Sarah Knox, MS, PhD, FACE

Dr. Knox's research currently focuses on systems biology and cancer, with a primary emphasis on biophysical signaling in tumor initiation and progression

Professor Emerita

Organization:

West Virginia University School of Public Health

Department:

Epidemiology and Biostatistics

Classification:

Faculty

• PhD, Stockholm University, 1981
• MS, Stockholm University
• BA, University of New Hampshire

Biomedical Paradigm / Cancer / Biophysics

Knox, SS, Why the Biomedical Research Paradigm Must Change if we are to Win the “War on Cancer”. American J of Biomedical Science & Research, 2020. DOI: 10.34297; ISSN: 2642-1747.

Knox SS. Wave / Particle Duality in Biomedical Research Design. Molecular Biology 2018; 7:3: DOI: 10.4172/2168-9547.1000215.

Knox SS, Basu S, Remick S. A systems approach to cancer health disparities in Appalachia. Austin J Public Health 2014, 1:1004. ISSN 2381-9014.

Knox SS, Funk R. Oncology and Biophysics: The need for integration. J of Clinical and Experimental Oncology. 2014:S1. doi:10.4172/2324-9110.S1-001.

Knox SS, Ochs MF. Implications of systemic dysfunction for the etiology of malignancy. Gene Regulation and Systems Biology 2013;7:11-22.

Knox SS The science of acupuncture: Biomedicine, physics and beyond. In Hans Rainer Sepp (Ed.), Libri Nigri Series, Verlag Traugott Bautz GmbH, Germany. In press, 2021.

Knox SS. Science, God, and the Nature of Reality: Bias in Biomedical Research. (book) BrownWalker Press, 2010.

Gene x Environment Interactions

Knox SS. Gene x environment interactions as dynamical systems: Relevance for clinical care. Aims Mol Science 2015:3:1-11.

Knox SS. The elusiveness of major heart disease genes. Science 2011, Feb 10, 1148.

Knox SS, Guo X, Zhang Y, Weidner G, Williams S, Ellison RC. AGT M235T genotype / anxiety interaction and gender in the HyperGEN Study. PLoS One 2010;5:e13353.

Knox SS. From “omics” to complex disease: a systems biology approach to gene-environment interactions in cancer. Cancer Cell International 2010; 10:11.

Knox SS, Wilk JB, Zhang Y, Weidner G, Ellison RC. A genome scan for hostility: The National Heart, Lung and Blood Institute Family Heart Study. Molecular Psychiatry, 2004;9:124-126.

Toxicology

Pilkerton CS*, Hobbs GR, Lilly C, Knox SS. Rubella immunity and serum levels of perfluoroalkyl substances: sex and analytic strategy. Plos One 2018; https://doi.org/10.1371/journal.pone.0203330

Javins B, Hobbs G, Ducatman AM, Pilkerton C, Tacker D, Knox SS. Circulating maternal perfluoroalkyl substances during pregnancy in the C8 health study. Environmental Science and Technology 2013;47:1606-13.

Knox SS, Jackson T, Javins B, Frisbee SJ, Ducatman AM. Implications of early menopause in women exposed to perfluorocarbons. J of Clinical Endocrinology Metabolism, 2011; 96:1747-1753, 2011.

Knox SS, Jackson T, Frisbee SJ, Javins B, Ducatman AM. Perfluorocarbon exposure, gender and thyroid function in the C8 Health Project. The J Toxicological Sciences, 2011;36:403-410.

Fellow American College of Epidemiology – 2015 - ongoing

NICHD Leadership Excellence Award – 2008, for outstanding contributions to the National Children’s Study, the Eunice Kennedy Shriver National Institute of Child Health and Human Development

NIH Blueprint for Neuroscience Research Directors Award – 2007, for significant achievement as part of the Neuroepidemiology Project Team, NIH. 

National Institutes of Health Award of Merit – 2007, for successfully developing the Research Plan and establishing the majority of Centers to carry out the National Children’s Study 2007.

National Institutes of Health Award of Merit – 2006, for outstanding service towards the mission of the National Institute on Aging.

National Institutes of Health Award of Merit – 2005, for high performance in evaluating and selecting the Coordinating Center and developing the exposure protocol for the National Children’s Study.

National Heart, Lung and Blood Equal Opportunity Special Achievement Award – 2001, for contributions to the Institute’s Equal Opportunity and Affirmative Action Efforts.

Keynote Address: “Biophysics, Systems Biology and Cancer”; 10th International Conference on Genomics and Molecular Biology & 6th International Conference on Integrative Biology, Barcelona, Spain, May, 2018.

Plenary talk:” Wave / particle duality in biomedical research”. 10th International Conference on Genomics and Molecular Biology & 6th International Conference on Integrative Biology, Barcelona, Spain, May, 2018

Invited presentation: . “Physics, Biology and Acupuncture: The Need for a New Paradigm”. Conference: Non-Newtonian Program for Acupuncture. Vienna, Austria, June, 2018

Keynote Speaker International Conference in Medical Physics, Birmingham, UK, August, 2015

Member International Advisory Board of the German National Cohort Study - 2011- ongoing

Executive Steering Committee, National Children’s Study - 2004-2008

Trans-NIH Neuroscience Blueprint Team – 2005 – 2008

NIH Roadmap Epigenetics Project Team – 2007 – 2008

Symposium Chair,” NATO Advanced Research Workshop: Increase in Coronary Heart Disease in Central and Eastern Europe: Stress- and Gender Related Factors – 2000

PO. (Director), U.S. – Sweden Bilateral Agreement between the National Heart, Lung, and Blood Institute and the Karolinska Institute and the Institute for Psychosocial Factors and Health (Sweden), "Biobehavioral Mechanisms of Cardiovascular Disease in Woman," 1991–2002

Sweden-Estonia research collaboration: The SWESTONIA Cardiovascular Study, 1999-2002

American Psychological Association Conferences on Women’s Health : Member of Planning committees for conferences: "Psychosocial Behavioral Factors in Women's Health," 2001, 1994, 1996 and Summit on Women and Depression, 2000.

Capitol Hill Forum, "Understanding and Healing the Human Brain," hosted by Senator Edward Kennedy and Congressman, Henry Waxman, 1994. Member NIH Neuroscience and Behavior Working Group that planned the conference

WHO Advisor, "Meeting on vulnerability among long-term unemployed, longitudinal approaches." Ljubljana, Yugoslavia, 1985

Systems Biology and Biophysics in the Etiology of Malignancy -The mainstream view of cancer as a mutated cell that has become dysfunctional & multiplied out of control (the somatic mutation model) is much less consistent with extant data than the context dependent model. The latter focuses on interactions between the cell and its surrounding environment as the initiator & driver of malignancy.  The genome-wide epigenetic changes that precede cancer and confer risk for cancer, strongly suggest that multiple systems are affected, creating host vulnerability before tumors even manifest. This might explain the failure of built-in DNA repair mechanisms and other defenses (e.g. apoptosis, immune defenses) to eliminate mutated cells in the normal way.  The cellular and tumor microenvironment is dynamic & provides a partial explanation for cancer’s ability to adapt to targeted therapies. In this Systems Biology approach, dynamical systems theory is utilized to explain the conundrum of tumors’ ability to adapt to medications, & as a model for transitioning the body’s dynamic responses from a healthy attractor that attacks and eliminates abnormal cells, to a carcinogenic attractor that adapts to maintain malignancy.  What has been left out of the mainstream conversation is the fact that in addition to biochemical signaling, biophysical signaling is an important component of malignancy.  Endogenous bioelectric signals stemming from cell & mitochondrial membrane potentials, as well as microtubules in the cytoplasm, play a central role in cancer initiation & progression. They influence cell proliferation, cell cycle progression, apoptosis, cell migration & orientation, as well as cell differentiation. Membrane voltage depolarization of epithelial cells happens in the initial stages of tumor development & research in amphibians has shown that changes in membrane potentials can initiate malignancy without any oncogene, mutation or carcinogen. Dr. Knox is collaborating with a molecular biologist at WVU (Dr. Tim Eubank) & the originator of much of the amphibian work at Tufts, Dr. Michael Levin, to try to move this work on biophysical signaling into a mammalian model of breast cancer in mice.

Non-Programmatically Aligned Cancer Center Members