Five questions with physician-scientist Dr. Steven Hicks

As a pediatrician, Dr. Steven Hicks understands how invasive testing like drawing blood can be traumatic for a child. And as a pediatrician, he also understands the importance of limiting subjectivity in diagnosing certain conditions.

As a researcher, Dr. Hicks decided to do something about both. He researches the use of spit to assist doctors in diagnosing conditions related to brain development, including concussions and autism.

Hicks recently completed his involvement in Penn State Clinical and Translational Science Institute‘s Early-Stage Investigator Training Program. The program, also known as KL2, invests in researchers who are early in their careers and building their research programs. The program protects the researcher’s time to work on a specific project. Dr. Hicks’s project involved the use of saliva as an objective measure to diagnose autism.

A full interview with Dr. Hicks is available in episode 9 of Penn State Clinical and Translational Science Institute’s Engage Podcast. Each episode educates listeners about the research process and how Penn State is improving our neighbors’ and communities’ health.

What do you research?

Hicks: I’m interested in conditions that affect brain development, like autism and concussions. The type of research that I do involves biomarkers. I look for molecules circulating in the body that help us either diagnose a condition or predict the course of a medical condition for patients and their families. Specifically, I’m focused on markers in saliva. As a pediatrician, it’s important to me that diagnostic medical tests are as non-invasive as possible for my patients and their families.

How does being a physician-scientist benefit your work?

Hicks: I think that being both a clinician who sees patients and a scientist who does research is vital to what I do on a day-to-day basis. When I’m in the clinic, I’m trying my best to take good care of my patients. In the back of my mind, I’m keeping an eye out for scenarios or medical conditions where I recognize that we don’t have the best tools possible to take care of patients. And that’s from where my work in concussion arose. I see patients come into our clinic who hit their head and may have a mild headache. Maybe they are saying that they feel dizzy. That sounds like a concussion to their parents and to me. But I have no great way of making that diagnosis or predicting for their family how long those symptoms might last. At the end of the day, it’s just my best guess.

It’s scenarios like that where I go back to the lab the next day and think about, “well, how could we make a test that makes that diagnosis of concussion more objective or more accurate?”

What is your research into concussions?

Hicks: Our research in concussion is using microRNA, which is non-coding RNA in the saliva of children, to try and build new tools for making a diagnosis of a concussion or for predicting for patients and families when a concussion will resolve. We’ve identified a specific set of microRNAs. Some of these go up after a child has had a concussion and some of these go down in terms of their levels in saliva. By measuring the levels of about five microRNAs, we can predict pretty accurately which children have a concussion and which ones may just have symptoms that mimic a concussion.

How can your work apply to the current pandemic?

Hicks: One of the great things about the biomarker work that I do is that it can easily be applied to many different clinical scenarios or medical conditions. When the COVID pandemic arose last spring, I immediately thought about applying what I do in saliva biomarkers to COVID. And what emerged was a collaboration between myself and clinicians at UPMC in Pittsburgh and Detroit Children’s Hospital. The National Institutes of Health recently funded us to look at saliva microRNA and saliva cytokines in children who have COVID to help try and determine which of those children are going to become critically ill and need hospitalization or ventilator support, and which children will be able to ride the illness out at home and probably recover on their own in just a few days. That’s been an exciting application of my work to the current medical issues of the day.

How does collaboration advance your research?

Hicks: I am a huge proponent of collaborative science. Almost every project that I’m involved with has some collaboration, and that’s because I’m a general pediatrician. We like to say that we’re “masters of none” in general pediatrics because we understand a little bit of everything. We also know that we need to call in an expert once in a while. In most of the studies that I do, whether it’s concussion or autism, I call in a clinical expert in that field.

Fortunately, at a big medical center like Penn State, you can always find somebody who’s specializing in a particular disease state. Just about every project that I work on, I have another clinical specialist who helps me out. That’s been rewarding, and I love it because I learn something new every day from coworkers.

Our research team deserves credit for the papers that I publish and the grants that I get. Just to mention a few of those people by name, Alle Confair is my research coordinator. She’s been fantastic at working with families and enrolling children and parents into our studies. Katie Warren is my lab technician, and she’s done an outstanding job processing samples. Those two people, in particular, have been critical to the work that my lab has accomplished.

About Penn State Clinical and Translational Science Institute

Penn State Clinical and Translational Science Institute provides tools, services and training to make health research more efficient at Penn State. It is an advocate for translational science at the University and is a bridge between basic scientists and clinical researchers. The institute encourages collaboration to discover new treatments, medical procedures and ways to diagnose disease. Learn more at ctsi.psu.edu. Subscribe to its newsletters here.

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