Dr. Randolph's research is best described as translational and clinical in nature. He is engaged in several lines of ongoing research which can be summarized in the following categories: 1. Development of novel diagnostic lab testing methods for underdeveloped countries; 2. Sickle cell disease; 3. Optimizing current diagnostic testing methods; and 4. Chronic rhinosinusitis.
Current Research Project
- Development of novel diagnostic lab testing methods for underdeveloped countries: Sickle cell, HbC, HbF, Total hemoglobin using density gradients, Typhoid, STD, Bilirubin, mini-CBC using centrifugation
- Sickle cell disease: Investigating molecular and clinical markers to predict adverse events in college athletes with sickle cell trait
- Optimizing current testing diagnostic methods: New method for serum viscosity, stability of cytochemical staining methods, effect of lipemia on automated differentials
- Non-allergic chronic rhinosinusitis: Investigating anti- Fcε receptor autoantibodies as a potential cause
Study Design: Translational, clinical, and quantitative research
- to improve laboratory diagnosis of disease and healthcare delivery in underdeveloped countries
- to predict and thus prevent adverse events in athletes heterozygous for sickle cell
- to improve accuracy and precision of existing diagnostic laboratory test methods
- to investigate the cause(s) of non-allergic chronic rhinosinusitis
Background:Dr. Randolph is Founder and President of Randolph World Ministries, Inc. a medical mission ministry primarily serving Haiti. Haiti is one of the poorest countries in the western hemisphere with an equally poor health care system. Based on an analysis of the most common disorders encountered in Haiti coupled with an assessment of the diagnostic effectiveness of laboratory testing methods currently being used, we are investigating alternative testing methods that overcome the testing barriers encountered in Haiti.
Over the past decade, several sudden death events have occurred in athletes who are sickle cell heterozygotes. It is hypothesized that sickle cell formation can occur in heterozygous patients under situations of extreme exertion and might be related to thrombotic or rhabdomyolytic events. We are following collegiate athletes with sickle cell trait to identify clinical or molecular markers that can serve to predict adverse events before they occur.
As laboratory testing continues to grow in the US and as reference labs assume more esoteric testing, samples are increasingly being transported to reference and commercial labs for testing, sometimes at great distances. As a result, specimen integrity becomes an issue. Investigating sample stability is necessary to develop sample handling procedures to ensure accurate and precise results.
Non-allergic chronic rhinosinusitis is a growing condition in the US and the cause(s) is (are) unknown. Annually there are nearly 30,000 cases of chronic rhinosinusitis with about 60% of these being diagnosed with non-allergic chronic rhinosinusitis. One hypothesis to explain a portion of the cases involves autoantibodies to the Fcε receptor. This antibody would cross link the Fcε receptor on mast cells and basophils triggering degranulation in the absence of antigen (allergin). Patients are treated with and respond to anti-histamines suggesting a mast cell mediated process. This hypothesis explains conditions that are histamine mediated but allergin independent.
Images of Research Results
1. Development of novel diagnostic lab testing methods for underdeveloped countries
HbC Assay (Intracellular crystal induction)
Novel Sickle Cell Test (Sickle Confirm)
Sponsor: American Society for Clinical Laboratory Science (ASCLS) Education and Research (E&R) Fund
Project Title: Mechanisms and Laboratory Documentation of Adverse Events in Athletes with Sickle Cell Trait
Role: Principal Investigator
Funding Period: 2011-2013
Sponsor: Jack DeLoss Taylor Charitable Trust
Project Title: Continuation Grant. Sickle Cell Anemia in Haiti: Turning Death to Life through Novel Testing and Adequate Therapy
Role: Principal Investigator
Funding Period: Annual from 2008-2013
Randolph TR and Wheelhouse J. Novel Test Method (Sickle Confirm) to Differentiate Sickle Cell Anemia from Sickle Cell Trait for Potential Use in Developing Countries. Clinical Laboratory Science Vol 25/Number 1, Winter 2012:26-34.
Laudicina R, Fenn J, Freeman V, McCoy C, McLane MA, Mundt L, Polancic J, Randolph TR, and Shanahan K. Research in Clinical Laboratory Science: Professionals' Involvement. Clinical Laboratory Science. Vol 24/Number 4, Fall 2011: 235-242.
Laudicina R, Fenn J, Freeman V, McCoy C, McLane MA, Mundt L, Polancic J, Randolph TR, and Shanahan K. Research in Clinical Laboratory Science: Professionals' Educational Preparation. Clinical Laboratory Science. Vol 24/Number 4, Fall 2011: 243-248.
Randolph TR. Hemoglobinopathies (Structural Defects in Hemoglobin). Chapter 26, pages 366-389. In: Hematology: Clinical Principles and Applications. (4th ed) Bernadette F. Rodak, George A. Fritsma, and Elaine M. Keohane (eds), Saunders Elsevier, St. Louis, MO, 2011.
Randolph TR. Myeloproliferatve Neoplasms. Chapter 34, pages 508-532. In: Hematology: Clinical Principles and Applications. (4th ed) Bernadette F. Rodak, George A. Fritsma, and Elaine M. Keohane (eds), Saunders Elsevier, St. Louis, MO, 2011.
Randolph TR. Estimated Prevalence of Sickle Cell in Northern Haiti. Clinical Laboratory Science. Vol 23/Number 2, Spring, 2010: p 79-83.
Randolph TR. Thalassemia. Chapter 11, pages 231-256. In: Clinical Laboratory Hematology (2nd ed). Shirlyn McKenzie and J. Lynne Williams (eds.), Pearson-Prentice Hall, Upper Saddle River, NJ, 2010.