Sundeep Khosla, M.D., Named 2009 Rochester Distinguished Investigator

Photo of Sundeep Khosla, M.D.

Sundeep Khosla, M.D.

Endocrinologist and renowned researcher Sundeep Khosla, M.D., has been named the 2009 Rochester Distinguished Investigator. Dr. Khosla, who specializes in treating metabolic bone diseases and osteoporosis research, has been with Mayo Clinic for 21 years.

"I identify myself as a clinician investigator," says Dr. Khosla. "One of the most attractive things about the Mayo system is the opportunity it offers to add meaningful clinical research to one's medical practice. Not only does our research lead to better treatments for our patients, but the challenges and questions we face each day in the practice inform and direct our research, completing the translational cycle."

Dr. Khosla credits a long line of mentors, dating back to his days as a medical student at Harvard, with his decision to pursue a career in endocrinology and bone metabolism research. "I was drawn to the logical thought process of endocrinology diagnostics and treatment, which I learned from my first mentor, Dr. Daniel Federman of Harvard Medical School," recalls Dr. Khosla. "But it wasn't just his clinical skills – it was who he was as a person. I knew I wanted to be like him." Dr. Hank Kronenberg at Massachusetts General added training in cellular and molecular biology during Dr. Khosla's residency and fellowship. When he joined the Mayo Clinic staff as a senior associate consultant in 1988, Dr. Khosla's research career flourished under the mentorship of Dr. Larry Riggs and Dr. Joe Melton.

While most osteoporosis research has focused on postmenopausal women, Dr. Khosla believes some of his lab's most significant work has been in identifying causes of osteoporosis in men. Somewhat surprisingly, his research has shown that in men, it is estrogen, and not testosterone, that is the major regulator of bone metabolism; moreover, decreases in biologically available levels of estrogen with aging can lead to osteoporosis, just as in women. This understanding of the disease mechanism has important implications both for using estrogen levels to help identify men at risk for osteoporosis as well as to the possible use of selective estrogen receptor modulators to help prevent and treat osteoporosis in men.

Translational Research

Dr. Khosla and his colleagues also focus on novel methodologies, including high resolution CT, to study bone structure. Working with Drs. Shreyasee Amin, Merry Jo Oursler, Jennifer Westendorf, Michael Yaszemski, Salman Kirmani and others, Dr. Khosla has identified structural and cellular markers that predict susceptibility to bone fracture in adults and children. "As we understand more about the pathways to bone loss and bone building, we will be able to develop medications to strengthen bones and, eventually, regenerative cell therapies to replace bone that has been lost to osteoporosis and fractures," says Dr. Khosla.

It is at the intersection of research and clinical practice that Dr. Khosla finds his greatest satisfaction. "You have to be excited about your work, about the chance to help our patients," he says. "My passion, my motivation, and sometimes my heartbreak, all come from that. Because of the worldwide reputation our Metabolic Bone Group enjoys, very complex and unusual cases are often referred to us. I am constantly learning from my patients and my colleagues, and using those interactions to spark ideas for new lines of research that will give us the answers we need for our patients."

In addition to his clinical duties, research and teaching responsibilities, Dr. Khosla serves as the chair of the Thematic Research Subcommittee. "The research themes were created to bring investigators together in multidisciplinary teams to address complex issues such aging or musculoskeletal disorders," explains Dr. Khosla. "No single discipline has all the answers – it takes a team approach to understand the complex and interrelated disease mechanisms, develop multi-system animal and human models and navigate the translational continuum from clinical trials to standard patient care." The broad themes also offer portals for funding agencies and benefactors that allow them to leverage their investment across many labs and clinical disciplines to target high impact diseases and conditions such as age-related cognitive losses, diabetes and obesity.

Mentoring Others

Now at the height of his career, Dr. Khosla works to launch the careers of promising young clinicians and scientists at Mayo. "Mentoring is increasingly rewarding to me," he says. "I enjoy watching their careers grow. I feel personally accountable to the people I mentor. In return, they make fantastic contributions to our lab's work and to our patients." Dr. Khosla credits scientists David Monroe, Ph.D. and Ulrike Moedder, Ph.D., with keeping his Osteoporosis Research Lab running smoothly even as he devotes time to patient care, administrative duties and travel. And he takes time to share with young physicians such as Dr. Matthew Drake the importance of balancing hard work with "compartments of time" devoted to family and personal pursuits.

Dr. Khosla says receiving the Distinguished Investigator award is "the highlight of my career at Mayo" because it conveys his colleagues' recognition of his life's work. He has no plans to slow down, however; if anything, the award motivates him to continue to learn and innovate.

"You never stop being a young investigator," according to Dr. Khosla. "To keep my edge, I constantly challenge myself. Yesterday's achievements are great, but what have I done today? What plans do I have, what questions will I answer tomorrow? It's tomorrow's research that gets funded."