Amosy E. M'Koma, M.D., Ph.D.

Associate Professor

amosy.e.mkoma@vanderbilt.edu

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Faculty Appointments
Associate Professor of Biochemistry and Cancer Biology at Meharry Medical College Adjunct Associate Professor of Surgery at Vanderbilt University School of Medicine
Education
Ph.D., Surgery, Karolinska Institutet, Stockholm, SwedenLicentiate Diploma, Surgery, Karolinska Institutet, Stockholm, SwedenM.D., Medicine, Kharkov Medical Institute, Kharkov, Ukraine
Office Address
Vanderbilt University
Department of Surgery, Colon & Rectal Surgery
D-5248 MCN
Nashville, TN
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 colitides.
• Predict future direction of indeterminate colitis (IC) into 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 or fistulae.
• Predict which patients with UC are likely to develop pouchitis or/ and cufittis following RPC.

Research Keywords
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.
Clinical Research Keywords
Predominantly, colonic IBD, the colitides, encompasses UC and CC, and (when state-of-the-art diagnostic criteria for either are inconclusive) IC. UC and CC share demographic and clinical features, yet differ in tissue inflammation and damage suggesting a distinct mechanisms and etiopathogenic trigger. Differentiating UC from CC among patients with IC is a major challenge in endoscopic medicine. Since treatments differ, a molecular diagnostic tool from accessible clinical samples would greatly benefit IC patients. Our work focuses on the improvement of diagnostics precision using molecular biometric profiling to discriminate UC and CC, potentially to predict IC immediate eventual clinical diagnosis into either UC or CC phenotype during the first clinic visit biopsy. The goal is to study differentially expressed proteomic patterns that occur as a result of the colitides. We believe that the proteomic signatures between the colitides differs and will eventually enable more informed pharmacologic and surgical management by more definitively identifying their underlying diagnosis. We analyze tissue proteomes using a strategy based on MALDI MS and recombinant single-chain antibody to identify peptides found in tissue and later in serum to provide diagnostic and discriminatory markers for IBD. These researches are important for diagnostic accuracy as relates specifically to the understanding of the physiology of the restoration of intestinal continuity after operation for IBD. The research is a long-term and continued effort related to the physiology of restorative ileal pouches after proctocolectomy for IBD.
Publications
Vaiopoulou A, Gazouli M, Papadopoulou A, Anagnostopoulos AK, Karamanolis G, Theodoropoulos GE, M'Koma A, Tsangaris GT.. Serum Protein Profiling of Adults And Children With Crohn's Disease. 2015.

Korolkova OY, Myers JN, Pellom ST, Wang L, M'Koma AE. Characterization of Serum Cytokine Profile in Predominantly Colonic Inflammatory Bowel Disease to Delineate Ulcerative and Crohn's Colitides. 2015.

Ballard BR, M'Koma AE. Gastrointestinal endoscopy biopsy derived proteomic patterns predict indeterminate colitis into ulcerative colitis and Crohn's colitis. 2015.

Williams AD, M'Koma AE. Molecular differentiation of ulcerative colitis and Crohn's colitis: is it achievable?. 2015.

Myers JN, Schaffer MW, Korolkova OY, Williams AD, Gangula PR, M'Koma AE. Implications of the Colonic Deposition of Free Hemoglobin-a Chain: A Previously Unknown Tissue By-product in Inflammatory Bowel Disease. 2014.

M'Koma AE. Diagnosis of inflammatory bowel disease: Potential role of molecular biometrics. 2014.

Seeley EH, Washington MK, Caprioli RM, M'Koma AE. Proteomic patterns of colonic mucosal tissues delineate Crohn's colitis and ulcerative colitis. Proteomics Clin Appl [print-electronic]. 2013 Aug; 7(7-8): 541-9. PMID: 23382084, PMCID: PMC3737405, DOI: 10.1002/prca.201200107, ISSN: 1862-8354.

Smith JC, Schaeffer MW, Ballard BR, Smoot DT, Herline AJ, Adunyah SE, M'Koma AE. Adenocarcinomas after Prophylactic Surgery for Familial Adenomatous Polyposis. 2013.

M'Koma AE. Inflammatory Bowel Disease: An Expanding Global Health Problem. 2013.

M'Koma AE, Herline AJ, Adunyah SE. Subsequent Adenomas of Ileal Pouch and Anorectal Segment After Prophylactic Surgery for Familial Adenomatous Polyposis. 2013.

M'Koma AE. Letter to the Editor, Advances in Enzyme Research. 2013.

Um JW, M'Koma AE. Dysplasie und Adenokarzinome im Ileum-Pouch nach restaurativer Proktokolektomie wegen Colitis ulcerosa. 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. 2011; 17((4)): 875-83.

Um JW, M'Koma AE. Pouch-related dysplasia and adenocarcinoma following restorative proctocolectomy for ulcerative colitis. Tech Coloproctol. 2011; 15((1)): 7-16.

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. 2011; 26((5)): 533-52.

Amosy M'Koma. Biochemical Laboratory Data Following Restorative Proctocolectomy: Observations on Essential Biochemical Data Profile in Connection with Restorative Proctocolectomy in Humans. Book. 2010; ISBN 978-3-8383-2057-1((P Lambert Academic Publishing)): 1-140.

M'Koma AE, Wise PE, Schwartz DA, Muldoon RL, Herline AJ. Prevalence and outcome of anemia after restorative proctocolectomy: a clinical literature review. Dis. Colon Rectum. 2009 Apr; 52(4): 726-39. PMID: 19404082, PMCID: PMC4154485, PII: 00003453-200904000-00031, DOI: 10.1007/DCR.0b013e31819ed571, ISSN: 1530-0358.

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. 2009; 52((4)): 726-36.

Blum DL, Koyama T, M'Koma AE, Iturregui JM, Martinez-Ferrer M, Uwamariya C, Smith JA, Clark PE, Bhowmick NA. Chemokine markers predict biochemical recurrence of prostate cancer following prostatectomy. Clin. Cancer Res. 2008 Dec 12/1/2008; 14(23): 7790-7. PMID: 19047106, PMCID: PMC3050736, PII: 14/23/7790, DOI: 10.1158/1078-0432.CCR-08-1716, ISSN: 1078-0432.

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. 2008; 14((23)): 7790-7.

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 [print-electronic]. 2007 Oct; 22(10): 1143-63. PMID: 17576578, DOI: 10.1007/s00384-007-0331-x, ISSN: 0179-1958.

M'Koma AE, Longo WE. Postoperative liver enzyme abnormalities are related to staged restorative proctocolectomy. Int J Colorectal Dis [print-electronic]. 2007 Mar; 22(3): 283-8. PMID: 16583192, DOI: 10.1007/s00384-006-0130-9, ISSN: 0179-1958.

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 [print-electronic]. 2007 Feb 2/16/2007; 353(3): 829-34. PMID: 17194448, PMCID: PMC2562600, PII: S0006-291X(06)02787-2, DOI: 10.1016/j.bbrc.2006.12.111, ISSN: 0006-291X.

M'Koma AE. Serum biochemical evaluation of patients with functional pouches ten to 20 years after restorative proctocolectomy. Int J Colorectal Dis [print-electronic]. 2006 Oct; 21(7): 711-20. PMID: 16437210, DOI: 10.1007/s00384-005-0076-3, ISSN: 0179-1958.

M'Koma AEM, et al. Advances and challenges in the diagnostic accuracy for surgical management of inflammatory bowel disease: Potential role of molecular biometrics. J Clin Cell Immunol. c2004 Sep 9/29/2004.

Swedish Government. Swedish Ministry of Heath. [place unknown: publisher unknown]; 2004. (SOU 2004:13). Available from: http://www.regeringen.se/sb/d/189/a/3004.

M'Koma AE. Sex and HIV in the city: economy of desire in urban Tanzania. HIV Perspektiv. 2003; 310((14)): 846-9.

MKoma AE. AIDS mobility Europe. [place unknown: publisher unknown]; 2003. Available from: http://www.atc.org.yu/data/File/Trgovina%20ljudima/Access%20to%20care-priviledge%20or%20right.pdf.

M'Koma AE. Myths, beliefs, taboos and sexual behaviour. The Second National conference on HIV/STD-prevention. Swedish Institute of Public Health/ Kunskap Utveckling. 2001; 1:25((October 18-19)): 36.

M'Koma AE. European Partenariat between Migrant communities and Health Partners for HIV/AIDS Prevention in Europe. Swedish Institute of Public Health/ Kunskap Utveckling. 2001; 1:26((October 18-19)): 37.

M'Koma AE. Karolinska University Press. [place unknown: publisher unknown]; 2001. Available from: http://diss.kib.ki.se/2001/91-7349-007-5/.

M'Koma AE, Lindquist K, Liljeqvist L. Observations in the blood lipid profile in patients undergoing restorative proctocolectomy. Int. J. Surg. Investig. 2000; 2(3): 227-35. PMID: 12678523, ISSN: 1028-5229.

M'Koma AE, Lindquist K, Liljeqvist L. A study of plasma immunoglobulins profile in connection with restorative proctocolectomy. Int. J. Surg. Investig. 2000; 2(2): 125-31. PMID: 12678510, ISSN: 1028-5229.

M'Koma AE, Samaletdin D, Hedman H. AIDS is future threat to African future. HIV perspective. 2000; 10((10)): 567-74.

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. 2000; MoPeD2842.

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). 2000; ((Juin GRDR/Secretariat)).

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. 1999 Mar; 42(3): 398-402. PMID: 10223764, ISSN: 0012-3706.

MKoma AE. Karolinska University Press. [place unknown: publisher unknown]; 1999. Available from: http://libris.kb.se/bib/2781394.

M'Koma AE. Demographic Data and HIV Risk in Tanzania. HIV perspective. 1998; 7((14)): 391-2.

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. 1998; ((June 7-11)): PC173.

M'Koma AE. Editor: Jeanette de Putter. The State of Affairs in Europe (AIDS Mobility). [place unknown: publisher unknown]; 1998. Available from: http://www.biblio.com/details.php?dcx=105972577&aid=frg.

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. 1997; 10 ICASA((December 7-11)).

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. 1997; 10 ICASA((December 7-11)).

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. 1997; 29 suppl 1((May 18-21)): 3.

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. 1997; 29 suppl 1((May 18-21)): 4.

MKoma AE, Lindgren S.. Umea University Hospital, Department of family medicine and Karolinska Institute, Huddinge University Hospital, Department of Clinical Science, Division of Obstetrics and Gynaecology. [place unknown: publisher unknown]; 1996. Available from: http://www.umu.se/.

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. 1995; ((2)): 330-4.

M'Koma AE. The HIV Psychosocial impact on the African community in Sweden. International Conference on AIDS and STD (ICASA), Kampala, Uganda. 1995; TuD672.

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. 1995; TuD603.

M'Koma AE. Report from AIDS IMPACT Conference. Stockholm County Council AIDS Prevention Program Journal (LAFA). 1995; ((1)): 24.

M'Koma AE. Institutional unawareness of immigrants competence. Swedish Daily News. 1995; ((January 21)): B16.

M'Koma AE. Follow-up results of hematology data before and after restorative proctocolectomy. Clinical outcome. Dis. Colon Rectum. 1994 Sep; 37(9): 932-7. PMID: 8076494, ISSN: 0012-3706.

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. 1994; 48(6): 525-34. PMID: 7847701, ISSN: 0003-3944.

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. 1994; ((1)): 22-7.

M'Koma AE. Migrants, Ethnic Minority and Substance Abuse: Experiences from Sweden. AIDS Mobility Europe. 1994; ((Leeuwenhortst, The Netherlands)): Appex 4.

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. 1993; 8th ICASA((December 12-16 )): 126.

M'Koma AE. Migration and Health a Global Problem, Etiology and possible solutions. Immigrants in Sweden against Narcotics Journal, S I M O N. 1993; ((1)): 5-6.

M'Koma AE. Screening Africans in the EU borders does not prevent HIV-spread. Solution is to increase information. Swedish Daily News. 1993; ((June, 6)): A07.

M'Koma AE, Lindquist K, Liljeqvist L. Chemical Laboratory Data in patients Undergoing Ileoanal Pouch Surgery. Annales de Chirurgie. 1992; Ileal pouch-anal anastomosis, International Symposium. Versailles, France((September 18-19)): 15:26.