By Jamie Williams, firstname.lastname@example.org
Like a promising athlete with pro potential, Caitlin Burk got noticed early. As a high school student at Durham Academy, she was recognized at an awards ceremony for her accomplishments in chemistry. Burk was classmates with the children of Wesley Burks, MD, now executive dean at the UNC School of Medicine. At that time Burks was a faculty member at Duke and happened to be in the crowd at the assembly that day. Afterwards, he approached Caitlin with an offer to come work in his lab over the summer.
“I had to turn him down,” Burk said laughing. “I already had plans to participate in another research program.”
The next summer, though, the offer was still on the table and Burk began studying food allergies in the Burks lab. Though she attended Columbia University for her undergraduate studies, she returned each summer – first to Duke, and later to UNC – to continue her work. It’s an eight-year relationship that has allowed her to expand her research skills and informed her perspective on patient care.
Name: Caitlin Burk
Mentors: Wesley Burks, MD, Evan Dellon, MD, MPH
Hometown: Durham, NC
Education: B.A. in Biology, Columbia University, currently a third-year medical student, UNC School of Medicine
Recent Publication: Earlier this year, Burk was lead author of a paper analyzing the mechanisms of sublingual immunotherapy in the treatment of peanut allergies and identifying the factors that predict success of the therapy was named an “Editor’s Choice” in the journal Clinical and Experimental Allergies.
Extracurricular Activity: Dance
“My parents are both physicians, but until I was about 14, I was determined to become a professional dancer. I was so serious about dance, practicing for hours each week. But as I began accumulating orthopaedic injuries I realized that probably wasn’t going to happen and I needed another plan. In a biology class in the 9th grade, we looked at algae under a microscope and I just thought it was the coolest thing I’d ever seen. I realize that sounds corny, but it’s 100 percent true.”
“I remember the week before I started working with Dr. Burks I read an article about a paper he had published, and I realized how important his work was and what an amazing opportunity I had in front of me. I had some previous research experiences in high school. I loved the people I worked with, but it was a lot of sitting in the dark with microscopes. What I’ve always loved about this research with Dr. Burks – and I probably didn’t even know this term then – is that it is truly translational. We can do an experiment, get the results, and then pick up a phone to call the nurse and discuss. The patient impacts are pretty immediate.”
“I was raised in Durham, and when it came time to apply to colleges, I wanted something new. Columbia was such a great experience, and I loved my time there. It was a great place to do biology just because there are amazing science courses and great faculty, but I also liked that Columbia also has a regimented liberal arts program. I was required to take art history as a part of my degree. But, the professor would take us to the [Metropolitan Museum of Art] for our class. I just enjoyed being there.”
“I’ve always liked the idea that I could be there for a family in their time of need. A lot of it goes back to a shadowing experience in high school in the ED at Duke. I remember a young patient, around 6 years old. It was 9 p.m. and the emergency physician just diagnosed the child with Type 1 diabetes right there in the ED. And the mom was just hysterical. Then, I remember the pediatric endocrinologist – who had left home in the evening to come to the hospital – showing up, looking the kid in the eye and saying ‘Hi, I’m going to be your new doctor.’
“Everyone immediately calmed down. It was such a ‘wow’ moment for me.
“Now, in my third year of medical school, I’ve loved my clinical rotations and the interactions that I’ve had with patients. I remember earlier this year a patient with a rare autoimmune disease. He’d come in after a flare-up and he really didn’t understand the condition. An intern asked me to print him out some literature on the condition. The next time I saw that the patient, he had highlighted the whole thing, really read it closely, identified other symptoms he’d experienced and began asking really informed questions. In that moment, he decided to take control of his care, and seeing that was really cool.”
“My most recent publication with the Burks Lab used samples collected during clinical trials of sublingual immunotherapy (SLIT) for peanut allergy. Daily therapy consists of a small number of drops of liquid containing peanut protein, which participants hold under their tongue for a short period of time before swallowing. In this analysis, we found that subjects who started off with lower levels of circulating immunoglobulin E (IgE) were more likely to be able to ingest peanuts without a reaction at the end of 12 months of SLIT. These findings could be used to better identify individuals who may be most likely to benefit from peanut SLIT.
“The findings also suggest that peanut SLIT may be more effective in younger children, who tend to have lower levels of peanut-specific IgE. In fact, a trial investigating SLIT in younger peanut-allergic children is currently in the enrollment phase at UNC and UT-Southwestern.
“Other related areas of research within the lab include studies to determine exactly what immune system components are changing in the same subjects published on in this paper. Similar studies are being applied to samples from the subjects in our oral immunotherapy (OIT) studies, in which peanut flour is ingested by participants. OIT is similar to SLIT but differs in the route of administration and the doses used.”
“As an undergraduate – or in my case, a high school student – you are in a lab for a summer and maybe you don’t get to see the end of a project or the next steps. But I’ve been with the Burks lab on and off for eight years now and have such a great connection to the members of the lab and the work. Through medical school, I’m constantly talking to an MD/PhD student about what’s going on. I know what papers are coming out soon. I’ve been able to develop my own research interests and also design projects. I’ve had the opportunity to go to conferences year after year and develop relationships with people in the field.
“This has been an amazing experience, and I’m so thankful to Dr. Burks and the entire lab team for the trust they have placed in me.”
Impact of Allergies
“For families, an allergic reaction is terrifying because sometimes you don’t know what in your environment caused it. Especially if there is a long gap between when something happens and when you’re actually able to get an appointment, you just don’t know what is happening. In some patients I’ve been able to see firsthand that anxiety disorders and anorexia can accompany allergies. I remember one pediatric patient who just would not eat because he didn’t know what was going to make him sick.
“Though I haven’t been in an allergy clinic in a long time, one thing I learned about children with chronic disease during my pediatrics clerkship this year is, as early as you can, it’s so important to make sure that kids understand it’s not their fault, they didn’t do anything wrong. You also have to build trust so that when you explain the best ways to keep the allergy under control, they will actually listen to you. Our nurses are so amazing at talking to kids in ways that they can understand. I’ve learned a ton from watching and listening to them.”
Expanded Research Focus
“In addition to working with Dr. Burks, I’ve also been working in Evan Dellon [MD, MPH, associate professor of medicine and epidemiology] on a study of eosinophilic esophagitis (EoE), which is also a food-triggered disease; your esophagus shrinks to the point that food will become stuck in it.
“In many cases, patients work to identify a food trigger and after they eliminate that, the symptoms go away. This condition is interesting to me because it is so related to food allergies and we see it quite a bit in our patients. Back in my first year of medical school, I heard about Dr. Dellon’s work, emailed him, and said I was interested in learning more. That summer, I worked with him through the Carolina Medical Student Research Program, and would both work on my project and shadow Dr. Dellon when he was expecting to see patients with EoE in a clinical setting.
“Now, the Burks lab and Dr. Dellon are doing research together, which brings together two great interests for me.
“Throughout my time in medical school, I’ve tried to pursue things I’m curious about and see where it goes. When I decided to work on this GI research, I did it because I thought it was interesting. I didn’t know I’d end up working on something with both groups.”
“Trying to finish medical school! Right now, I’m beginning the process of thinking about and applying to residency programs."