Dear Medical College of Georgia Friends,
Research adjusts to the reality of the coronavirus
We talked last week about how some of us underestimated how much coronavirus would impact life as we know it and how the continued impact on lives lost and changed, is awful and astounding. It feels like in a heartbeat many of us went from never hearing about coronavirus to that is all we hear about. In addition to touching all of us as people, it has touched us all as professionals here at MCG, as we move from our usually very interactive education in classrooms and clinics to teaching and learning online; as we move from wanting to take care of everyone’s medical needs to strictly focusing on essential, at the moment needs. Now it has also impacted research. Like our colleagues across Georgia and beyond, our definition of essential research — basic and clinical — has shifted from teams vigorously pursuing answers to all kinds of biological puzzles to no more than two people being in any one lab doing the absolute necessities and to seeing our clinical trials’ patients virtually when possible. We also are not starting new endeavors unless they are directly associated with the coronavirus. I hope this new normal will be short-lived for many reasons, but out of it, a new passion is emerging among you to take this virus down.
Unprecedented times demand accelerated research path
Let me note here that we usually don’t talk about science at these very early stages when Institutional Review Board approvals and funding are still being sought and some protocols are still developing. But I thought it was important that you see some examples of how, not only at the important fronts of patient care and education against this disease, you and MCG are rapidly readjusting to take the coronavirus on at a scientific level as well. I hope you will find both pride and solace in these efforts.
New research foci include coronavirus mouse models
We have all seen images of this spiky virus by now, which we know attaches to the molecule and receptor ACE2, found throughout our bodies in places like the lungs and blood vessels. ACE2 degrades angiotensin II, a hormone which, when uncontrolled, can do a lot of bad things like constricting our blood vessels too much and causing us to hold onto more sodium and fluid than we need. Many of us know about ACE inhibitors, a common type of blood pressure medication which helps prevent these unhealthy consequences by decreasing the production of angiotensin II. One hitch in studying this virus is that the ACE2 receptors for mice, our common research model, is different enough than ours so that mice are not really affected by COVID-19.
CRISPR experts Drs. Lin Gan and Joseph Miano have model plans
Our Dr. Lin Gan, an expert in the gene editing technology CRISPR who is founding director of the Transgenic and Genome Editing Core, is going to be swapping out the mouse ACE2 receptor for a human one, to help meet the immediate need for good mouse models. Gan and longtime colleague Dr. Joseph Miano, an experimental pathologist, molecular biologist and CRISPR expert as well, also are going back a few steps in the expression of the receptor, using CRISPR to replace the entire mouse gene with a human one that ultimately expresses this receptor. The idea here is to also look a little more broadly at how the receptor gets expressed in different organs and whether expression might be attenuated in some organs, like the lungs, to avoid some of the catastrophic damage we are seeing.
Dr. Jin-Xiong She is looking at antibodies we make and making others
Super scientist Dr. Jin-Xiong She, director of the Center for Biotechnology and Genomic Medicine, is also stepping up and out to take on COVID-19. He and his colleague, biochemist Dr. Sharad Purohit, recently published a fascinating paper about the special sugar coating cancer cells have and use for bad purposes like cell proliferation. Their cancer study focused on how women with cervical cancer who make antibodies against these sugars and have internal radiation as part of their therapy do better than others with stage 2 and 3 cervical cancer. He thinks something similar is happening for some with this virus. Dr. She hypothesizes that some of us are fortunate enough to make antibodies against sugars on this virus which could help explain the dramatic differences we see in people infected with this virus. His team is also examining the blood of patients looking at levels of things like cytokines and chemokines that indicate the level of immune response. They hope their search will yield good indicators of how sick an individual might get and whether a treatment is helping get them well. They also are working on a treatment, a lab-made antibody to help attack the virus.
Dr. Elizabeth Rutkowski is leading a team looking at neurological impact
You may have heard many patients with COVID-19 are reporting a loss of smell, an indication that the virus is directly impacting the brain. While we all are concerned about the persistent virus lingering for days on some surfaces, it’s believed that most of the spread happens through droplets in the air when someone coughs or sneezes, which is a solid reason for this social distancing that none of us like, but which is very important right now. Unfortunately access to the brain is not that hard for the virus. The nasal passages are pretty much a direct tunnel to the brain. And, we know that the cytokine storms — an immune overreaction that rapidly damages instead of healing and also can occur with the flu — we are seeing in the sickest patients can worsen lung problems and have neurological complications. So a group here also wants to look at the neurological impact of this infection now and long term. Neurologist Dr. Elizabeth Rutkowski, who came to us late last year from California Pacific Medical Center in San Francisco, will be leading the charge on the project to follow these patients, including those who got very sick and those who did not, to examine any short- and long-term neurological consequences. Her great partners in this include Dr. She; Dr. John Morgan, director of the Movement and Memory Disorder Program; Dr. Shaoyong Su, genetic epidemiologist at the Georgia Prevention Institute; Dr. Varghese George, chair of Population Health Sciences; biostatistician Dr. Daniel Linder; and Dr. Jeffrey Switzer, chair of neurology.
Dr. Ralf Lucas’ lung protective peptide is already in coronavirus trials in Europe
Here’s one MCG-born effort already happening, at least in Europe. Dr. Ralf Lucas, vascular biologist in the Vascular Biology Center, has been looking out for the lungs for a while. He developed a synthetic version of the tip of a molecule that activates ENaC-alpha, a part of the natural channels involved in sodium uptake and fluid movement and which helps keep air sacs and capillaries in our lungs tight. Bacteria-causing pneumonia can make them leaky and fill our lungs with fluid. Dr. Lucas’ peptide has already made it into clinical trials in Europe for problems like pneumonia. Now it’s being used in Europe to battle the lung damage wreaked by COVID-19. This was one of 17 projects involving 136 research teams funded by the European Commission in early March in areas like new treatments, vaccines and diagnostics. Dr. Lucas is now trying to organize trials in this country. The European Commission puts promoting peace, freedom and the well-being of citizens as some of its top goals. Hard to argue with that. Thank you Dr. Lucas and our European colleagues.
The pandemic medicine elective that started this week is a hit
Back to the home front and education, the pandemic medicine elective we talked about two Fridays ago kicked off this week with 198 participants. This was the largest group we have ever had sign up for an elective, another great example of how eager our students are to learn and to help with this and future crises. Like everything else these days, these classes are virtual and on topics like herd immunity, vaccines and the horrible reality of having to triage ventilators and personal protective equipment. As we mentioned, this course has a service arm that will have students and some faculty working with public health departments across the state. Like the rapidly developing research projects we just talked about, this course was born in about two weeks. Great work students and Office of Academic Affairs.
The Class of 2021’s fundraising to support caregivers also is a hit
We told you last week about how the Class of 2021 was working hard for those health care providers who have been working extra hard for us during this pandemic. The students set up a go fund me account to raise money for things like care packages, and Susan Brands, class president, shared this week that the effort has shot past their $5,000 goal so they are now working toward $7,500. I know they will get there. In keeping with their commitment to caregivers, last week Textron Specialized Vehicles, which includes E-Z-Go, donated 1,120 N95 masks for use by our residents. As you know the masks are essentials, which are in too much demand right now. VP/CFO Jim Pennoyer made this special delivery to me and vice dean Dr. Doug Miller in front of the beautiful Harrison Commons. We thank Jim and his company again for thinking of us and our residents at this worrisome time, and our students for thinking of our caregivers.
GEM Lab now offers COVID-19 testing statewide
One more important update today on the rapidly developing disease focus. We also talked recently about how the Georgia Esoteric and Molecular Laboratory, or GEM Lab, team in our Department of Pathology had rapidly developed a novel coronavirus test that could be done right here in two hours and required only the expertise of the staff (which is a lot) and the pieces needed to make it happen like the much-in-demand plastic cartridges you put patient samples in. An immediate goal was to reduce wait time locally for a test whose demand went from zero to through the roof. But a goal, as part of Georgia’s only public medical school, was to also serve the state in this time of great need. I am happy to report that with the continued hard work of the GEM Lab team, under the leadership of Dr. Ravindra Kolhe, we have now opened testing to our state and the calls and samples are pouring in.
State leaders, MCG faculty and staff, Georgia Tech enable the growth Great as this team is, this could not have happened without the support of our state, Gov. Brian Kemp, the University System of Georgia and Chancellor Steve Wrigley. But it also needed you. Because like always, you also rallied to the cause. More real-time PCR instruments, which are on back order for months and are needed to detect the virus in RNA, were loaned to the GEM Lab to enable this exponential capacity growth. Instruments came in from our own Dr. She (one more time today), Dr. Jessica Filosa, neurovascular physiologist in the Department of Physiology; Dr. Dave Mattson, chair of physiology; and Dr. Xingjun Fan, vision scientist in the Department of Cellular Biology and Anatomy. But this keeps going. Dr. Andrés Garcia, executive director of the Parker H. Petit Institute for Bioengineering and Bioscience at Georgia Tech, also loaned the GEM lab a PCR instrument. Drs. Kolhe and Garcia actually met as members of Gov. Kemp’s Coronavirus Task Force. The other piece of this is that two of our Athens students, John Parker and Matthew Schwartz, drove to Atlanta to pick the instrument up from Dr. Garcia and deliver it to Dr. Kolhe. All these efforts are why, come Monday, we will be able to do about 1,000 tests in a 24-hour cycle. Please let me say thank you again to all the great individuals who put these important pieces together to enable readily accessible testing for our community and now our state. While there has been much bad that has happened and is happening with the pandemic, so many of you continue to be standouts who stand up to help others. Thank you all so much, and please remember to also take care of yourselves.
April 17 – The Raft Debate, the annual fun, educational deliberation of which type of doctor should get the only raft on a sinking ship, sponsored by the MCG Alumni Association, 6:30 p.m., Harrison Commons. CANCELED.
April 24-26 – Alumni Weekend featuring the MCG Dean’s Reception and Alumni Association Banquet, 6 p.m., April 24 at the Augusta Marriott; Campus Discovery Tours, 9:45 a.m., April 25, starts at the Summerville Campus; President’s Cookout, noon, April 25, D. Douglas Barnard Jr. Amphitheater, Summerville Campus; Reunion Dinners, 6 p.m. reception, 7 p.m. dinner, 9 p.m. Alumni After-Party, Augusta Marriott; MCG Emeritus Club Breakfast, 9:30 a.m., MCG Alumni Memorial Service, 10:30 a.m., both in the J. Harold Harrison M.D. Education Commons. POSTPONED
April 29 – MCG Faculty Senate Awards, 5:30-7:30 p.m., Lee Auditorium. POSTPONED
April 30 – President Keel’s State of the University Address, 11 a.m., Maxwell Theatre, Summerville Campus. OPTIONS BEING EXPLORED.
May 7 – Hooding, 2 p.m., Bell Auditorium. Reception follows in the Old Medical College building on Telfair Street. CANCELED.WE ARE CURRENTLY LOOKING AT OPTIONS.
May 8 – Graduation, 2 p.m., James Brown Arena POSTPONED