Skip to main content

Sara Elizabeth Miller

Professor in Pathology
Pathology
Duke Box 3712, Durham, NC 27710
40 Medicine Circle, DHS 3083 - Yellow Zone, Durham, NC 27710

Overview


Our laboratory specializes in two areas, infectious diseases, particularlyviral diseases, and ultrastructure-function relationships. Electronmicroscopy (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 myotilin 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


Professor in Pathology · 2021 - Present Pathology, Clinical Science Departments

Recent Publications


Fibroblast growth factor 23 and fibroblast growth factor receptor 4 promote cardiac metabolic remodeling in chronic kidney disease.

Journal Article Kidney Int · May 2025 Chronic kidney disease (CKD) is a global health epidemic that greatly increases mortality due to cardiovascular disease. Left ventricular hypertrophy (LVH) is an important mechanism of cardiac injury in CKD. High serum levels of fibroblast growth factor (F ... Full text Link to item Cite

Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease.

Journal Article Ann Noninvasive Electrocardiol · January 2025 BACKGROUND: Electrocardiograms (EKGs) are routinely performed in pregnant patients with pre-existing cardiovascular disease. However, in pregnant patients with congenital heart disease (CHD), EKG changes during gestation have not been explored. METHODS: We ... Full text Link to item Cite

APOL1-mediated monovalent cation transport contributes to APOL1-mediated podocytopathy in kidney disease.

Journal Article J Clin Invest · January 16, 2024 Two coding variants of apolipoprotein L1 (APOL1), called G1 and G2, explain much of the excess risk of kidney disease in African Americans. While various cytotoxic phenotypes have been reported in experimental models, the proximal mechanism by which G1 and ... Full text Open Access Link to item Cite
View All Publications

Recent Grants


Transmission electron microscope (TEM)

EquipmentPrincipal Investigator · Awarded by National Institutes of Health · 2019 - 2021

Serial Block Face Scanning Electron Microscope

EquipmentPrincipal Investigator · Awarded by National Institutes of Health · 2016 - 2018

Modulation of CD8 T-Cells

ResearchConsultant · Awarded by National Institutes of Health · 2003 - 2007

View All Grants

Education, Training & Certifications


University of Georgia · 1972 Ph.D.