CME Course

The Paradoxical Role of Intestinal Stromal Cells in Healing and Disease

For the past 25 years, Dr. Powell’s research has focused on the biology of intestinal myofibroblasts, also called activated fibroblasts, intestinal mesenchymal cells, or intestinal stromal cells. This activity details information about this research.

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Target Audience

Healthcare providers of all specialties may benefit from the information presented.

Goals and Objectives

For the past 25 years, Dr. Powell’s research has focused on the biology of intestinal myofibroblasts, also called activated fibroblasts,intestinal mesenchymal cells, or intestinal stromal cells. Myofibroblasts are members of a family of mesenchymal cells such as pulmonary interstitial fibroblasts, hepatic and pancreatic stellate cells, and joint synoviocytes. Located at the interface between the epithelium and lamina propria, intestinal stromal cells modulate information transfer between these tissue compartments and play a pivotal role in the regulation of the epithelial stem cell niche.

By secreting stem cell factors and growth factors, stromal cells promote epithelial growth and repair. They are also non-professional antigen presenting immune cells which promote immune tolerance by expression of tolerogenic molecules such as the immune checkpoint inhibitor ligand Programed Cell Death Ligand 1 (PD-L1). When activated, they also secrete inflammatory cytokines and matrix molecules that cause inflammation and fibrosis. Thus, these cells play important roles in inflammatory diseases such as rheumatoid arthritis, asthma, and inflammatory bowel disease. Stromal cells (cancer-associated fibroblasts) are key components of the cancer microenvironment and promote cancer growth and metastasis. Immune checkpoint inhibitors such as monoclonal antibodies against PD-1 or PD-L1 have become potent anticancer immunotherapy drugs. At the conclusion of this activity, the learner should be able to:

  • Describe the role of intestinal stromal cells in wound healing, cancer, and fibrosis;
  • Identify the role of stromal cells in creating a niche for expanding epithelial stem cells during intestinal healing;
  • Recognize the important role of a specialized stromal cell, the cancer-associated fibroblast, in promoting tumor growth and metastasis;
  • Define the rationale for immune checkpoint immunotherapy of cancer and recognize its toxicities. 

Course Information

CME Release Date:  11/18/2021
Valid for credit through:  11/17/2022
Course type:  Video Course
Estimated time of completion: 30 minutes

Credits Available

Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Southern Medical Association designates this Internet Activity Enduring Material for a maximum of .50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. 

AANPCP: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Healthcare Professionals
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.  All healthcare professionals who are not MDs or DOs will receive a certificate of participation.

Instructions for Participation and Credit

This activity is designed to be completed within the time designated; learners should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period noted, following these steps:

  • Read the goals and objectives, accreditation information, and author disclosures.
  • Login in below to study the educational content and references.
  • Complete the attestation, post-test (if applicable), and evaluation.

Upon successful completion of these components, your certificate will be processed and emailed from [email protected] within approximately 1 hour. Credits will be archived for 6 years; at any point within this time period you may login to your account to print a duplicate copy of your certificate.

Disclosures of Conflicts of Interest

Southern Medical Association (SMA) requires instructors, planners, managers, and all other individuals who are in a position to control the content of this activity to disclose conflicts of interest (COI) with ineligible entities within the last 24 months of the development of this activity. All identified COIs are thoroughly vetted and mitigated prior to the release of the activity. SMA is committed to providing its learners with high quality activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The following individuals have no relevant financial relationships to disclose.

Speaker

Don W. Powell, MD
Dr. Powell is currently a Professor Emeritus in the Department of Internal/Medicine/Gastroenterology at the University of Texas Medical Branch (UTMB) in Galveston.  Previous academic roles there were the Edward Randel and Edward Randel, Jr Distinguished Chairman of Internal Medicine and Professor of Neuroscience, Cell Biology & Anatomy; Associate Dean for Research; Director of the UTMB Institute for Translational Sciences (CTSA) Clinical Research Center; Director of the Division of Gastroenterology and Hepatology, and Program Director of the Gastroenterology Fellowship.

A native of north Alabama (Powell, AL), he attended high school in Hattiesburg, MS. He received a BS in 1960 from Auburn University and MD with highest honors from the Medical College of Alabama (now UAB) in 1963.  While in medical school, mentorship by Dr. Basil Hirschowitz, a translational scientist and inventor of the fibro-optic endoscope, led to his interest and career in gastroenterology. He completed his internal medicine residency training at Peter Bent Brigham Hospital and Yale-New Haven Community Hospital and was a Special National Institutes of Health Fellow in Physiology at Yale University. He served as Captain in the Army Medical Corp from 1965-68 at the Walter Reed Army Medical Center. Following training and military service, he was a member of the faculty at the University of North Carolina Chapel Hill from 1971-1991, where he became Professor of Medicine, Chief of the Division of Digestive Diseases and Nutrition and Director the NIH-funded Center for Gastrointestinal Biology and Disease. 

SMA Education Planning Committee:
Christopher Morris, MD
Steven Strode, MD
Donald DiPette, MD

Course Materials

This Course is Free to All Healthcare Professionals

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Premium Access

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