Of Note

Winter 2019

Anantha Shekhar (Photo courtesy Indiana University)

Shekhar Named Dean and Senior Vice Chancellor

Anantha Shekhar, an MD/PhD, nationally recognized educator, researcher, and entrepreneur who has made major contributions in medicine and life sciences, has been named senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of the School of Medicine at the University of Pittsburgh. His start date is set for June 2020.

Shekhar joins Pitt from Indiana University (IU), the nation’s largest medical school, where he holds a number of leadership roles. These are: executive associate dean for research affairs, distinguished professor, associate vice president for university clinical affairs and research, executive vice president of academic affairs for clinical research at IU Health, and founding director of the Indiana Clinical and Translational Sciences Institute, the only statewide institute of its kind.

“This is a critical hire for the University of Pittsburgh,” says Chancellor Patrick Gallagher. “Anantha’s capacity to envision solutions, galvanize partnerships, and produce results is second to none, and his record of propelling both people and institutions to success is unparalleled. I could not be more excited to welcome Anantha into our community.”

Shekhar has received continuous funding from the National Institutes of Health for basic, clinical, and translational research since 1989. He is known for sweeping and robust collaborations across the private, public, and philanthropic sectors.

Among his many professional accomplishments:

  • Growing the IU School of Medicine’s research funding from the National Institutes of Health by 73 percent since 2015.
  •  Leading the Precision Health Initiative—a major strategic investment at IU with more than $140 million in clusters such as genomic medicine and big data sciences. This initiative resulted in an estimated economic impact of nearly $200 million in just four years, the hiring of more than 126 scientists, as well as the creation of four companies and recruitment of another to Indiana.
  • Cofounding or leading five biotech companies, including Anagin, a startup company that is developing treatments for post-traumatic stress disorder, traumatic brain injury, neuropathic pain, depression, Parkinson’s disease, and Alzheimer’s disease.
  • Demonstrating a novel mechanism of action—the first in more than 70 years—that is being developed as a new approach to treating schizophrenia.
  • Forming two commercial incubators within the Indiana Clinical and Translational Sciences Institute—one for therapeutics and another for medical devices—that currently host more than 15 companies in various stages of commercialization.
  • Directing a laboratory that has developed highly regarded translational models for panic and related anxiety disorders that resulted in patents for novel therapies and the discovery of new treatments.  

Pitt Provost and Senior Vice Chancellor Ann E. Cudd, PhD, who chaired the search committee, notes: “Anantha’s exceptional and deep experience in basic research leading to novel, patentable therapeutics and in directing large, multi-institutional research initiatives, as well as being an award-winning teacher, will provide transformative contributions to our efforts going forward.”

“I am honored and inspired to be joining one of the most respected medical and research communities in the world,” Shekhar says.

“Building on the University of Pittsburgh’s exceptional record of health sciences education, innovation, clinical excellence, and research preeminence is my top priority, and I look forward to advancing this goal in partnership with UPMC, for the greater good of society, in the months to come.”

Shekhar will succeed Arthur S. Levine, an MD, who announced in January 2019 his intention to transition to a new research role within the University. (For more on his legacy here, see "The Man Behind the Momentum.")   —University Communications Announcement

Photo by Wikimedia Commons

Far Out

Screenwriter Geoffrey S. Fletcher once said, “I don’t have to go into outer space to write about an astronaut.” And Pitt docs don’t have to leave campus to assist with experiments in space. The McGowan Institute for Regenerative Medicine recently teamed up with the International Space Station U.S. National Laboratory. The collaboration will focus on microgravity life sciences research. What’s that? These folks will be doing out-there experiments like seeing if microgravity could allow 3-D printers to create complex tissue structures that are difficult to achieve under terrestrial conditions. Pitt people will develop Earth-based facilities to advance research and meet with partners; they’ll also coordinate with the ISS Lab on opportunities at the orbiting laboratory.   —Gavin Jenkins




Jared Magnani (Photo by Aimee Obidzinski/University of Pittsburgh)

Overheard: On A-fib Literacy

Talking to a mechanic about transmissions can be frustrating if only one of you knows about cars. A lot of patients probably feel the same way when it comes to discussing chronic health conditions with their doctors.
The University of Pittsburgh’s Jared Magnani, cardiologist and associate professor of medicine, wants patients with atrial fibrillation to become experts in their own care. Magnani, in collaboration with Tim Bickmore, a computer scientist at Northeastern University, is behind a pilot program that places smartphones with a mobile health app in the hands of Afib patients in rural Western Pennsylvania. The typical treatment for Afib, a heart rhythm disorder that can lead to blood clots, stroke, and heart failure, requires patients to adhere to a complex, long-term therapy to reset the rhythm and rate of blood flow. This includes tracking and reporting their symptoms, which can prove difficult for a first-year medical student, let alone a patient who is not health literate. The yet-unnamed app was designed as an intervention to coach patients on how to address the daily challenges of their disease. Study participants use the app to assess their symptoms, track their medicine intake, gauge their stress levels, and even record their own heart rhythm, thus returning some agency to the patient. 
How did you end up pursuing this project?
As a cardiologist, I treat a lot of patients who experience chronic disease, and I find that there are tremendous obstacles toward their self care and their understanding of the disease. There are large barriers in terms of health literacy, as well as social limitations such as income, education, and transportation that impact how patients navigate health care. My aim is not to modify clinical care but to give something to the patient. The patient experience of atrial fibrillation is difficult because of its uncertain course. A patient could have a stroke at any time. Our goal for the patients enrolled in our program is to feel enfranchised so that they may deal better with us, so we can treat them better. 
What can go wrong in the doctor-patient relationship when the patient isn’t health literate?
At an appointment, a patient can hear a lot of gobbledygook—a lot of stuff said at them. We [doctors] do a poor job of listening, and we don’t have a way of addressing the social determinants that will impact a patient’s ability to adhere to health care. And, we don’t have a way of addressing the anxiety, frustration, and depression that accompany chronic disease. 
How does an empowered, health literate patient act?
That person is able to challenge their physician, ask questions, and clarify answers. I like that there is a platform included [in the app] that’s about how to prepare for a doctor’s visit. Users make a list by answering question prompts, and then review the list before the appointment.   —Nichole Faina


Class of 2023 Cheat Sheet

These incoming Pitt Med students have the kinds of backstories that reinforce one of our favorite topics: There is no one path to medical school.  
Marc Peretti was exposed to the rigors of medical school long before he arrived at Pitt Med this fall. After graduating from Princeton University with degrees in mechanical and aerospace engineering, he followed his future wife—Allison Serra, assistant professor of obstetrics, gynecology, and reproductive sciences—to North Carolina, where she attended medical school. Peretti became a stay-at-home dad when the couple had their second child during Serra’s residency at the University of California, Irvine. The Peretti-Serras moved to Pittsburgh when Serra landed a fellowship at UPMC Magee-Womens Hospital. Peretti gradually became interested in pursuing a career in medicine, and once their children entered school, he decided to apply to Pitt Med. 
After dropping out of high school, Solomon Johnson worked a series of odd jobs—landscaper, dishwasher, stereo repairperson. Eventually, he landed a job as a busboy and bartender at a nightclub in New York. The nighttime hours gave Johnson time during the day to complete his GED and undergraduate degree at SUNY, Purchase. One day, Johnson read an article about a high school dropout who ended up attending the Geisel School of Medicine at Dartmouth, and he thought: I could do that. With support from a mentoring program, Johnson was able to gain valuable experience shadowing health care professionals before applying to Pitt Med. 
A few weeks before 9/11, David Wilson entered the United States Military Academy at West Point. After commissioning as an officer, he completed two tours each in Iraq and Afghanistan. Later, he completed a program that included a master’s in policy management at Georgetown University and service in the Pentagon. Though he found the work rewarding, he also craved change. He’s now enrolled in the army’s Health Professions Scholarship Program and will return to military service upon graduation from Pitt Med.   
Jasmine Hect was a first-generation college student at Wayne State University. When a friend mentioned a lab researching brain development of babies, Hect’s curiosity was sparked. She fell in love with the work and stayed after graduation to become the lab manager. Her mentors encouraged her to apply to MD/PhD programs, which would meld her interests in neuroscience research and the personal side of medicine. Now at Pitt, Hect says, “I feel like I’m exactly where I’m meant to be.”   —Nichole Faina and Alyce Palko 


Painful Mysteries

Endometriosis, a condition in which endometrial tissue forms outside of the uterus, creating lesions and scars, can take up to 10 years to diagnose. Approximately 6.5 million American women suffer from this painful disorder, and laparoscopic surgery is the only way to know if they have it. Women with undiagnosed endometriosis often seek emergency care for their pelvic pain, but the basic tests and imaging do not show abnormalities. This can result in years of pain without relief. In the meantime, “the impact on quality of life is massive,” says Nicole Donnellan, a Pitt associate professor of obstetrics, gynecology, and reproductive sciences who specializes in minimally invasive gynecological surgery. 
As the director of the new Endometriosis and Chronic Pelvic Pain Center at UPMC Magee-Womens Hospital, Donnellan plans to transform how pelvic pain is diagnosed and treated. Using a tissue bank she collected from patients over eight years, she is developing a blood test to screen for endometriosis. In addition, she and other researchers will use the bank to learn more about the disease’s pathology and develop new treatment methods.
The center opened its doors in July. In addition to being a research hub, it provides comprehensive care to patients with pelvic pain, no matter the cause. Seventy percent of reproductive-age women experience pelvic pain; the cause might be gastric, urologic, neurological, or from something else. This means women in pain are often shuffled from doctor to doctor for years without relief. “My dream for the center is that we have a health navigator to fast-track people to the right specialist,” Donnellan says. “It’s my desire to empower my patients with options to make their day-to-day lives better.” —Elizabeth Hoover 


HIV in Spinal Fluid

Doctors have managed HIV symptoms in patients for decades by driving infected cells into hiding. Though patients aren’t cured, they can maintain an undetectable viral load. But John Mellors, who holds the University of Pittsburgh Chair for Global Elimination of HIV and AIDS and is chief of infectious diseases, wanted to know where those cells might be lurking in the body. 
With help from colleagues at Yale University and the University of North Carolina, Mellors and his team discovered that the brain acts as a sanctuary where HIV hides in spinal fluid. 
The study, which was published in the Journal of Clinical Investigation, examined 69 patients who had been receiving HIV therapies for an average of nine years and for whom treatment had been working. 
The study also revealed that these patients performed worse than noninfected controls on “a whole battery of spatial orientation, recall, calculation abilities, all kinds of performance tests,” notes Mellors. He says the study will both help how we treat HIV and how we think about viruses in general.
“We should be cognizant on a broader scale,” says Mellors. “The viruses we recover from may not be completely cleared from the brain.”   —Evan Bowen-Gaddy 

Courtesy Marisa Acocella Marchetto

It's Graphic

Marisa Acocella Marchetto was a self-described “fashion-fanatic, about-to-get-married, big-city girl cartoonist with a fabulous life.” Then she found a lump in her breast. Her graphic novel, Cancer Vixen, was a creative response to her experience dealing with, and overcoming, cancer. A new genre known as graphic medicine uses comics to tell powerful stories about health and illness. Visitors to a 2019 Falk Library exhibition, Graphic Medicine: Ill-Conceived and Well-Drawn!, got a taste of Marchetto’s story. The work of five other graphic medicine artists was on display as well in the National Library of Medicine traveling exhibition.   —Alyce Palko and Erica Lloyd


Faculty Snapshots

Charles Darwin gave us the classic picture of gene evolution: parent genes passed on from one generation to the next, the most useful of them conserved. However, Anne-Ruxandra Carvunis studies a different kind of gene—orphan genes. The NIH gave Carvunis a New Innovator Award grant this fall to study a concept she pioneered, “proto-genes,” or genes that have no ancestors and seem to have emerged out of thin air. Carvunis is an assistant professor of computational and systems biology, a recipient of the L’Oreal-Unesco Award for Women in Science, and a Searle Scholar.
Hydractinia, a genus of ocean-dwellers that live on discarded shells, have the ability to tell whether other organisms are also hydractinian by touching them. Matthew Nicotra, Pitt assistant professor of surgery and researcher in the Starzl Institute, received a National Science Foundation EDGE (Enabling Discovery through Genomic Tools) grant this year with colleagues at the University of Florida and National University of Ireland to study the organism. Nicotra is interested in the fight-or-fuse genetics of these colony-forming salties. The “self” identifying mechanism used by Hydractinia can teach us about the innate immune system of humans, Nicotra believes. And this can help us understand how we recognize and reject transplanted organs.
Dozens of Pitt and UPMC researchers have been awarded nine grants totaling more than $32 million to curtail the opioid epidemic. They’re investigating ways to improve prevention and treatment strategies for opioid misuse and addiction and to enhance pain management. The funding is part of the National Institutes of Health Helping to End Addiction Long-term, or the NIH HEAL Initiative. In fiscal year 2019, NIH HEAL awarded 375 grants across 41 states in an attempt to reverse the national opioid crisis. 
“It’s clear that a multipronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective nonopioid therapies for pain, and provide more flexible and effective options for treating addiction to opioids,” said NIH Director Francis S. Collins, when he launched the initiative.   —EBG and EL