Manish Arora, PhD, MPH, is known for his work on biomarkers—using human teeth to reconstruct the timing of exposure to harmful chemicals and essential nutrients.
Manish Arora, PhD, MPH, Vice Chair of the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, has been named a recipient of the Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed by the U.S. government on science and engineering professionals in the first 10 years of their independent research careers.
“Dr. Arora’s research is one of those rare paradigm shifts in science,” says Robert O. Wright, MD, MPH, Ethel H. Wise Professor of Community Medicine and Chair, Department of Environmental Medicine and Public Health, and Director, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory at the Icahn School of Medicine. “I first met him 10 years ago when he was a trainee with a big idea. When he explained the concept of using teeth to measure exposure to lead in pregnancy—to assign a date to an event that happened years ago—it felt like science fiction, but he was able to make it happen, which is a testament to both his intellect and perseverance.”
Dr. Arora, an environmental epidemiologist and exposure biologist with a clinical background in dentistry, has long been passionate about the environment and inventing. He earned a PhD analytical chemistry, and nuclear beam methods from the University of Sydney in Australia. He had a joint appointment at that university and at Harvard University’s School of Public Health before being recruited by Dr. Wright to Mount Sinai in 2013. But he credits a source close to home for his current success: his late mother. “She was a big proponent of generating new knowledge,” Dr. Arora says, but as a young girl in India, her education ended in middle school. “So she always valued education, much more than most people do, because it was not easily attainable to many of her generation.”
Dr. Arora focuses his research, which is funded by the National Institute of Environmental Health Sciences, on the effects of prenatal and early childhood chemical exposures on lifelong health. In the same way that trees have growth rings, he says, “we have growth rings in teeth, and because those start forming before you are born, we can actually go back in time and figure out, for example, what you were exposed to in the second or third trimester.”
A baby tooth being prepared for analysis by a laser.
Dr. Arora and his team collect teeth donated by families and dentists all over the world. To study the teeth, they invented novel techniques and equipment, including a robot that cuts, or “micro-dissects,” samples the width of a human hair. The samples are then analyzed for thousands of chemicals the donors may have been exposed to at different times of their development.
“There are two big findings: One is that it’s not just how much you are exposed to, it’s also when you get exposed to it,” Dr. Arora says. “That is what we are finding for diseases like Lou Gehrig’s disease (ALS), in which you become symptomatic at age 50, 60, 70. But the initial exposure—what altered your trajectory—may have occurred early in life. We are also discovering this is true for autism and schizophrenia.” Dr. Arora says the second finding is that a single chemical is not always the key. “What happens when you get exposed to a mixture of chemicals is not the same as when you get any single component. Previously, the technology to study these mixtures of chemicals didn’t exist, but the methods we are developing allow measurement with novel precision. We now have an NIH laboratory hub for this new technology.”
For this work, Dr. Arora received a New Innovator Award in 2014, which included $2.2 million from the NIH. Dr. Arora is now seeing results in the search for metal and organic risk factors. “The next phase will be finding approaches to mitigate the risk, both at a clinical level, with the goal of personalized environmental medicine, and also at a population level, to support public health and policy development,” Dr. Arora says. “The idea is that as clinicians we can treat people one-on-one, but taking broader action like getting rid of lead in gasoline helps all of us.”