Meet Eric Chien-Wei Liao, MD, PhD, founding Director of the Center for Craniofacial Innovation at Children’s Hospital of Philadelphia (CHOP).
Dr. Liao is a pediatric plastic surgeon-scientist who leverages convergent advances in fetal care, human genetics and developmental biology to initiate first-in-child trials and treatments. As a surgeon, Dr. Liao cares for patients born with orofacial clefts and complex craniofacial conditions. Prior to joining CHOP, Dr. Liao was a Professor of Surgery at Harvard Medical School, led the Mass General Department of Surgery as Vice Chair of Research, and led Shriners Children’s Boston as Chief of Staff.
Q: Why did you come to CHOP?
A. There are several reasons. CHOP is one of the best pediatric hospitals in the world, especially when it comes to the Craniofacial Program — it has one of the highest volumes of any program and treats the most complex patients. Another reason I came is the fetal surgery performed at the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, where they’re making advances in maternal-fetal medicine to treat congenital problems. And I’m really impressed by how much CHOP values research and invests a large amount of the bottom line back into research. That’s extremely rare.
The things that will drive medical advances for the next decades are all at CHOP. Genomic sequencing. Multi-omics, a broad term covering how to integrate all the genomic data and the clinical data. Biobanking — the biobanking effort at CHOP is second to none. In the Colket Translational Research Building, there’s a basement big enough to park several 767s. It’s a biobank full of minus-80 freezers. It’s massive. We make use of that genomic data to cure patients. It’s called gene therapy.
Q. What is the mission of the Center for Craniofacial Innovation?
A. The center has four pillars.
- Functional genomics: Gene sequencing is happening at ever-increasing speeds. Making use of that genomic information requires experiments to validate this sequencing data — that’s what my lab does.
- Multi-omics: This is now we connect that data to clinical information to guide treatments. It’s the realization of the idea of personalized medicine.
- Next-generation treatments: In plastic surgery, we use a lot of screw and plates. These are metal — they don’t grow with kids. We can make better devices. Let’s find other materials we can use.
- Clinical outcomes: We need to improve what we do in clinical research in order to establish best clinical practices. For example, the most common diagnosis in plastics, cleft lip and palate, doesn’t have a consensus about the timing of treatment and number of procedures. We need to establish standards of care.
The mission of the Center for Craniofacial Innovation is to understand why these birth conditions happen, to imagine treatments that are possible, and make them available to patients everywhere.
Q. What balance will you strike between research and clinical care?
A. About 20% of my role will be caring for patients. I am part of the Cleft Lip and Palate Program team, and beyond cleft lip I care for patients with complex craniofacial conditions. Because every child with cleft lip and palate also has an asymmetrical nose, I perform rhinoplasty. I also perform breast surgeries.
Q. Will it ever be possible to prevent cleft lip and palate?
A. This will happen through the use of safe drugs. We know that folic acid taken during pregnancy can help prevent some major birth defects, such as spina bifida. We need to find the folic acid for clefts. That requires understanding how these conditions happen. We understand the genetics behind it. We have zebrafish with cleft lip and palate that are helping us discover drugs to prevent it. You take an embryo of a fish with a cleft lip and see if their cleft gets cured by being exposed to a drug. Understanding the genetics gives us a clue as to which genes can be made better with a certain compound.