Ferguson Laboratory Feature | Melissa Yunting Tang, MD

Melissa Yunting Tang, MD, is a second-year resident in the University of Pittsburgh Department of Orthopaedic Surgery and a current research fellow in the Ferguson Laboratory for Orthopaedic and Spine Research. Dr. Tang is pursuing the research track of the residency program and is on the path toward becoming an academic spine surgeon. She came to the University of Pittsburgh after earning her medical degree from the University of Arizona College of Medicine in 2021. While becoming a doctor and scientist was a long-standing ambition, she developed an interest in orthopaedic surgery during her first semester of medical school.

"One of my first classes was on the musculoskeletal system, and my professor was a female orthopaedic surgeon who allowed me to shadow her in the operating room," says Dr. Tang. "The first time I held a drill and a hammer, I knew orthopaedic surgery was my calling. I also knew that I not only wanted to do surgery, but I wanted to make treatments better by becoming a physician scientist.”

Dr. Tang matched at her first choice for orthopaedic residency at the University of Pittsburgh.

“I ranked Pitt #1 because of the legacy in producing academic surgeons and leaders in the field,” she says.  “Freddie Fu personally trained more chairmen than any other orthopaedic chair in the country.”

Dr. Tang was overjoyed when she received a phone call from the world-renowned Freddie Fu, MD, the department’s former longtime chairman who sadly passed away much too soon in 2021.

"In his usual passionate and energetic voice, he said, 'You come to Pittsburgh okay? You do six year, okay?’ and he hung up. So, we were on the same page,” says Dr. Tang. “I wanted to come here and continue his legacy. He was my personal hero and I was so honored to have been the last class that he chose before he passed. This is one of the foremost training programs for orthopaedic surgeons in the world, built by Dr. Fu, his predecessor Dr. Ferguson, and everyone else that's come before them.”

Research in the Ferguson Laboratory

Dr. Tang chose to pursue her dedicated research year of residency in the Ferguson Laboratory for a number of reasons. As she explains, there is not only the opportunity to work in a multidisciplinary basic science lab studying spine pathologies, but she also has the ability to work with other research groups in the department, including the Biodynamics Laboratory and the Pittsburgh Orthopaedic Spine Research Group (POSR). Dr. Tang also talks about the leadership of the Ferguson Lab – Nam Vo, PhD; Gwendolyn Sowa, MD, PhD; Joon Lee, MD, and William Anderst, PhD, from the Biodynamics Lab, and the incredible mentorship and training opportunities she has received under their guidance.

"You have, at once, an incredibly accomplished, multidisciplinary group of leaders to train under who are working to better understand the pathophysiology of, and develop effective treatments for, common spine conditions, such as adjacent segment disease and intervertebral disc degeneration, which will make a significant clinical impact. We are using cutting edge technologies, such as biplane radiology and targeted gene therapy," says Dr. Tang.

Since beginning work in the lab, Dr. Tang has been involved in studies investigating ligamentum flavum hypertrophy and the potential for targeting the condition through a novel microRNA, miR-29a. This is a continuation of concept developed by her predecessor, Dr. Richard Wawrose, also a resident research fellow of the Department of Orthopaedics.

“The lab will have a new paper coming out soon about this work and how miR-29a controls gene expression in several important fibrotic pathways important to ligamentum flavum hypertrophy and lumbar spinal stenosis,” says Dr. Tang.

These studies are now progressing with additional work that will develop 3D ligament models that can be used to study the effects of static and cyclic loading on ligament remodeling. She is also developing a small animal model of ligamentum flavum hypertrophy for in vivo testing of miR-29a with guidance from Drs. Joon Lee, Peter Alexander, and Prashanta Silwal.

Dr. Tang also has been studying gene therapy approaches to treat intervertebral disc degeneration and is the lead author of a new forthcoming review paper that discusses current and emerging gene therapy approaches for delivering potential therapeutic options targeting the intervertebral disc.

"Gene editing, through methods such as CRISPR, are beginning to open a lot of new pathways to investigate disease-modifying therapies," says Dr. Tang. "The Ferguson Lab continues to be a leading center for these kinds of studies, building upon the work of former lab director James Kang, MD. There's a rich history to tap into from a learning perspective."

Upcoming Presentations at the Orthopeadic Research Society 2023 Annual Meeting

Numerous faculty from the Department and the Ferguson Laboratory will be presenting research at the upcoming annual meeting of the Orthopaedic Research Society (ORS) in mid-February. Dr. Tang is the author of 11 abstracts. She will be presenting eight of these abstracts as the lead author.

The first, titled “Adjacent Segment Motion Does Not Increase Three Years After Cervical Arthrodesis," is a collaborative study between faculty in the departments of Orthopaedic Surgery and Neurosurgery, and the Biodynamics Laboratory. This abstract is also nominated for a spine section poster award at the conference. Briefly, the investigation has found from in vivo testing that adjacent segment range of motion, a measurement for adjacent segment loading, does not increase over time after cervical arthrodesis, which contradicts the prevailing theory of why adjacent segment disease is common after fusion. The study used a cutting-edge, validated tracking process that measures intervertebral range of motion through a combination of CT-based bone modeling and biplane radiographs of patient kinematics.

The second abstract Dr. Tang will present from her current work in the Ferguson Lab is "Rapamycin Ameliorates Age-Associated Intervertebral Disc Degeneration in Marmosets with Sex-Specific Effects." The team has been investigating the use of rapamycin as a potential treatment for age-related disc degeneration. Their study, which is the first to investigate sex-specific in vivo effects of rapamycin on age-associated IDD in a nonhuman primate model, suggests that rapamycin may be a viable treatment for male and female patients with IDD. They found that rapamycin promoted favorable disc matrix proteoglycan homeostasis in both sexes but only improved disc histology in males, highlighting sex differences in response to rapamycin therapy. The results indicate that one-year daily rapamycin treatment delayed IDD progression in males and females despite sex-specific effects and is thus a potential therapeutic target for patients with IDD.