 years after restorative proctocolectomy. Int J Colorectal Dis, 21(7), 711-20, 2006.
- Swedish Government States Committee of inquiry into HIV/ AIDS. Socialdepartementet, SamhÃ¤llets insatser mot hiv/STI - att mÃ¶ta fÃ¶rÃ¤ndring, SOU 2004:13(ISBN 91-38-220806), 2004.
- MKoma AE Access to Care: Privilage or Right? Migration and HIV Vulnerability in Europe. AIDS mobility Europe, (October), 127-136, 2003.
- M'Koma AE Sex and HIV in the city: economy of desire in urban Tanzania. HIV Perspektiv, 310(14), 846-849, 2003.
- M'Koma AE European Partenariat between Migrant communities and Health Partners for HIV/AIDS Prevention in Europe. Swedish Institute of Public Health/ Kunskap Utveckling, 1:26(October 18-19), 37, 2001.
- M'Koma AE Myths, beliefs, taboos and sexual behaviour. The Second National conference on HIV/STD-prevention. Swedish Institute of Public Health/ Kunskap Utveckling, 1:25(October 18-19), 36, 2001.
- M'Koma AE Observation on Biochemical Data Profile in Connection with Restorative Proctocolectomy in Humans. Vitamin B12 and Fat Absorption Cited. Karolinska University Press, 1-130, 2001.
- M'Koma, AE, Lindquist, K, Liljeqvist, L A study of plasma immunoglobulins profile in connection with restorative proctocolectomy. Int J Surg Investig, 2(2), 125-31, 2000.
- M'Koma AE, Samaletdin D, Hedman H AIDS is future threat to African future. HIV perspective , 10(10), 567-574, 2000.
- M'Koma AE, (Sweden); Revault P, Fanget D (France); Partidario A (Portugal); Boahene K (The Netherlands); Castillo S (Spain); Murray A (UK); Louhenapessy M (Belgium) European partenariat with African communities. XIII International AIDS2000 Congress, MoPeD2842, 2000.
- M'Koma, AE, Lindquist, K, Liljeqvist, L Observations in the blood lipid profile in patients undergoing restorative proctocolectomy. Int J Surg Investig, 2(3), 227-35, 2000.
- MKoma AE, Revault P, Fanget D; Partidario A, Boahene K, Castillo S, Murray A, Louhenapessy M Partenariat Europaen entre communautes africaines et acteurs de sante pour la prention du VIH/sida. Rapport deactivite intermediaire - S12.83594 (99CFV4-006), (Juin GRDR/Secretariat), 2000.
- M'Koma, AE, Lindquist, K, Liljeqvist, L Effect of restorative proctocolectomy on gastric acid secretion and serum gastrin levels: a prospective study. Dis Colon Rectum, 42(3), 398-402, 1999.
- MKoma AE Observation on Biochemical Data in Connection with Restorative Proctocolectomy (an analysis with specific reference to lipoproteins and gastric acids. Karolinska University Press, 1999.
- M'Koma AE. Editor: Jeanette de Putter AIDS & STDs and migrants, ethnic minorities and other mobile groups. The State of Affairs in Europe (AIDS Mobility), 2007-2008, 1998.
- M'Koma AE Demographic Data and HIV Risk in Tanzania. HIV perspective, 7(14), 391-392, 1998.
- MKoma AE, Lindquist K, Liljeqvist L Effect of restorative proctocolectomy on gastric acid secretion and serum gastrin levels. A controlled prospective study. XVII Biennial Congress of the International Society of University Colon and Rectum Surgeons (ISUCRS), Malmo, Sweden, (June 7-11), PC173, 1998.
- MKoma AE, Makonnen G. Nzamba J AIDS Outreach program targeting Academics from Africa to promote behaviour change. X International Conference on STD/AIDS in Africa, Abidjan Cote dIvoire, 10 ICASA(December 7-11), E-579, 1997.
- M'Koma AE, Lindquist K, Liljeqvist L Effect of restorative proctocolectomy on gastric acid secretion and serum gastrin levels. A controlled prospective study. Eur Surg Res, XXXII Congress of the European Surgical Research (ESSR), Corfu, Greece, 29 suppl 1(May 18-21), 4, 1997.
- M'Koma AE, Lindquist K, Liljeqvist L Effect of restorative proctocolectomy on lipid metabolism. Eur Surg Res, XXXII Congress of the European Surgical Research (ESSR), Corfu, Greece, 29 suppl 1(May 18-21), 3, 1997.
- MKoma AE, Makonnen G Evaluation of home based cultural and professionally care and counselling to PLWHIV/AIDS. X International Conference on STD/AIDS in Africa, Abidjan Cote dIvoire, 10 ICASA(December 7-11), C-008, 1997.
- MKoma AE, Lindgren S. Migration and Health. Gender and HIV/AIDS awareness in the African population of Sweden. Umea University Hospital, Department of family medicine and Karolinska Institute, Huddinge University Hospital, Department of Clinical Science, Division of Obstetrics and Gynaecology, 1996.
- M'Koma AE, Lindquist K, Liljeqvist L. Adaptive returns to normal serum electrolytes after depletion following restorative proctocolectomy and ileal-pouch anal anstomosis. A controlled, prospective study. Int J Surg Sci, (2), 330-334, 1995.
- M'Koma AE Institutional unawareness of immigrants competence. Swedish Daily News, (January 21), B16, 1995.
- Eriksson L, Kosmowski AM, MKoma AE Long jail sentence to drug trafficker women from Africa and the HIV/ AIDS. International Conference on AIDS and STD in Africa (ICASA), Kampala, Uganda, TuD603, 1995.
- M'Koma AE Report from AIDS IMPACT Conference. Stockholm County Council AIDS Prevention Program Journal (LAFA) , (1), 24, 1995.
- M'Koma AE The HIV Psychosocial impact on the African community in Sweden. International Conference on AIDS and STD (ICASA), Kampala, Uganda, TuD672, 1995.
- M'Koma, AE, Lindquist, K, Liljeqvist, L Biochemical laboratory data in patients before and after restorative proctocolectomy. A study on 83 patients with a follow-up of 36 months. Ann Chir, 48(6), 525-34, 1994.
- M'Koma, AE Follow-up results of hematology data before and after restorative proctocolectomy. Clinical outcome. Dis Colon Rectum, 37(9), 932-7, 1994.
- M'Koma AE Migrants, Ethnic Minority and Substance Abuse: Experiences from Sweden. AIDS Mobility Europe, (Leeuwenhortst, The Netherlands), Appex 4, 1994.
- M'Koma AE Report from the VII International Conference on HIV/ STDs In Africa. Immigrants in Sweden against Narcotics Journal, S I M O N, (1), 22-27, 1994.
- M'Koma AE, Makonnen G. Nzanba J HIV-spread among Drug user immigrants in Stockholm - Sweden. 8th International Congress on AIDS and STD in Africa (ICASA) Marrakech, Morocco, 8th ICASA(December 12-16 ), 126, 1993.
- M'Koma AE Migration and Health a Global Problem, Etiology and possible solutions. Immigrants in Sweden against Narcotics Journal, S I M O N, (1), 5-6, 1993.
- M'Koma AE Screening Africans in the EU borders does not prevent HIV-spread. Solution is to increase information. Swedish Daily News, (June, 6), A07, 1993.
- M'Koma AE, Lindquist K, Liljeqvist L Chemical Laboratory Data in patients Undergoing Ileoanal Pouch Surgery. Annales de Chirurgie, Ileal pouch-anal anastomosis, International Symposium. Versailles, France (September 18-19), 15:26, 1992.