Sara Elizabeth Miller
Professor in Pathology

Our laboratory specializes in two areas, infectious diseases, particularly
viral diseases, and ultrastructure-function relationships. Electron
microscopy (EM) is the focus of the investigative techniques and includes
preparative methods such as negative staining, thin sectioning,
ultracryomicrotomy and immunolabeling of acrylic and frozen sections.

We are especially interested in methods for diagnosing viral illnesses by
EM, and are involved in developing better, more sensitive and faster,
methods for detection. While molecular techniques for detecting organisms
are very sensitive, they all require specific reagents, and if the correct
probe is not determined a priori, the test is negative. EM offers an open
view of any viruses or unsuspected organisms that may be present. We make
use of concentration and enhancement methods to increase the chances of
detecting viral agents in fluid specimens. Additionally, we have
described a method for selecting small focal areas of pathology in tissue
by confocal microscopy to be embedded and examined by EM, increasing the
chances of visualizing organisms. Infectious diseases are the leading
cause of death worldwide and the third leading cause in the US. With
advanced therapies for cancer patients and many patients living longer
with their disease, a whole new population of infectious
disease-susceptible patients has emerged. Chemotherapy, radiation, and
bone marrow transplantation are permitting longer survival, but cause
immunosuppression and consequently, strange, unusual diseases, such as
polyomavirus infections, sometimes in uncommon body sites. We work
closely with physicians to detect and monitor the clearance of
polyomavirus infections in bone marrow and kidney transplant patients. We
detect food-borne outbreaks on campus, and we test numerous specimens from
patients with infectious diseases. We also serve on the Duke Biodefense
Team due to our capability to detect and differentiate poxvirus infections
from those of herpesvirus infections rapidly (within minutes).

Several research collaborations are underway. We have worked with Dr.
David Pickup on a structural protein that directs intracellular virus
particle movement and maturation. A project with Drs. William Parker and
Randal Bollinger, involves looking at microbes and mucous membrane
immunity. It concentrates on biofilms in appendix and lower intestine.
We are collaborating with Dr. Meta Kuehn on immunostaining bacterial
vesicles possibly containing endotoxin that have been internalized by
human cells. A different project with Drs. Celia LeBranche and Brian
Cullen has examined morphological differences in various retrovirus outer
membranes. With Dr. Barton Haynes' laboratory, we determined that cells
transfected with single retroviral genes produced subviral particles.
With Dr. Michael Hauser's lab, we are examining the difference of
myotillin concentration in normal muscle and muscle from muscular
dystrophy patients. We worked with a postdoctoral student in the
laboratory of Dr. Shirish Shinolokar on staining and examining actin and
actin-bundling protein by EM. Finally, we train and assist graduate
students, post doctoral students and medical residents how to use electron
microscopic techniques in their own studies.

Current Appointments & Affiliations

Contact Information

  • 201 Trent Drive, DHS 3083 - Yellow Zone, Durham, NC 27710
  • Duke Box 3712, Durham, NC 27710

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