Balancing Bold Ideas and Financial Challenges: Dr. Amali Samarasinghe’s Resilient Journey to Success

Amali Samarasinghe, PhD, associate professor in the Department of Pediatrics, was recently awarded $2.3 Million from the National Heart, Lung, and Blood Institute for a study to explore eosinophils' role in combating flu-related bacterial infections. Photo credit: Le Bonheur Children's Hospital

Amali Samarasinghe, PhD, associate professor in the Department of Pediatrics at UT Health Science Center, describes herself as an aficionada of the alternative hypothesis. "I have a passion to uncover the inner workings of non-dogmatic possibilities."

Dr. Samarasinghe is the lead author of a comprehensive review on eosinophils published in the September 2024 edition of The Journal of Leukocyte Biology. She collaborated with her colleagues from George Washington University, the NIH, and Universitätsklinikum Erlangen, to detail how these white blood cells serve as modulators of host defense during various infections-parasitic, fungal, bacterial, and viral-challenging conventional views that restrict their role merely to allergic reactions. Her research on eosinophils earned her the 2023 mid-career achievement award from the national Society of Leukocyte Biology and was featured at the 2023 International Eosinophil Society Conference.

Dr. Samarasinghe's life experiences developed in her a certain comfort level in challenging accepted truths and exploring new possibilities beyond traditional textbook knowledge. Born and raised in Sri Lanka, she remembers that when it came time to sit for her college entrance exam her school objected to her facing an exam taken by all high school seniors. "The school I attended didn't allow me to sit for the A levels with my peers," she says. "They made me apply privately because they believed I might fail." That experience led her to immigrate to the U.S. for a fresh start. She flourished in developing her own philosophical pathways in the American education system, where analytical thinking was emphasized over rote memorization.

Completing her undergraduate and master's degrees with distinction at California State University, Northridge, she was recruited to North Dakota State University Molecular Pathogenesis Program with a Presidential Fellowship. After earning her PhD with honors in 2010, Dr. Samarasinghe moved to Memphis as a Postdoctoral Fellow in the Department of Infectious Diseases at St. Jude Children's Research Hospital and joined the department of Pediatrics at UT Health Science Center in 2012. She earned her place in 2018 as the youngest person at the UT Health Science Center to be granted endowed chair status and is now the Director of the Pediatric Asthma Research Program and co-director of the Medical Student Summer Research Fellowship Program.

It was the emphasis on critical thinking she first experienced during her undergraduate years, and the resilience she adopted during her early years in the U.S., that emboldened her to explore controversial ideas, like the one in her latest project.

Dr. Samarasinghe's lab is also dedicated to uncovering why asthma patients do not suffer long-lasting damage from flu or other respiratory pathogens. Photo credit: Le Bonheur Children's Hospital

Dr. Samarasinghe's research explores respiratory diseases like influenza and bacterial pneumonia in patients or hosts with fungal asthma. She began by studying comorbidities, revealing significant insights into the interplay between various health conditions. While healthy individuals provide valuable data when infected with the flu, real-world patients often face a barrage of chronic health issues such as diabetes, cardiac problems, autoimmune disorders, or neurological conditions. During the swine flu pandemic and similarly with COVID-19, conventional wisdom suggested that asthma patients were at high risk. Pulmonologists took extensive measures to protect these patients. However, her findings challenged this notion; asthma patients were not among those severely affected or needing intensive care.

"Contrary to expectations, they were not the ones in ICU or requiring mechanical ventilation. They did not succumb to the virus," she says. Reflecting on historical pandemics like the 1918 flu epidemic that claimed millions of lives globally, it struck her that one would expect asthmatics to be disproportionately affected given their chronic condition. Yet asthma has persisted for greater than 2,000 years, suggesting an evolutionary preservation mechanism at work. "This paradox highlights a yin-yang balance-while asthma impairs quality of life under normal circumstances, it appears to confer immune defense during influenza virus infection." Her lab is dedicated to uncovering why asthma patients do not suffer long-lasting damage from flu and other respiratory pathogens.

They identified eosinophils-a granule cell often linked to asthma-as key to this observed protection. Despite their negative reputation in asthma, eosinophils exhibit protective properties against influenza virus, rhinovirus, SARS-CoV-2, and even bacteria. In one project focusing on bacterial pneumonia caused by Streptococcus-typically harmless but potentially damaging post-influenza infection-her team discovered that eosinophils play a critical role in prevention. Their animal models showed that asthma subjects with abundant eosinophils had a 100% survival rate when co-infected with influenza virus and Streptococcus pneumoniae compared to non-asthma subjects who faced 100% mortality.

The resilience it took to pursue controversial ideas has also served her well when dealing with the administrative end of securing funding. Her most recent award, a $2.3 million grant from the National Heart, Lung, and Blood Institute, was hard-won, and the direct result of persistence in the face of major objections. The funding supports her research on the protective role of eosinophils in asthma during bacterial infections. This lays the foundation with the potential for new therapeutic approaches to combat bacterial co-infections during flu seasons. But it was only on her third try, after refining her ideas and addressing feedback from her first two failed submissions, did the proposal finally achieve a 1st percentile ranking.

She also faced an unforeseen challenge in the process. The proposal was automatically routed by an electronic system to the wrong institute, one that did not provide the five years of funding she was seeking. Determined to find a solution within the system, she reached out to the program officers at National Heart, Lung, and Blood Institute (NHLBI) and explained the situation - and they granted more annual funding than initially budgeted. "Although this did not entirely compensate for losing one year of funding overall, the experience underscored that persistence and human interaction within large institutions like NIH can make a huge difference. I now look at setbacks as just part of the submission process," she said.

"This was a true rags to riches story founded in perseverance and embracing criticism," Dr. Samarasinghe continues. "I went through a year and half funding gap between R01 grants from the NIH. I was fortunate to have successfully competed for bridge funds from the office of the Vice Chancellor for Research at UT Health Science Center and have a two-year grant from the American Lung Association to cover my research program. This successful R01 grant application was submitted during a time when a close family member was severely ill, and I had surmounting pressure at work. I am so grateful for my mentors and sponsors who supported me to stay focused on what was important."

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