UB medicine summer 2013
UB Medicine is published by the University at Buffalo School of Medicine and Biomedical Sciences to inform its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in Buffalo, Western New York and beyond.
summer 2013 UB Medicine the University at Buffalo School of Medicine and Biomedical Sciences Connecting alumni, friends and community THE EXCITEMENT IS BUILDING Medical School moves downtown, set to open in 2016 S umm e r 2 0 1 3 UB Medicine In a u is gu su r e al 1 DEAN’S MESSAGE D e a r A l u m n i , F r i e n d s a n d c o m m u n i t y, I am pleased to introduce UB Medicine, a magazine that will inform you about our school’s pivotal role in medical education, research and advanced patient care in Buffalo, Western New York and beyond. This inaugural issue is devoted to an overview of the transforma- tive changes underway in the school. These changes are guided by UB 2020, the university’s long-term strategic plan, a key aim of which is to ensure that our school is at the forefront of academic medicine in the 21st century. This bold plan, created by administrative and faculty leaders at UB and strongly sup- ported by the governor and SUNY chancellor, calls for the medical school to expand and move downtown to the Buffalo Niagara Medical Campus, in close proximity to our regional health care partners. These steps represent change on an order of magnitude few in our generation have known and provide a unique opportunity for you—our alumni, faculty, students, trainees, health care partners and friends—to take part in an initiative that will benefit our community and its medical school long into the future. I invite you to join me in helping to realize this vision, a collaborative effort that will be chronicled—and celebrated—in this and future issues of UB Medicine. Michael E. Cain, MD Vice President for Health Sciences Dean, School of Medicine and Biomedical Sciences TA B L E O F C O N T E N T S UB MEDICINE MAGAZINE, Summer 2013 UBMedicine Michael E. Cain, MD Vice President for Health Sciences and Dean, School of Medicine and Biomedical Sciences Editor Stephanie A. Unger 2 Vital Lines Progress notes Contributing Writers Jim Bisco, Ellen Goldbaum, Charlotte Hsu, Judson Mead Copy Editor Tom Putnam Photography Philip J. Cavuoto, Sandra Kicman, Douglas Levere Design & Production Alan Kegler, Nick Peterson Office of University Communications Editorial Advisers John J. Bodkin, II, MD ’76 Elizabeth A. Repasky, PhD ’81 Major Affiliated Teaching Hospitals Erie County Medical Center Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System Kaleida Health’s Buffalo General Medical Center Women & Children’s Hospital of Buffalo Millard Fillmore Suburban Hospital Catholic Health’s Mercy Hospital of Buffalo Sisters of Charity Hospital Correspondence, including requests to be added to or removed from the mailing list, should be sent to: Editor, UB Medicine, University at Buffalo, 901 Kimball Tower, Buffalo, NY 14214; or email email@example.com UB Medicine is published by the UB School of Medicine and Biomedical Sciences to inform its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in Buffalo, Western New York and beyond. Visit us: www.medicine.buffalo.edu 13-DVC-005 26 Collaborations Partnerships at work 28 Doctor Visits 30 Research Reflections on careers Discoveries at UB 36 Pathways People in the news 40 Q & A Conversations with experts New medical school entrance, Main and High streets 8 6 Anatomy of Change UB and its health care partners in the community are transforming Buffalo’s medical-science landscape A New Medical School, a New era The school is expanding and moving downtown to anchor a world-class medical campus and biomedical research corridor Research that reaches patients The UB Clinical and Translational Research Center is dramatically changing how clinical research is conducted in Buffalo 8 14 Cover Image: New medical school at Main and High streets. The Allen Medical Campus metro station will be located in the building to the left of the pedestrian archway. 18 Competitors Reorganize as Partners 22 Collaborative health care initiatives are the new order in Buffalo Expansion by degrees With leadership provided by a new generation of chairs, the medical school will grow its faculty and increase enrollment U B M E D V I TA L L I N E S New design brings home the excitement Largest Gift in School History A World War II-era graduate of the School of Medicine and Biomedical Sciences who spent his career practicing medicine in a small town has left the school $40 million in his estate—the largest gift from an individual in UB’s 167-year history. The donor, who wished to remain anonymous for a period after his death, directed that his bequest be used for the priorities of the medical school as determined by the dean. “This gift ensures that we can continue hiring top physicianscientists to teach and perform groundbreaking research in the UB medical school,” says Michael E. Cain, MD, UB vice president for health sciences and dean, School of Medicine and Biomedical Sciences. “It truly is a gift that will keep on giving for many years to come.” Funds from the gift have already been used to support the hiring of a new generation of physician-scientist leaders and to acquire core equipment for their laboratories in the Clinical and Translational Research Center (see related article on page 22). In the future, when the restriction of anonymity has been lifted, UB Medicine will tell the full story of this remarkable gift. Guests were eager to view the design for the new school when it was unveiled at a special event on April 9. The final design for the new School of Medicine and Biomedical Sciences was unveiled at a special preview event held on April 9 in the Clinical and Translational Research Center on the Buffalo Niagara Medical Campus. In attendance were invited guests, including UB faculty, alumni, student leaders, friends and community health care partners. The following day, a public viewing of the design was held that was well attended and reported on by media across the state. The architectural renderings displayed at these events are featured throughout this magazine. Mrs. Judy Marine, Mrs. Judith Katz, left, and Leonard Katz, MD, right, talking with Kenneth Drucker, lead architect for the project. Douglas Levere The excitement was palpable at the unveiling, as guests were eager to get a first glimpse of the new school, which will be built on Main and High streets—returning it to where it resided for 60 years, prior to moving to its current location on the South Campus in 1953. Pictured in the foreground are Robert Puleo, University Facilities, left; Animesh Sinha, MD, PhD, chair of dermatology, and his wife, Kristina Seiffert Sinha, MD, center; and C. Richard Zobel, MD, right. 2 Summer 2013 UB Medicine SCHOOL WEBSITE WINS TOP HONORS The Office of Communications in the School of Medicine and Biomedical Sciences has received the highest honor from the Association of American Medical Colleges’ Group on Institutional Advancement (AAMC-GIA) for its transformation of the Department of Psychiatry website. The AAMC-GIA Award for Excellence recognizes the most creative and effective approaches used to promote academic medicine in the United States. Only a few institutions won the award in 2013, making UB’s accomplishment that much more notable, explained awards chair David B. Anderson, associate dean for advancement at the University of North Carolina School of Medicine. “Your entry represents the best of the best,” he said. The Office of Communications won the award in the electronic communications/website category. The group launched the psychiatry department site in the summer of 2012. The award was presented at the annual AAMC meeting in Hollywood, Fla. on April 4. our training programs continues to improve, so students are more receptive, not only staying in Buffalo for postgraduate training, but some who leave also will return once their training is complete. The growth of the Buffalo Niagara Medical Campus, including the forthcoming medical school downtown, is also attracting young —Roseanne C. Berger, MD physicians here.” Seventy-three percent of the UB Class of 2013 are New York State residents. A total of 75 students, half of the class of 2013, will stay in New York State to do their training. “This is a vote of confidence for UB’s residency programs. We do know that the residents have a tendency to remain in the areas where they train, so many will start their careers here, providing quality health care for our region.” More Students Choosing UB for Residency Fifty percent more students in the UB School of Medicine and Biomedical Sciences have chosen a UB residency program this year than last year, according to statistics compiled on the graduates at Match Day 2013 held March 15. Thirty-eight out of the 150 students who make up the Class of 2013 have chosen to stay in Buffalo and do their residencies at UB, up from 24 in 2012, according to Roseanne C. Berger, MD, senior associate dean for graduate medical education. “This is a vote of confidence for UB’s residency programs,” says Berger. “We do know that the residents have a tendency to remain in the areas where they train, so many will start their careers here, providing quality health care for our region.” “We’re excited to see this,” agrees David A. Milling, MD ’93, senior associate dean for student and academic affairs in the UB medical school. “We have recruited so many new faculty and the quality of David A. Milling, MD ’93, and Roseanne C. Berger, MD S umm e r 2 0 1 3 UB Medicine 3 Sandra Kicman U B M E D V I TA L L I N E S ub key to ‘buffalo billion’ plan Gov. Andrew M. Cuomo’s $1 billion pledge to Buffalo took a big step forward when UB president Satish K. Tripathi and civic leader Howard Zemsky, co-chairs of the Western New York Regional Economic Development Council, presented the governor with a plan for the state’s investment in the region during a visit he made to Buffalo. Before a crowd gathered at the Buffalo Convention Center to hear the plan, Cuomo and other speakers pointed to the powerful role UB continues to play in regional economic development. “The big ideas and the big economies across the country all have the same formula,” Cuomo said. “Ideas are now birthed in institutions of higher education. They come up with a new great idea, a great concept, and they then become fertilized in the entrepreneurial private sector to form businesses. That’s what’s working all across the country, and that’s the magic that we have to bring to Western New York.” The UB Regional Institute, in partnership with the Urban Design Project in the School of Architecture and Planning, worked with the council and teams from the Brookings Institution and McKinsey & Co. to frame the plan, identify the region’s distinctive assets and advantages, and outline investment options. The council’s economic development plan identifies two sectors for investment that will involve the university: advanced manufacturing and life sciences. These sectors will leverage UB faculty strengths in materials science, as well as research now underway at the Clinical and Translational Research Center and commercialization efforts at UB’s New York State Center of Excellence in Bioinformatics and Life Sciences. The life sciences sector, in particular, will benefit from the relocation of the medical school to the Buffalo Niagara Medical Campus, where there will be a continued push to develop medical innovations and bring them to market. Lt. Gov. Robert Duffy thanked Tripathi and Zemsky for their work in support of the entire region. “These two gentlemen have done an extraordinary job leading this effort, bringing people together and getting the job done,” he said. Following the presentation of the plan, Cuomo announced the state’s investment of $50 million to attract Albany Molecular Research Inc. to —Gov. Andrew M. Cuomo the Buffalo Niagara Medical Campus. He explained that the biomedical company was drawn to the area by the potential to collaborate with UB and other local research institutions in drug development and commercialization. “The big ideas and the big economies across the country all have the same formula. Ideas are now birthed in institutions of higher education.” First Niagara Provides Land for New UB Medical School First Niagara Financial Group Inc. has given to UB a parcel of land to be used in the construction of the university’s new School of Medicine and Biomedical Sciences on the Buffalo Niagara Medical Campus. The parcel is one of three properties UB is acquiring in downtown Buffalo for its new medical school. The .85-acre parcel, appraised at approximately $2 million, is at 973 Main St., where a First Niagara retail bank branch is currently located. “The magnitude of First Niagara’s generosity far surpasses the physical boundaries of the land that is changing hands,” says UB President Satish K. Tripathi. “With this acquisition, UB can move ahead with its plans for the new medical school, which will help to dramatically improve health care and medical education in our region while providing a significant boost to the local economy.” “When we were made aware of how important the land was to the university, we jumped at the chance to help,” says Gary Crosby, First Niagara’s interim president and chief executive officer. “We are committed to doing great things in our community and we are proud to collaborate with UB in order to provide the final piece of the puzzle for the medical school to move forward,” Crosby continues. “Western New York is a globally recognized leader in life sciences, innovation and research, and we are thrilled to help make the new medical school a reality, as it will positively impact our area for many generations to come.” Douglas Levere From left, Lt. Gov. Robert Duffy, Gov. Andrew Cuomo, Howard Zemsky and President Satish K. Tripathi. 4 Summer 2013 UB Medicine UB Med Addition to Roswell Park Cancer Institute New facility will connect to the main hospital building Roswell Park Cancer Institute is building an 11-story Clinical Sciences Center on the northwest corner of Michigan Avenue and Carlton Street. The 142,000-square-foot facility will connect to the main hospital building. It will include a breast care center, a new mammography center, an expanded chemotherapy infusion clinic, a clinic for adolescents and young adults, patient education programs and office space for physicians and researchers. Construction of the Clinical Sciences Center stems from growth in clinical demandâ€”a nearly 40 percent increase in patients at the comprehensive cancer center over the past five years and a 60 percent rise in outpatient visits over the past decade. Relocation of some services to the new center also will allow for renovation and expansion of other services in the main hospital building. The project is envisioned in two phases. Phase one, at a cost of $40 million, will involve completion of seven floors by fall 2015. The building was designed by FXFOWLE Architects of New York City. The addition will include a breast care center, a new mammography center, an expanded chemotherapy infusion clinic, a clinic for adolescents and young adults, patient education programs and office space for physicians and researchers. 5 S umm e r 2 0 1 3 UB Medicine Building rendering by FXFOWLE Architects of New York City Anatomy of Change UB and its health care partners are transforming Buffaloâ€™s medical-science landscape New medical school, looking west on High Street toward Main Street 6 Summer 2013 UB Medicine Health care in Buffalo and Western New York is taking on a new life. That’s because systems and structures that not long ago were bending and breaking under the weight of competition are now being taken apart and rebuilt, piece by piece—collaboratively. New leadership in the UB School of Medicine and Biomedical Sciences, new demands on medical education in the 21st century and new economic realities for health care providers have resuscitated ideas and partnerships that until recently would have been dismissed as implausible. In this inaugural issue of UB Medicine, we will describe this resurgence by providing you with a synopsis of some of the more notable—and concrete—alterations to Buffalo’s health sciences’ landscape. These changes include plans underway to move the UB School of Medicine and Biomedical Sciences downtown, to the Buffalo Niagara Medical Campus—close to where it resided between 1893 and 1953 on what was known as “the High Street Campus.” We will also tell you about the recently completed UB Clinical and Translational Research Center (CTRC), a world-class facility constructed in conjunction with Kaleida Health’s Global Vascular Institute. Located at Goodrich and Ellicott streets and connected by a sky bridge to Buffalo General Medical Center, the CTRC serves as an anchor for UB’s medical-science facilities downtown. You will also learn about the soon-to-be constructed John R. Oishei Children’s Hospital on the Buffalo Niagara Medical Campus, which will be connected to the new school and to the recently opened research and clinical care buildings. In addition to these “bricks-and-mortar” projects, there is another exciting building project taking place that we will report on. In the last six years, under the leadership of Dean Michael E. Cain, MD, the school has recruited nine nationally prominent medical educators to chair departments and divisions, many in close collaboration with our community health care partners. More new faculty leaders will be joining the school before 2016, when the first class of medical students enters its new home downtown. This begins a planned expansion of the school, the goal of which is to add 100 new faculty and increase enrollment by 30 percent. While these are the most visible components of change currently taking place, many other collaborative projects are unfolding behind these and other, yet-tobe-built walls. Each is serving in its own way to break down old barriers and revitalize a regional health care economy being transformed with the ultimate goal of improving care for residents of our community and beyond. We look forward to telling you these stories in the years ahead as change takes place, one collaboration at a time. S umm e r 2 0 1 3 UB Medicine 7 Anatomy of Change a nEW ERA Construction is set to begin on a new, larger school downtown A New Medical School When the UB medical school was founded in 1846, the year 2020 must have seemed like science fiction to those living at the time. The same could perhaps have been said in 2005, when UBâ€™s leaders began to articulate a long-term strategic plan they called UB 2020â€”the centerpiece of which was a bold idea to build a new, larger medical school downtown in close proximity to its life sciences partners on the Buffalo Niagara Medical Campus (BNMC). B y S . A . U nger 8 Summer 2013 UB Medicine The seven-story medical school, viewed from Main Street, features two L-shaped structures linked to create a six-story, light-filled glass atrium that includes connecting bridges and a stairway. “Moving the medical school downtown is an appropriate first step toward realizing our university’s vision of excellence.” Yet today this plan is a reality. Construction of the new school is scheduled to begin this summer. The first students will enter the new facility in 2016, which, serendipitously, designates them the Class of 2020. The factors driving this dramatic transformation of UB’s medical school are threefold: the need to modernize medical education for the 21st century, the need to more rapidly translate basic-science discoveries into clinical care, and the need to grow the medical school and reorganize health care in our region to better serve its population and to address economic realities. “Moving the medical school downtown is an appropriate first step toward realizing our university’s vision of excellence,” says UB president Satish K. Tripathi. The move also presents alumni and friends of the school with a unique opportunity to take part in an educational initiative that is transformative both in its scope and its potential impact on generations to come. “This is a once-in-a-lifetime opportunity to build a new school from the ground —President Satish K. Tripathi up,” says Michael E. Cain, MD, vice president for health sciences and dean of the School of Medicine and Biomedical Sciences. “We are instituting change on an order of magnitude few in our generation have known. Yet this change responds to a necessity similar to what the founders of our school identified over 167 years ago when they galvanized efforts to establish a medical school in Buffalo.” High and Main Streets Revisited Phase 1 of the $375 million plan was begun in May 2011, when Gov. Andrew M. Cuomo and SUNY chancellor Nancy L. Zimpher announced a $35 million grant—long in the planning—that served as a down payment for the medical school’s new home. In addition to the state grant, the new medical school will be financed by UB capital and other sources; a medical school program fee; private gifts from medical school alumni and friends, corporations and foundations; and research grants. In May 2012, following a year-long international competition, UB selected HOK—a premier U.S. architectural firm with an extensive portfolio of health sciences and academic buildings—to design the new medical school. In the months following, land was acquired for the new 520,000-square-foot building, which will sit at the southeast corner of High and Main streets. This locates the school at the center of the region’s emerging biosciences corridor and returns it to High Street, where it formerly resided for 60 years before moving to its current location on UB’s South Campus in 1953. S umm e r 2 0 1 3 UB Medicine 9 Anatomy of Change Larger Classes, More Faculty As a central part of the UB 2020 strategic vision, UB will add 100 new faculty positions to the school between now and 2016 in order to enlarge its medical education capacity, enrich its research activities and expand its clinical programs. Medical school enrollment will grow from its current class size of 140 to 180, producing 40 more MD graduates per year by 2020. This will address both the regional and the national physician shortage and help to better meet the health care needs of a local population that has higher-than-average rates for diabetes, cardiovascular diseases and neurological disorders. Medical school faculty growth is also designed to close gaps in the region’s clinical specialties and add training programs in those areas. It is anticipated that many residents training in those specialties will stay and practice in Buffalo and Western New York. This, in turn, will make it possible for patients to stay in Buffalo for specialty care that currently is not available here. Under Dean Cain’s leadership, the school is recruiting nationally prominent medical educators to chair departments and divisions. Nine of these leaders have joined the faculty since 2008 and more will be joining the school before 2016 (see related article on page 22). What Will Happen to the South Campus? UB’s master plan calls for the current medical school buildings (Cary, Farber and Sherman halls), dating to the 1940s, to be taken down. This will free up that portion of campus to be renovated as green space and to accommodate new and expanded uses that will provide a stronger link between the campus and the community, with an orientation to civic engagement and the urban setting. Implementation of the master plan for the South Campus will restore its classic collegiate beauty, including the stately stone buildings, intimate quadrangles, expansive lawns and classic views—all core features of the E.B. Green campus plan of 1930. The plan for the South Campus will reinforce historic quadrangles, remove unsightly temporary buildings, recover grand lawns from parking and revitalize landscapes. Access to campus and way-finding will be improved with new facilities for transit patrons and bicycle commuters, a simplified campus loop road, an improved Bailey Avenue entrance and better connections to the neighborhood. Proximity to Patients and Labs In its new location at Main and High streets, the school will be connected by sky bridges to Kaleida Health’s Buffalo General Medical Center and the new John R. Oishei Children’s Hospital, projected to open in early 2016. The school also will connect to the UB-Kaleida Health building that houses UB’s Clinical and Translational Research Center, Kaleida Health’s Gates Vascular Institute The university is fully committed to engaging faculty, staff and students and Roswell Park Cancer Institute; and to a new medical of the five schools that will remain, in creating a strong and vibrant South office building that will house offices for UBMD, the mediCampus community. They are: cal school faculty practice group (see related articles on School of Architecture and Planning pages 18 and 22). This will create a “coatless” environment in which stu School of Dental Medicine dents, faculty, biomedical researchers and clinicians can School of Nursing move easily from classroom to bedside to lab. Locating the medical school with Buffalo’s primary School of Pharmacy and Pharmaceutical Sciences health care delivery systems improves all aspects of the School of Public Health and Health Professions school’s mission: It embeds medical education in a clinical environment, brings biomedical researchers together with their colleagues in a clinical setting and strengthens clinical care for the region, notes Cain. It will also be a boon to the Buffalo economy. Creating a Strong Sense of Place “Postindustrial cities, like Pittsburgh, Cleveland and The new medical school facility will be one of the largest buildings to St. Louis, have achieved dramatic economic turnarounds by aligning be built in Buffalo in decades. university medical centers with community hospitals to build thriv It will serve as a gateway to UB’s Downtown Campus, offering a ing biomedical industries that improve patient care,” Cain says. potentially seamless connection to surrounding Allentown and Fruit Belt neighborhoods, as well as to the rest of downtown. The site also includes a new Allen Medical Campus metro station. 10 Summer 2013 UB Medicine UB is finalizing an agreement with the Niagara Frontier Transportation Authority to permit the station to be incorporated into the medical school building. In addition, the Allentown historic district and the historic houses on Washington Street, as well as the Roosevelt Building on Main Street, are being incorporated into the site plan. The new medical school design includes green space and pedestrian ways, such as a park along Ellicott Street and a pedestrian passage through the building —Robert G. Shibley, dean, School of from Allen Street. The goal Architecture and Planning is to create a strong sense of place for both campus and community, as well as physical connections between them. “This move is a milestone in UB’s master plan for its downtown campus, which is to create a lively, urban, mixed-use district, well-connected to the surrounding neighborhood and downtown communities.” “This move is a milestone in UB’s master plan for its downtown campus, which is to create a lively, urban, mixed-use district, well-connected to the surrounding neighborhood and downtown communities,” Shibley says. It is anticipated that implementation of Phase 1 of UB 2020 will create more than 3,000 jobs in Western New York by 2018. The medical school project is also a catalyst for additional development with Kaleida Health and other private and public entities, making it an estimated $655 million investment in the Buffalo Niagara Medical Campus (see related article on page 18). James R. Kaskie, president and CEO of Kaleida Health, notes that the momentum created by UB and Kaleida Health’s expansion in downtown Buffalo will make the region a national hub for patient care and medical research. “We have an unprecedented opportunity before us to pioneer new treatments and innovative health care and to transform our region’s economy,” Kaskie says. Jeremy M. Jacobs, CEO of Delaware North Companies and chairman of the UB Council, says UB’s plans have earned unprecedented support in the region—from business leaders to legislators to students to faith-based organizations. “UB’s plan is a strategy for our entire region to move forward— economically, culturally and socially,” Jacobs says. “A better UB will yield a better, stronger Western New York.” Judson Mead, John DellaContrada and Ellen Goldbaum contributed to this article. Win-Win for Western New York The medical school move will bring 1,200 students, faculty and staff downtown, explains Robert G. Shibley, dean of the UB School of Architecture and Planning, who headed the architect selection committee. Overview The primary goals of this move are to: Benefits to the region . . . and beyond: * UB will graduate more physicians annually and many will stay in the region (starting in 2016, class size will increase from 140 to 180). * The medical school will expand faculty by more than 100, primarily in specialty areas not now available in Buffalo (the number of medical school faculty will grow from 715 to approximately 850 by 2016). * Buffalo will become a destination for individuals seeking advanced medical care in certain specialty areas. * Thousands more people will be brought downtown each day. * More than 3,000 jobs will be created. * Opportunities will arise for revitalization of surrounding neighborhoods. UB’s relocation of its School of Medicine and Biomedical Sciences to the Buffalo Niagara Medical Campus downtown is a major aspect of the university’s UB 2020 plan. * enhance academic excellence by expanding and modernizing the school and situating it closer to its affiliated teaching hospitals * stimulate biomedical innovations leading to commercial development * improve health care in Western New York * boost the local economy S umm e r 2 0 1 3 UB Medicine 11 Anatomy of Change Conventus Medical Office Building; estimated completion spring 2015. See page 18. UB School of Medicine; completion 2016. See page 8. high UB Institute for Healthcare Informatics John R. Oishei Childrenâ€™s Hospital; estimated completion, early 2016. See page 18. Roswell Park Cancer Institute ma in n CO LLI TT wash i ngto E auptman-Woodward H Medical Research Institute UB New York State Center of Excellence in Bioinformatics and Life Sciences Roswell Park Cancer Instituteâ€™s Center for Genetics and Pharmacology 12 Summer 2013 UB Medicine BUFFALO NIAGARA MEDICAL CAMPUS NEW UB SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES aleida Health’s K Buffalo General Medical Center UB Clinical and Translational Research Center/Kaleida Health’s Gates Vascular Institute. See page 14. Roswell Park Cancer Institute’s Clinical Sciences Center addition; estimated completion, fall 2015. See page 5. C arlto n Roswell Park Cancer Institute EL M M ich iga n S umm e r 2 0 1 3 UB Medicine 13 Anatomy of Change Research That Reaches Patients Clinical and Translational Research Center is a milestone for UB health sciences Any biomedical scientist will tell you that conducting world-class research is a lot like growing a healthy organism: Itâ€™s not enough to have all the constituent parts; you also have to have them in the right place at the right time and in the right amount. This ideal alignment of resources is how many scientists are describing the new UB Clinical and Translational Research Center (CTRC) on the Buffalo Niagara Medical Campus. B y S .A. U n g e r 14 Summer 2013 UB Medicine The 170,000-square-foot center was designed with input from UB physician-scientists and grew from a “build-it-and-they-will-come” confidence that is proving well justified. Since opening in September 2012, the CTRC has been steadily filling with UB faculty along with top physician-scientists recruited from around the world—all gravitating toward what they consider to be an optimal setting for translating laboratory findings more rapidly into improved treatments for some of society’s most intractable diseases such as Alzheimer’s, diabetes, heart disease, stroke and multiple sclerosis. Joining them in the CTRC are start-up lifesciences companies relocating to downtown Buffalo to take advantage of the building’s biosciences incubator—operated by UB’s Office of Science, Technology Transfer and Economic Outreach—and its proximity to potential research and clinical partners. “The CTRC will transform clinical research in Buffalo as we know it,” says Timothy F. Murphy, MD, director of the new center and senior associate dean for clinical and translational research in the School of Medicine and Biomedical Sciences. He explains that the quest to better integrate clinical and laboratory research reflects a nationally recognized need to change the way science is conducted due to a dearth of basic-science discoveries that are being translated into improved patient care. “If you look at basic biomedical research over the last 30 years, the advances have been nothing short of remarkable—genomics, cell biology, structural biology, immunology. But if you look at how effectively we’ve translated those great advances into new treatments—new drugs, vaccines, preventions, diagnostics—it’s not spectacular.” Product of an Innovative Partnership The CTRC is a four-story building that sits atop the Gates Vascular Institute (GVI), a clinical care building constructed by Kaleida Health, Buffalo’s largest health care provider. The five-story GVI is home to Kaleida’s cardiac, vascular and neurosurgery units. It also houses the new emergency department for Buffalo General Medical Center, Kaleida’s flagship hospital and a UB teaching affiliate. The two buildings-within-a-building—located at Goodrich and Ellicott streets and connected to Buffalo General Medical Center—are the unique product of an innovative partnership between UB and Kaleida. To maximize cost efficiencies, they share infrastructure and an exterior; however, they were funded, designed and constructed separately for a total of $291 million ($118 million for the CTRC and $173 million for the GVI). (continued on page 16) Douglas Levere / Sandra Kicman Photos from top to bottom: Timothy F. Murphy, MD, director of the CTRC and senior associate dean for clinical and translational research in the School of Medicine and Biomedical Sciences; Stephen Rudin, PhD, SUNY Distinguished Professor of radiology and co-director of the Toshiba Stroke and Vascular Research Center; and John M. Canty Jr., MD ’79, who holds the Albert and Elizabeth Rekate Chair in Cardiovascular Disease in the UB Department of Medicine. Summer 2013 UB Medicine 15 Anatomy of Change (continued from page 15) The cost for UB’s portion of the construction was received from New York State; funds to further equip and furnish the building will be provided through alumni, grateful patients, and corporate and foundation gifts. isolated from researchers in another. This atypical floor space encourages the exchange of ideas and collaboration between researchers in different areas of inquiry. “There are very few other places in the world that I’m aware of where—under one roof—physicians and scientists are given the tools they need to conduct basic and clinicaltranslational research and to commercialize their discoveries.” Breaking Down Silos and Opening up Collaborations Enormous Advantages for Biomedical Education This single-location integration of laboratory and clinical resources creates an optimal environment for teaching, which in turn aids in the recruitment of students, as well as world-class researchers. It also may play a role in encouraging more students to consider careers as physician-scientists. The push for translational research is already reshaping the curriculum at UB, making it increasingly interdisciplinary. A new clinicalresearch-track master’s program in epidemiology, for example, was recently designed by faculty in all five of UB’s health sciences schools and Roswell Park Cancer Institute. “The CTRC strengthens our educational and training programs by giving UB students, residents, fellows and postdocs—as well as scientists in our region—the opportunity to participate in state-of-the-art research in a single, interdisciplinary setting,” says Stephen Rudin, PhD, SUNY Distinguished Professor of radiology and co-director of the Toshiba Stroke and Vascular Research Center. “The science and engineering researchers in our laboratory are now located just a few floors above the surgical and interventional suites where our clinical colleagues provide care to patients, all of which provides a more real-world, dynamic learning environment.” Despite being separately constructed, the two buildings are fully utilized as one functional entity by the physician-scientists who practice in one part and conduct their research in another. “This new building is the most exciting development I’ve seen in my career at UB,” says John M. Canty Jr., MD ’79, who holds the Albert and Elizabeth Rekate Chair in Cardiovascular Disease in the UB Department of Medicine. “Its vertical integration allows physician-scientists to work in their labs and to provide a full spectrum of care for their patients, —Dean Michael E. Cain, MD all in one building.” This care includes conducting state-of-the-art imaging studies, evaluating patients for clinical trials and following them as outpatients, he adds. Further integration takes place within the CTRC’s laboratories, where open designs put researchers side-by-side, when traditionally they would be isolated in individual labs. The goal was to break down the “silos” that result when researchers in one discipline are A Sampling of Laboratories The new UB Clinical and Translational Research Center features state-of-the-art laboratories to house the research programs of 20 to 25 principal investigators, a biosciences incubator, an imaging center, a clinical research center, and a central biorepository. The following is a sampling of some of the UB physician-scientists now located in the center and a description of their research focus: Alzheimer’s Disease and Memory Disorders Director: Kinga Szigeti, MD, PhD Assistant Professor, Neurology Director, UB Alzheimer’s Disease and Memory Disorders Center Focus: new treatments for Alzheimer’s disease based on the identification of biomarkers and a comprehensive understanding of the disease’s genetic mechanisms. Asthma, HIV/AIDS, Prostate Cancer Director: Stanley A. Schwartz, MD, PhD UB Distinguished Professor, Medicine Focus: better treatments for three serious public health problems that involve immune system dysfunction. Skin Disorders Director: Animesh A. Sinha, MD, PhD Rita M. and Ralph T. Behling, Professor and Chair, Dermatology Focus: next-generational diagnostic, prognostic and therapeutic strategies for autoimmune disorders of the skin. Cardiovascular Disease Director: John M. Canty Jr., MD Albert and Elizabeth Rekate Chair, Cardiovascular Diseases Focus: better understanding of heart and vascular disorders in order to develop new therapies. 16 Summer 2013 UB Medicine Integrating Academic and Community-Based Research The CTRC is more than its laboratories, clinics and meeting places. It is a hub for the clinical and translational research programs of the institutions that comprise the Buffalo Translational Consortium. Created during the planning for the CTRC, the consortium includes the five UB health sciences schools, Kaleida Health, Erie County Medical Center, Roswell Park Cancer Institute, the medical school’s faculty practice group, and other leading Buffalo medical research institutes and centers. Consortium members are national leaders in areas of research that include biomedical informatics and ontology, behavioral health, cancer, community-based care, cardiovascular disease and pharmaceutical sciences. The Clinical Research Center in the CTRC assists consortium researchers with technical issues ranging from research design consultation to regulatory support. It also supports CTRC researchers with expertise in human-subjects research, including “best practices” for conducting clinical trials, study design and planning, recruitment of participants in studies and assessing study outcomes. By sharing expertise, the consortium research community is able to bridge gaps between disciplines of biomedical science and the treatment interventions of clinical medicine. Also located in the CTRC, on the fifth floor, is the independent, nonprofit Jacobs Institute established to foster partnerships involving UB, Kaleida Health and physicians and biomedical companies. Elevating UB in the Ranks of Research Universities The CTRC also is an important component of UB 2020, the university’s long-term strategic plan to elevate UB to the ranks of the nation’s elite research universities while having a positive impact on the health of citizens in Buffalo, Western New York and beyond. “The CTRC brings together for the first time at UB the critical components needed for interdisciplinary, disease-focused research that will more rapidly translate basic biomedical research into improved public health,” says Michael E. Cain, MD, vice president for health sciences and dean of the School of Medicine and Biomedical Sciences. “There are very few other places in the world that I’m aware of where—under one roof— physicians and scientists are given the tools they need to conduct basic and clinical-translational research and to commercialize their discoveries. I’m confident this facility will contribute enormously to reshaping UB’s health sciences culture in the future.” Judson Mead contributed to this article. Diabetes and Obesity Director: Paresh Dandona, MD, PhD SUNY Distinguished Professor, Medicine Focus: understanding the role of inflammation in diabetes and obesity in order to discover new treatments. Ear and Respiratory Tract Infections Director: Timothy F. Murphy, MD SUNY Distinguished Professor, Medicine and Microbiology Director, Clinical and Translational Research Center Focus: vaccines to prevent ear infections in children and bacterial respiratory tract infections in adults with COPD. Stroke and Heart Disease Co-directors: Stephen Rudin, PhD SUNY Distinguished Professor, Radiology L. Nelson “Nick” Hopkins, MD Professor and Chair, Neurosurgery Director, Toshiba Stroke and Vascular Research Center Focus: tools and technologies that improve the effectiveness of minimally invasive procedures used to treat vascular disease in the brain and heart. Future issues of UB Medicine will profile the work being conducted in these labs by established UB physician-scientists, as well as by new faculty recruits from around the world. Summer 2013 UB Medicine 17 Anatomy of Change Great Lakes Health System leaders, from left, James R. Kaskie, president and CEO of Kaleida Health; Michael E. Cain, MD, vice president for health sciences and dean, School of Medicine and Biomedical Sciences; and Jody L. Lomeo, CEO of Erie County Medical Center Collaborative health care initiatives are the new order in Buffalo Competitors Reorganize as Partners UB’s new medical school, scheduled for completion in 2016, and its recently opened Clinical and Translational Research Center are not the only major changes to Buffalo’s health sciences landscape. The medical school’s two major teaching affiliates—Kaleida Health and Erie County Medical Center (ECMC)—also have begun large, transformative building projects. B y S .A. U n g e r 18 Summer 2013 UB Medicine Douglas Levere General Medical Center, the Gates Vascular The two entities—once competitors—are Institute and the UB Clinical and Translanow partners, working in close collaborational Research Center. tion with UB via a new, overarching struc Shepley Bulfinch Richardson & Abbott, ture called the Great Lakes Health System. one of the country’s top pediatric health care The aim of the new alliance is to replace architects, is designing the facility, which will competition with cooperation, eliminating replace the existing site on Bryant Street. costly duplication of services while enhanc In 2010, the hospital made public its ing patient care, medical education and plans to relocate to the Buffalo Niagara Meditranslational research. cal Campus, at the urging of its physicians. These new relationships are an out Teresa Quattrin, MD, A. Conger Goodgrowth of a seminal report published in year Professor and chair of the UB Depart2007 by the New York State Commission ment of Pediatrics and pediatrician-in-chief on Health Care Facilities in the 21st Centuat Women & Children’s Hospital of Buffalo, ry (also known as the Berger Commission). led the new hospital planning group, comIn the report, the commissioners reviewed —Michael E. Cain, MD, vice president for prising more than four dozen UB and privatehospital and health care capacity throughhealth sciences and dean, School of Medicine practice physicians. out the state and issued recommendations. and Biomedical Sciences “From the standpoint of the physicians, The formation of the Great Lakes Health all the data we gathered pointed to the fact System significantly impacts UB in a posithat integrating the children’s hospital into the medical campus is estive way because ECMC and Kaleida Health (through its Buffalo Gensential for us to provide high-quality care,” she says. eral Medical Center and Women & Children’s Hospital of Buffalo) The 430,000-square-foot facility will house a state-of-the-art house UB’s academic-medicine departments and provide the setting neonatal intensive care unit, which received a $2 million gift from for most of the medical school’s clinical education programs. the Children’s Guild Foundation; an ambulatory care center; and an “With planning led by UB faculty and community physicians, emergency department, named the Alfiero Family Emergency Care Great Lakes is creating centers of excellence for clinical care by Center in honor of a $5 million gift from Buffalo-area businessman identifying dispersed but formidable resources from throughout the Sal H. Alfiero. community and placing them in dedicated, world-class venues,” says Future plans include a women’s pavilion to house labor and Michael E. Cain, MD, vice president for health sciences and dean of delivery, postpartum care, a regional perinatal center for high-risk the School of Medicine and Biomedical Sciences. pregnancies and a women’s health center providing prenatal and “These efforts are both revitalizing health care in Buffalo and supgynecological care. porting the mission of UB’s medical school by expanding the number “When you think of the building on Bryant being replaced with of clinical specialties optimal for teaching, training and research,” a modern, state-of-the-art facility, properly sized and properly he adds. equipped with technology, staff and resources, it’s an amazing The following is an overview of some of the more high-profile accomplishment and leverages all of the partners on the Buffalo Nicollaborative projects that are currently underway or being planned. agara Medical Campus,” says James R. Kaskie, president and CEO of Future issues of UB Medicine will update these and other new projKaleida. “All of those pieces are now coming together to really make ects as they evolve. a difference in the lives of the people that we serve.” John R. Oishei Children’s Hospital Integrated Pediatric HemaKaleida Health is constructtology-Oncology Program ing a new 10-story, $200 Women & Children’s Hospital million children’s hospital of Buffalo and Roswell Park at Main and High streets on Cancer Institute are esthe Buffalo Niagara Medical tablishing a physician-led, Campus, across the street unified pediatric hematologyfrom the future site of the oncology program in the new UB medical school. John R. Oishei Children’s The John R. Oishei ChilHospital. dren’s Hospital—named in For over 40 years, the two honor of a $10 million gift entities have operated the pefrom the Buffalo-based John diatric hematology-oncology R. Oishei Foundation—is service for the Western New scheduled for completion in York region, with separate late 2015 or early 2016. It and complementary services will connect via walkways to offered at each hospital. the medical school, Buffalo John R. Oishei Children’s Hospital, scheduled to open in late 2015 or early 2016 “With planning led by UB faculty and community physicians, Great Lakes is creating centers of excellence for clinical care by identifying dispersed but formidable resources from throughout the community and placing them in dedicated, worldclass venues.” S umm e r 2 0 1 3 UB Medicine 19 Anatomy of Change “Together, and in conjunction with the University at Buffalo academic programs, we will jointly operate a center of excellence for children with cancer and blood diseases.” “We’ve been developing plans for enhancing our program under one roof for many years,” says Martin L. Brecher, MD, chief of the UB Division of Pediatric Hematology-Oncology, chair of pediatrics at Roswell, and chief of hematologyoncology at Women & Children’s Hospital. “Each institution contributes unique expertise and services to children and young adults with cancer and blood disorders such as sickle cell disease, hemophilia and —James R. Kaskie, president and anemia. The new hospital CEO of Kaleida presents a great opportunity to develop a true pediatric center of excellence.” The unified program will incorporate inpatient beds, an outpatient clinic, isolation beds for blood and bone marrow transplant/ high-dose therapy patients, and infusion facilities for chemotherapy and blood products, all in a protected environment on the top floor of the new hospital. “Roswell Park Cancer Institute and the new John R. Oishei Children’s Hospital have joined forces in a collaborative model to further expand and improve the diagnosis, treatment and research programs available locally for children and their families who face this most difficult of diseases,” says Kaleida Health’s Kaskie. “Together, and in conjunction with the University at Buffalo academic programs, we will jointly operate a center of excellence for children with cancer and blood diseases where expert clinical services are provided, innovative and pioneering research is advanced to find a cure and improve treatment options, and current and future health care professionals are trained and educated.” Kaleida Health and ECMC Integrate Cardiac Care Kaleida Health and Erie County Medical Center (ECMC) have integrated cardiac services to create a regional center of excellence for heart care. All heart surgery, angioplasty and heart attack care now takes place at the Gates Vascular Institute. The ECMC campus continues to have on-site cardiology medicine services, diagnostic catheterization and thoracic services for trauma patients. ECMC, a strong proponent of the Gates Vascular Institute, made a $20 million investment in the facility and has worked since its inception to integrate ECMC cardiac services in the institute, which opened in March 2012. “When we opened the Gates Vascular Institute, we said it would revolutionize health care in our community,” says Kaleida Health’s Kaskie. “That is happening today as we combine two cardiac programs under one roof.” Kaleida Health and ECMC’s combined cardiac program account for 8,000 catheterization procedures and nearly 1,000 heart surgeries each year in Western New York. Kaleida’s cardiac program has been rated in the top 10 percent for heart surgery and among the top 5 percent in the nation for coronary angioplasty. ECMC is an accredited Chest Pain Center and has received numerous gold awards from the American Heart Association for its quality of care and response time for emergency angioplasty. ECMC also has some the best trauma survival statistics in New York State. “The integration of ECMC cardiac services with the Gates Vascular Institute to create one program at both sites continues our goal to provide quality care for patients, support for the region’s trauma center, and further enhance the clinical expertise at the Gates Vascular Institute,” said Jody L. Lomeo, CEO of ECMC. “Working with Kaleida Health, we continue to see true results of collaboration as we improve health care for our entire community.” Center of Excellence for Transplantation & Kidney Care: Dialysis Unit Regional Center of Excellence for Transplantation & Kidney Care The Regional Center of Excellence for Transplantation & Kidney Care—a clinical collaboration between Erie County Medical Center and Kaleida Health System—was opened on the ECMC campus in December 2011. With the collaboration, it became the only kidney and pancreas transplant center in Western New York, concentrating in one location the expertise and resources of two formerly competing centers. “The opening of this new center was the first clinical collaboration between ECMC and Kaleida Health, and we couldn’t be more pleased,” says ECMC’s Lomeo. “It is a historic accomplishment for the community and is the culmination of a three-year physician-led planning effort to ensure excellence in patient care.” Brian M. Murray, MD, associate professor of medicine at UB, chief medical officer and transplant program director for ECMC, is the interim medical director of the new $27 million center, which experts hail as an impressive national model in the transplantation and kidney care field. “The new transplant center is truly a state-of-the-art facility for kidney patient care and transplantation,” says Edward Y. Zavala, administrator of the Vanderbilt University Transplant Center. “There are 236 kidney transplant programs approved by the Organ Procurement and Transplant Network in the United States and this is among the newest and most comprehensive in the country.” The center—housed on a floor of a new free-standing building, as well as on the 10th floor in the main hospital—is projected to handle 150 to 200 transplants a year. 20 Summer 2013 UB Medicine It features 36 modern hemodialysis stations, facilities for home dialysis training, outpatient and community outreach offices, clinical support spaces and room for additional dialysis stations to meet future growth needs. The redesigned area on the hospital’s 10th floor includes doctors’ offices and patient and family reception areas, a new vascular access center for inpatients and outpatients that includes two operating rooms, a new inpatient dialysis center with six state-of-the-art stations, and administrative and conference rooms. “This is a major milestone for our two boards, our doctors, nurses and staff, our neighbors, the Great Lakes Health board and the University at Buffalo,” says Kaskie. “The center brings two very good programs together into one great program. We now have a nationally recognized facility to help people from all over Western New York, Southern Ontario and the United States, cope better with kidney and pancreatic disease.” Center of Excellence for Behavioral Health Care ECMC and Kaleida Health are consolidating mental health and drug dependency treatment in one $35 million Center of Excellence for Behavioral Health Care. The initiative—supported by a $15 million HEAL NY grant from the New York State Department of Health—creates a new, state-ofthe-art center on the ECMC campus that will include a comprehensive psychiatric emergency program and inpatient facilities. Yogesh Bakhai, MD, associate professor of clinical psychiatry at UB and clinical director of psychiatry at ECMC; and Maria Cartegena, MD, chief of psychiatry at Kaleida, are leading the effort. The consolidation combines ECMC and Buffalo General Medical Center’s behavioral health programs to create one 180-bed inpatient psychiatric program. It also incorporates ECMC’s 22 detoxification beds and 20 inpatient chemical dependency rehabilitation beds, as well as outpatient clinics operated by both entities. The new center, scheduled to open in March 2014, will expand ECMC’s current emergency behavioral health facilities from 6,500 square feet to 16,000 square feet. Mental health care in Western New York, like that in the rest of the state, is fragmented and costly to the state’s Medicaid payment system. In the last 20 years, the Buffalo Psychiatric Center has been downsized from 1,200 to 160 beds, and the Gowanda Psychiatric and West Seneca Developmental centers were closed. Other inpatient facilities have been closed or reduced in size in recent years. While outpatient services exist, there is a shortage of psychiatrists in the region and a lack of coordination among community providers. These factors have combined to create a crisis for mental health patients and their families. “This new center—by having all our expert physicians and staff in one place—will deliver a level of care that the mentally ill in our community deserve,” says ECMC’s Lomeo. “And this is another example of the success of Great Lakes Health.” Conventus, A Center for Collaborative Medicine Ciminelli Real Estate Corporation is constructing a seven-story, 300,000-square-foot office building on the block bounded by Main, High, Ellicott and Goodrich streets in downtown Buffalo, at the northern gateway to the Buffalo Niagara Medical Campus. Center of Excellence for Behavioral Health Care: Scheduled to open in March 2014 Major tenants will be the University at Buffalo medical practice group, UBMD; Kaleida Health; services related to the new John R. Oishei Children’s Hospital and a variety of supporting retail services. Ciminelli has named the new building “Conventus,” which is Latin for coming together. This reflects the building’s planned “coatless connections,” which include walkways to the new medical school when completed, the UB Research Institute on Addictions and the new children’s hospital. The pediatric outpatient surgery center in the children’s hospital will use space in the building, which will serve as the “front door” of the surgery center. The second and third floors of the building will connect to the hospital. Kaleida Health, which owns the land, also will use the new building for a number of other children’s services, including a pharmacy; a laboratory and clinics, including dialysis; infusion therapy; and the Robert Warner Rehabilitation Center. Scheduled for completion in spring 2015, Conventus will include two levels of underground parking and limited retail businesses, primarily in support of tenants. The $98 million project, designed by Kideney Architects of Amherst, is the most expensive single building that Ciminelli has developed and represents the first major private investment on the Buffalo Niagara Medical Campus. Conventus medical office building: Scheduled to open in spring 2015 S umm e r 2 0 1 3 UB Medicine 21 EXPANSION BY DEGREES New chairs, more faculty, increased enrollment In addition to its “bricks-and-mortar” projects, the School of Medicine and Biomedical Sciences is engaged in another historic effort to build toward the future. This involves recruiting prominent academic physicians and scientists, adding medical specialties and research programs, hiring new faculty and expanding educational and training infrastructure to support an increase in enrollment. The overarching goal—as envisioned by UB 2020, the univerThis expansion is in keeping with the sity’s long-term strategic planning effort led by President Satish K. school’s mission of medical education, Tripathi—is to increase the net number of full-time medical school patient care and research. faculty by 100 and to increase enrollment by 30 percent. It is pivotal to the future of Buffalo’s This hiring initiative is being led by Michael E. Cain, MD, who health care community, the growth and development of which since being named dean of the school in 2006 has appointed nine have been closely tied to the medical school since its founding new chairs and high-level physician167 years ago. scientists. By expanding its clinical special Of the school’s 26 academic deties, the medical school will be better partments, about half are currently able to attract and retain faculty being led by new chairs or are actively who have expertise that will draw engaged in a search for one. top students, residents, postdocs Six additional searches for new and fellows. chairs are underway in the depart A larger faculty also supports the ments of Biochemistry, Physiology school’s goal to increase enrollment and Biophysics, Family Medicine, in order to offset projected physician Neurosurgery, and Orthopaedics, as shortages and to help keep highly well as in Biomedical Informatics, skilled practitioners in our region. a department newly established in This will preclude patients from havconjunction with the Department ing to travel to other cities, such as of Health Policy and Practice in the Rochester and Cleveland, to receive — Michael E. Cain, MD, vice president for health sciences UB School of Public Health and care in certain specialties. and dean, School of Medicine and Biomedical Sciences Health Professions. B y E l l e n G o l d bau m a n d S .A. U n g e r “Very few people in the course of their career have the opportunity to take part in building a new medical school. The faculty we recruit can sense momentum at UB and in Buffalo. They are excited by the possibilities we put in front of them.” 22 Summer 2013 UB Medicine “Department chairs are the keystone of a school of medicine, so it is our responsibility to recruit a new generation of visionary leaders to fulfill our school’s mission,” says Cain, an internationally recognized cardiologist who also serves as vice president for health sciences. Each of the new clinical recruits also holds a leadership position with the school’s community health care partners, and some are already filling gaps in medical specialties and research. “The Western New York community gains from the new clinical expertise that chairs and their faculty bring,” says Cain, who explains that they apply this expertise through UBMD—the faculty practice plan—and affiliated hospitals, where UB faculty and more than 800 UB medical residents work as attending physicians. Opportunity to Help Build a New School Currently, the medical school has 715 full-time faculty. Cain expects it to employ approximately 850 by 2016, when the new school opens. In the past four years, the school has hired approximately 50 new faculty per year. About 40 percent of the space in UB’s Clinical and Translational Research Center will be occupied by new faculty. “Very few people in the course of their career have the opportunity to take part in building a new medical school,” Cain says. “The faculty we recruit can sense momentum at UB and in Buffalo. They are excited by the possibilities we put in front of them. The respected faculty who already serve our school are helping to recruit and retain other distinguished physicians and scientists.” The hiring of new faculty at the medical school is receiving support from a $40 million gift in 2011 from a medical school alumnus— UB’s largest gift ever—as well as resources provided by NYSUNY 2020, a landmark piece of New York State legislation that enables the university to pursue the next phase of its strategic plan. Further support needed to fulfill this hiring initiative will be provided by gifts from alumni, grateful patients and friends of the school. I n t e r n at i o n a l L e a d e r s i n T h e i r F i e l d s Recent high-profile appointments at the chair or equivalent level include the following physician-scientists: Animesh Amart Sinha, MD, PhD, is an expert in immunological tolerance and autoimmunity in skin diseases, such as alopecia, lupus and psoriasis. He came to Buffalo in 2011 to chair the Department of Dermatology at UB and Roswell Park Cancer Institute and to become UB’s inaugural Rita M. and Ralph T. Behling, MD, Professor of Dermatology. Sinha was formerly at Michigan State University, where he served as chief of the N.V. Perricone Division of Dermatology and Cutaneous Sciences and director of the university’s Center for Investigative Dermatology. Anne B. Curtis, MD, is an expert in cardiac arrhythmias and one of the world’s leading clinical cardiac electrophysiologists. She joined UB in 2010 to chair the Department of Medicine and to serve as its inaugural Charles and Mary Bauer Professor. A key figure in developing national guidelines for treating atrial fibrillation, Curtis came to UB from the University of South Florida, where she served as professor of medicine, chief of the Division of Cardiology and director of Cardiovascular Services. Gil I. Wolfe, MD, is a leading authority on neuromuscular disorders, with special expertise in myasthenia gravis. He came to UB in 2011 to serve as the Irvin and Rosemary Smith Professor and Chair of the Department of Neurology. Wolfe was formerly at the University of Texas Southwestern Medical School, where he held the Dr. Bob and Jean Smith Foundation Distinguished Chair in Neuromuscular Disease Research and served as professor of neurology and neurotherapeutics. S umm e r 2 0 1 3 UB Medicine 23 Anatomy of Change designed by a renowned architectural All Pulling in the Same Direction firm, a new children’s hospital soon to Anne B. Curtis, MD, the Charles and Mary be constructed, and a new medical ofBauer Professor and Chair of the Departfice building going up. We have many ment of Medicine, arrived in Buffalo in the new department chairs enthusiastic fall of 2010. Since then she has chaired about the potential here. searches for new division chiefs for the “I believe we have already reached department’s Division of Gastroenterology, a critical mass that is attracting attenHepatology and Nutrition; and Division tion across the country.” of Nephrology (see related articles on New recruits to UB praise page 36). She also is chairing searches —John E. Tomaszewski, MD, chair of Pathology the consistent vision expressed by for division chiefs of geriatrics, palliative and Anatomical Sciences Tripathi, Cain and other UB and medicine, and hematology, and co-chaired medical school administrators. And the search committee for UB’s new provost, they admire the way this vision Charles F. Zukoski. extends beyond the university to Western New York and the “What’s making it easier to recruit to Buffalo is the energy about state capital in Albany. building the new medical school on the growing Buffalo Niagara “The leadership alignment here is a huge plus,” says Medical Campus,” she says. “We have a new medical school being “The key is that the university’s leaders are in alignment with where we all want to go and how to get there.” Teresa Quattrin, MD, is an internationally known expert in childhood diabetes and obesity. A former UB professor of pediatrics, she was named A. Conger Goodyear Professor and chair of the Department of Pediatrics in 2010. Quattrin also serves as chief of the department’s Division of Pediatric Endocrinology, as Kaleida Health’s pediatrician-in-chief, and as director of the Diabetes Center in the Women & Children’s Hospital of Buffalo. Margarita L. Dubocovich, PhD, is an internationally recognized expert in molecular pharmacology and drug discovery who specializes in the neuropharmacology of melatonin and its receptors. She came to UB in 2008 to chair the Department of Pharmacology and Toxicology. Dubocovich was formerly at Northwestern University’s Feinberg School of Medicine, where she served as professor of molecular pharmacology and biological chemistry and psychiatry. John E. Tomaszewski, MD, is an expert on genitourinary malignancies and immunopathology, with an emphasis on renal transplantation and advanced tissue image analysis. A past president of the American Society for Clinical Pathology, he came to UB in 2011 to chair the Department of Pathology and Anatomical Sciences. Tomaszewski was formerly professor of pathology and laboratory medicine and interim chair of the Department of Pathology and Laboratory Medicine at the Perelman School of Medicine at the University of Pennsylvania. 24 Summer 2013 UB Medicine John E. Tomaszewski, MD, who was hired in 2011 from the University of Pennsylvania as UB’s new chair of Pathology and Anatomical Sciences. “The potential of UB’s strategic plan, UB 2020, is a consistent story from SUNY to President Tripathi on down through the ranks and into the community. It’s a coherent, consistent story that resonates with people. The key is that the university’s leaders are in alignment with where we all want to go and how to get there.” Teresa Quattrin, MD, an internationally known physicianscientist and an expert in childhood diabetes and obesity, was named A. Conger Goodyear Professor and chair of the Department of Pediatrics in 2010. “Potential leaders look for consistency in the culture at different levels within an organization,” she says. “In recruiting new faculty, I make it a point to emphasize that the leadership at UB pays great attention to making sure all players are pulling in the same direction.” “I believe we have already reached a critical mass that is attracting attention across the country.” —Anne B. Curtis, MD, the Charles and Mary Bauer Professor and Chair of the Department of Medicine Lawrence Wrabetz, MD, is a highly regarded translational scientist who specializes in the study of myelin, the sheath protecting brain nerve fibers essential for all normal functioning of the nervous system. He came to UB in 2010 as director of the university’s Hunter James Kelly Research Institute, which was established in 2004 by UB and the Hunter’s Hope Foundation. The institute conducts research on remyelination techniques and the biology and pathophysiology of Krabbe Disease, with the goal of discovering ways to correct the genetic defect responsible for it and other leukodystrophies. Wrabetz was formerly head of the myelin biology unit at San Raffaele Scientific Institute in Milan, Italy. James “Jay” D. Bangs, PhD, is an expert in the cell biology of the agent that causes African sleeping sickness. He came to UB in 2012 to serve as the inaugural Grant T. Fisher, MD, Professor and Chair of the Department of Microbiology and Immunology. Bangs was formerly professor of medical microbiology and immunology at the University of Wisconsin-Madison School of Medicine and Public Health. Vanessa M. Barnabei, MD, PhD, is an expert on the effects of hormone replacement therapy in postmenopause. She came to UB in 2012 to serve as chair of the Department of Gynecology and Obstetrics. Barnabei was formerly the Patrick and Margaret McMahon Endowed Professor of Obstetrics and Gynecology and director of General Obstetrics and Gynecology at the Medical College of Wisconsin in Milwaukee. S umm e r 2 0 1 3 UB Medicine 25 U B M E D C O L L A B O R AT I O N S thalamus and its association with clinical impairment in MS, starting with the earliest stages of the disease. “The location of the thalamus in the brain, its unique function and its vulnerability to changes wrought by the disease make it a critical barometer of the damage that MS causes to the brain.” At the annual meeting of the American Academy of Neurology in March, Zivadinov discussed a study he performed in collaboration with colleagues from Charles University in Prague. The study found that atrophy of the thalamus, determined with MRI, can help identify which patients with clinically isolated syndrome—a patient’s first episode of MS—are at risk for going on to develop clinically definite MS. “This study, which included more than 200 patients, shows that thalamic atrophy is one of the most important predictors of clinically definite MS,” says Dana Horakova, MD, PhD, the principal investigator at Charles University. “Based on these findings, we think MRI should be used to determine which patients are at highest risk for a second attack,” explains Zivadinov. Associated with cognitive deterioration Another study that the UB researchers conducted, in collaboration with Stavanger University Hospital in Norway, is the first to look at the evolution of thalamic atrophy over a 10-year period in MS patients. Involving 81 patients, it found that atrophy in the cortex and in subcortical deep gray matter, including the thalamus, was significantly related to patients’ declining cognitive abilities. “We found that cognitive dysfunction appears early in the course of MS and that thalamic atrophy plays a central role in predicting cognitive deterioration over the long term,” says Zivadinov. Loss of thalamic volume and its tissue integrity can also predict cognitive impairment in MS patients, according to a study recently published in Multiple Sclerosis Journal that was led by UB neurology professor Ralph Benedict, PhD, in collaboration with Jeroen J.G. Geurts, PhD, from VU University Medical Center in Amsterdam, the Netherlands. A New Image of Multiple Sclerosis UB neurologists reveal key role of thalamus in the disease Neurologists at UB and their international collaborators have found that measuring atrophy of the thalamus using routine magnetic resonance imaging can be an important tool in detecting, evaluating and predicting the course of multiple sclerosis. B y E l l e n G o l d bau m from cognitive decline and motor deficits to fatigue and chronic pain. They also have found that measurement of Providing a new window on MS this atrophy has the potential to become Situated on top of the brainstem, near the a valuable method for assessing new MS center of the brain, the thalamus is key to a treatments. wide variety of motor and sensory func MS has traditionally been viewed as a tions. It is involved in the regulation of disease of the brain’s white matter because sleep and wakefulness, memory, emotion, it gradually destroys myelin, the fatty consciousness, awareness and attention. It material that surrounds neurons and allows serves as a kind of relay center in the brain, them to signal. taking in sensory information and sending The recent discoveries by UB researchers it to the cerebral cortex; it also processes are revealing how the thalamus and other information coming from the cortex. parts of the brain’s gray matter play a key “The thalamus is providing us with a new role as well. window on MS,” says Robert Zivadinov, Over the past three years, the UB MD, PhD, UB professor of neurology and researchers and their partners around the leader of the research team. “In our recent world have published journal papers and studies, we have used large datasets to given presentations demonstrating that investigate the evolution of atrophy of the the thalamus region is key to a host of issues involving MS. In a review paper published in the January 2013 issue of Neurology, the researchers noted that gray matter injury can not only be detected in the disease’s earliest stages but also that it is associated with a wide range of symptoms — Robert Zivadinov, MD, PhD “Since progressive pathology of the thalamus has been shown in all different MS disease types, including in pediatric MS patients, we must look at the thalamus as a biomarker for assessing new therapies.” 26 Summer 2013 UB Medicine A potential biomarker for assessing new therapies Research currently in press by the UB team and performed in collaboration with colleagues from Charles University in Prague also was the first prospective, longitudinal study to investigate and find associations between gray matter atrophy and physical disability progression in patients with relapsing-remitting MS, the most common and most disabling type of MS. The five-year study, led by Eva Havrdova, MD, PhD, covered 180 patients. It found that the assessment of thalamic atrophy could potentially serve as a way to evaluate new therapies for MS. “Since progressive pathology of the thalamus has been shown in all different MS disease types, including in pediatric MS patients, we must look at the thalamus as a biomarker for assessing new therapies,” says Zivadinov. “Measurement of thalamic atrophy may become an ideal MRI outcome for MS clinical trials. “Atrophy in MS patients happens in the thalamus more rapidly than in other brain structures,” he continues. “It is detectable very early in the disease and it is less affected by fluid shifts in the brain, an effect of anti-inflammatory drugs used in MS. This feature, in particular, makes thalamic atrophy an ideal candidate for assessing novel therapies.” These findings, says Zivadinov, are just the beginning. “Until now, existing information about thalamic involvement in MS has stemmed mainly from neuropathologic and neuroimaging studies with a limited number of subjects and that contain no clear practical implications for clinicians. The team of researchers and neuroimaging fellows at UB, together with our global partners, is planning to undertake larger, longitudinal studies in order to comprehensively determine how best to apply these very promising findings.” The UB research described here was conducted in the Department of Neurology’s Buffalo Neuroimaging Analysis Center. The center, directed by Robert Zivadinov, MD, PhD, is located in Kaleida Health’s Buffalo General Medical Center, a UB teaching affiliate. “The location of the thalamus in the brain, its unique function and its vulnerability to changes wrought by the disease make it a critical barometer of the damage that MS causes to the brain.” — Robert Zivadinov, MD, PhD Robert Zivadinov, MD, PhD, recently gained worldwide attention for imaging studies he conducted on chronic cerebrospinal venous insufficiency (CCSVI) and its relationship to multiple sclerosis. Turn to page 31 to read more about this research and a related study conducted by UB neurosurgeons that examined the “liberation treatment” for MS. S umm e r 2 0 1 3 UB Medicine 27 U B M E D doctor visits “Psychotherapy is the art of relating to patients and helping them to gain an understanding of themselves, something that is very hard to acquire.” Still Practicing After 65 Years Harold J. Levy, an early advocate of collaborative psychiatry Harold J. Levy, MD, ’46, recalls the old UB medical school on High Street that he attended. The facilities were antiquated, he says, but the faculty was very dedicated and provided an excellent education for the practice of medicine. “The entrance ramp went through the building and out the back. It was built in the days when the doctors-professors had their carriages driven into the building so they didn’t have to walk through inclement weather.” Minus such accommodations, Levy welcomes the school’s return to the site. “I think it’s a much more functional arrangement. The proximity to Buffalo General, Gates Vascular Institute, Children’s Hospital and Roswell Park—and the inclusion of research facilities— creates a type of campus that is much more efficient.” The Levy name has been associated with the medical school for a century. His father, Sidney, received his medical degree in 1915 and became one of the first radiologists to practice in Buffalo. At age 21, Harold became the youngest UB medical school graduate and was elected to the Alpha Omega Alpha Honor Medical Society. By Jim Bisco His son, Sanford, continued the family tradition by earning his medical degree in 1986 and beginning his practice as an internist with a special interest in holistic medicine. After an internship, residency and a teaching position at the school, Levy served as chief of psychiatry in the army in Korea and Hawaii from 1948 to 1950. He then returned to Buffalo where he resumed his faculty position and pursued a research fellowship in the budding field of psychosomatic medicine—the combined study of psychiatry and internal medicine—at what was then the E.J. Meyer Memorial Hospital (now Erie County Medical Center). Because the psychosomatic approach lacked recognition at the time, Levy chose psychiatry and began his practice. At age 88, he is still practicing parttime in his longstanding office in Buffalo’s Central Park area. An early advocate of the collaborative approach of psychiatry, he recalls establishing the first private practice in the community that incorporated psychologists and psychiatric social workers. “Psychotherapy is the art of relating to patients and helping them to gain an understanding of themselves, something that is very hard to acquire,” he says. He worries that the field has become too reliant on prescribing medications. “I still believe we need to talk to our patients.” Last year at the school’s Spring Clinical Day, Levy was honored with a Lifetime Achievement Award for his work in the community and at the school where he taught for more than 50 years. “I chose the profession because I wanted to help others, which is why I’m still practicing after 65 years,” he says. 28 Summer 2013 UB Medicine “As I go through residency, I get a lot of calls from people asking who’s a good psychiatrist and how they can be reached. The wait lists are long.” A Community in Need Michael DiGiacomo finds a home in psychiatry Michael DiGiacomo, MD ’09, was an English major who worked his way through college as By Jim Bisco a jazz saxophonist in a popular local band. He contemplated a career as a professional musician before deciding to enter UB medical school. At first he thought he wanted to become a surgeon, but an influential course during his second year turned him toward psychiatry. “I loved hearing about the different disorders,” he recalls. “From there, I really liked the idea of sitting and talking with patients, trying to understand their thought process. In college I was really interested in studying characters in the novels I was reading. I thought that going into psychiatry would be an extension of being an English major.” DiGiacomo describes a medical education that prepared him to immediately grasp hospital demands. “As soon as I started as an intern, I felt like I had a good sense of how to solve the problems that I needed to solve in the hospital. Maybe I didn’t know exactly what medications to give or exactly what intervention, but I had a good sense of how to get to that point.” After three years of residency in the Department of Psychiatry at Erie County Medical Center, a UB teaching affiliate, he became chief resident and now helps supervise 25 young doctors. “My training here involves both psychotherapy and pharmacology and has been excellent,” he says. “By meeting and speaking with my patients, I’m able to gain a good understanding of them and can help them get on the right medications to relieve their symptoms.” DiGiacomo feels that the new Center of Excellence for Behavioral Health Care at ECMC—a collaborative effort with Kaleida Health and UB—will have a great impact in a community with a severe shortage of psychiatrists (see related article on page 18). “As I go through residency, I get a lot of calls from people asking who’s a good psychiatrist and how they can be reached. The wait lists are long. Families in crisis often don’t know where to bring their family members. I think that having a center here through the university will be a great resource for the community and for our students.” A clinical rotation on the adolescent unit during his second year of residency sparked an interest in child psychiatry. After graduation from residency in June, DiGiacomo begins a two-year fellowship at UB that will prepare him to practice as a clinical child and adolescent psychiatrist. “There aren’t a lot of child psychiatrists right now. There’s a need for more,” says DiGiacomo, who intends to stay and practice at home in Western New York. S umm e r 2 0 1 3 UB Medicine 29 U B M E D r esea r c h New Clues to an Urgent Problem Discovery shows promise against antibiotic resistance By Charlotte Hsu UB researchers have discovered that a protein complex found in human breast milk can help reverse the antibiotic resistance of bacterial species that cause dangerous pneumonia and staph infections. In petri dish and animal experiments, the protein complex—called HAMLET—increased bacteria’s sensitivity to multiple classes of antibiotics, such as penicillin and erythromycin. The effect was so pronounced that bacteria, including penicillinresistant Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA), regained sensitivity to the antibiotics they were previously able to beat, says researchers Anders Hakansson, PhD, Laura Marks, and Hazeline Hakansson, PhD, all in the Department of Microbiology and Immunology. “HAMLET has the potential to reduce the concentrations of antibiotics needed to fight infections and makes it possible to effectively kill bacteria with the well-established antibiotics they are resistant against,” says Anders Hakansson, lead researcher. The findings hold great promise in an era when hospitals are struggling to contain drug-resistant “superbugs” like MRSA, a major culprit behind lethal hospital-acquired staph infections. Bacteria also seem to have difficulty developing resistance to HAMLET, dying in huge numbers even after being exposed to it for many generations, a notable advantage of the molecule. Naturally Occurring, Not Synthetic Marks, an MD/PhD student in the UB Medical Scientist Training Program, described another of HAMLET’s benefits: “Unlike synthetic drugs, HAMLET is a naturally occurring human milk protein-lipid complex, so is not associated with the types of toxic side effects that we so frequently see with the high-powered antibiotics needed to kill drug-resistant organisms.” The idea to test HAMLET in combination with other antibiotics was inspired, in part, by a presentation Marks saw on using drug cocktails to treat HIV. “What really hit home for me in this lecture was the idea of using drug combinations where each drug had a different mechanism that could enhance the action of the other drug as an appealing way to optimize therapy for resistant organisms,” she says. “I was immediately curious to see if using HAMLET together with existing therapies could result in synergistic interactions.” Patent Filed and Company Founded UB’s Office of Science, Technology Transfer and Economic Outreach (STOR) has filed a provisional patent application detailing Anders Hakansson, PhD HAMLET’s antibiotic capabilities, and Anders and Hazeline Hakansson have founded a company called Evincor to further develop HAMLET. “The pharmaceutical industry is currently reluctant to develop antibiotics because they are only used for a short time, and they will be used infrequently and only when nothing else works,” says Hazeline Hakansson. “HAMLET, on the other hand, is an adjuvant that has no killing activity in itself but sensitizes bacteria to antibiotics. HAMLET can therefore be used widely in combination with common antibiotics, which provides a huge potential market that is only going to increase in the next couple of years as antibiotic resistance increases.” The Hakanssons, a husband-and-wife team, say the next step is to test HAMLET on additional strains of S. pneumoniae and S. aureus—including those currently infecting patients—and to expand the in-vivo infection models used for testing to provide a proof of principle. HAMLET’s effects on S. aureus were published in the journal PLOS ONE on May 1, 2013, with Marks, Anders Hakansson and UB PhD student Emily Clementi as authors. HAMLET’s effects against S. pneumoniae were published in PLOS ONE in August 2012. 30 S umm e r 2 0 1 3 UB Medicine Landmark Multiple Sclerosis, CCSVI Studies In 2008, Italian vascular surgeon Paolo Zamboni, MD, proposed that a condition called chronic cerebrospinal venous insufficiency (CCSVI) contributes to MS symptoms and might even cause the disease by constricting veins in the brain. The hypothesis attracted intense interest worldwide and over the past three years an estimated 30,000 MS patients have undergone interventional endovascular therapy (balloon angioplasty) to open their veins in the hope of relieving or curing their disease. Sometimes called the “liberation treatment,” the surgical procedure costs between $10,000 and $40,000 and has resulted in at least two reported deaths. UB researchers led by Robert Zivadinov, MD, PhD, have published or presented more than 25 imaging studies on CCSVI and its relationship to multiple sclerosis and other neurological diseases (see related article on page 26). “Our findings over the last three years indicate that CCSVI is more prevalent in MS patients than in healthy controls but the cause or consequence of these venous abnormalities has not been established,” says Zivadinov, professor of neurology and director of the UB Buffalo Neuroimaging Analysis Center, where the studies took place. In 2010, researchers in UB’s departments of neurosurgery and neurology collaborated on the first controlled clinical trial to test the safety and efficacy of the “liberation treatment.” Their study, called the Prospective Randomized Endovascular Therapy in MS (PREMiSe) trial is believed to be the first prospective randomized double-blinded, controlled study of balloon angioplasty for MS performed in the U.S. with institutional review board approval. Results were presented in March at the annual meeting of the American Academy of Neurology. “What we found was rather surprising and unexpected,” says Adnan Siddiqui, MD, associate professor of neurosurgery and principal investigator. “The study showed that endovascular treatment of stenosed veins had no effect in MS patients.” The UB researchers found no difference in clinical symptoms, brain lesions as determined on MRIs or quality of life outcomes between MS patients who underwent balloon angioplasty to correct CCSVI and those who did not receive the treatment. “Our strong recommendation to patients and to practitioners who have, in earnest, been seeking betterment for their disease and a cure for MS is that they should instead consider enrolling in trials, rather than undergoing these procedures on a fee-for-service basis,” said Siddiqui. The researchers stressed that the UB study was small and that larger, controlled trials should be conducted in a rigorous fashion, as was PREMiSe. “HAMLET has the potential to reduce the concentrations of antibiotics needed to fight infections and makes it possible to effectively kill bacteria with the well-established antibiotics they are resistant against.” —Anders Hakansson, PhD ABOUT HAMLET + HAMLET stands for Human Alpha-lactalbumin Made Lethal to Tumor Cells. Discovered during Anders Hakansson’s time in Catharina Svanborg’s laboratory in Lund, Sweden, HAMLET has shown the ability to selectively kill both tumor cells and bacteria. + In certain bacteria (including S. pneumoniae and S. aureus), HAMLET binds to and halts the activity of biological pumps and transporters that help regulate the flow of ions in and out of a cell. HAMLET also binds to and blocks the activity of two enzymes needed for glycolysis, a process bacteria use to obtain energy. + In the bacteria it kills, HAMLET appears to spark a chain of chemical reactions that mirrors what happens in nature when bacterial cells self-destruct for the greater good of a bacterial community (a “biofilm”). This deadly process includes an influx of calcium and the activation of a serine/threonine kinase, and ends with cells rupturing. S umm e r 2 0 1 3 UB Medicine 31 U B M E D researc h These two antibodies—called “Ro” and “La”—appear late in the disease. The researchers team found at least one of the new antibodies in 76 percent of patients with symptoms lasting less than two years, but without the Ro and La antibodies. Their findings were published as a highlighted article in Clinical Immunology with an editorial by Robert I. Fox, MD, considered one of the world’s top Sjogren’s scientists. Although Sjogren’s syndrome is one of the three most common autoimmune diseases, it is not well known. The condition often takes years to diagnose, according to Julian L. Ambrus Jr., MD, professor of medicine and senior author on the paper. —Julian L. Ambrus Jr., MD, “Sjogren’s patients get diagnosed professor of medicine too late,” he says, noting that 90 percent of patients are women. Discovery Changes Treatment Paradigm Enables early intervention for painful autoimmune disease B y E l l e n G o l d bau m Researchers at UB and the local company Immco Diagnostics have discovered novel antibodies that will allow for much earlier diagnosis of an autoimmune disease affecting more than 4 million Americans. Their breakthrough means that people with Sjogren’s syndrome, a condition characterized by painfully dry eyes and mouth, will receive treatment when they’re more likely to benefit from it. Late Diagnosis, Little Relief for Patients The research team observed the novel antibodies in 45 percent of patients who met most of the clinical criteria for Sjogren’s syndrome except the two antibodies currently required for a diagnosis. “Sjogren’s patients get diagnosed too late. They go to the doctor because their eyes are dry or they can’t swallow, but by that time, their salivary or tear glands are already dead.” Julian L. Ambrus Jr., MD, left, and Long Shen, PhD, first author, research assistant professor of medicine 32 Summer 2013 UB Medicine “They go to the doctor because their eyes are dry or they can’t swallow, but by that time, their salivary or tear glands are already dead. They’re way past the point where they can generally benefit from treatment.” Locally Developed Test with International Impact The discovery of the novel antibodies grew out of a collaboration between UB and Immco that in 2006 resulted in a superior animal model for Sjogren’s syndrome now being used in labs worldwide. “Our animal model has completely changed how people think about this disease,” Ambrus says. “Sjogren’s disease in our animal model marches along in exactly the same way that the human disease does, reproducing every stage of the disease.” Once scientists detected the new antibodies in mice, they started testing patients at Buffalo General Medical Center, finding the same antibodies, even at early stages of the disease. UB has filed a patent on the biomarker-based method and licensed the technology to Immco, which has developed a new diagnostic tool based on the research that has significant proprietary value. “We will be the only company in the world to offer and market this test across any platform,” says Immco CEO William Maggio. Once the assay undergoes New York State Department of Health validation this year, physicians will be able to start using it. Because Sjogren’s syndrome presents with various symptoms, the test will be marketed to several different types of physicians, including oral surgeons, ophthalmologists, rheumatologists and dentists. Immco will test patient samples from around the country. The company also is developing a diagnostic kit to market worldwide. “This is a very good example of how research and industry collaborate to produce something that will bring a lot of good to the health care industry—and it’s happening here in Buffalo,” Maggio says. Finding Help for Chronic Pain In addition to the chronic pain resulting from an inability to produce tears or saliva, Sjogren’s syndrome is associated with mild kidney and lung disease. Five to 10 percent of people with Sjogren’s develop lymphoma. “Sjogren’s patients are miserable,” says co-author Lakshmanan Suresh, DDS, Immco’s vice president for research and development and a clinical associate professor of oral diagnostic sciences in the UB School of Dental Medicine. “They cannot taste anything, they often have serious tooth decay, and they feel as though they have sandpaper or grit in their eyes all the time. If we can find the antibodies early, then we can start to develop therapies to target them. The first step, though, is to make the diagnosis.” NIH Grant Furthers Sjogren’s Research The UB researchers recently received a $450,000 grant from the National Institutes of Health to study how the immune system becomes dysfunctional in Sjogren’s syndrome. Last summer, the project received financial support from UB’s Center for Advanced Biomedical and Bioengineering Technology, one of 15 centers funded by the Empire State Development’s Division of Science, Technology and Innovation to encourage university-industry collaboration in research, education and technology transfer. First author on the Clinical Immunology paper is Long Shen, PhD, research assistant professor of medicine at UB. Along with Ambrus and Suresh, co-authors are Jingxiu Xuan, PhD, research assistant professor in the UB Department of Medicine; and Matthew Lindemann, PhD, director of assay development, Przemek Kowal, PhD, director of biopolymers, and Kishore Malyavantham, PhD, director of scientific initiatives, all from Immco. Potential Culprit in Neurodegenerative Diseases First time molecular mechanism is described Research conducted by Jennifer Surtees, PhD, assistant professor of biochemistry, has revealed a molecular mechanism that could contribute to neurodegenerative diseases. In collaboration with researchers at the University of Rochester Medical School, Surtees and her lab have described the means by which a DNA mismatch repair promotes trinucleotide repeat expansions (TNR), the genetic basis for Huntington’s disease, myotonic dystrophy and other neurodegenerative disorders. “This is the first time that a real mechanism has been described for replication and repair factors in promoting expansions,” says Surtees, whose research was published in the Aug. 30 issue of Cell Reports. Although genetic evidence indicates errors in DNA replication and repair cause neurodegenerative diseases, clear molecular mechanisms have not been described until now. Surtees and colleagues studied the role of the mismatch repair complex Msh2-Msh3 in TNR expansions. The complex previously had been shown to Jennifer Surtees, PhD, assistant professor of biochemistry promote expansions in mouse models of Huntington’s disease and myotonic dystrophy, but researchers did not know how this happened. The current research indicates that Msh2-Msh3 interferes with normal DNA processing at the replication fork, particularly in the presence of trinucleotide repeats, leading to incremental increases in repeat lengths during processing. This mismatch repair system, best known for its role in postreplicative mismatch repair, provides a critical line of defense in protecting the integrity of the genome. Researchers don’t fully understand the molecular mechanisms for these critical repair pathways, which regulate genome stability. Surtees aims to learn how the correct repair pathway is initiated. In the long term, she seeks to examine and clarify the mechanisms that bridge damage recognition by MSH complexes and DNA repair. — Carol Blackley S umm e r 2 0 1 3 UB Medicine 33 U B M E D researc h Programmed for Obesity in Infancy Babies’ diet may lead to obesity in adulthood B y E l l e n G o l d bau m For nearly 20 years, Mulchand S. Patel, PhD, and his UB colleagues have conducted innovative animal studies that have helped to elucidate the biochemical mechanisms underlying obesity. Recently, the team received wide media attention when they reported that feeding rat pups a milk formula high in carbohydrates immediately after birth programs them for weight gain and obesity throughout their lives, even if they diet intermittently as adults. “This is the first time that we have shown in our rat model of obesity that there is a resistance to the reversal of this programming effect in adult life,” explains Patel, a SUNY Distinguished Professor of biochemistry and associate dean for research and biomedical education in the School of Medicine and Biomedical Sciences. The research, Patel further explains, has implications to the problem of obesity in the U.S., particularly as it relates to infant nutrition. “Many American baby foods and juices are high in carbohydrates, mainly simple sugars,” he says. “Our hypothesis has been that the introduction of baby foods too early in life increases carbohydrate intake, thereby boosting insulin secretion and causing metabolic programming that in turn can predispose the child to obesity later in life.” Critical Period for the Hypothalamus For the past two decades, Patel and his UB colleagues have studied how the increased intake of carbohydrate-enriched calories just after birth can program individuals to overeat. For their rat model of obesity, they administered to newborn rat pups special milk formulas they developed that are either similar to rat milk in composition (higher in fat-derived calories) or enriched with carbohydrate-derived calories. “The pups who were fed a high-carbohydrate milk formula are getting a different kind of nourishment than they normally would,” explains Patel, “which metabolically programs them to develop hyperinsulinemia, a precursor for obesity and type 2 diabetes.” At three weeks of age, the rat pups fed the high-carbohydrate (HC) formula were then weaned onto rat chow either with free access to food or with a moderate calorie restriction, so that their level of consumption would be the same as pups reared naturally. “When food intake for the HC rats was controlled to a normal level, the pups grew at a normal rate, similar to that of pups fed by their mothers,” Patel says. “But we wanted to know, did that period of moderate calorie restriction cause the animals to be truly reprogrammed? We knew that the proof would come once we allowed them to eat ad libitum, without any restrictions. “We found that when the HC rat undergoes metabolic reprogramming for development of obesity in early postnatal life and then is subjected to moderate caloric restriction, similar to when an individual goes on a diet, the programming is only suppressed, not erased,” he says. This is due to developmental plasticity, which extends from fetal development — Mulchand S. Patel, PhD into the immediate postnatal period. According to Patel, previous research by others has revealed that during the immediate postnatal period, pancreatic islets and neurons continue to mature. “That’s why an altered nutritional experience during this critical period can independently modify the way certain organs in the body develop, resulting in programming effects that manifest later in life,” Patel says. “During this critical period, the hypothalamus, which regulates appetite, becomes programmed to drive the individual to eat more food. We found that a period of moderate caloric restriction later in life cannot reverse this programming effect.” “During this critical period, the hypothalamus, which regulates appetite, becomes programmed to drive the individual to eat more food. We found that a period of moderate caloric restriction later in life cannot reverse this programming effect.” 34 Summer 2013 UB Medicine Kosman Nominated to faculty of 1000 Daniel Kosman, PhD, UB Distinguished Professor of biochemistry, has been named to the Faculty of 1000, joining a worldwide body of experts who select and evaluate the most significant articles from biomedical research publications for inclusion in the F1000 directory. He was nominated by section heads Stephen Benkovic, PhD, of Pennsylvania State University; Judith Klinman, PhD, of the University of California at Berkeley; and JoAnne Stubbe, of the Massachusetts Institute of Technology. “I’m honored that people who are at the top of the field would ask me to do this,” Kosman said, noting that all three section heads belong to the National Academy of Sciences. “As a senior faculty member, I feel strongly that it’s my responsibility to serve my community. When you’re asked to serve by people you admire a great deal, it’s quite an honor.” Kosman says that F1000Prime is particularly useful for spotlighting valuable articles that appear in lower-profile journals. “Biocatalysis is quite broad, so some of the papers you see recommended in the directory are ones you might not have read if you picked up your favorite journal. “This is a way of broadening the readership of articles that would be of interest to your own community.” Mulchand Patel, MD Lifestyle Change Required These findings indicate that in order to address the obesity epidemic in our country significant lifestyle changes must be encouraged, notes Patel, who emphasizes the need for permanent caloric restriction. “As long as you restrict intake, you can maintain normal body weight,” he says. To avoid metabolic reprogramming that predisposes a baby to obesity later in life, he says parents should follow the American Academy of Pediatrics’ guidelines, which state that infant supplemental foods should not be given before a baby is 4-6 months old. Patel adds that this study involved only moderate caloric restriction; he and his colleagues would like to study whether or not more severe caloric restriction for a limited period can result in true metabolic reprogramming to normal metabolic phenotype. The research described in this article was published in the March 2013 issue of the American Journal of Physiology: Endocrinology and Metabolism. The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Co-authors with Patel are Malathi Srinivasan, PhD, research assistant professor, and Saleh Mahmood, PhD, postdoctoral associate, both in the UB Department of Biochemistry. Popescu’s Paper Selected by Faculty of 1000 A paper by senior author Gabriela K. Popescu, PhD, associate professor of biochemistry, has been selected and evaluated by the Faculty of 1000, placing her work in its library of the top 2 percent of articles in biology and medicine. The article received two out of three stars—or a “very good” rating—by an evaluator with the post-publication peer review service. To be recommended for F1000Prime, a research article has to have been recognized as being “of special excellence,” says senior managing editor Martin Delamare. Popescu’s paper sheds light on processes involving the synaptic protein NMDA receptor, whose overactivity has been implicated in neurodegenerative conditions and mental illness. Bruce E. Maki, a PhD candidate in neuroscience at UB, is lead author on the paper, which was originally published in the October 19, 2012 issue of the Journal of Biological Chemistry. Co-authors are Teresa K. Aman, a postdoctoral associate in biochemistry, and former PhD students Stacy A. Amico-Ruvio and Cassandra L. Kussius. S umm e r 2 0 1 3 UB Medicine 35 U B M E D P at h w a y s Canty Elected President of Cardiology Association John M. Canty Jr., MD ’79, Albert and Elizabeth Rekate Professor and chief of cardiovascular medicine, has been named president of the Association of Professors of Cardiology, the foremost professional organization for division directors of cardiology and cardiovascular medicine at accredited institutions. A faculty member in the Department of Medicine since 1983, Canty focuses on developing bench-tobedside personalized treatments for heart disease patients. Since his appointment as head of cardiovascular medicine in 2006, he has helped advance programs in education, research and clinical care. He has also integrated UB’s cardiology sections at Erie County Medical Center, Kaleida Health and Buffalo Veterans Affairs Medical Center, where he is a staff cardiologist. neurosurgeon leaders skilled in catheterbased technology for minimally invasive neurosurgery. A strong believer in translational medicine, Hopkins is president and CEO of the Jacobs Institute—located in UB’s Clinical and Translational Research Center—which aims to catalyze medical collaboration and innovation through partnerships between UB, Kaleida Health, community physicians and industry. He also serves as chairman of the board and president of the Gates Vascular Institute. sity. He completed residency training at SUNY at Stony Brook and served research and clinical fellowships at Boston University Medical Center. Expert in HCV Named Division Chief Andrew H. Talal, MD, MPH, a highly regarded authority on viral hepatitis in HIV-infected individuals, has been named professor of medicine and chief of the Division of Gastroenterology, Hepatology and Nutrition in the Department of Medicine. He came to UB from Weill Cornell Medical College, where he was an associate professor and a physician-scientist in the Center for the Study of Hepatitis C, a consortium between Weill Cornell, Rockefeller University and New York Presbyterian Hospital. Talal earned his medical degree at the University of Texas Health Science Center in San Antonio. He completed his residency at the University of Iowa and clinical fellowships in gastroenterology at the University of North Carolina, where he also received his MPH. Quigg Named Chair in Nephrology, Divsion Chief Richard J. Quigg Jr., MD, an internationally known researcher on the pathogenic mechanisms that underlie kidney disease, has been named the inaugural Arthur M. Morris Chair in Nephrology and chief of the Division of Nephrology in the Department of Medicine. Quigg came to UB from the University of Chicago, where he served as professor of medicine, chief of the Section of Nephrology and director of its Functional Genomics Facility. He received his undergraduate and medical degrees from Boston Univer- Hopkins Appointed SUNY Distinguished Professor L. Nelson Hopkins, MD, professor and chair of neurosurgery, is one of three University at Buffalo faculty members appointed SUNY Distinguished Professor, the highest faculty rank in the SUNY system. Hopkins pioneered the field of endovascular neurosurgery and has trained a new generation of Dubocovich Heads Office of Inclusion, Cultural Enhancement Margarita L. Dubocovich, PhD, has been named the inaugural senior associate dean for inclu- 36 Summer 2013 UB Medicine sion and cultural enhancement in the School of Medicine and Biomedical Sciences. She also will continue as chair of the Department of Pharmacology and Toxicology. In 2008, UB recruited Dubocovich from Northwestern University, where she had founded and directed a highly successful professional development program for a diverse group of doctoral students in the biosciences. In her first year at UB, she established a similar series of programs, named CLIMB (Collaborative Learning and Integrated Mentoring in the Biosciences). In 2012, the National Institutes of Health awarded CLIMB’s graduate student program $1.9 million to fund the education of 20 new biomedical and behavioral scientists. tal role in implementing an electronic medical records system for UBMD. The Institute for Healthcare Informatics is a computing center on the Buffalo Niagara Medical Campus that stores, aggregates and innovatively analyzes health care data that can be used to improve health locally, statewide and nationally. Alumni— We want to hear from you! We are currently creating a new webpage for our alumni that will include a Classnotes section. We encourge you to send news about your career and family to: firstname.lastname@example.org In the next issue of UB Medicine, we will publish the address for the new webpage, where your Classnotes and other alumni news will be posted. Alumnus Receives 2012 National Academy of Sciences Award Zhijian (James) Chen, who earned his doctorate in biochemistry at UB in 1991, received the 2012 National Academy of Sciences Award in Molecular Biology. The prestigious award recognizes a recent notable discovery in molecular biology by a young scientist who is a U.S. citizen. The academy cited Chen for his creative use of elegant biochemistry in elucidating processes important to understanding cancer and immunity. Chen is a Howard Hughes Medical Institute Investigator and the George L. MacGregor Distinguished Chair in Biomedical Science at the University of Texas Southwestern Medical Center. “Past recipients of the National Academy of Sciences Award in Molecular Biology represent an all-star list of prominent scientists, including numerous who have gone on to win the Nobel Prize,” says Kenneth M. Blumenthal, PhD, chair of the Department of Biochemistry and senior associate dean for research and graduate education at UB. “Howard Hughes Medical Investigators are also an elite group to which James has belonged since 2005. We all congratulate him on his outstanding accomplishments.” At UB, Chen completed his doctoral work in the laboratory of the late Cecile Pickart, PhD. In addition, he studied under Ed Niles, PhD, another former biochemistry faculty member, whom he credits with teaching him molecular biology. Winkelstein Leads Institute for Healthcare Informatics Peter Winkelstein, MD ’90, MBA, professor of pediatrics and chief medical informatics officer for UBMD, the faculty practice plan, has been named executive director of the Institute for Healthcare Informatics. Winkelstein played an instrumen- Chen traces his current research interests back to his thesis work in Pickart’s lab, where he studied the role of ubiquitin in protein degradation. The academy cited Chen for his creative use of elegant biochemistry in elucidating processes important to understanding cancer and immunity. As an independent investigator, Chen uncovered novel roles for ubiquitin in signaling pathways unrelated to degradation—findings recognized by the National Academy of Sciences in the presentation of the award. These pathways include those important to innate and adaptive immune responses as well as those in normal cell cycle regulation that can be corrupted in some types of cancer. Last fall, Chen returned to UB, where he was honored as the School of Medicine and Biomedical Sciences 2012 Distinguished Biomedical Alumnus. S umm e r 2 0 1 3 UB Medicine 37 U B M E D Pat h way s “Michael has been a key player in a coalition of stakeholders that is committed to creating a more efficiently integrated health care system for Western New York.” —Michael and Isabel Robitaille his strong leadership and vision during an exciting, transformative time for UB and our community. “Michael has been a key player in a coalition of stakeholders that is committed to creating a more efficiently integrated health care system for Western New York,” they stated. They noted that, in addressing complex changes in the community’s health care environment, “Michael has worked thoughtfully and collaboratively with his colleagues to consider these issues and to maintain respectful, open dialogues that support consensus.” The couple also praised Cain for creating an Office of Inclusion and Cultural Enhancement; involving the school in community outreach, such as the Lighthouse Free Medical Clinic; and appointing women to leadership roles. Erie County Medical Center. During that time, the unmet needs of the community, especially in poor and medically underserved areas, made a strong impression on him. Calkins believes medical institutions have an obligation to improve the quality of, and access to, health care throughout the community. The Calkins Research Award grants $1,500 to residents whose projects are implemented in community settings, including community-based clinical practices, ambulatory clinics and emergency room settings in UB-affiliated hospitals. Recipients of the award are expected to present their projects at the following year’s Scholarly Exchange Day. the senses of hearing, touch and balance. He is responsible for finding the only drug to inhibit these channels and applying it to find possible therapies and cures for diseases such as muscular dystrophy and sickle cell anemia. Along with Fanjie Meng, PhD, research assistant professor of physiology and biophysics, Sachs invented fluorescent probes that measure stress in proteins of living cells and transgenic animals. These probes may eventually help physicians diagnose metastatic cancers. He also invented a device to electrically measure cell volume in real time with collaborator Susan Zonglu Hua, PhD, from the departments of mechanical and aerospace engineering and physiology and biophysics. Sachs conducted the first voltage clamp studies of isolated adult heart cells and is responsible for the first single channel recording from tissue cultured cells. He has been involved in developing the patch clamp electrophysiological technique since its inception in the late 1970s. The Cole award, given by the Membrane Biophysics Subgroup, has been previously awarded to such dignitaries as Nobel laureate Erwin Neher. Cain Receives Leadership Buffalo Award Michael E. Cain, MD, vice president for health sciences and dean of the School of Medicine and Biomedical Sciences, was honored with a Leadership Buffalo Value Award for inclusion. These annual awards honor community leaders who embody one of Leadership Buffalo’s four core values: inclusion, service, diversity and openness to change. The 2013 awards were presented on May 2 during a luncheon at the Hyatt Regency Buffalo. The “inclusion” designation reflects a leader who seeks multiple perspectives on issues and considers the interests of various stakeholders. Broadcaster and former Buffalo Sabre Michael Robitaille and his wife, Isabel, CEO of Robitaille Relocation and Real Estate in Williamsville, nominated Cain for the award. In their nomination, the couple lauded Cain for Sachs Receives Cole Award Calkins Establishes Research Award Evan Calkins, MD, has established a Community-Based Research Award. The annual award will be given to residents and junior faculty members who conduct community-based research or quality improvement projects. Calkins served as chair of the Department of Medicine at UB from 1968 to 1977. He also served for 12 years as director of medicine at what is now Frederick Sachs, PhD, SUNY Distinguished Professor of physiology and biophysics, has won the 2013 Kenneth S. Cole Award from the Biophysical Society. The award is given annually to an investigator who has made significant contributions to the understanding of cell membrane biophysics. In 1983, Sachs discovered mechanosensitive ion channels. Found in every cell, these are sensors for systems including 38 S umm e r 2 0 1 3 UB Medicine in mem o riam John P. Naughton, MD, School’s Longest-Serving Dean John P. Naughton, MD, the longest-serving dean in the history of the School of Medicine and Biomedical Sciences, died May 21, 2012. He was 79. As dean for 21 years (1975-1996) and vice president for clinical affairs for the last 12 of those years, Naughton is credited with elevating the national stature of the medical school, dramatically reshaping UB’s relationship with its affiliated teaching hospitals and improving the university’s ties with the Western New York medical community. Naughton was one of the key players in establishing UB’s innovative consortium of teaching hospitals—a model that subsequently garnered national attention as a new approach to medical education. Under his guidance, the school instituted aggressive new approaches to medical training for underrepresented groups and placed a renewed emphasis on programs in primary care medicine. Naughton also developed the UB Faculty Management Plan, the precursor of UBMD, the university’s physician practice plan. A graduate of St. Louis University, Naughton received his medical degree from the University of Oklahoma College of Medicine. Before coming to UB in 1975 to serve as dean, he was professor of medicine and dean for academic affairs at George Washington University. Naughton was an internationally known cardiologist with expertise in the prevention of coronary heart disease. He developed the Naughton Treadmill Protocol, widely used in exercise testing. Naughton was a fellow of the American College of Sports Medicine— which he served as president—the American College of Cardiology, the American College of Chest Physicians and the American College of Physicians. After stepping down as dean in 1996, Naughton returned to the UB faculty as a professor in the Department of Rehabilitation Medicine, where he also served as interim chair from 1993 until retiring in 2009. In 1997, he received the Chancellor Charles P. Norton Medal, UB’s highest award, given to individuals whose accomplishments have greatly added to the prestige of the city of Buffalo and the university. Naughton is survived by his partner, Nancy Glieco, a retired medical school staff member; four sons, George, Michael, Thomas and Bruce, an associate professor of medicine and chief of the Division of Geriatrics; two daughters, Marsha Lutostanski and Lisa Bolten; a brother, Joseph M.; and a sister, Anne F. Edlefson. F. Carter Pannill, Former Dean, VP for Health Affairs Fitzhugh Carter Pannill Jr., MD, former UB vice president for health affairs, acting dean and professor of medicine, died June 30, 2012, in New Braunfels, Texas, after a brief illness. He was 91. Pannill was recruited to UB in 1973, serving as vice president for health affairs and, for the first two years of his tenure, the medical school’s acting dean. Among other accomplishments, Pannill is credited with integrating the educational programs of the five health science schools and steadying the medical school’s course a little more than a decade after the university merged with the State University of New York system. Under his leadership, John Naughton, MD, was recruited to UB. A 1945 graduate of Yale University School of Medicine, Pannill trained in internal medicine in Houston and began his career in academic medicine in 1951 at Baylor University Medical College. He subsequently spent six years in private practice before re-entering academic medicine in 1960, holding positions in Philadelphia and Dallas. In 1965, he was recruited to serve as the founding dean of the University of Texas Medical School at San Antonio, a position he held until coming to UB. At UB, his family and colleagues established the F. Carter Pannill Award in his honor, given annually to a junior faculty member in the Department of Medicine who demonstrates the exemplary bedside teaching that Pannill modeled. Pannill is survived by his wife of 66 years, the former Mildred Treat; a son, Fitzhugh Carter III, MD; two daughters, Elizabeth, and Mary Gilroy; a sister, Lelia Birrell; three grandchildren and two great-grandchildren. S umm e r 2 0 1 3 UB Medicine 39 UB MED Q & A “We need to be doing science differently in this country; it needs to be more translational.” This refrain drives medical research today, yet many people don’t know why. UB Medicine asked Timothy F. Murphy, MD, director of the Clinical and Translational Research Center, to explain. An internationally recognized researcher, Murphy led landmark studies at UB in the late 1990s that overturned conventional wisdom about chronic obstructive pulmonary disease (COPD). Q: Is translational research new? A: What we call “translational research” is not new. For example, there has been drug development throughout the modern era in medicine. What is new is that we now recognize translational research as being a distinct stage in moving a discovery from the lab bench to actual treatment. We also recognize that there are particular requirements for doing it well and that we can train researchers in those areas. Q: The National Institutes of Health [NIH] made translational research a priority a few years ago and UB has just opened its $118 million Clinical and Translational Research Center. Why all this interest now? A: Over the past 30 years, the advances in basic medical science have been just amazing—in genomics, immunology, structural biology, to name three areas. But when you look at how these discoveries are affecting health care, the record isn’t as impressive. New drug development has been essentially flat since 1980. In fact, there were more new drugs introduced in 1980 than in 2011. Q: So, in practical terms, what’s different today from, say, 10 years ago? A: I think the biggest difference is the emphasis on overcoming interdisciplinary barriers. We can’t expect everyone to know everything, so in order to develop new drugs, for instance, we need people with many types of expertise on a project. We need to get good at doing what’s called “team science,” which is new for most researchers. We need to sit together, learn each other’s languages. This is not as simple as it may sound. A second important way that today’s outlook is different is that we and other institutions are investing in training programs for this kind of work. Until now, people like me have sort of wandered into clinical research. There’s been no map. We need to do a better job of training young investigators for careers in clinical and translational research. Here at UB we’ve developed a master’s degree in clinical research. We’ve also developed a nondegree program that teaches 14 core clinical and translational research competencies identified by the NIH. “Until now, people like me have sort of wandered into clinical research. There’s been no map.” Q: How did your own research career develop? A: Other than an undergraduate summer experience doing lab work on antifouling paints, I didn’t set foot in a lab until the second year of my fellowship in infectious diseases at Tufts. I’d done maybe five or six months of research—I had no papers, no grants—when Michael Apicella hired me here at UB. I was very lucky. I really learned to be a researcher as a young faculty member under his mentorship. I was studying Haemophilus influenzae with the hope that if I understood the bacterium I might someday create a vaccine to prevent the illnesses that it caused. I was driven to understand the disease in order to know where to go. I thought of what I was doing as basic science, but in a lot of ways I was doing translational research right from the beginning of my career. I still am. —Judson Mead 40 Summer 2013 UB Medicine Looking for a way to grow your income? A charitable gift annuity lets you earn fixed income while you support UB. * Receive guaranteed income for life * Reduce your taxes * Create a named scholarship * Help support the School of Medicine and Biomedical Sciences Charitable gift annuity rates AGE 60 65 70 75 80 85 90 RATE 4.4% 4.7% 5.1% 5.8% 6.8% 7.8% 9.0% For information, contact Wendy Irving, Esq., Assistant Vice President, Office of Gift Planning Toll free: 877-825-3422 email@example.com S umm e r 2 0 1 3 UB Medicine 41 Nonprofit Org. U.S. Postage UB Medicine University at Buffalo 901 Kimball Tower Buffalo, NY 14214-8028 PAID Buffalo, NY Permit No. 311 Forwarding Service Requested Thanks to you, I’ll work to improve my patients’ lives. Natalie Gugino knew a good university when she saw one, so she made UB her top choice for medical school after earning a BA in biomedical sciences in 2011. “UB has everything a student could want: supportive and progressive faculty, fun campus events, and a friendly atmosphere conducive to academic success.” A UB Medical Alumni Association scholarship recipient, Gugino has a brother with autism spectrum disorder. She hopes to treat similarly disabled patients: “I know what a difference a competent, caring physician can make in the lives of those struggling with such a devastating illness.” The best reason to support UB is what students like Natalie will do in the future. The best public universities have the strongest private support. www.giving.buffalo.edu 5 Summer 2013 UB Medicine