Mary Nan S. Mallory, M.D., M.B.A., has been elected president of the American Board of Emergency Medicine (ABEM). Mallory is vice dean for clinical affairs for the University of Louisville School of Medicine, a professor in the Department of Emergency Medicine and an attending physician at UofL Health - UofL Hospital.

Mallory has been a member of the ABEM Board of Directors since July 2012 and was elected to the Executive Committee in 2019. She has served ABEM as chief examiner and editor for the Oral Certification Examination and co-editor of the In-training Examination, as well as secretary-treasurer and chair of the Finance, Bylaws and Continuing Certification committees.

"I look forward to my role as ABEM president and continuing conversations with diplomates and candidates, navigating certification examination transitions and ensuring certification standards and value as we move through these challenging times together" Mallory said.

Mallory received her medical degree from the Joan C. Edwards School of Medicine at Marshall University and completed residency training in emergency medicine at UofL. She also earned an M.B.A. from UofL College of Business.

August 10, 2020

Mike Onu Udoh, a second-year UofL medical student, has been appointed vice chair of the Minority Issues Committee in the American Medical Association’s Medical Student Section. The standing committee charged with addressing issues of concern to minority populations through policy development, health education and service, as well as identifying minority student needs and ways to increase membership awareness and knowledge of minority issues.

Udoh also is president of the American Medical Association/Kentucky Medical Association chapter at University of Louisville and the health care representative for the class of 2023 in the School of Medicine Student Government.

August 8, 2020

The third cohort of the Leadership and Innovation in Academic Medicine (LIAM) program completed an 11-month course to develop faculty leaders by presenting their projects designed to improve academic work or health care at the University of Louisville. LIAM is one of the most popular programs offered by the HSC Office of Faculty Development.

The 25 members of the class of 2019-2020, organized in five teams, outlined plans for improving faculty research productivity, patient access, employee recognition, communication and active learning in July. This was the first LIAM class to include faculty from the Belknap Campus.

The mission of the LIAM program is to develop the next generation of leaders at UofL by teaching them the skills needed first to lead themselves, then lead with others and finally, lead an organization. Faculty members enroll in an 11-month training program that includes regular discussions and the capstone team projects.

“Leadership is a set of skills that you can practice. It’s not something you are born with or not born with, but there is a set of definable skills, and with any skill, if you practice it, you get better at it,” said Gerard Rabalais, M.D., M.H.A., who developed and directs the LIAM program with Staci Saner, M.Ed.

LIAM originally was designed as a program for faculty in the School of Medicine, but has evolved quickly to include faculty members across the university.

“Our five-year goal is for 15 percent of the faculty at the Health Sciences Center campus to complete this program. Once you get to that tipping point, synergy is going to start to kick in,” Rabalais said. “That is the result of the cross-disciplinary relationships that develop, meeting and working with people they would never have worked with before from different departments or across colleges. Now that we have increased interest from faculty on the Belknap Campus, with 16 people completing the program by July 2021, we likely will set the same target for Belknap Campus.”

During the event, the program’s fourth cohort of 40 faculty members was introduced. It is the largest class in the program’s history and includes 11 members from Belknap Campus and 9 from Health Sciences Center schools other than the School of Medicine.

Projects and team members in the LIAM class of 2019-2020:

Improving Faculty Research Productivity:
David Brown, Ph.D., Linda Fuselier, Ph.D., Brandon McCormack, Ph.D., Susan Ryan, Ph.D., Siobhan Smith-Jones, Ph.D.

Patient Access at UofL Physicians:
Jennifer Daily, M.D., Luz Huntington-Moskos, Ph.D., Marija Sasek, D.M.D., Maria Mendoza, M.D., Rodolfo Zamora, M.D.

Employee Recognition:
HimaBindu Dukka, B.D.S., M.S.D., M.P.H., Arpita Lakhotia, M.D., W. David Lohr, M.D., Suzanne McGee, M.D., Michael Sweeney, M.D.

Communication:
Brit Anderson, M.D., Tamer Mohamed, Ph.D., Kimberly Pate, M.D., William Tse, M.D., Ph.D.

Driving Active Learning:
Michael Egger, M.D., James Harrison, D.M.D., Chithra Ram, M.D., Jennifer Stiff, M.D., Tracy VanMeter, M.D., Beverly Williams-Coleman, D.N.P., A.P.R.N., FNP-C

LIAM program class of 2020-2021:

• Jason Gainous, PhD                                              Arts & Sciences
• Kandi Walker, PhD                                                Arts & Sciences
• Regina Roebuck, PhD                                            Arts & Sciences
• Benjamin Mast, PhD, ABPP                                  Arts & Sciences
• Kevin Gawley                                                        Arts & Sciences
• Dawn Heinecken, PhD                                          Arts & Sciences
• Amy Flint, PhD, MEd                                             Education and Human Development
• Douglas Craddock, PhD                                        Education and Human Development
• Andrew McCart, PhD, MBA                                  Education and Human Development
• Ishwanzya Rivers, PhD                                          Education and Human Development
• Brigitte Burpo, PhD, MEd                                     Education and Human Development
• Jill Steinbach-Rankins, PhD                                  Speed School of Engineering
• Matthew Fox, MD                                                 Medicine
• Adam Ross, MD                                                    Medicine
• Ashley Iles, MD                                                     Medicine
• April Herrity, PhD                                                  Medicine
• Beatrice Ugiliweneza, PhD                                   Medicine
• Timothy Ford, DPM                                               Medicine
• Siddharth Shah, MD                                             Medicine
• Becca Hart, MD                                                     Medicine
• Kelly Jackson, MS                                                  Medicine
• Sunnye Mayes, PhD                                              Medicine
• Jeff Meyer, MD                                                     Medicine
• Courtney Smith, PhD                                            Medicine
• Joshua Sparks, MD                                                Medicine
• Rebecca Starr Seal, DO                                         Medicine
• Amanda LeBlanc, PhD                                           Medicine
• Leslie Sherwood, DVM                                          Medicine
• Samuel Carson, MD                                              Medicine
• Clayton Tyler Ellis, MD                                          Medicine
• Kellen Choi, DO                                                     Medicine
• Cynethia Bethel-Jaiteh, DNP, APRN, CPNP, CLC   Nursing
• Muna Hammash, PhD, RN                                    Nursing
• Imelda Wright, PhD, RN, CNOR                            Nursing
• J'Aime Jennings, PhD                                            Public Health and Information Sciences
• Brian Marrillia, DMD                                             Dentistry
• Lavina Myers                                                         Dentistry
• Juhi Bagaitkar, PhD                                               Dentistry
• Gill Diamond, PhD                                                Dentistry
• Ashley King-Tinsley, DMD                                     Dentistry

A University of Louisville-born therapy that helps people with Type 1 diabetes stay off immunosuppressants by re-educating the body’s immune system to accept transplanted insulin-producing cells now has a commercial partner.

iTolerance Inc., a San Mateo, Calif.-based biotech company, has signed an exclusive license and intends to develop the therapy toward clinical use. The technology was co-invented at UofL and at the Georgia Institute of Technology with support from the National Institutes of Health and JDRF, which funds Type 1 diabetes (T1D) research.

“Our goal is to help people with Type 1 diabetes, so they don’t have to suffer the side effects that come with immunosuppressants,” said Haval Shirwan, Ph.D, inventor and gratis professor in the UofL Department of Microbiology and Immunology.

In Type 1 diabetes, a condition affecting some 1.6 million Americans, the body’s immune system attacks cells in the pancreas that produce insulin, a hormone that regulates blood sugar. As a result, patients that receive pancreatic islet transplants need to be placed on immunosuppressants and cope with the possible side effects, including loss of appetite, nausea and increased risk of infection.

The technology works by training the immune system to accept insulin-producing cells through transplanted islets — cells taken from the pancreas. The islets are laced with a recombinant protein pioneered by Shirwan and Esma S. Yolcu, Ph.D., a gratis faculty member at UofL, known as Fas ligand (FasL), which “teaches” the immune system to see new graft as beneficial rather than a threat.

Once the immune system has been re-trained, the idea is to transplant healthy islet cells so the patient again can produce insulin on their own.

The UofL scientists teamed up with researchers at Georgia Tech to generate a hydrogel formulation delivering FasL to the graft site to ward off rejection. The technology has the potential to be an “off-the-shelf” treatment, and the hydrogels which hold the islets can be prepared up to two weeks ahead of the transplant. The islets also don’t need to be modified for the individual patient.

“We look forward to leveraging the technology to locally and durably induce immune tolerance of organ transplants,” said Cameron Gray, Ph.D., J.D., founder and chairman of iTolerance. “We believe the technology has potentially far-ranging implications for engraftment."

iTolerance holds an exclusive license to the technology through Georgia Tech and the UofL Commercialization EPI-Center, which works with startups and industry to commercialize university-born technologies.

IMAGE: Immunomodulatory signal presentation via synthetic hydrogel material promotes generation of T regulatory cells (green) in the local graft microenvironment (CD3+ T cells in red, and nuclei staining in blue) after implantation into a clinically relevant transplant model for the treatment of Type 1 diabetes. (Image courtesy Georgia Tech)

August 6, 2020

Amid efforts to stem the spread of the COVID-19 pandemic, social isolation and loneliness have emerged as a significant public health crisis, particularly for older adults. Isolation and loneliness affect those living in facilities as well as those living on their own in the community.

In addition to the mental health implications such as depression, studies gathered by the National Institute on Aging demonstrate that prolonged social isolation can lead to other health complications, including cognitive decline, high blood pressure, heart disease and a weakened immune system. These side effects are particularly concerning during COVID-19 when such comorbid conditions put individuals at higher risk for adverse reactions from the virus. 

The University of Louisville Trager Institute is developing technologies and services to reduce social isolation while maintaining social distancing. 

“Social distancing does not have to mean social isolation,” said Anna Faul, Ph.D., executive director of the UofL Trager Institute. “We are working with community partners to bring technology and social supports to older adults facing increased social isolation due to the current pandemic.”

In April, for example, the UofL Trager Institute and Brent Wright, M.D., of the UofL School of Medicine, introduced SmartGlasses technology to long-term facilities and primary care offices. This technology allows a health care professional who is with the patient to put on the web-connected glasses and dial in with an attending physician. A camera and microphone attached to the glasses allow the physician to see and interact directly with the patient in real time.

Recent awards of nearly $190,000 from multiple organizations will allow the Trager Institute to support the expansion of additional resources, including:

• Telehealth and teletherapy for residents in long-term care facilities
• Training of staff and students to offer virtual interdisciplinary care coordination and chronic disease management
• Caregiver resources such as training, support groups and counseling services focused on Jefferson County and surrounding rural counties 
• Specialized mental health services for older adults to reduce social isolation and depression (PEARLS program)
• A state-wide virtual-friendly visitor program that provides patients, families, caregivers and nursing home residents and staff with resources to reduce social isolation

The funding is provided by the Geriatric Workforce Enhancement Program CARES Act, the National Family Caregiver Program Title IIIE (Administration on Aging) the Health Promotion and Disease Prevention Title IIIE (Administration on Aging) as well as others throughout Kentucky. These grants have created statewide partnerships and expanded the footprint of the institute and of the university.

“Given the expansion of social isolation in our community, our team has prioritized the dissemination of technology to community-dwelling older adults,” Faul said. “In addition to the currently funded efforts, we are looking forward to the possibility of additional funds that will allow us to provide iPads and Bluetooth technology to vulnerable community-dwelling older adults in Jefferson County and several rural counties, to establish a mini-virtual health clinic network across multiple Appalachian counties and to disseminate innovative contact tracing efforts through app-based, wearable devices and AI-based services.” 

The Trager Institute hosts weekly COVID-19 information sessions that focus on the experiences of older adults, caregivers and people with chronic conditions during the pandemic. The Aug.4 information session will explore the broader efforts of our community to address social isolation through technology innovation. This session will feature Wright, associate dean for rural health innovation in the UofL School of Medicine, and Rebecca Brown Rice, director of operations at the Louisville Healthcare CEO Council. This session will explore the innovative ways technology is used to reduce social isolation and loneliness both during and after the COVID-19 pandemic. As part of this conversation, the speakers will explore the latest developments in technology, such as SmartGlasses, and creative ways to re-imagine existing technology.

The virtual session will be held Tuesday, Aug. 4, at 10 a.m., at https://zoom.us/j/884298617.

If you or someone you know is experiencing social isolation or loneliness, contact the care team at the Republic Bank Foundation Optimal Aging Clinic at the UofL Trager Institute for assistance. The care team can be reached at 502-588-4340, Option 1, Option 1, or at tragerinstitute@louisville.edu. Additional resources are available at Community Action Kentucky Partnership and Area Agencies on Aging and Independent Living, which provide social interaction programs as well as other essential services such as in-home care and food delivery programs. 

You may be confident in your potential to pursue a career in biomedical research when the National Institutes of Health funds your work before you receive your Ph.D.

Two doctoral students in the University of Louisville Department of Anatomical Sciences and Neurobiology, Zach Whiddon and Kyle Whyland, have received funding from the NIH to support their research projects. The highly competitive F31 predoctoral training awards help set the researchers on a path to a career in research, requiring the same rigorous application process that seasoned investigators must go through to obtain NIH funding for their research.

“The receipt of an F31 award is an excellent credential and is an important part of building a career in science,” said Robin Krimm, Ph.D., a professor of anatomy and neurobiology and Whiddon’s mentor. “The award of an F31 also enable the student to be become more independent; their salary is paid from their own grant and they are responsible for reporting their research progress to the NIH.”

Whiddon, who moved to Louisville to pursue his Ph.D. after completing his master’s degree in cell and molecular biology at Eastern Michigan University, is working in Krimm’s lab to capture images of nerve cells within taste buds using a specialized technique Aaron McGee, Ph.D., another faculty member in the department, brought to UofL.

Neurons send long projections from the base of brain to the taste buds on the tongue, where terminal arbors, or branches, undergo rapid structural change. Using the technique McGee introduced, two-photon laser scanning microscopy, Whiddon developed a method to capture high resolution images of the branches as they connect to taste buds in live animal models and to document how those branches change over days and weeks.

“Taste bud cells have a very short life span, maybe 10 days. How do these neurons connect with replacement taste cells? To answer that we needed to be able to watch the neurons over time,” Whiddon said. “No one in the taste field has even attempted to look at the neurons over time. They did not think it was possible – until now.”

Already the research is showing that structural change happens much more rapidly than previously thought.

“We saw that in just a 12-hour period the arbors can add or subtract new branch ends, as much as 10 microns in length, which is very quick in terms of neural plasticity,” Whiddon said.

He plans to continue this field of research after he completes his Ph.D.

“Not a lot of people are doing this work, which is what makes it so exciting,” Whiddon said. “I think this research will be a good basis for a career – to adapt it and answer more questions. I’m interested in the plasticity aspect and what is controlling the structural rearrangements.”

Whyland’s research is focused on describing poorly understood brain circuits related to vision. The Jeffersonville, Ind., native earned a bachelor’s degree from Indiana University, majoring in psychology. Now working toward his Ph.D. with Professor Martha Bickford, Ph.D., Whyland is investigating how two specific parts of the brain, the superior colliculus and the parabigeminal nucleus, work together to process visual information and to control motor reflexes and defensive behaviors such as freezing or fleeing.

“We are trying to reverse engineer a little piece of wiring in the brain to give a model for how that might work in similar areas of the brain,” Whyland said.

Whyland’s research also takes advantage of specialized techniques being used in the labs at UofL.

“During the completion of his project, Kyle will receive training in a variety of neuroanatomical techniques, in vitro physiology and a technique called optogenetics in which specific brain cells can be activated with light pulses to interrogate brain circuit function,” Bickford said.

Both Whyland and Whiddon are grateful for the funding provided by the NIH – about $32,000 per year each – as well as the opportunity to learn the ropes of funding applications.

“If Kyle and Zach continue as research-active faculty members, they will be applying for grants throughout their careers,” Bickford said. “The F31 application gives students their first in-depth exposure to the NIH application process, including stringent reviews by a panel of experts.”

As with any competitive process, success is validating. For Whyland, however, the opportunity to revise and resubmit a project that initially was rejected was one of the most rewarding aspects of the experience.

“The first time I submitted it, it wasn’t even scored. By addressing the NIH reviewers’ specific concerns, I was able to resubmit it and get it funded,” Whyland said. “It was very satisfying to know that if you don’t get discouraged and try to address the criticisms, you can be rewarded. It was really motivating.”

 PhD student Kyle Whyland

Mengwei Jiang, a pharmacology and toxicology program PhD candidate in the laboratory of Dr. Wenke Feng, has been awarded a Ruth L. Kirschstein Predoctoral Individual National Research Service Award (F31) from the NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM for his PhD research entitled “Probiotic and intestinal miR194 regulation of bile acid metabolism in alcoholic liver disease”. This three year fellowship will support Mengwei’s research in the field of alcoholic liver disease.

Mengwei matriculated into the PhD program in pharmacology & toxicology via the PhD partnership program with Jilin University.

On Monday August 10 the Department of Microbiology & Immunology will host a virtual orientation for our Fall 2020 incoming students.  Faculty who are accepting new students into their laboratories will e-present their programs.  Welcome Taylor Garrison, Michelle Hallenbeck, Katelyn Sheneman, Peter Shin, Shikha Srivastava and Cassie Woolley!

Results from the second phase of the University of Louisville’s groundbreaking project to track COVID-19 in Jefferson County show that 4 to 6 times more people than previously reported may have been exposed to the virus since the beginning of the pandemic.

From June 10-19, researchers conducting Phase II of the Co-Immunity Project tested members of the Louisville community for both the presence of the novel coronavirus in the participant’s nasal passages and for antibodies against the virus in their blood. Samples were collected at five community drive-up locations across Louisville by UofL Health and researchers from the University of Louisville’s Christina Lee Brown Envirome Institute. Samples were analyzed by UofL’s Center for Predictive Medicine for Biodefense and Emerging Infectious Disease (CPM) in its Regional Biocontainment Laboratory (RBL).

To obtain a representative sample for the study, households in Jefferson County were organized into geographic regions based on U.S. Census Bureau tract boundaries. Households within each region were sent invitations to participate in proportion to the population of that region. Within the regions, areas that had higher concentrations of non-White residents were sampled at a higher rate to increase their representation.

Invitations were mailed to a total of 18,232 addresses. Based on the ages and sexes of all adults in the household as provided by those responding to the invitation, one adult from each household was asked to provide a sample.

The researchers tested 509 people who responded to the mailed invitations. An additional 1,728 community members booked appointments on their own and were tested after hearing about the study in the news or on social media. Many individuals who were invited to participate did not book an appointment. 

Of the 2,237 individuals who were tested, 10 percent were non-White. The ages of tested individuals was as follows:

• 21 percent between 18-34
• 40 percent between 35-59
• 40 percent age 60 or older

Residential locations of the 2,237 participants are shown in Map 1.  Overall, nearly 0.4 percent of the population of Jefferson County was sampled.

Analysis of the study data found that at least 0.05 percent of the participants had an active infection during the time of the study and approximately 4 percent (5.1 to 3.2 percent) of people had detectable levels of antibodies in their blood, indicating they had been exposed to the virus earlier in the year.

“These results allow us, for the first time, to more accurately estimate the spread of coronavirus within our community. If we extrapolate the results from this study to the general population, it would suggest that as many as 20,000 people may have been exposed to the virus – many more than the 3,813 cases reported in the city by the end of June,” said Aruni Bhatnagar, Ph.D., director of the Brown Envirome Institute.

This difference may be due to the fact that people did not have symptoms and were not aware they were infected.

“We were told by several participants that they believed they had COVID-19 before testing was widely available. Nonetheless, our preliminary data suggest that the estimated number of people who have had COVID-19 may be 4-6 times higher than those who have tested positive to-date,” said Rachel Keith, Ph.D., assistant professor of environmental medicine at UofL who conducted the study. “This suggests that the virus is much more widespread in our community than previously estimated. I believe this indicates a need for continued and widespread testing, including antibody testing, which plays an important role in understanding the spread of disease.”

“The random sampling of the population also allows us to calculate the true mortality associated with COVID-19,” Bhatnagar said. “Previous estimates of COVID-19-related mortality have varied from 0.5 to 15 percent. However, given that the city had reported 209 deaths by the end of June, our results suggest that the rate of mortality associated with the virus, at least in Kentucky, may be 1.3 percent. This is significantly higher than the 0.65 percent rate suggested by the CDC. Our research suggests that many who are infected with the virus nationwide have not been tested and that there is urgent need to continue random testing so that we can calculate the most accurate mortality rate,” Bhatnagar said.

The study data also provide an estimate of the spread of the infection in Louisville.

“Because participants were drawn from all parts of the city, we could estimate which areas have had the highest rates of infection,” Keith said. “Although we are still analyzing all our data, our early results show that the highest cluster of individuals exposed to the virus is in Western Louisville. (See Map 2).  We found that the prevalence of exposure was twice as high in non-White participants as in White participants. Most (54 percent) of those who tested positive for the antibody were between the ages of 35-59 years old,” she said.

The researchers cautioned that because so little is known about SARS-CoV-2 and because the rates of community infection and exposure are changing rapidly, the results of this survey are applicable only to the period of June 10-19.

“Although many individuals had detectable levels, the amount of antibodies in blood varied greatly among the participants,” said Kenneth Palmer, Ph.D., director of the CPM. “As a result, we are not sure to what extent they are protected from re-infection. Indeed, some of our early results show that the levels of antibodies decline rapidly within a month. Therefore, we are planning to re-measure individuals who had antibodies in their blood to see if those levels are maintained over time and if so, for how long.”

Currently, the researchers are repeating the antibody test in those health care workers who were found to have anti-SARS-CoV-2 antibodies during Phase I of the Co-Immunity Project. They also plan to repeat community-wide testing in Jefferson County in September.

This study was supported in part by the James Graham Brown Foundation. The Co-Immunity Project is a collaboration of the UofL Christina Lee Brown Envirome Institute, the Louisville Healthcare CEO Council and three health systems in Louisville – Baptist Health, Norton Healthcare and UofL Health.

A University of Louisville-born invention that may help treat cancer now has a commercial partner.

Qualigen Therapeutics Inc., a California biotechnology company focused on developing novel therapeutics for the treatment of cancer and infectious diseases, has signed a license agreement for the technology and plans to fund continued development with UofL to ready it for market.

The technology works by targeting the RAS protein, which sends signals that regulate when and where the body produces and grows new cells. When mutated, the protein turns into a “stuck accelerator pedal,” according to UofL researcher Geoffrey Clark, Ph.D., who co-invented the technology with colleagues John Trent, Ph.D., and Joe Burlison, Ph.D.

“Normally, it gets pressed when you need to grow and then the foot comes off and the cell slows down,” said Clark, professor of pharmacology and toxicology at UofL. “When it becomes mutated, the accelerator’s jammed on, with cells continuing to grow and ultimately becoming a cancerous tumor.”

The drug targets only the active RAS protein and, so far, has little toxic effect on healthy cells. Many current non-targeted treatments, such as chemotherapy, can hurt both healthy and cancerous cells, leading to painful side effects. By some estimates, targeting this mutation could stop the growth of at least a third of human tumors.

“The patient impact could be extremely broad because RAS is involved in a lot of different cancers,” Trent said. “It’s one of the holy grails that there has been limited success in targeting.”

Trent leads the Molecular Modeling Facility (MMF) at UofL Health – James Graham Brown Cancer Center and the UofL partnership with Dataseam, a non-profit with a network of school computers across the state. When the computers aren’t being used by students, they’re connected to act as a distributed supercomputer, allowing researchers to process and analyze huge amounts of data.

Trent used that capability to run through millions of cancer-fighting drug possibilities in a matter of days. The result was a drug that could inhibit the deregulated RAS protein. Development of the technology was supported by the UofL NIH REACH ExCITE program.

Qualigen holds an exclusive license to the technology through the UofL Commercialization EPI-Center, which works with startups and industry to commercialize university-owned technologies. This license agreement builds on a sponsored research agreement with Qualigen for the development of several small-molecule RAS Inhibitor drug candidates. Qualigen also has licensed and is developing other UofL technologies for fighting COVID-19 and cancer.

“Partnering on this new cancer-fighting technology is another example of the relationship we’ve developed with the University of Louisville,” said Michael Poirier, CEO of Qualigen. “We look forward to working with UofL and to advancing this important clinical program with the goal of developing an effective treatment for this unmet need."

If you are interested in supporting this cancer research at UofL, visit give.louisville.edu/JGBCC-Enhancement or contact Elea Fox at elea.fox@louisville.edu.

The University of Louisville is conducting a clinical trial on a new treatment for critically ill COVID-19 patients meant to lessen some of the most severe and deadly respiratory effects.

The treatment, a new formulation of Aviptadil (RLF-100), produced by Pennsylvania-based NeuroRx and Relief Therapeutics Holding, SA, of Geneva, works by combating “cytokine storm,” an unchecked overreaction of the body’s immune response. These storms can cause severe lung inflammation and stiffening that make it difficult, if not impossible, for patients to breathe on their own.

“We want to mitigate these storms,” said the clinical trial lead, Rainer Lenhardt, M.D., associate professor of anesthesiology and critical care in the UofL School of Medicine. “We’re doing anything we can to improve outcomes.”

COVID-19 is primarily a respiratory disease and about 80 percent of cases are mild to moderate, according to WebMD. But in severe and critical cases, the lungs can swell and fill with fluid as the body tries to fight off the infection. This severe respiratory failure is a major cause of COVID-19-related death.

“These patients are terribly ill,” said Forest W. Arnold, D.O., M.Sc., an investigator on the clinical trial and an associate professor in the UofL Division of Infectious Diseases. “And because this virus is so novel, options for treatment are just now being developed. This gives us another option.”

In this Phase 2b/3 trial, UofL and other sites will treat at least 144 patients. To be eligible, participants must be patients at UofL Hospital receiving intubation and mechanical ventilation due to COVID-19-induced severe respiratory failure. Phase 2 and Phase 3 trials determine effectiveness and monitor for adverse reactions. A list of other ongoing clinical trials at UofL is available here.

The drug has previously been used for other indications, but in this formulation, it acts as an anti-inflammatory agent. The formulation is believed to protect alveolar type-2 cells in the lungs which are essential to oxygen exchange and are thought to be a major target of the SARS-CoV-2 virus.

In Phase 1 trials, designed to assess safety and dosage, seven of eight patients with acute respiratory distress caused by sepsis were taken off breathing machines after receiving the drug and six eventually left the hospital.

“Our No. 1 goal is to provide a potentially life-saving therapy to critically ill patients with COVID-19. The FDA has granted fast-track designation for RLF-100 underscoring the urgent need for new treatment options,” said Jonathan Javitt, M.D., M.P.H., CEO and chairman of NeuroRx. “We are excited to work with UofL and leverage its clinical research and infectious disease expertise to advance research in COVID-19.”

Since the coronavirus pandemic began, UofL has taken a leadership role in investigating and developing innovative ways to prevent, diagnose and treat the virus. Researchers are working to block coronavirus from infecting human cells, launching groundbreaking initiatives for testing, building robots that can sanitize high-risk areas and more. If you are interested in supporting this or other COVID-19 research at UofL, contact Lisa Warner at lisa.warner@louisville.edu or visit give.louisville.edu. 

Joern B. Soltau, M.D., has been named the Dr. William H. and Mrs. Blondina F. Evans Endowed Chair of the Department of Ophthalmology and Visual Sciences in the University of Louisville School of Medicine.

Soltau served as acting chair of the department since November 2018 and has been a member of the UofL faculty since 1998. In clinical practice, Soltau is a glaucoma specialist with UofL Physicians – Eye Specialists. He is board certified by the American Board of Ophthalmology.

Soltau was born in Hong Kong and grew up in Germany. He earned his M.D. from Ruprecht-Karls Universität in Heidelberg, Germany, in 1988, followed by an internship in ophthalmology at Klinikum Mannheim in Germany. After spending two years in research at UofL in the Kentucky Lions Eye Center, he completed his residency at Washington University School of Medicine in St. Louis, followed by a year as chief resident at the same institution. He then completed a glaucoma fellowship at the Bascom Palmer Eye Institute in Miami.

At UofL, Soltau served as residency program director from 2001-2016. He received the American Academy of Ophthalmology Achievement Award in 2018 and was listed among Louisville’s Top Surgeons in Louisville Magazine for Cataract Surgery in 2010 and 2018.

“I am confident Dr. Soltau will continue to be a good fit for leading the department into the future, building on its strong tradition of research, clinical care and education,” said Toni Ganzel, M.D., M.B.A., dean of the School of Medicine.

Soltau’s appointment as chair of the department was effective April 1.

The University of Louisville has named Sohail Contractor, M.B.B.S., the J.T. Ling M.D. Endowed Chair of Radiology in the UofL School of Medicine.

Prior to joining UofL, Contractor was a professor of Radiology at Rutgers New Jersey Medical School.

In addition to his role as chair of the Department of Radiology in the School of Medicine, Contractor is a radiologist at UofL Health – UofL Hospital. He is board certified by the American Board of Radiology and the American Board of Internal Medicine. His clinical and research focus is on hepato-biliary and transplant interventions.

Contractor is a 1992 graduate of Grant Medical College in Bombay, India. He completed residencies in internal medicine at Coney Island Hospital in Brooklyn, N.Y., and diagnostic radiology at the University of Medicine and Dentistry of New Jersey, Newark. He completed a fellowship in vascular and interventional radiology at New York University Medical Center in New York. Contractor is a founding member of the Society of Interventional Oncology and a Fellow of the Society of Interventional Radiology.

Contractor was named among “New Jersey Top Doctors, The Very Best Physicians, Experts in Their Field” and received the “Golden Apple Award” as a subspecialty teacher at Rutgers New Jersey Medical School in 2015. He received a Certificate of Leadership Mastery at the Radiology Leadership Institute, American College of Radiology, in 2016 and completed MBA Essentials at the London School of Economics in 2018.

“Dr. Contractor’s talent, skills and energy will be a good fit for leading the department into the future,” said Toni Ganzel, M.D., M.B.A., dean of the School of Medicine. “I know he will build on the department’s many strengths and will seek new opportunities in this changing clinical environment.”

Contractor’s appointment as chair of the Department of Radiology was effective June 1.

The global pandemic has brought significant changes to most industries, including health care. Adoption of telemedicine is on the increase, an achievement recognized by one of the newest inductees to the American Telemedicine Association (ATA) College of Fellows – Robert Caudill, M.D., DFAPA, FATA.

Caudill is professor and director of Telemedicine and Information Technology programs in UofL’s Department of Psychiatry and Behavioral Sciences, and will be recognized as part of the Class of 2020 Fellows during the ATA virtual conference on June 25.

“It is so important for individuals to have access to mental health care especially during this arduous time, and it is encouraging to see both practitioners and patients utilizing the technology that allows for remote access to services,” Caudill said.

The ATA College of Fellows recognizes individuals and organizations for significant achievements in telehealth, service to the general telehealth community and service to the ATA.

Caudill is past chair for the ATA’s Telemental Health Special Interest Group and co-chair of the Telehealth Interest Group of the National Network of Depression Centers. He serves as a founding member of the American Psychiatric Association’s committee on telepsychiatry.

He also is the residency training director in the Department of Psychiatry, and has an interest in optimizing the role of technology in post-graduate medical education and psychiatric patient care. He lectures on topics related to technology, community psychiatry and psychopharmacology. Along with his faculty appointment, Caudill serves as a staff psychiatrist with several community mental health agencies in Kentucky.

Jun Yan, M.D., Ph.D., professor of surgery and microbiology and immunology at the University of Louisville, led a team of researchers in the discovery of an important biomarker that predicts a crisis in COVID-19 patients that could lead to death.

Yan, an immunologist and researcher with the UofL Health - James Graham Brown Cancer Center, along with UofL Professor of Anesthesiology Jiapeng Huang, M.D., Ph.D., and M.D./Ph.D. student Samantha Morrissey, Ph.D., conducted a patient study to better understand the most severe cases of COVID-19.

Approximately 20 percent of COVID-19 patients experience severe disease, including pneumonia and acute respiratory distress syndrome (ARDS). In some of these patients, the rapid influx of immune cells to the lungs to fight the infection leads to complications in the lung and blood coagulation disorders, resulting in heart attack, pulmonary embolism, stroke or deep vein thrombosis.

To better understand these serious complications, Yan’s team evaluated levels of various immune cells in blood samples of COVID-19 patients and compared those levels with those of healthy individuals. They discovered that one type of immune cells, low-density inflammatory neutrophils, became highly elevated in some patients whose condition became very severe. This elevation signaled a point of clinical crisis and increased likelihood of death within a few days.

Neutrophils are one type of immune cells that serve as the first line of defense in the body. When an individual acquires an infection, neutrophils rush to the site to clear the pathogen causing the infection. However, if their presence is persistent or there is a very high volume of cells at the site of infection, in this case the lungs, they can cause unwanted adverse effects. In the case of patients with severe COVID-19, a blood clotting disorder known as coagulopathy occurred, that can manifest as pulmonary embolism, heart attack or stroke.

The study, published online as a preprint, details shifting levels of these neutrophils and other immune cells through repeated blood samples from study participants, correlated with improvement or worsening of the patients’ condition. If clinicians could detect a rise in these cells, they may be able to provide therapy to prevent the potential life-threatening conditions associated with them.

“Based on this study, we believe that the low-density inflammatory band neutrophil population contributes to COVID-19-associated coagulopathy (CAC) and could be used as a clinical marker to monitor disease status and progression,” Yan said. “Identifying patients who are trending toward a cellular crisis and then implementing early, appropriate treatment could improve mortality rates for severe COVID-19 patients.”

To provide additional clinical options for physicians in addressing these crises, Yan is now working with other researchers at UofL to test potential therapies.

Data analysis by Corey T. Watson, Ph.D., David Tieri, Ph.D., and M.D./Ph.D. student Anne Geller.

June 17, 2020

The Co-Immunity Project, a groundbreaking collaboration to track and curb COVID-19 in Kentucky, has received $1.5 million from the James Graham Brown Foundation, as well as additional gifts, to expand community coronavirus testing and launch a public ”virus radar” for understanding its spread.

“We are deeply grateful for this timely philanthropic support that enables us to begin the next phase of the Co-Immunity Project," said Neeli Bendapudi, president of the University of Louisville. “It is vital for decision makers to have the information to track virus activity as the economy continues phased reopening. Knowing where the virus is will help us avoid a second wave.”

The new investment will support unique, three-step testing of individuals in the community for COVID-19 and SARS-CoV-2 antibodies along with testing of wastewater. The goal is to develop a real-time picture of the virus, beginning in Jefferson County, with the hope of later spreading this model to other affected communities worldwide.

“The James Graham Brown Foundation is pleased to join the efforts of the University of Louisville and other funders in this crucial work that will benefit and inform how we manage the COVID-19 pandemic,” said Mason Rummel, president and CEO of the James Graham Brown Foundation (JGBF). “The University of Louisville and the Co-Immunity Project team’s swift action and proactive approach will help our community mitigate the impact of this virus now and in the future.”

A previously announced substantial gift from the Jewish Heritage Fund for Excellence and other individual donations enabled the completion of Phase I of the research, which included the testing of more than 1,000 health care workers in all three area hospital systems: Baptist Health, Norton Healthcare and UofL Health. The results of this work will be shared very soon.

The JGBF gift will help the project launch its Phase II, in which some 22,000 community members will be tested for the virus and associated antibodies.

Households will receive invitations in the mail to participate in this research from the University of Louisville. From those who sign up in response to the mailing, individuals will be selected to participate in testing based on age, race, sex, background and location to create a sample that matches the demographics of the overall population of Jefferson County.

A new group of participants will be selected every six weeks for virus testing and antibody testing. If someone receives the mailing and signs up on the Co-Immunity Project website, they may be called right away, they may be called for a later group or they may not be called.

Participants in this project will receive more than COVID-19 diagnostic tests. They also will be tested using cutting-edge antibody testing available at UofL to determine how much immunity was generated by such exposure and to identify those with the best immune responses as donors of high-quality plasma for treating patients with advanced COVID-19. This antibody testing is more accurate, specific and reliable than most antibody tests, providing much more significant data.

The three-step antibody testing to understand and make use of patient immunity is conducted at the UofL Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases (CPM), which has established a high-throughput, real-time assay for antibodies from SARS-CoV-2, the coronavirus variant that causes COVID-19.

This comprehensive testing program identifies people with antibodies, their levels and quality, and tracks the evolution of the participants’ immunity. The CPM will utilize its NIH-designated Regional Biocontainment Laboratory, one of just 12 such facilities in the United States and the only one in Kentucky, to test for the neutralizing activity of the antibodies.

“It is very important that the citizens of Jefferson County respond to this call for particpants,” said Aruni Bhatnagar, Ph.D., director of the Envirome Institute. “We cannot do this research without the participation of residents from every part of the metro area.”

Scientists from across the globe will have access to the resulting anonymized data for future study on the effectiveness of antibody therapy. The data also may be used to better identify individuals who are better able to fight off the coronavirus.

The Co-Immunity Project is a collaboration of the University of Louisville Christina Lee Brown Envirome Institute and the Louisville Healthcare CEO Council, along with Louisville’s three major health systems, Baptist Health, Norton Healthcare and UofL Health.

Follow this link for a video of the news conference announcing Phase II and the James Graham Brown Foundation gift. 

A University of Louisville study will evaluate how health care, public health and social services organizations are working together to improve the health and well-being of individuals served through Freedom House programs in Louisville and Manchester, Ky.

Freedom House, operated by Volunteers of America Mid-States (VOAMID), is a residential treatment program for alcohol and/or drug dependent pregnant women and women with young children.

The research will examine Freedom House and its recent expansion into eastern Kentucky, determining how well and in what ways the urban and rural partners align in terms of purpose, data sharing, financing and governance.

Aligning Systems for Health Program, led by the Georgia Health Policy Center and supported by the Robert Wood Johnson Foundation, has awarded UofL more than $290,000 to fund the two-year study. UofL is one of seven institutions to receive the competitive funding. 

UofL researchers Liza M. Creel, Ph.D., MPH, assistant professor, School of Public Health and Information Sciences, and co-director, Commonwealth Institute of Kentucky, and Deborah Winders Davis, Ph.D., director, Child and Adolescent Health Research Design and Support Unit, Division of Clinical and Translational Research in the Department of Pediatrics, will lead the study. 

“We’ll focus on health equity and investigate similarities and differences between settings as it relates to program implementation and success of clients in the Freedom House program. We look forward to sharing data-driven insights around how organizations across sectors can work together to improve outcomes for the people and the communities they serve,” Creel said. 

“We are so pleased to collaborate with UofL on this study that will ultimately help pregnant and parenting moms in our Freedom House programs have even better recovery outcomes in both our urban and rural communities,” said Jennifer Hancock, president and chief executive officer of Volunteers of America Mid-States. 

VOAMID operates three evidence-based residential, licensed clinical treatment programs in Louisville. The Freedom House programs treat mothers’ substance use disorder, promote the birth of healthy babies, reunite families and reinforce positive behavior changes. Annually, the Louisville programs serve approximately 170 women, and more than 200 babies and children. 

Earlier this year, the organization expanded into eastern Kentucky with a new site in Clay County, a rural area hit hard by opioid use, with high rates of Neonatal Abstinence Syndrome and out-of-home foster care placements much higher than Kentucky’s overall rate (91 vs. 43 per 1,000 children). This location can serve more than 60 women, 30 newborns, and 50 minor children each year.

Polypharmacy is an underappreciated factor in undesirable patient outcomes. In older adults, polypharmacy is considered a syndrome of harm and presents a challenge to primary care providers. The United States has one of the highest medication use rates per capita in the world.
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0095454317300532?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0095454317300532%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.ncbi.nlm.nih.gov%2F

Physician burnout is an emerging condition that can adversely affect the performance of modern-day medicine. Chronic overwork, constant stressors, and a poor work environment cause emotional exhaustion, depersonalization, and a reduced sense of personal achievement.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682395/

 A searchable database of accredited continuing education (CE) activities and additional resources that can help the CE provider and clinician community respond to the novel coronavirus (COVID-19) public health emergency.
https://accme.org/resources-category/novel-coronavirus-education