1. < Message from the Chair

Faculty in the department of medicine (DoM), not only deliver best in class health care, but we also lead in making discoveries that will shape the future of medicine, as we train tomorrow's leaders and innovators. Each week, I receive a report of scientific and other publications authored by our faculty. The scientific output is impressive and I would like to give you a flavor of last week’s publications which demonstrate the depth and breadth of our scientific bench. The papers that I am highlighting are just a sample of published work led by UCLA researchers in the DoM. There is a much larger list of studies in which our faculty are collaborating with teams from across the world and making important contributions.

We are working on developing an easy way for you to see all these publications each week from our department’s home page on the web. More on that in due course, although the launch might be delayed by UCLA Health’s big migration of uclahealth.org’s infrastructure to a new platform. In the meantime, I will periodically feature some papers in my posts, and we will feature these publications on the DoM’s Twitter feed, as best we can in real time. I hope you enjoy reading about some of these recent and influential discoveries. Keep reading until the end where you will learn about two important achievements by members of our faculty.

MOPPING UP COVID-19 SPIKE PROTEINS WITH A NANOPARTICLE SPONGE

In a collaboration with colleagues at UC Riverside, a paper in the journal Theranostics, led by post-doctoral researcher Dr. Sandro Satta in the UCLA Cardiovascular Engineering Research Laboratory, led by Dr. Tzung Hsiai Professor of Cardiology and Bioengineering, designed a decoy nanoparticle carrying the ACE2 receptor, which is the receptor on cells that binds the SARS COV2 virus leading to COVID infection. As shown in the cartoon, in an experimental system, the viral spike protein binds to the decoy nanoparticle and is no longer available to infect macrophages to induce an immune response. Imagine an injectable sponge (no bleach) that mops up the virus, that when infused sequesters viral particles!

PROGRESS ON THE BREAST CANCER FRONT

The secret sauce of our colleagues in the division of hematology and oncology has been the development of novel therapies for various cancers, seamlessly moving from proof-of-concept studies in cell lines to first in man applications. In a new study published in Molecular Cancer Therapeutics, our team led by Dr. Dennis Slamon, show efficacy of a small molecule inhibitor of HER2 Tucatinib, to augment the killing activity in breast cancer cells, of the established agent trastuzumab in a dish or in animal models. I will ask Dennis when the clinical trial is set to start!

DETECTING COPD EARLIER WITH SPIROMETRY

Our pulmonary and critical care COPD dream team including Dr. Nathan Yee, Daniela Markovic MSc, Dr. Russell G. Buhr, Dr. Christopher B. Cooper, Dr. Donald P. Tashkin and led by Dr. Igor Z. Barjaktarevic published a paper in the journal Chest that analyzed a readily available measure (the FEV3/FEV6ratio) obtained from pulmonary function tests that could predict future disease severity and outcome. A reduced FEV3/FEV6 can identify those at risk for future development of COPD and respiratory exacerbations. I was pleased to see the involvement of one my Iowa colleagues Spyridon Fortis in this work.

PRIMARY CARE PHYSICIANS VOTE WITH THEIR FEET AND THE POOR GET POORER

An important tenet of the affordable care act, aka “Obamacare,” was the expansion of Medicaid. Across the United States, some states expanded Medicaid and others did not. A study, published in the journal Medical Care, led by our Executive Vice Chair for Faculty Affairs Dr. Jose Escarce, demonstrated that states with Medicaid expansion added primary care physicians (PCPS), at the expense of those states without expansion which lost PCPS particularly in the most disadvantaged areas.  A striking example of the relationship between public policy and access to health care.

RECRUITING UNHOUSED PEER ADVOCATES TO INCREASE COVID-19 VACCINE ACCEPTANCE

A study led by Dr. Kristin Choi in the UCLA School of Nursing and anchored by Dr. Chelsea L. Shover, in the division of general internal medicine, published an interesting article in the Journal of General Internal Medicine. Its objectives were to evaluate community health workers (CHW) perspectives on an unhoused peer ambassador (PA) COVID-19 vaccine outreach program in Los Angeles. They concluded that CHWs were in a unique position to empower unhoused PAs to take a leadership role in reaching their peers with COVID-19 vaccines and advocate for long-term employment and housing needs.

I deeply respect the strong vein that runs through our department to increase health equity and to include the active participation of all members of our community in health care delivery, despite their personal circumstances.

PSORIASIS IS ASSOCIATED WITH CHRONIC LIVER DISEASE

I chose this one because it was written by our busy clinical dermatologists Dr. Kyle Cheng and DGSOM medical students Dr. Jason Yang (now a dermatology resident at Harbor-UCLA) and Kevin Nguyen. This research letter published in the Journal of the American Academy of Dermatology analyzed a large national database, the National Inpatient Sample, and found a significant association between psoriasis and nonalcoholic fatty liver disease and other liver pathologies.

GETTING FAT OUT OF THE CIRCULATION INVOLVES ELECTRICITY

When you eat a fatty meal, your body needs to efficiently move that fat out of the circulation to store it in fat cells or to burn it for energy. An important enzyme that releases this fat is an enzyme called lipoprotein lipase (LPL), which must move across the lining of blood vessels (endothelium) to work on the circulating fat. If this system fails to work properly, increased fat in the circulation can contribute to vascular disease and other disorders such as pancreatitis. Distinguished Professor of Cardiology Dr. Stephen Young, is the world’s leader in deciphering how the enzyme LPL releases fats from triglyceride-rich particles in the circulation, so that the fatty acids can move out of the circulation into cells. A recent study from their laboratory led by post-doctoral fellow Dr. Wenxin Song and published in the Journal of Clinical Investigation revealed that a key mechanisms involved in moving LPL into capillaries is to block the electrostatic interactions (think static electricity), that keeps them on the other side. Little did we know that static electricity is at work in our veins!

OUR NEXT MASTER OF THE AMERICAN COLLEGE OF PHYSICIANS

I started this piece by noting that we no not only discover new therapies, but we deliver the best care. One way in which our most distinguished clinical faculty are recognized, is when they receive the highest honors by the American College of Physicians. I learned last week that Dr. Carolyn Crandall was elected as a Master of the American College of Physicians. Here is an excerpt from her notice of appointment.

"Over the past year or so, without your knowledge, a number of your colleagues, peers and/or students have been assembling a dossier outlining the impact you have had on your community, this wonderful profession of medicine, medical science and for many of you, your patients. We are very pleased to be able to recognize you as a recipient of Mastership in the American College of Physicians!

As I am sure you know, Mastership is conferred only on a select number of worthy candidates who are deemed distinguished through a combination of achievements, including the practice of internal medicine, academic contributions to our specialty, and service to the College. In making decisions about each candidate’s suitability for Mastership, the Committee considered qualities such as strength of character, integrity, perseverance, leadership, compassion, and devotion, as well as clinical expertise and commitment to advancing the art and science of medicine. Emphasis was placed on service as a teacher and mentor, advocacy for quality in internal medicine, a commitment to social justice, deep interest in people, and the creation of communities of medicine. Additionally, those elected to Mastership should be "citizen physicians," educational innovators, humanists, and learner-teachers who inspire others to seek high standards and excellence in our cherished specialty of Internal Medicine. As an MACP, you embody these qualities.”

Congratulations Carolyn!

RECOGNIZING OUR COMMITMENT TO EQUITY AND INCLUSION IN MEDICAL EDUCATION

Our department is at the forefront of developing tomorrow’s leaders in medicine. An important aspect that should not be overlooked is ensuring that we develop leaders who reflect the diversity of our community, and open doors for advancement to all who entrust their education to us, irrespective of background. Thus, I was delighted to learn that Dr. Alejandra Casillaswas the recipient of the UCLA Academic Senate’s Student Development (DEI) Award.

The notification of award stated:

“Your selection for this distinguished honor is a tribute to your notable accomplishments and your manifest commitment to diversity.  Your excellent work has made a real difference, and we are proud to acknowledge your contributions in fostering an equitable and inclusive UCLA.”

“Your selection for this distinguished honor is a tribute to your notable accomplishments and your manifest commitment to diversity.  Your excellent work has made a real difference, and we are proud to acknowledge your contributions in fostering an equitable
Dr. Mangione her division chief and mentor provided some additional context:
“This award honors a faculty member who has excelled in teaching and mentoring a diverse student body, has taught or is currently teaching a large number of undergraduate classes, has aided in the development of academic support or mentoring programs, has established pipeline programs from high schools and community colleges, has created curricula enabling students to appreciate the dynamics of Intergroup relations by enhancing free exchange of ideas surrounding controversial issues or has developed teaching methods that are especially inclusive and interactive."

“Dr. Casillas was selected as one of UCLA Health’s top 100 trailblazing women in the health system for 2020 and the 2020 UCLA Medical Student Training in Aging Research (MSTAR) Program Outstanding Research Mentor. In September 2021, she was named as one of 10 early career Emerging Leaders in Health and Medicine in the United States by the National Academy of Medicine (NAM).”

“…. leadership roles as the Director of the UCLA CTSI Health Disparities Student Research Program and founder of the DGSOM First Generation (First Gen) College Graduate Program. The creation of the First Gen program in 2017 established DGSOM as one of the first medical schools to offer this type of support and mentorship for first generational students."

Congratulations Alejandra. You are an inspiration to all of us.

Dale

P.S.

I know that many of you celebrated various holidays with your families over the past days. I hope that you had meaningful times to connect with loved ones and shared traditions. Last week, my wife and I celebrated our 33rd wedding anniversary. So, we are counting our blessings too.

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