By Dayna Kerecman Myers
Stanford Blood Center (SBC) is honored to welcome Dr. Elizabeth Trachtenberg on board as a new Professor of Pathology and Co-Director of SBC’s Histocompatibility, Immunogenetics, and Disease Profiling Laboratory.
Ensuring a successful bone marrow or organ transplant requires delicate, painstaking effort to find the best match possible between donors and recipients, or the transplants may fail. Dr. Trachtenberg has devoted her career to bringing about the best possible outcomes for transplant recipients, researching the complexities of the human immune system, and searching for answers for people suffering from autoimmune diseases.
By all accounts, Dr. Trachtenberg is breathtakingly accomplished in the field of immunogenetics, both in terms of her research and her clinical contributions.
But she was almost an artist.
Growing up spending summers on farms in Indiana and Pennsylvania, learning about the natural world of plants and animals, Dr. Trachtenberg’s early interest was in biology and science. Her other passion was art. When she went to UC Berkeley as an undergrad, rather than choosing between these two passions, she decided to major in both biology and art — imagining that perhaps she’d go into medical illustration. With minors in French and art history, her studies also led her to Paris, to study the French language and culture at the Sorbonne.
As a senior at Berkeley, though, she took a genetics course. Ultimately, that course set her on the path that brought her to Stanford Blood Center. On choosing her field, she commented, “The field of genetics was fascinating to me. It seemed to be a broad, opening, growing field — a creative field with a lot of questions to answer.”
In graduate school, her research centered on examining both normal and aberrant hemoglobins, Thalassemias, in Southeast Asian populations, from both a clinical and population genetics perspective. Studying the interesting hemoglobin gene families set the stage for Dr. Trachtenberg to move on to the more complex human leukocyte antigen (HLA) gene cluster. The HLA genes are the most diverse of all known genes. The HLA genes code for proteins on the surface of cells, and they help the body determine which cells are friendly, or ‘self,’ and which are not friendly, or ‘non-self.’ Because there is a constant barrage of new pathogens, these genes have had to continually evolve within the population to manage new pathogens.
After completing her undergraduate studies, Dr. Trachtenberg moved to Hawaii, where she earned an MS in Genetics and a PhD in Molecular Genetics from the John Burns School of Medicine, U Hawaii. Upon completing her studies, she was invited to become an adjunct Professor of Pathology, and to direct Hawaii’s first clinical HLA-DNA diagnostics laboratory at the St. Francis Medical Center, Honolulu.
Dr. Trachtenberg eventually returned to Northern California, where she continued to study complex immunologic systems. She has spent the last 20 years at Children’s Hospital & Research Center Oakland (CHRCO), where she directed a clinical immunogenetics and molecular diagnostics lab, a center for applied genomics, and a major research program focused on molecular immunogenetics of transplantation and disease.
At Children’s Hospital Oakland, Dr. Trachtenberg began to focus on natural killer (NK) cells (a type of lymphocytes – white blood cells – that play an important role in defending our cells against viruses and tumors). In particular, Dr. Trachtenberg explores their receptors, known as Killer Immunoglobulin Receptors, or KIR. These receptors look for HLA on the cell surfaces to let them know that the cell is healthy, and if HLA is not found, the KIR signals to the NK cells to kill the cell and alert other cells via special immunologic hormones.
The HLA and KIR systems work together to modulate the immune response, and Dr. Trachtenberg’s system explores how they work in health and disease. With NIH funding, she is currently studying their role in transplantation (both stem cells and solid organs), as well as their role in autoimmune diseases like Inflammatory Bowel Disease (IBD), multiple sclerosis, and rheumatoid arthritis. She is also exploring the role of HLA and KIR cells in HIV acquisition and disease progression, and the population genetics of HLA and KIR variation.
Her third major area of interest is in developing novel, high accuracy and through-put molecular assays, and through her research, translating these to the clinical lab to improve care of patients. Dr Trachtenberg’s group has developed a number of assays using specialized mass spectrometers for DNA variant analysis, and using next-generation sequencing platforms for rapid determination of an individual’s HLA and KIR gene variation. These gene clusters are very complex, and this is why correct sequence from these regions has been missing from the Human Genome and other such national human sequencing projects. The novel next generation sequencing assays and data obtained on these regions will open the regions up for much needed, deeper study.
Of her decision to join Stanford Blood Center, Dr. Trachtenberg said, “The opportunity was profound. Joining Stanford’s Department of Pathology opened up so many doors.” She appreciates the potential to collaborate with other researchers and practitioners, and the intellectual and financial support that will allow her to focus and develop her research. As an HLA clinical immunogeneticist specializing in bone marrow transplants, the opportunities to deepen her clinical focus were a primary draw for her. She especially looks forward to working alongside her co-Directors, Dr. Dolly Tyan and Dr. Marcelo Fernandez-Vina. She has worked with them for over 20 years, and they enjoy a mutual respect and trust.
In addition, Dr. Trachtenberg will continue her NIH-funded studies and assay development, for both research and clinical use. Along with Dr. Fernandez-Vina and Tyan, she’ll also be busy preparing for the 17th International Histocompatibility & Immunogenetics Workshop, which will take place at Stanford in September 2017. This international effort will focus on deep sequencing and gene array analysis of the HLA and KIR complexes to significantly broaden and sharpen our knowledge of these regions of the genome.
In a field where finding a perfect HLA match is key, Dr. Trachtenberg’s experience, creativity, and ability to see the world from different perspectives — that of an artist, a geneticist, an anthropologist learning about other cultures, a compassionate clinical practitioner — all help to make her the perfect match for SBC’s HLA lab.