Eiki Koyama, DDS, PhD Eiki Koyama, DDS, PhD, is a pediatric orthopaedic researcher at Children's Hospital of Philadelphia focusing on early limb patterning, craniofacial development and synovial joint formation. Appointments and Referrals: 1-800-TRY-CHOP (1-800-879-2467) Background I have been a biomedical researcher for more than 20 years and currently am a faculty member in the Translational Research Program in Pediatric Orthopaedics at Children's Hospital of Philadelphia (CHOP). My research interest involves early limb patterning, craniofacial development and synovial joint formation. In the early 1990s, my colleagues and I studied the roles of retinoic acid (RA) in early limb development. At that time, RA was thought to be one of the strong candidates of morphogen, which can determine the anteroposterior axis of developing limb buds. We have tackled this notion and found that RA is unlikely a morphogen, but it acts as an inducer of the morphogen to control the limb patterning. This notion has been widely accepted and has lead to the finding of the real morphogen, Hedgehog, which can be induced by RA. I've started to study the mechanisms of synovial joint. At prospective joint sites, the first overt sign of joint development is the appearance of a layer of closely-packed mesenchymal non-chondrogenic cells referred to as interzone. The cells have been thought to be very important for joint formation, but its real function was obscure at that time. To tackle this key issue, my team and I carried out genetic cell tagging and tracking studies. We found that interzone cells gave rise to most of all joint tissues, including articular cartilage layers, synovial lining, inner capsule and intra-joint ligaments and clarified at the molecular level the interzone cells represent a specialized cohort of progenitor cells exclusively determined for joint formation. This study has shed light on the mechanisms of synovial joint formation and the work has been highly quoted by other biomedical researchers. Currently I am focusing on several congenital conditions including Hereditary Multiple Exostoses (HME) that affects children and young adults. Based on our extensive knowledge of the normal processes of skeletal development and growth, I would like to clarify the molecular mechanisms of HME formation and growth. We hypothesized that the Heparan sulfate deficiency in HME causes mis-distribution and mis-expression of potent growth factors, such as Hedgehog protein and other pro-chondrogenic factors and enhances the responsiveness of perichondrial cells to these and other local factor. To verify this hypothesis, we have currently exploited a number of mouse models for HME. We expect that these powerful and unique models will also allow us to test possible rational pharmacologic therapies based on those insights. Education and Training Medical SchoolDDS — Matsumoto Dental University, Shiojiri, Nagano, Japan (1985) Graduate DegreePhD, Developmental Biology — Okayama University, Okayama, Japan (1992) Titles and Academic Titles Faculty, Biomedical Research Program in Pediatric Orthopaedics Departments and Services Division of Orthopaedics Research Interests Early limb patterning Craniofacial development Synovial joint formation Patient Experience Ratings About the Patient Experience Rating System The Patient Experience Rating is an average of all responses to the care provider related questions shown above from our nationally-recognized Press Ganey Patient Satisfaction Survey. Patients that are treated in outpatient or hospital environments may receive different surveys, and the volume of responses will vary by question. Responses are measured on a scale of 1 to 5 with 5 being the best score. We are committed to true transparency. However, to ensure the comments are fair and correctly attributed, we review each one before posting to the website. We exclude entire comments that disclose patient's protected health information, are off-topic, or include other confidential or inappropriate content. Comments will appear on provider bios only if providers have a minimum number of comments. Comments are shared internally for education purposes to ensure that we are doing our very best for the patients and families for whom we are privileged to care. The comments are submitted by patients and families and reflect their views and opinions. The comments are not endorsed by and do not reflect the views of Children’s Hospital of Philadelphia.