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Amosy Ephreim M'Koma, M.D., Ph.D., M.S.

  • Associate Professor of Biochemistry and Cancer Biology,Meharry Medical College
  • Adjunct Associate Professor of Surgery, Vanderbilt University School of Medicine

Phone

(615) 343-4612

Email

amosy.e.mkoma@Vanderbilt.Edu
Vanderbilt University Medical Center
Division of General Surgery, Colon and Rectal Surgery
D-5248 Medical Center North
Nashville, TN 37231-2543

Amosy Ephreim M'Koma, M.D., Ph.D., M.S.

  • Associate Professor of Biochemistry and Cancer Biology,Meharry Medical College
  • Adjunct Associate Professor of Surgery, Vanderbilt University School of Medicine

(615) 343-4612

amosy.e.mkoma@Vanderbilt.Edu

Vanderbilt University Medical Center
Division of General Surgery, Colon and Rectal Surgery
D-5248 Medical Center North
Nashville, TN 37231-2543

Research Program

  • Non-Programmatically Aligned

Profile

Dr. M'Koma is Adjunct Associate Professor of Surgery, Colon and Rectal Surgery in the Division of General Surgery at Vanderbilt University Medical Center and Associate Professor of Biochemistry and Cancer Biology at Meharry Medical College School of Medicine. 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.

Education

  • 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

Research Emphasis

One of the greatest advances in colorectal surgery over the past three decades has been the development of RPC with IPAA for patients suffering from 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 evidence-based personalized medical therapy, surgical intervention and prognosis, as well as delineation of IBD by non-invasive, easier, accurate and faster screening.

Research Description

The research is focused on understanding the pathophysiology of inflammatory bowel disease (IBD), particularly on diagnostic methodologies and surgical management of ulcerative colitis (UC), specifically relating to the physiology of restorative proctocolectomy (RPC) and/or ileal pouch-anal anastomosis (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 the colitides.
• Predict future direction of indeterminate colitis (IC) into authentic UC or Crohn's colitis (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 and/or fistulae.
• Predict which patients with UC are likely to develop pounchitis or/ and cufittis after IPAA surgery.
• Predict which patients with UC are likely to transform and/or convert to de novo Crohn's disease after IPAA surgery.

Publications

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