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Update from the Dean - Fall/Winter 2014
Dear UCSF School of Pharmacy Family and Friends:
These past months have seen remarkable progress, accomplishment—and change.
Our strategic planning process, launched at a Schoolwide retreat last January, is well under way. The three main themes of research, education, and patient care align well with our broader mission. We have developed and vetted goals with the faculty and are developing objectives to guide our work for the next five years. Once these objectives are in place, I will share the draft document again with the faculty and with our alumni, students, campus, and other partners, for their important input.
This past June the School was ranked number one in NIH funding, with more than $32 million in support, and number one in overall grant funding, which includes NIH and other sources totaling more than $46 million. A snapshot of our current science follows.
Recently received research funding
Using systems pharmacology computer models to improve treatment of TB
Rada Savic, PhD, Department of Bioengineering and Therapeutic Sciences, received a three-year, $1.4 million grant from the Bill and Melinda Gates Foundation to build computer models to speed the development of more effective antitubercular therapy. Tuberculosis (TB) claimed 1.3 million lives in 2012 and is second only to HIV as an infectious killer of adults worldwide. Current treatment is long term and is associated with an increase in multidrug-resistant strains. Using a systems biology/pharmacology approach, Rada and her interdisciplinary team will create computer models that integrate molecular-level analyses of disease progression and persistence, immune response, pharmacokinetics (absorption, distribution, metabolism, excretion), and associated antibacterial actions (pharmacodynamics). The goal is to more efficiently determine if new treatments will be more effective against drug-resistant TB.
Determining how human gut bacteria modulate immune responses
Michael Fischbach, PhD, Department of Bioengineering and Therapeutic Sciences, received a five-year, $500,000 grant from the Burroughs Wellcome Fund “Pathogenesis of Infectious Disease” program. Michael studies molecules synthesized by bacteria that commonly live in the human body, particularly in the gastrointestinal tract. The grant will fund his research specific to certain molecules—discovered by his laboratory—that may play a role in modulating the body’s immune response. The goals are to identify the bacterial genes that express these “druggable” molecules and the mechanisms by which they modulate the innate and adaptive immune response. An important potential outcome would be the discovery of new immunoregulatory drugs for the treatment of a number of disorders.
Imagenomics—monitoring, mapping genome activity via microscopy
Bo Huang, PhD, Department of Pharmaceutical Chemistry, received a $1 million grant over four years from the W. M. Keck Foundation to develop “imagenomics,” in which fluorescence microscopy monitors the impact of modifications of the genome. While our genetic sequences are fixed, gene activity is not; this activity is regulated by genome interactions with proteins, RNA, and other chemical changes. Bo is leading a team whose goal is to map these dynamic changes, altering gene function (epigenetics) in real time. A future goal is the development of live animal imagenomics, starting with C. elegans, the well-studied transparent nematode.
Recent faculty publications
Detecting potential biomarkers of chemotherapy efficacy
James Wells, PhD, chair of the Department of Pharmaceutical Chemistry, is senior author of a May paper in the Proceedings of the National Academy of Sciences that examines a technology to rapidly determine whether a cancer therapy is effective. Many chemotherapies induce cancer cell apoptosis—programmed self-destruction by which cells enzymatically cleave proteins into peptides, which are then released with the cell’s implosion. Jim’s lab efficiently sorts out these peptides via mass spectrometry. The team identified 153 such apoptotic peptides in plasma taken from patients within 24 hours of receiving chemotherapy. Potential impact: These peptides could be biomarkers that may be used to immediately determine whether a therapy is working for a particular patient.
Discovering genetic variations in diabetes drug response
Kathy Giacomini, PhD, and Rada Savic, PhD, both in the Department of Bioengineering and Therapeutic Sciences, are co-authors of a June paper in Clinical Pharmacology & Therapeutics that evaluates why certain patients with type 2 diabetes do not respond to metformin, the first-line therapy for this disease. Previous studies revealed variations in genes expressing specific transporters—proteins in cell membranes controlling the entry and exit of drugs—to explain the variations in metformin response. But this genetic variation accounted for only a small fraction of the differences in patients’ drug response. In the new study the team went upstream, probing variations in genes expressing transcription factors—proteins that activate or suppress genes—that, in turn, modulate multiple genes expressing whole systems of metformin-relevant transporters. The researchers correlated patient genomes with metformin response (blood sugar levels via HbA1c) and renal clearance of the drug from the body. Kathy and Rada discovered genetic variants in specific transcription factors that significantly alter drug response and/or clearance. Potential impact: Pharmacogenetic testing could lead to personalized metformin therapy and improved outcomes for people with type 2 diabetes.
Injecting microstructures to reduce scar tissue after heart attacks
Tejal Desai, PhD, chair of the Department of Bioengineering and Therapeutic Sciences and senior author of a July paper in Biomaterials, evaluated the injection of microstructures into myocardial infarction sites, with a goal of reducing debilitating scar tissue following heart attacks. These microstructures are made of hundreds of thousands of polymer rods or cubes, each measuring only thousandths of millimeters. Stabilization of the infarction site microenvironment with appropriately rigid structures may reduce the mechanical stress on fibroblast repair cells, resulting in a reduction in function-inhibiting scarring. Administration of single injections of the microstructures at cardiac infarction sites in rodents reduced the generation of proteins that sense such mechanical stress and control the fibrotic injury response. More than six weeks of follow up revealed stability of cardiac function (ejection fraction) in these animals. Potential impact: Injection of microstructures could provide a cost-effective, minimally invasive therapy to reduce chronic complications associated with heart attack.
Daniel Wandres, PharmD, chief pharmacy officer for UCSF Medical Center, associate dean of the School of Pharmacy, and vice chair of the School’s Department of Clinical Pharmacy, coined the phrase “OneUCSF Pharmacy.” The term means that our Department of Clinical Pharmacy and the Medical Center’s Department of Pharmaceutical Services are critically necessary and committed partners in meeting the goal of safe, effective, and appropriate medication use in the Medical Center. Toward that end, we share day-to-day responsibilities and are developing several pilot projects. We look forward to creating deep synergies that will be unique among academic medical centers in the United States.
As an example of the “OneUCSF Pharmacy” approach, Bret Brodowy, PharmD, director of the School’s Medication Outcomes Center, and his team of Candy Tsourounis, PharmD, and Sheri VanOsdol, PharmD, led a comprehensive formulary review for UCSF Medical Center. Interdisciplinary panels were guided by principles of national best practices, safety (warnings, alerts, REMS), and effectiveness (therapeutic benefit, potential for therapeutic interchange). These panels included pharmacists from both the Medical Center and the School of Pharmacy. The Medication Outcomes Center team has also initiated monthly teleconferences with its pharmacy counterparts at other UC medical centers with the goal of sharing formulary information and improving efficiencies.
In my last Update, I mentioned the UCSF MedList Clinic as a program in the new Walgreens at UCSF, which opened on the Parnassus campus. (See "A MedList Clinic: perspectives of a pharmacist and a student pharmacist.")
Department of Clinical Pharmacy faculty members are implementing, as part of the clinic, a pilot project for discharged patients. Patients receive a comprehensive review of their medications to help ensure that they take the right medications the right way. In delivering these services, our faculty members integrate information from hospital electronic medical records, community pharmacy systems, third-party data, and patient interviews. The goal of the project is the management of accurate, therapeutically appropriate medication lists and patient engagement in medication management during the transition from hospital to home. Marilyn Stebbins, PharmD, is spearheading the clinic with faculty colleagues Jennifer Cocohoba, PharmD; Lisa Kroon, PharmD; Kirby Lee, PharmD, MAS; Kevin Rodondi, PharmD; and Sharon L. Youmans, PharmD, MPH.
Marilyn Stebbins, PharmD and Kirby Lee, PharmD, MAS, are partnering with the UCSF Medical Center nursing discharge team using an automated telephone system to identify medication-related issues in recently discharged patients. Preliminary data reveal that medication-related issues comprise a large portion of discharge problems. These issues include patients who did not start or pick up their medications, among other medication-related problems. The most complex drug-related problems are triaged to Marilyn and Kirby for resolution.
Lisa Kroon, PharmD; Robin Corelli, PharmD; Marilyn Stebbins, PharmD; Kevin Rodondi, PharmD, and Jennifer Cocohoba, PharmD, continue to lead the School’s SB 493 implementation efforts. The California Board of Pharmacy has convened an SB 493 Implementation Committee, which held its second meeting on August 6, and our faculty members are intimately involved. You will recall that California Senate Bill 493 expands the scope of practice of California pharmacists and, with additional certification, provides for the designation of an Advanced Practice Pharmacist.
While the School’s Doctor of Pharmacy (PharmD) curriculum is superb, we must always be ready for change. Today’s health care environment is intensely dynamic, and our curriculum must be equally, if not more, dynamic.
In June, we gathered formally to consider the future of the profession and the knowledge and skills our graduates will need to remain professional leaders. (See "Retreat kicks off major transformation of School curriculum.") An outstanding panel—Jim Buchanan, PharmD, BioSoteria, Inc.; Anna Chang, MD, UCSF School of Medicine; John Flaherty, PharmD, Gilead Sciences; Rita Jew, PharmD, UCSF Medical Center; and Parisa Vatanka, PharmD, Safeway, Inc.—shared its perspectives.
Under the direction of Vice Dean Sharon L. Youmans, PharmD, MPH, the School is beginning a transformation of the PharmD curriculum. It will be highly interdisciplinary and will focus on problem solving and the development of early student pharmacist responsibility for the care of patients. I will have more specifics regarding curricular reform in future Updates.
The Kidney Project in Washington, DC
Shuvo Roy, PhD, Department of Bioengineering and Therapeutic Sciences, presented on Capitol Hill in May to a meeting co-sponsored by the Congressional Kidney Caucus and attended by more than 100 members of Congress and advocates. His presentation, Innovations in Kidney Research: New Hope for Patients, with collaborator William Fissel, MD, of Vanderbilt University, summarized their progress toward the development of an implantable bioartificial kidney. (See The Kidney Project.)
The project is now in Phase II of development, in which philanthropic support is essential. Proof of concept must be demonstrated in animals to facilitate venture capital and other grant funding toward ultimate approval. I recently learned that Medicare spends almost $35 billion every year to treat patients with chronic kidney failure; this cost burden is greater than the entire annual National Institutes of Health budget of nearly $30 billion. An effective, implantable bioartificial kidney would not only help patients, but also potentially lower our national health care expenditure on chronic kidney disease treatment.
New UCSF-Stanford Center of Excellence in Regulatory Science and Innovation
We recently launched a new joint center with Stanford University and the U.S. Food and Drug Administration (FDA) aimed at spurring innovation in the development, standardization, and evaluation of safer and more effective medical products. (See "FDA launches UCSF-Stanford center for innovation in drug development, regulation.") The UCSF-Stanford Center of Excellence in Regulatory Science and Innovation (UCSF-Stanford CERSI) is funded by an FDA grant of $3.3 million for three years.
The two universities and the FDA—together with foundations and commercial entities interested in the development of FDA-approved medical products—will work collaboratively on projects that promote regulatory science, including innovative research, education, and scientific exchange.
The center’s aims include:
- Improving the safety and efficacy of drug and medical device testing performed prior to human trials (preclinical)
- Improving the process of conducting clinical trials and evaluations
- Harnessing the power of computational and bioinformatics approaches (known as quantitative pharmacology) to understand “big data” and to accelerate and improve the development of new medical products
Kathy Giacomini, PhD, former chair of the Department of Bioengineering and Therapeutic Sciences, is leading the UCSF-Stanford CERSI with colleague Russ Altman, MD, PhD, at Stanford University.
Jennifer Cocohoba, PharmD, Department of Clinical Pharmacy, was selected as an American Association of Colleges of Pharmacy Academic Research Fellow for 2014–2015. As part of her fellowship, Jen will develop an intensive grant-writing clinic to guide early-career Department of Clinical Pharmacy investigators with potentially fundable research ideas.
Deanna Kroetz, PhD, Department of Bioengineering and Therapeutic Sciences, was honored with the 2014 Judith Pool Award from the Northern California Association for Women in Science. The award recognizes a senior scientist for both scientific achievement and support of other women in science.
Student pharmacist Isabel Fong, Class of 2017, received the San Francisco Bay Area Albert Schweitzer Fellowship for 2014–2015. In partnership with the LifeLong Medical Care’s Over 60 Health Center in Berkeley, Isabel will be working to improve medication adherence for low-income seniors during the time they transition their care from hospitals to the Health Center.
Our business-minded student pharmacist team was named one of three finalist teams in the 2014 National Community Pharmacists Association (NCPA) Student Business Plan Competition. The competition involves the creation of a business plan for opening a community pharmacy. Team members are Jay Barcelon, Class of 2017; Chris Shahrooz-Foo, Class of 2017; Nancy Wong, Class of 2016; and Mariko Yokokura, Class of 2016. Their dedicated chapter advisor is Brian Komoto, PharmD, '81. The team is preparing for the final competition on October 18, 2014, at NCPA's Annual Convention in Austin, Texas.
Student pharmacist Nadya Hristeva, Class of 2015, received an American Foundation for Pharmaceutical Education Gateway to Research Scholarship for a research project exploring the effects of single-dose rifampin on the pharmacokinetics of rosuvastatin. Nadya is working with Leslie Benet, PhD, Department of Bioengineering and Therapeutic Sciences.
Doctor of Pharmacy alumnus and past UCSF School of Pharmacy Bowl of Hygeia winner, Pamela (Salas) Schweitzer, PharmD ’87, was promoted to rear admiral and chief pharmacist officer for the United States Public Health Service. Pam previously served with distinction in the Indian Health Service, Veterans Administration, and Centers for Medicare and Medicaid Services.
Robert Ignoffo, PharmD ’71, is the California Society of Health-System Pharmacists (CSHP) 2014 Pharmacist of the Year. The award is one of the highest honors bestowed by CSHP and will be presented to Bob this fall at the CSHP Seminar in San Francisco. Bob is an emeritus professor, Department of Clinical Pharmacy, a pharmacy specialist in oncology, an author of oncology texts and research publications, and an active and highly respected member of the professional community.
Congratulations to all for their accomplishments.
New faculty members
Bani Tamraz, PharmD ’03, PhD ’11, an expert in pharmacogenomics, joins the Department of Clinical Pharmacy. Collaborating across campus, Bani will be investigating the application of pharmacogenomics data to practical decision making for medication therapies. His expertise fits well with the department’s strategic objective to accelerate the use of precision medicine to improve outcomes and reduce the adverse effects of medication. He earned a PharmD and completed a pharmacy practice residency at UCSF. He also earned a PhD at UCSF in Pharmaceutical Sciences and Pharmacogenomics, working in the Institute for Human Genetics. In just two months, Bani has already been awarded a Center for AIDS Research grant to address the application of pharmacogenomics to the problem of treatment failure with the antiretroviral drug darunavir.
Michael Grabe, PhD, joins our Department of Pharmaceutical Chemistry and the Cardiovascular Research Institute at UCSF. Michael earned a PhD in physics at UC Berkeley and was a postdoctoral fellow at UCSF, working at the Howard Hughes Medical Institute. Prior to his return to San Francisco, he was an associate professor at the University of Pittsburgh. The Grabe Lab uses computational methods to understand biological phenomena, focusing on ion transport across cellular membranes.
Michael Keiser, PhD, joins our Department of Pharmaceutical Chemistry and the Institute for Neurodegenerative Diseases and is already an active member of the systems pharmacology community at UCSF. An alumnus of our PhD program pathway in Bioinformatics, he pioneered the Similarity Ensemble Approach (SEA), a computational method for large-scale, automated prediction of interactions between small molecules, which can be used to predict possible drug side effects and new therapeutic opportunities. Michael describes his group’s research this way: “Thinking of each target as a musical note, we predict and test entire chords at a time via experiments in models of complex diseases such as neurodegeneration.”
Lani Wu, PhD, and Steven Altschuler, PhD, join the Department of Pharmaceutical Chemistry. They each earned a PhD in mathematics from UC San Diego, and they combine their backgrounds in mathematics, biology, and engineering in their study of cell polarity and signaling heterogeneity in cancer and metabolism. Prior to arriving at UCSF, these investigators operated their joint research lab at UT Southwestern. Both Lani and Steven have also worked at the Bauer Center for Genomics Research at Harvard University, Rosetta Informatics, the Research Division at Microsoft, and Princeton University. The Altschuler and Wu Lab investigates mechanisms of drug resistance, cancer evolution, and new therapeutic strategies.
New department chair
I am pleased to announce that Tejal Desai, PhD, professor and bioengineer, is the new chair of the Department of Bioengineering and Therapeutic Sciences (BTS), effective August 1, 2014. Tejal brings tremendous experience in academic leadership, research, and teaching to the position. She joined UCSF in 2005 after serving on the bioengineering faculty at the University of Illinois at Chicago, where she was instrumental in developing new approaches to bioengineering education. In her next position, as a biomedical engineering faculty member at Boston University, she served as the associate director of the Center for Nanoscience and Nanobiotechnology. She has served as chair of the UCSF/UC Berkeley Joint Graduate Group in Bioengineering and as UCSF director of the UCSF/UC Berkeley Master of Translational Medicine program.
Tejal’s research focuses on the application of microscale and nanoscale technologies to create new and improved ways to deliver medicines to target sites in the body and to enable the body to heal itself. As chair, Tejal plans to ensure the continued growth of the department, particularly at the interface of bioengineering and drug delivery.
We thank past Chair Kathy Giacomini, PhD, and previous Co-chair Sarah Nelson, PhD, for their dedication in launching and advancing this unique department, which was formed in 2009 as a joint department within the Schools of Pharmacy and Medicine.
School of Pharmacy history
Preservation of our history
As you know by now, this year marks the 150th anniversary of the beginnings of UCSF. In close collaboration with UCSF Archivist Polina Ilieva, PhD, I have made it a priority this year to ensure our rich School history is preserved.
Following the recently completed oral history of Robert Day, PharmD, will be an oral history of Leslie Benet, PhD, and a present-day video interview with E. Leong Way, PhD (our first PhD alumnus). The video will complement a previous history of Eddie conducted many years ago.
We recently uncovered a rich trove of historical records and images in deep storage that were slated to be destroyed. UCSF Archives will process and catalogue the materials and store them safely in the library. A selection of the photos will be available for online viewing.
Sincere thanks to all alumni who have come forward this year to donate to UCSF Archives.
Words from Dean Schmidt
I recently enjoyed a visit with Alfred Schmidt. Al is the son of Carl Schmidt, PhD, our dean from 1937 to 1944. Dean Schmidt elevated the pharmacy curriculum through the recruitment of world-class scientists and the introduction of strong basic science courses. He also recruited Troy C. Daniels, with whom he worked closely to transform the pharmacy curriculum, and who would later become dean. During our visit, Al shared some of Dean Schmidt’s materials; I came across the following quote:
In unity there is strength. This old axiom again finds support in the developments that have taken place on the Medical Center campus of the University. The days of splendid isolation of each of the activities have been relegated to the past. Instead, we now have cooperation in the use of teaching facilities, mutual aid in the solving of research problems—most of which do not take cognizance of artificially created academic boundaries—and the unity of purpose of student activities…. Singly, no one person could have done what cooperative effort has achieved.
These words resonate with me as descriptive of UCSF today.
I am pleased to share the news, effective July 17, 2014, that Sam Hawgood, MBBS, is our new chancellor, succeeding Susan Desmond-Hellmann, MD, MPH. Since joining UCSF in 1982, Sam has served as chief of the Division of Neonatology, then as chair of the Department of Pediatrics and physician-in-chief of the UCSF Benioff Children’s Hospital, before becoming dean of the School of Medicine. He has maintained his own neonatology research lab since 1984. Sam earned his degree in medicine and surgery from the University of Queensland in Brisbane, Australia. Beyond his skill as a physician, researcher, and administrator, Sam has a deep commitment to the success of UCSF as a whole, which will surely guide his tenure as chancellor.
As always, stay tuned.
B. Joseph Guglielmo, PharmD
Troy C. Daniels Distinguished Professor of Pharmaceutical Sciences
UCSF School of Pharmacy
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.