Update from the Dean - Spring/Summer 2011

Dear UCSF School of Pharmacy Family and Friends:

The UCSF School of Pharmacy faculty and students never cease to amaze me. How brilliant and tireless they are! Our faculty members, in particular, are also innovative, bold, and strategic. To this point, I took additional time in writing this Update to bring you examples of how our actions fall purposefully in line with our three 2007-2012 strategic plan goals and their many objectives. I think you will find the exercise interesting. Our 3 major goals are to:

  1. Create a new framework for the discovery and development of drugs, devices, and diagnostics
  2. Ensure that more patients get the best results from their drugs
  3. Shape the future of pharmacy science, policy, education, and patient care by working in fresh and collaborative ways.

Our ultimate aim is to improve health through the best possible therapeutics used safely and effectively. I hope you enjoy this latest summary.

Faculty Awards

I begin with a few of the awards our faculty members have received since I last wrote.

Timothy Cutler, PharmD, Department of Clinical Pharmacy, received the 2011 Albert B. Prescott/GlaxoSmithKline Pharmacy Leadership Award from the American Pharmacists Association. The award spotlights a young pharmacist who the association believes will become a significant leader of the profession. Among his many accomplishments, Tim co-led a partnership among 7 California pharmacy schools to train student pharmacists to teach seniors, health professional students, and prescribers about Medicare Part D.

(Objectives: Prepare our doctor of pharmacy students to be leaders and agents of change. Find new ways for pharmacists to help patients make the best use of medicines. Find ways to provide pharmacy care to underserved patients.)

Danica Galonić Fujimori, PhD, Departments of Pharmaceutical Chemistry and Cellular and Molecular Pharmacology, is a 2011 Searle Scholar. Her pharmaceutical chemistry department colleague Bo Huang, PhD, earned the honor in 2010. This prestigious award supports young, accomplished biomedical scientists who show great continuing promise. Bo is developing super-resolution optical microscopy techniques to enable researchers to "see" the macro-molecular details of health and disease playing out in cells. Danica is developing chemical probes that will help researchers better understand the function of enzymes that change the ways genes are expressed, and thus alter the behavior of cells in both health and disease.

(Objective: Create new research tools.)

James Wells, PhD, Department of Pharmaceutical Chemistry chair, received the 2011 Bristol-Myers Squibb Smissman Award from the Division of Medicinal Chemistry of the American Chemical Society. The award spotlights a senior scientist whose work has substantially affected the development of medicinal chemistry. Jim is known for the discovery and design of small molecules that trigger or modulate cellular processes.

(Objective: Develop small molecules that can probe biological processes and serve as therapeutic agents.)

New faculty members

You know from past letters how excited we are to welcome exceptionally talented new scientists and clinicians into our School and campus families. I know you will be impressed with this group!

Adam Abate, PhD, recently joined our Department of Bioengineering and Therapeutic Sciences as an assistant professor. His research passions include high-throughput biology using microfluidics. What is this? Imagine fitting the reactions of a huge warehouse full of test tubes into one test tube filled with billions of tiny droplets, each housing a chemical reaction. Then imagine using robots to quickly sort these droplets to isolate the results you want. Adam is also engineering proteins through what is called directed evolution. This means that instead of adding chemicals to experiments to manipulate atoms and molecules—as chemists traditionally do—he is using the innate tools within biological systems, in this case enzymes, to create new kinds of protein molecules. Adam earned an AB in physics from Harvard College, an MS in physics from UCLA, and a PhD in physics from the University of Pennsylvania. He then returned to Harvard for postdoctoral work in physics and engineering before accepting his UCSF appointment.

(Objectives: Amplify and integrate physics into our work to more deeply understand health and disease. Create new research tools.)

Sherilyn VanOsdol, PharmD, is now with our Department of Clinical Pharmacy as an assistant professor of clinical pharmacy and drug information expert. She earned a BS in molecular, cellular, and developmental biology from UC Santa Cruz and a PharmD from UC San Diego. Then she completed a general pharmacy practice residency and a drug information specialty residency at the University of Illinois Medical Center. Her focus is on medication safety, an area of critical importance to the UCSF Medical Center and our Department of Clinical Pharmacy's Medication Outcomes Center. As therapeutic regimens become more complicated and new technologies—such as robotic dispensing and electronic medical records—become more widely used, we see more research questions surrounding best practices for medication safety. We look to Sherilyn to help reveal many of the answers.

(Objectives: Minimize medication errors. Find new ways for pharmacists to ensure patients get the best use of medications.)

We welcome Kevin Rodondi, PharmD, as an associate professor in our Department of Clinical Pharmacy. A longtime volunteer member of the faculty before this appointment, Kevin is also an alumnus with well-honed pharmacy practice and business success in the therapeutics sector, including: vice president of corporate operations for OnCare, Inc.; vice president, clinical, for Consensus Health; co-founder, chief operating officer, and president of the National Oncology Alliance, Inc.; and vice president and general manager of McKesson Specialty Solutions Group. Kevin will be developing new models of pharmaceutical patient care for both inpatient and outpatient settings.

(Objective: Design and validate pharmacy practice models that improve patient health.)

Retiring faculty members

While we welcome new faculty members, we celebrate with deep gratitude a cohort of senior faculty members as they retire. Most recently, Stephen Kahl, PhD, Richard Shafer, PhD, and C.C. Wang, PhD, in the Department of Pharmaceutical Chemistry, and Steven Kayser, PharmD, and Peter Koo, PharmD, both in the Department of Clinical Pharmacy, officially retired. There is not enough room in a dozen Dean's Updates to chronicle the contributions made by these 5 talented professionals. As a group, they are the most extraordinary, dedicated, and accomplished academicians anywhere. And they are—to a person—exceptional teachers, mentors, colleagues, and friends of many of you who read my letter. I invite you to share your memories and stories with me and to check the web page as we more fully honor the contributions of these individuals.

PharmD Students

Our student pharmacists never slow down. Here are a few awards that signal their successes during the past 6 months:

Hilary Campbell, PharmD, is the California Pharmacists Association (CPhA) 2011 Student Pharmacist of the Year.

(Objective: Prepare our doctor of pharmacy students to be leaders and agents of change.)

Melissa Wheeler, MS, just began a year-long competitive fellowship offered by UCSF's Pathways to Careers in Clinical and Translational Research (PACCTR) program. She will be working in the UCSF School of Medicine Department of Pathology to test the hypothesis that by blocking a specific cytokine—CSF-1—mesothelioma tumors may become more susceptible to chemotherapy.

(Objective: Broaden our students' experiences in novel health care practice and research settings.)

Tien Ho, Lisa Lam, Hilary Campbell, PharmD, and Aimee Loucks, PharmD are the 2nd-place winners in this year's national Pharmacy and Therapeutics Competition, sponsored by the Academy of Managed Care Pharmacy (AMCP). Gina Marotto and Paul Huynh placed 2nd, and Daniel Luu and Joshua Chua placed 3rd in the Student National Pharmaceutical Association (SNPhA) Kroger Clinical Skills Competition.

(Objective: Prepare our doctor of pharmacy students to be leaders and agents of change.)

Cynthia Stephens was part of a group that received a Leveraging/Collaboration Award from the Food and Drug Administration (FDA) for their work educating physicians about the FDA's Expanded Access Rule and its public health importance.

(Objectives: Prepare our doctor of pharmacy students to be leaders and agents of change. Advance interprofessional learning.)

PhD students

Congratulations to Daniel Gray, PhD, who recently earned his PhD from the Chemistry and Chemical Biology Graduate Program. Daniel won the 2011 Julius R. and Patricia A. Krevans Distinguished Dissertation Award for the most outstanding doctoral dissertation by graduate department nominees who completed their PhDs at UCSF during the past year. Daniel's research annotated roles of particular protein-cleaving enzymes essential to the normal cellular self-destruction that fails to occur in cancers or that occurs too much in inflammation and neurodegenerative diseases. Many of you will remember that Julie Krevans is a UCSF chancellor emeritus. He and Patsy are dear friends of the School.

New appointments in support of education… and more

I recently created a new position in the Dean's Office—associate dean of teaching and learning—and appointed education researcher Tina Penick Brock, BSPharm,MS, EdD, as the first holder. Tina's charge is twofold: to promote contemporary ways of teaching that will meet the rapidly changing learning needs of our students, and to develop the School as a leader in educational research and evidence-based teaching. Tina has designed and delivered pharmacy curricula in Africa, Southeast Asia, London, and at the University of North Carolina. She earned an EdD from the University of North Carolina at Chapel Hill, and an MS in pharmaceutical sciences and undergraduate degrees in German and pharmacy from the University of Mississippi. Tina brings the teacher's passion for education, the scientist's inquiring mind, and the researcher's insistence on change based on evidence of success.

(Objectives: Promote interprofessional learning and practice. Test and apply new teaching models.)

Along with Tina's appointment, I created the new position of executive director of academic, administrative, and research technology and appointed Michael Williams, MA. Michael and Tina will work together to transform the way we deliver, evaluate, and work with other schools on our curricula. I also look to Michael to help the School meet its business and communications needs through the wisest use of information technology. Michael earned an MA in instructional systems and technology from the University of Minnesota and has had extensive experience and success in directing and developing information systems for complex units within UCSF, as well as in the public sector.

Research update

Here are just 3 examples of recent research funding awarded to School faculty members.

Kathy Giacomini, PhD, Department of Bioengineering and Therapeutic Sciences co-chair, is leading the UCSF arm of the largest and most comprehensive study to date of the interaction between prescription drugs and membrane transporters. Her work is part of a larger grant awarded to Optiva Biotechnology from the National Institute of General Medical Sciences within the National Institutes of Health (NIH). Kathy's team will profile 2,000 prescription drugs against key membrane transporters that take these drugs into liver and kidney cells. As we learn more about this journey, we will be better able to manage how these drugs are best used safely and effectively in patients.

(Objective: Discover genetic factors that affect therapeutic and adverse drug reactions.)

Vuk Uskokovic, PhD, a researcher in the Desai Lab, Department of Bioengineering and Therapeutic Sciences, received one of about 200 five-year Pathway to Independence Awards (i.e., K99/R00s) given annually by the NIH. Vuk will develop nanostructured biomaterials that have antibiotic and bone-repair properties. These "smart" biomaterials will be able to hold drugs and release them at an adjustable rate to treat osteomyelitis and other hard tissue inflammatory diseases.

(Objective: Apply nanoscience to the development of tools to diagnose and treat disease.)

Janel Long-Boyle, PharmD, PhD, Department of Clinical Pharmacy, received a contract from the NIH to develop ways to personalize the dosing of fludarabine, a potent anti-neoplastic agent with significant toxicities that is used to treat leukemias and to prepare children for bone marrow transplant. Her goal is to identify patient-specific factors that influence fludarabine drug levels in order to improve engraftment and reduce toxicity.

(Objective: Find new ways for pharmacists to help patients make the best use of medicines.)

I share here far more examples than usual of our research publications to demonstrate how our science supports our strategic plans.

In an invited commentary in the May 23, 2011 issue of Archives of Internal Medicine, Christine Cheng, PharmD, Department of Clinical Pharmacy and Joseph Guglielmo, PharmD, the department's chair, call for prioritization in prescription labels' increasingly long lists of adverse drug events (ADEs).

(Objective: Steer policy that affects health sciences research and health care.)

Kathryn Phillips, PhD, Department of Clinical Pharmacy, co-authored an analysis, published in the May 2011 joint issue of Journal of Oncology Practice and The American Journal of Managed Care, of the medical records for hundreds of breast cancer patients. The authors found that although the lowest-income women were less likely to get testing for the HER2 gene, which predicts responsiveness to trastuzumab (Herceptin), they were more likely to receive the drug. These results indicate that a key genetic test could be more consistently applied to assure that only women who are HER2-positive receive trastuzumab and that inappropriate use of this costly therapy is avoided.

(Objective: Use evidence to steer policy that affects health care.)

A study by Lisa Bero, PhD, Department of Clinical Pharmacy, and colleagues found that the Medicaid program is likely paying far more than necessary for medications and not offering patients the most effective ones available. The study, posted online June 16, 2011 in American Journal of Public Health, compared the Medicaid program's Preferred Drug Lists in 40 states against the World Health Organization's 2009 Essential Medicines List.

(Objective: Advance our understanding of health care decision making.)

A study in Annals of Emergency Medicine, August 2011, co-authored by Steven Kayser, PharmD, and Cathi Dennehy, PharmD, Department of Clinical Pharmacy, and research colleagues, found that improvements could be made in the management of patients taking the anticoagulant drug warfarin who are seen in and discharged from the emergency department (ED). Almost half of those tested did not have therapeutic blood clotting ratios, and this was largely unaddressed. Furthermore, recommendations for anti-coagulation follow-up were documented for only one in 5 patients. Drugs that had the potential to interact with warfarin were administered in the ED or prescribed in some cases as well. The authors make recommendations to minimize adverse drug events that could arise from these observations.

(Objectives: Minimize medication errors and adverse events. Steer policy that affects health sciences research and health care.)

Patrick Finley, PharmD, Department of Clinical Pharmacy, was the lead author of a study examining the economic impact of a pharmacist-managed depression program in Asheville, North Carolina. In collaboration with the American Pharmacists Association Foundation, Patrick and research colleagues established an employer-sponsored depression clinic, enrolling 151 patients during the 2-year study period. More than 80% of the subjects remained in the program for a full year, and the economic analysis revealed a savings in overall medical costs of about $500 per subject annually. Full results were published in Journal of the American Pharmacists Association, January/February 2011.

(Objective: Design and validate pharmacy practice models that improve patient health.)

Esteban González Burchard, MD, MPH, Department of Bioengineering and Therapeutic Sciences, and colleagues at Stanford, published a commentary in the July 14, 2011 issue of Nature, stressing the need to increase the diversity of the populations involved in studies that associate genes with disease risk and, potentially, drug response. 96% of the subjects in such studies conducted so far have been people of European descent, and the findings do not necessarily apply to the rest of the world's population. On August 22, 2011, Esteban and colleagues published a study in the online edition of Pediatrics examining the association between smoking and asthma. Children born to mothers who smoked while pregnant developed a more severe form of asthma 8 years after their birth. Because fetal tobacco smoke exposure was so significant, the authors suggested a way to improve health outcomes through targeted smoking cessation during pregnancy.

(Objectives: Make the promise of personalized medicine a reality. Steer policy affecting health care.)

Researchers at the National Bio-Organic Biomedical Mass Spectrometry Resource Center revealed how the addition of certain simple sugars (N-acetylglucosamines) to specific amino acids (serines, threonines) in the proteins of mouse embryonic stem cells are crucial to embryo development. In a study published on June 7, 2011, in Proceedings of the National Academy of Sciences, center director and Department of Pharmaceutical Chemistry faculty member Al Burlingame, PhD, and UCSF colleagues, identified specific locations on dozens of proteins in stem cell nuclei that are modified and regulated by addition of the sugars. Some of those proteins are so-called transcription factors that are vital to the cells' maintenance and self-renewal.

(Objective: Use sophisticated physical methods to reveal normal biological, as well as pathological, processes at the detailed molecular level.)

James Wells, PhD, has been probing allosteric sites on enzymes as potential drug targets. Though less prominent than the traditional active sites, these can nonetheless affect enzyme reactions. Jim and his colleagues used a site-directed chemistry technique he developed called disulfide trapping, or tethering, to do this work. Target enzymes and small molecule fragments were engineered to enhance binding at an allosteric site on a protein kinase, PDK-1, which is a target for potential cancer treatments. The research, published in Proceedings of the National Academy of Science, March 23, 2011, remarkably identified some compounds that could activate and others that could inhibit the enzyme from the same site. Matt Jacobson, PhD, also in the Department of Pharmaceutical Chemistry, was one of several collaborators with Jim.

(Objective: Use sophisticated chemical methods to reveal normal biological, as well as pathological, processes at the detailed molecular level.)

Research in the laboratory of Danica Galonić Fujimori, PhD, whom I profiled earlier, explored how an enzyme that confers antibiotic resistance in dangerous bacteria performs its task. Danica uncovered a unique process that could lead to selective ways to target this mode of resistance. Her paper was first published in Proceedings of the National Academy of Sciences on February 22, 2011.

(Objective: Use sophisticated physical methods to reveal normal biological, as well as pathological, processes at the detailed molecular level.)

Adam Renslo, PhD, Department of Pharmaceutical Chemistry, Small Molecule Discovery Center, collaborated with Nobel laureate Stanley Prusiner, MD, and colleagues at UC's Institute for Neurodegenerative Diseases, to chemically optimize the structure of a class of small molecules called aminothiazoles, which they discovered as potential drug leads for treating prion diseases (e.g., Creutzfeldt-Jakob disease in humans and Bovine Spongiform Encephalopathy in animals). Specifically, they modified the aminothiazole molecules so that they would better cross the blood-brain barrier. In findings published in Journal of Medicinal Chemistry, October 1, 2010, and featured in The Economist, March 3, 2011, Adam and research colleagues showed that in mice, oral administration of the improved molecules produced brain concentrations far higher than those needed for anti-prion activity in in vitro neuron cultures. Indeed, preliminary results suggest that the best of the aminothiazole molecules are effective at extending the lives of prion-infected mice.

(Objective: Develop small molecules that can probe biological processes and serve as therapeutic agents.)

Marie and Claire retire

Our senior director of development and alumni affairs, Marie Parfitt Pattie, retired at the end of June after 11 years with the School. Marie helped us secure 2 chairs, 2 professorships, at least 8 endowments that support students and faculty members, and many important estate gifts. And thanks to Marie, our alumni involvement is vibrant. With us still, since 2010, is Melanie Derynck, our terrific director of alumni relations, who works under the senior director.

Retired as well is the exceptional Claire Lee, a 23-year UCSF employee, who served as the astute education manager in our Department of Clinical Pharmacy. Claire practiced daily the art of transforming challenges into opportunities and reminding us all of the importance of the human stories behind all of those with whom we work, especially our students. For her contributions she was awarded the 2011 Chancellor's Award for Exceptional University Service.

Budget

Expiration of the increases in sales, income, and vehicle taxes put in place by former California Governor Arnold Schwarzenegger resulted in an additional $150 million cut in state funds from the state legislature for the University of California (UC) system in June 2011. This, coupled with an earlier cut of $500 million, brings UC's 2011-2012 fiscal year total cut in state funds to $650 million. In response, the UC Board of Regents raised the general education fee for undergraduate and graduate students by 9.6% beginning this fall term. This fee increase will not fully offset this 2nd round of cuts to the UCSF campus of about $3 million dollars. The School of Pharmacy's share of this shortfall has not yet been determined, but it will add to the $1.16 million dollar shortfall we face this year—from decreased state funds coupled with mandated faculty salary merit increases, mandated increases in employee health care benefits, and mandated increases in the campus' share of contributions to the employee retirement plan.

As you have read above, we are moving ahead aggressively in spite of these serious financial blows. At the same time, we are focusing on doing our work more efficiently, securing new revenue streams, and developing collaborations with government, business, and industry. This is a time of great potential for the UCSF School of Pharmacy, and we are pressing ahead at full speed.

Extraordinary Leadership

As we face state budget cuts, we are inspired by the financial support of UCSF Chancellor Susan Desmond-Hellmann, MD, MPH, and her husband Nicholas Hellmann, MD, who have launched UCSF's first comprehensive fundraising effort in support of education. They personally pledged a total of $1 million to UCSF to form a Chancellor's Endowed Scholarship Fund. The fund challenges each school to match up to $250,000 with a single gift. What a tremendous, selfless gesture this is! Lisa Rodondi, PharmD, and Kevin Rodondi, PharmD, our alumni from the classes of 1984 and 1985 respectively, met this challenge for our School with a $250,000 gift, which establishes a $500,000 endowed scholarship fund for student pharmacists, with a preference for students demonstrating leadership and a commitment to public service. I profiled Kevin earlier in this Update. Lisa completed a general residency and a research fellowship in infectious diseases at UCSF. During her pharmacy career, she developed innovative programs to improve the appropriate clinical use and cost management of antibiotics that served as regional models for other institutions. Her research has been published in The American Journal of Medicine, Antimicrobial Agents and Chemo-therapy, and Clinical Pharmacology & Therapeutics. Her current focus is international philanthropy using art and education to empower women. She is a board member of the Carr Educational Foundation, which provides secondary education for impoverished girls in Kenya through its Daraja Academy.

Campus and Medical Center

As I mentioned in my last Update, our chancellor has instituted a campus-wide program named Operational Excellence to improve the efficiency and effectiveness with which we work. The roll-out is beginning. I am deeply involved with Operational Excellence and vested in its success as well as the success of an important plan to assess and reshape the current UCSF business model. I should have more to report on this topic in my next Update.

The UCSF Clinical and Translational Science Institute (CTSI) is one of 10 institutes, within a national network of 60, to receive renewed funding from the National Institutes of Health. In fact, the $112 million CTSI grant was the largest renewal among peer institutes.

David Vlahov, PhD, RN, is our new dean of the School of Nursing, and I have found him to be a creative colleague and fast friend. David's passion is urban health. While in New York, he worked with community pharmacists to address health issues for the underserved. We are already beginning to think together about ways pharmacists and nurses can better partner to provide more accessible and effective care. David's expertise encompasses epidemiology, infectious diseases, substance abuse, and mental health. His most recent position was at the New York Academy of Medicine, where he was senior vice president of research and director of the Center for Urban Epidemiologic Studies. David is a welcome addition to the UCSF leadership team.

Keith Yamamoto, PhD, is our new vice chancellor for research. Keith is a seasoned and savvy science leader and a national voice in the shaping of science policy. His charge is to drive our research agenda into a new era of discovery that fully integrates the computational, biological, and physical sciences. Keith has been a close professional colleague for years, and I know that under his wise leadership new doors will open for UCSF research.

On the UCSF Medical Center front, U.S. News and World Report this summer named the Medical Center the 7th best hospital in the country.

Whew! I am always astonished at how much occurs in the School and at UCSF in just 6 short months, and how much I am forced to edit down what I share to keep this letter a reasonable length. We have been busy! As always, I look forward to your feedback. Until I write again, be sure to look for news and more details related to this Update on our website. Sign up as a friend on our School of Pharmacy facebook page, and watch our YouTube channel.

With warm regards until I write again,

signature

Mary Anne Koda-Kimble, PharmD
Professor and Dean
Thomas J. Long Chair in Community Pharmacy Practice

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About the School: The UCSF School of Pharmacy aims to solve the most pressing health care problems and strives to ensure that each patient receives the safest, most effective treatments. Our discoveries seed the development of novel therapies, and our researchers consistently lead the nation in NIH funding. The School’s doctor of pharmacy (PharmD) degree program, with its unique emphasis on scientific thinking, prepares students to be critical thinkers and leaders in their field.