Carissa Thomas

Carissa Thomas
University of Alabama at Birmingham | UAB · Division of Otolaryngology, Head and Neck Surgery

Doctor of Medicine

About

45
Publications
6,035
Reads
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932
Citations
Citations since 2017
23 Research Items
656 Citations
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2017201820192020202120222023020406080100120
2017201820192020202120222023020406080100120
2017201820192020202120222023020406080100120
Introduction
Experienced otolaryngologist with fellowship training in head and neck surgical oncology and microvascular reconstruction. Research experience and interests in microbiome, tumor microenvironment-bacteria interactions, novel prognostic and therapeutic targets in head and neck squamous cell carcinoma, and cancer pain. Also focused on understanding and improving outcomes following microvascular reconstruction of head and neck defects and using fluorescence imaging to predict flap failure.
Skills and Expertise
Education
July 2018 - July 2019
University of Toronto
Field of study
  • Head and Neck Surgical Oncology and Microvascular Reconstructive Surgery
June 2013 - June 2018
University of Colorado Hospital
Field of study
  • Otolaryngology - Head and Neck Surgery
July 2006 - October 2011
Baylor College of Medicine
Field of study
  • Cell and Molecular Biology

Publications

Publications (45)
Article
Full-text available
Background Risk of contralateral nodal metastases in oropharyngeal squamous cell carcinoma (OPSCC) is relatively low, however, many OPSCC patients receive bilateral neck treatment. This study evaluates the oncological outcomes with management of the contralateral cN0 neck based on lymphatic mapping with single photon emission computed tomography (S...
Article
Oral squamous cell carcinoma (OSCC) patients suffer from poor survival due to metastasis or locoregional recurrence, processes that are both facilitated by perineural invasion (PNI). OSCC has higher rates of PNI than other cancer subtypes, with PNI present in 80% of tumors. Despite the impact of PNI on oral cancer prognosis and pain, little is know...
Article
Assess outcomes of pediatric facial reconstruction with fibula free flaps. Free flap reconstruction of complex maxillofacial defects in pediatric patients is rare. Post‐operative complications, donor site morbidity, impact on craniofacial growth, and oro‐dental rehabilitation are unknown. Our study assesses the outcomes of pediatric maxillofacial r...
Article
Full-text available
Background Oral squamous cell carcinoma (OSCC) has poor survival rates. There is a pressing need to develop more precise risk assessment methods to tailor clinical treatment. Epigenome-wide association studies in OSCC have not produced a viable biomarker. These studies have relied on methylation array platforms, which are limited in their ability t...
Article
Background Perioperative management of advanced osteoradionecrosis of the head and neck requiring free flap (FF) reconstruction varies. Our objectives included assessment of practice patterns and outcomes. Methods Multi-institutional, retrospective review of FF reconstruction for head and neck osteoradionecrosis (n = 260). Results Administration...
Article
Background Flap necrosis is a feared complication of reconstructive surgery. Current methods of prediction using Indocyanine green (ICG) lack specificity. IntegriSense750 is a fluorescence agent that binds sites of vascular remodeling. We hypothesized that IntegriSense750 better predicts flap compromise compared to ICG. Methods Fifteen mice underw...
Preprint
Full-text available
Background Oral squamous cell carcinoma (OSCC) has poor survival rates. There is a pressing need to develop more precise risk assessment methods to tailor clinical treatment. Epigenome-wide association studies in OSCC have not produced a viable biomarker. These studies have relied on methylation array platforms, which are limited in their ability t...
Preprint
Full-text available
Background Oral squamous cell carcinoma (OSCC) has poor survival rates. There is a pressing need to develop more precise risk assessment methods to tailor clinical treatment. Epigenome-wide association studies in OSCC have not produced a viable biomarker. These studies have relied on methylation array platforms, which are limited in their ability t...
Article
Full-text available
Background Oral squamous cell carcinoma (OSCC) is a capricious cancer with poor survival rates, even for early-stage patients. There is a pressing need to develop more precise risk assessment methods to appropriately tailor clinical treatment. Genome-wide association studies have not produced a viable biomarker. However, these studies are limited b...
Article
Objectives This paper describes a simple method of securing tissue coverage of the great vessels at the initial surgery by rotating the divided sternal heads of the sternocleidomastoid muscle, a routine step during laryngectomy, and approximating them to the prevertebral fascia. The paper presents an illustrated case example where this technique in...
Article
Objective Review long-term clinical and quality-of-life outcomes following free flap reconstruction for osteonecrosis. Study Design Retrospective multi-institutional review. Setting Tertiary care centers. Methods Patients included those undergoing free flap reconstructions for osteonecrosis of the head and neck (N = 232). Data included demograph...
Article
Objective To understand changes in frailty and quality of life (QOL) in frail versus non‐frail patients undergoing surgery for head and neck cancer (HNC). Methods Prospective cohort study of patients (median age 67 (50, 88)) with HNC undergoing surgery from December 2011 to April 2014. Fried's Frailty Index, Vulnerable Elders Survey (VES‐13), and...
Article
Full-text available
Background Being able to predict negative postoperative outcomes is important for helping select patients for treatment as well for informed decision‐making by patients. Frailty measures are often time and resource intensive to use as screening measures, whereas the Braden scale, a commonly used measure to assess patients at risk of developing pres...
Article
Background: Risk of contralateral nodal metastases in oropharyngeal squamous cell carcinoma (OPSCC) is currently based on clinical risk factors. We propose lymphatic mapping with single photon emission computed tomography (SPECT-CT) for tumor-specific delineation of lymphatic drainage to guide treatment. Methods: Retrospective review of lymphati...
Article
Objectives: To demonstrate and quantify, in a preclinical setting, the benefit of three-dimensional (3D) navigation guidance for margin delineation during ablative open surgery for advanced sinonasal cancer. Materials and methods: Seven tumor models were created. 3D images were acquired with cone beam computed tomography, and 3D tumor segmentati...
Article
Importance Clinicians should understand the prevalence of depression and decision regret in patients with head and neck cancer and whether these factors differ with age or frailty. Objectives To assess whether age and frailty are associated with preoperative and/or worsening postoperative depression and postoperative decision regret in patients un...
Article
Objectives: To describe differences in cancer stem cell (CSC) presence and behavior associated with their intratumor compartment of origin using a patient-derived xenograft (PDX) model of oral cavity squamous cell carcinoma (OCSCC). Materials and methods: Four HPV-negative OCSCC PDX cases were selected (CUHN004, CUHN013, CUHN096, CUHN111) and th...
Article
Objectives/hypothesis: The objectives of this study were to summarize externship experiences among recent graduates and current residents in otolaryngology residency programs and determine whether externships affect the match process. Study design: Cross-sectional survey. Methods: A survey was distributed to otolaryngology residents in allopat...
Article
This is a rare presentation of a morbidly obese male with a massive retropharyngeal goiter causing laryngeal compressive symptoms and unique airway management challenges. Flexible laryngoscopy revealed a retropharyngeal mass circumferentially compressing the oropharynx and supraglottis and preventing the visualization of the glottis. Awake tracheos...
Article
Full-text available
Multiple, simultaneous skin cancers of the face are common. This is the first description of reconstructing discontinuous facial defects (i.e., separate sites of the face) with simultaneous ulnar perforator flaps. The distinct innovations of this multiple flap design are the ability to restrict the harvest site to one extremity, to obtain vein and...
Article
Objectives: To identify the culturable microbes associated with infectious laryngitis and outline effective treatment strategies. Methods: This is a retrospective chart review of adult patients with persistent dysphonia plus evidence of laryngeal inflammation who underwent biopsy for culture at a tertiary care medical center. Demographic factors...
Data
Table S2. Bacterial strains, vectors, and primers used in this study.
Data
Figure S1. FolC2 was necessary for suppression of TNF production at protein and mRNA levels. (A) L. reuteri cell‐free supernatants (normalized to an OD600 of 1.5) were tested for the ability to inhibit TNF production by TLR2‐activated THP‐1 cells. THP‐1 cells were treated with 100 ng/mL PCK (TLR2 agonist) in the presence of L. reuteri for 3.5 h an...
Data
Table S1. Final Gene Set of Interest – 125 genes potentially involved in immunomodulation by wild‐type 6475.
Article
Full-text available
Bacterial-derived compounds from the intestinal microbiome modulate host mucosal immunity. Identification and mechanistic studies of these compounds provide insights into host-microbial mutualism. Specific Lactobacillus reuteri strains suppress production of the proinflammatory cytokine, tumor necrosis factor (TNF), and are protective in a mouse mo...
Article
Full-text available
Human microbiome-derived strains of Lactobacillus reuteri potently suppress proinflammatory cytokines like human tumor necrosis factor (TNF) by converting the amino acid l-histidine to the biogenic amine histamine. Histamine suppresses mitogen-activated protein (MAP) kinase activation and cytokine production by signaling via histamine receptor type...
Article
Full-text available
Beneficial microbes and probiotic species, such as Lactobacillus reuteri, produce biologically active compounds that can modulate host mucosal immunity. Previously, immunomodulatory factors secreted by L. reuteri ATCC PTA 6475 were unknown. A combined metabolomics and bacterial genetics strategy was utilized to identify small compound(s) produced b...
Data
Triple quadrupole mass spectrometry standard curve. Standard curve generated from deuterated histamine and used for the triple quadrupole MS quantification of histamine in HILIC-HPLC fractions and bacterial culture supernatant. Each sample was spiked with deuterated histamine as an internal standard. (TIF)
Data
THP-1 cells express the H1 and H2 receptors. Unstimulated THP-1 cells were examined for cell surface expression of the histamine H1 and H2 receptors. Cells were labeled with rabbit anti-human H1R or H2R pAb and FITC-conjugated goat anti-rabbit IgG pAb or FITC-conjugated goat anti-rabbit IgG pAb alone (IgG Control) and analyzed with FACS. Shown is o...
Data
Elevated cAMP inhibited TNF production from activated human monocytoid cells. Treatment of TLR2-stimulated THP-1 cells with a synthetic analog of cAMP, dcAMP, was sufficient to inhibit TNF production. Results represent the mean ± SD (n = 3), *p value<0.05 compared to medium control. (TIF)
Data
TNF-inhibitory phenotype was modified by the carbon source in the growth medium. Supplementing the growth medium with various simple sugars, such as glucose, glucose+fructose, and sucrose, altered the ability of TFA-treated cell pellets (CP) from L. reuteri 6475 to inhibit TNF production. Results represent the mean ± SD (n = 3), *p value<0.05 compa...
Data
A complete histidine decarboxylase gene cluster was found only in lactobacilli. Analysis of the HMP reference genomes (GI bacteria) for histidine decarboxylase gene homologs revealed that out of 349 reference genomes, only four bacterial strains contained the complete histidine decarboxylase gene cluster. The strains were L. reuteri JCM 112, L. reu...
Data
Genes in the histidine decarboxylase gene cluster were necessary for production of histamine. A. Quantitative real-time PCR demonstrated increased expression of all three hdc genes, hdcA, hdcB, and hdcP, when L. reuteri 6475 was grown in LDMIIIG medium supplemented with 4 mg/mL L-histidine compared to unsupplemented LDMIIIG. Gene expression data we...
Data
Inhibition of ERK1/2 activation suppressed TNF production from activated human monocytoid cells. Inhibition of the MEK/ERK signaling pathway with a MEK-specific inhibitor, U0126, was sufficient to block TNF production. Results represent the mean ± SD (n = 3), *p value<0.05 compared to RPMI medium control, #p value<0.05 compared to LDMIIIG medium co...
Data
TNF-inhibitory compounds were isolated in three distinct HILIC-HPLC fractions. Compounds from TFA-treated L. reuteri cell pellets were separated based on relative hydrophobicity. A. TNF-inhibitory compounds from L. reuteri 6475 grown in a glucose-containing medium were isolated in 3 fractions (B3, B5, and B6). Results represent the mean ± SD (n = 3...
Data
Pixel density analysis of MEK1/2 and ERK1/2 immunoblots. Immunoblots of MEK1/2 and ERK1/2 were quantified by pixel density analysis. A. MEK1/2. Results represent the mean ± SEM (n = 3), *p value<0.05 compared to medium control. B. ERK1/2. Results represent the mean ± SEM (n = 3), *p value<0.05 compared to medium control, #p value<0.05 compared to L...
Article
Full-text available
Although commensal microbes have been shown to modulate host immune responses, many of the bacterial factors that mediate immune regulation remain unidentified. Select strains of human-derived Lactobacillus reuteri synthesize immunomodulins that potently inhibit production of the inflammatory cytokine TNF. In this study, genetic and genomic approac...
Article
Full-text available
This review explores the abilities of beneficial microbes including probiotics to stimulate mucosal and systemic immunity, so that global vaccination strategies may be enhanced. Beneficial microbes secrete microbial factors and express cell surface features that stimulate different types of immune cells to alter their gene expression programs and p...
Article
Full-text available
The intestinal microbiota includes a diverse group of functional microorganisms, including candidate probiotics or viable microorganisms that benefit the host. Beneficial effects of probiotics include enhancing intestinal epithelial cell function, protecting against physiologic stress, modulating cytokine secretion profiles, influencing T-lymphocyt...

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Projects

Projects (7)
Project
Each year 3% of all new cancer cases are oral cavity cancer, which equates to approximately 53,000 cases per year. Rates of survival have remained poor at approximately 60% and relatively stagnant for decades. The Thomas lab is focused on understanding how bacteria in the oral cavity (microbiome) may regulate chronic inflammation and malignant transformation in head and neck cancer as well as metastatic disease. We are investigating the oral cavity microbiome as a biomarker of disease and predictor of prognosis with the future goal of altering the microbiome to improve treatment response and prevent recurrence and metastases. Active areas of scientific work include: 1) bacterial regulation of PD-L1 expression on tumor cells and immune cells in the tumor microenvironment; 2) bacterial regulation of immune cell populations in the tumor microenvironment, specifically macrophage recruitment and differentiation into tumor associated macrophages; 3) bacterial regulation of tumor cell invasiveness.
Project
Oral squamous cell carcinoma (OSCC) is associated with moderate to severe pain at the primary site affecting speech, mastication, and swallowing. In addition, patients with OSCC typically require higher doses of opioids and are at increased risk for opioid dependence resulting in a reduced quality of life and survival. Effective pain management in patients with OSCC is challenging because of our limited understanding of mechanisms of cancer pain. In other disease processes, the gut microbiome is known to modulate pain via mechanisms of bacteria-derived mediators, metabolites and neurotransmitters acting on immune cells and nociceptors (pain receptors). Our research aims to identify biomarkers within the local oral cavity microbiome and distant gut microbiome that modulate OSCC cancer pain. Understanding mechanisms and mediators of pain in OSCC will allow for development of alternative targeted therapies and potentially reduced opioid dependence.
Project
Many head and neck cancers are treated with surgery, which involves tumor extirpation and reconstruction with local, regional, and microvascular free tissue transfer reconstructions. Wound complications are frequent due to a multitude of factors including smoking, diabetes, prior radiation or chemoradiation, immunosuppression, malnutrition, hypothyroidism, and constant contact with saliva. Wound complications are a burden to our healthcare system by increasing hospital length of stay and requiring additional surgeries. In addition, poor wound healing increases patient morbidity, delays the ability to receive additional cancer treatment such as radiation, and delays the ability to resume eating by mouth and speaking. These delays impact survival as well as quality of life. Our research is examining if modifying the saliva microbiome and decreasing bacterial load can reduce post-operative wound complications in patients with head and neck cancer.