SHARE
Education
-
- Washington and Lee University, Lexington, Virginia, B.S. Biology & B.A. Studio Art, 2008
- State University of New York at Stony Brook, Stony Brook, New York, M.D., 2013
Residencies
-
- University of California San Francisco, San Francisco, California, Plastic Surgery Residency, 2013-present
Clinical Interests
-
- Hand and microsurgery
- composite tissue allotransplantation
Research Interests
-
- Composite tissue allotransplantation
- Hand Surgery
- Immune tolerance
Biography
- Nicole is an Integrated Plastic and Reconstructive Surgery resident at UCSF. She received her BS in Biology and BA in Studio Art from Washington and Lee University, and her medical degree from SUNY Stony Brook. She is spending two years in the Transplantation Immunology Lab ("Tang Lab") researching chimeric antigen receptor T-regulatory cell therapy for rejection in a mouse model of composite tissue transplantation. Her fellowship is funded by a Ruth L. Kirschstein National Research Service Award F32 grant through the National Institute of Allergy and Immunologic Diseases. Her primary surgical interests are Hand and Microsurgery.
Awards & Honors
- Resident Scientist Scholarship, American Society of Transplant Surgeons, 2017
- Glasgow-Rubin Award for Academic Achievement, Stony Brook University School of Medicine, 2013
- Scholarly Concentration in Research Program Certificate, Stony Brook University School of Medicine, 2013
- Alpha Omega Alpha Honor Medical Society, Stony Brook University School of Medicine, 2012
- School of Medicine Alumni Association Merit Scholarship, Stony Brook University School of Medicine, 2011
- John Graham Award in Fine Arts, Washington and Lee University, 2008
- Class of '64 Award in Fine Arts, Washington and Lee University, 2007
Research Overview
Vascularized composite tissue allotransplantation (VCTA) still faces many challenges regarding the unique immunologic demands of composite grafts and their propensity toward rejection. Acute rejection is extremely common in clinical VCTA, and chronic rejection remains poorly described. Interest has emerged in cellular therapies as an alternative to immunosuppressive drugs to treat rejection. T-regulatory cells (T-regs), which induce a more tolerogenic state, are known to be instrumental in long-term graft survival, attenuating the long-term sequelae of chronic rejection. Engineered chimeric antigen receptor (CAR) T-regs activated by donor antigens may allow for efficient, targeted therapy for VCTA rejection.
This study employs a murine hindlimb transplant model with two specific aims. First, transplanted mice will be observed clinically and serially biopsied to study the kinetics and cellular aspects of VCTA rejection, examining the architecture of the tissues and populations of graft cellular infiltrates. Second, recipients with rejection will be treated with CAR T-regs as salvage therapy. We hypothesize that CAR T-reg infusion will halt or reverse the rejection process.This project seeks to elucidate what is known about rejection in VCTA, as well as apply a targeted cellular intervention for salvage of rejected grafts. CAR T-cells have shown clinical promise in other fields, and they could feasibly be translated to the treatment of rejection in human VCTA. CAR T-regs represent a powerful tool for treating composite allografts threatened by rejection, as well as progress toward achieving the goal of tolerance without the life-long use of immunosuppressive drugs.
Grants & Funding
- NIH/NIAID F32AI126943, PI: Nicole Conkling, MD, Award period: Jan. 2017 - Jan. 2019, Ruth L. Kirschstein National Research Service Awards (NRSA) for Individual Postdoctoral Fellows (Parent F32), Allograft rejection and salvage therapy with chimeric antigen receptor T-regulatory cells in murine hindlimb transplant, Mentor: Qizhi Tang, PhD
- American Society of Transplant Surgeons Resident Scientist Scholarship, Award period: July 2017 - June 2018, Chimeric antigen receptor T-regs for targeted rejection therapy in murine hindlimb composite tissue transplant, Sponsor: Peter Stock, MD, PhD
Resident Publications
RESIDENT SHOWN IN BOLD. RESEARCH MENTOR(S) SHOWN IN COLOR.
- Timashpolsky A, Dagum AB, Sayeed SM, Romeiser JL, Rosenfeld EA, Conkling N. A prospective analysis of physical examination findings in the diagnosis of facial fractures: Determining predictive value. Plast Surg (Oakv). 2016; 24(2):73-9. View in PubMed
- Wang ED, Conkling N, Xu X, Chern H, Finlayson E, Varma MG, Hansen SL, Foster RD, Hoffman WY, Sbitany H. Perineal flap reconstruction following oncologic anorectal extirpation: an outcomes assessment. Plast Reconstr Surg. 2015 Jan; 135(1):176e-84e. View in PubMed
- Fourman MS, Phillips BT, Fritz JR, Conkling N, McClain SA, Simon M, Dagum AB. Laser-assisted indocyanine green dye angiography accurately predicts the split-thickness graft timing of integra artificial dermis. Ann Plast Surg. 2014 Aug; 73(2):150-5. View in PubMed
- Jain V, Phillips BT, Conkling N, Pameijer C. Sentinel lymph node detection using laser-assisted indocyanine green dye lymphangiography in patients with melanoma. Int J Surg Oncol. 2013; 2013:904214. View in PubMed
- Bhatnagar D, Conkling N, Rafailovich M, Phillips BT, Bui DT, Khan SU, Dagum AB. An in vivo analysis of the effect and duration of treatment with botulinum toxin type A using digital image speckle correlation. Skin Res Technol. 2013 Aug; 19(3):220-9. View in PubMed
- Fritz JR, Phillips BT, Conkling N, Fourman M, Melendez MM, Bhatnagar D, Simon M, Rafailovich M, Dagum AB. Comparison of native porcine skin and a dermal substitute using tensiometry and digital image speckle correlation. Ann Plast Surg. 2012 Oct; 69(4):462-7. View in PubMed
- Conkling N, Bishawi M, Phillips BT, Bui DT, Khan SU, Dagum AB. Subjective rating of cosmetic treatment with botulinum toxin type A: do existing measures demonstrate interobserver validity? Ann Plast Surg. 2012 Oct; 69(4):350-5. View in PubMed
- Phillips BT, Lanier ST, Conkling N, Wang ED, Dagum AB, Ganz JC, Khan SU, Bui DT. Intraoperative perfusion techniques can accurately predict mastectomy skin flap necrosis in breast reconstruction: results of a prospective trial. Plast Reconstr Surg. 2012 May; 129(5):778e-88e. View in PubMed
- Sanchez JE, Conkling N, Labropoulos N. Compression syndromes of the popliteal neurovascular bundle due to Baker cyst. J Vasc Surg. 2011 Dec; 54(6):1821-9. View in PubMed
In the News
-
UCSF General Surgery Residency Program - Richard Barg - May 21, 2018The 31st Annual J. Engelbert Dunphy Resident Research Symposium was held Wednesday, April 25, 2018 at UCSF Medical Center at Mission Bay. The program showcased the laboratory research of residents, fellows and medical students in the Department of Surgery, and honors the life and accomplishments of J. Engelbert Dunphy, M.D., a legendary surgeon and a former chair of the UCSF Department of Surgery. This year's J. Englebert Dunphy Visiting Professor, Carla M. Pugh, MD, PhD, FACS, Professor of [...]
-
UCSF Resident Research Program - Richard Barg - July 19, 2017
-
UCSF General Surgery Residency Program - August 21, 2014Second-year General and Plastic Surgery residents (pictured left to right) Jeremy Sharib, M.D., Kelly Mahuron, M.D., Rachel Lentz, M.D., Nicole Conkling, M.D., Yeranui Ledesma, M.D., Anamaria Robles, M.D., Evan Werlin, M.D., Jarrett Moyer, M.D., Courtney Green, M.D., Daniel Balkin, M.D, Ph.D, and Hubert Luu, M.D. were the recipients of surgical loupes at the annual "Historical Perspectives" from the Department of Surgery Grand Rounds. A set of loupes was gifted to each resident in honor of a [...]