April 21, 2023

Dear Medical College of Georgia Friends,

Drs. David Munn and Ted Johnson are a team taking on pediatric brain cancer

Legacy to me is the impact we make now and on the future. It is about doing things that matter, because they matter and like they matter. One of my many privileges as dean of one of the nation’s first medical schools is the 360-degree view it affords me of what each of you do and what we collectively, as the Medical College of Georgia, accomplish. It is a constantly unfolding story that, even with its frustrations, I love to watch and to tell. Dr. Ted Johnson, was about a year into his MD/PhD education here when longtime colleagues Dr. David Munn, a pediatric hematologist/oncologist and MCG graduate, and Dr. Andrew Mellor, a molecular geneticist and immunologist, first reported in the journal Science a discovery that would have ramifications for some of the most vulnerable children. They would find that the enzyme indoleamine 2,3-dioxygenase, or IDO, is one key way the fetus survives in the womb. While most of us don’t think of our children as foreign invaders (at least until they become teenagers), the mother’s immune system should recognize them as foreign during pregnancy because they also have the genetic material of their father. This dynamic scientific duo found that cells in the placenta express IDO, which locally disables the immune response you might expect against something that appears foreign. Bottom line, the fetus is protected. Dr. Mellor, now an Emeritus faculty member here and professor of translational immunology at Newcastle University in the UK, reminded us at the time that we were all “transplants” for the first nine months of our lives. Drs. Mellor and Munn would soon report that tumors also use IDO as a way to escape the immune response. Dr. Johnson, who as a student was already established as one thorough professional who was thinking about a career as an oncologist, would join this dynamic team looking for “natural” foes of cancer. Let me add here that some of his first experiences in the hospital showed Dr. Johnson that what he really wanted was to be a pediatric cancer doctor. 

Dr. Johnson is presenting at the American Academy of Neurology Annual Meeting; CURESEARCH for Children’s Cancer funds new innovative study for pediatric brain cancer 

The story continues to unfold, and this coming week Dr. Johnson will be in Boston at the American Academy of Neurology Annual Meeting presenting the results of the phase 1 trial of an IDO inhibitor in children with brain cancer that has relapsed. The study included children as well with newly diagnosed diffuse intrinsic pontine glioma, or DIPG, a brain tumor for which there is no standard therapy considered curative. More to come on that soon on the MCG home page and elsewhere but let me say that this team quickly recognized that children with brain tumors needed more treatment options. Eventually they hope that this immunotherapy developed right here will be available as a way to help children with many cancer types strengthen their ability to fight cancer. I second that emotion and thank you all for what you have done to get us to today and help children tomorrow. About the same time we were learning of the upcoming presentation, CURESEARCH for Children’s Cancer was announcing its support of a new trial adding to the IDO inhibitor another immunotherapy, ibrutinib. Drs. Munn and Johnson think that the two, in combination with chemotherapy, will potentially pack an even more powerful punch against pediatric brain cancer. This too is a first in humans trial (phase 1) of this innovative grouping of treatments. I think Drs. Munn and Johnson in combination also are powerful foes against cancer and advocates for children. Thank you both for your pioneering contributions and steadfast commitment. It’s hard to imagine much that could matter more. 

Senior student Elena Diller is guest editor for April issue of AMA Journal of Ethics

Elena Diller will join Drs. Munn and Johnson in the esteemed ranks of MCG graduates next month and she is already the guest editor for this month’s edition of the American Medical Association’s Journal of Ethics. Elena, from beautiful Rome, Georgia, worked with Dr. Laura Williamson, director of the Center for Bioethics and Health Policy at AU, to make this happen. She had already been thinking about not just what we eat, particularly meat and dairy products, but the impact of their production on the frontline production workers and the environment. The AMA journal, which explores ethical challenges medical students and practicing clinicians face, was a great opportunity to put these issues out there. Thank you for this extraordinary effort, Elena. I know you will continue to make us proud as you pursue an internal medicine residency at the University of Texas Medical Branch in Galveston and beyond.

Gastroenterologist Amol Sharma gets NIH grant to explore new treatment for painful gastroparesis

Dr. Amol Sharma, gastroenterologist, also worries about what we eat and when we cannot eat. “Imagine yourself as a patient with diabetes and you count how many calories you are eating and carbs you are eating and you give yourself the right amount of insulin to cover those carbs to prevent it from raising your sugars… and then the food gets in the stomach and you end up vomiting up all that food because you are so nauseous and because your stomach doesn’t tolerate it very well. But the insulin doesn’t go anywhere,” Dr. Sharma says. That becomes the definition of a “brittle” diabetic whose blood sugar is all over the map and the way they feel rises and falls with it. The debilitating nausea and pain he is talking about is called gastroparesis, a rare condition but one which is most commonly associated with diabetes. Dr. Sharma is among the early thinkers that gastroparesis is a dysfunction in communication between our gut and brain and vice versa. He tells us conditions more of us likely have heard about like irritable bowel syndrome are also thought to be a problem with this two-way communication. With the support of a $958,000 grant from the National Institute of Diabetes and Digestive and Kidney Diseases, he is conducting a clinical trial to see if painless noninvasive magnetic stimulation, similar to what our Psychiatry Chair Vaughn McCall, and Vice Chair Peter Rosenquist use for depression, can reset the hyperactive firing of a group of neurons in the back that are at a midpoint of communication between the brain and stomach.  He already has some evidence that just a few days of this treatment can make a big difference with this debilitating condition. We all know what miscommunication can do to our lives and that appears to be the case between our stomach and brain as well. More great work here at MCG that should have an impact where impact is needed. Good luck with your work Dr. Sharma and please keep us posted.

Drs. Abdulla Kutlar, Betty Pace receive $2.3 million NIH grant to explore new sickle cell treatment

Dr. Abdullah Kutlar is another great physician who is relentless in his pursuit of still better care for patients here and beyond. He came to us in 1982 to study with another of the greatest among the greats in blood disorders, Dr. Titus H.J. Huisman. By 1994 Dr. Kutlar was running the Sickle Cell Center at MCG, which is now more globally dubbed the Center for Blood Disorders and which he still directs. He has led clinical trials here of some of the handful of drugs currently approved for treatment of sickle cell disease by the Food and Drug Administration, including the first FDA-approved drug hydroxyurea. While we still don’t really understand exactly how, hydroxyurea increases the expression of fetal hemoglobin. Hemoglobin is the oxygen-carrying component of our blood and with sickle cell disease the hemoglobin becomes misshapen and less effective at this important job, causing pain crises and blood vessel and organ damage. Fetal hemoglobin cannot sickle, but it’s gone in most of us not long after birth. Dr. Kutlar is now leading a clinical trial of HDAC inhibitors, which can change expression of certain genes, and he has evidence from his work with Dr. Betty Pace that the HDAC inhibitor panobinostat may help turn the fetal hemoglobin gene back on. Like Drs. Munn and Johnson, he and Dr. Pace eventually want to see if paring panobinostat with hydroxyurea, can enable even more response. He and fellow longtime sickle cell researcher Dr. Pace, who was just honored for her work by the American Medical Women’s Association, recently received a $2.3 million grant from the National Heart, Lung and Blood Institute to fund the first early stage trial of panobinostat. Thank you Drs. Kutlar and Pace. As I talked about with you all recently, this is what academic medical centers – a medical school and its health system – do. They take exceptional care of people with often complex health problems and they continue to search for better treatments as they educate the next generation who will carry on this legacy. 

Alumni Weekend is April 28-30 in Augusta; Dean’s reception 6-7 p.m. April 28  

Next weekend is a great celebration of MCG’s legacy of the next generation. It’s Alumni Weekend April 28-30 when our graduates come home. Please let me encourage you all to stop by our Dean’s Reception from 6-7 p.m. next Friday at the Augusta Marriott. It’s great food and fun and another chance to look our successes right in the eyes. During the weekend we also will honor four MCG graduates. Dr. Van Cise Knowles, a 1966 graduate and longtime general surgeon in Albany whose contributions as a medical missionary earned him the 2007 Surgical Volunteerism Award from the American College of Surgeons, is our Distinguished Alumnus for Professional Achievement. Dr. Melvin Haysman, a 1971 graduate and retired allergist/immunologist from Savannah who has loved to host alumni retreats at his home and our medical students at his practice, is our Distinguished Alumnus for Loyalty. The late Dr. Daniel Sullivan, a 1949 graduate who practiced surgical oncology in Augusta and was a longtime medical leader here including helping start important community resources like St. Joseph Hospice and our Georgia Radiation Therapy Center, is being posthumously honored as our Distinguished Alumnus. And, 2008 MCG graduate Dr. Sherita King, a urologic surgeon specializing in male and female sexual medicine and prosthetic urology, who also happens to have been a track star at Evans High School and at UGA, where she is still in the top 10 for speed in the 55, 100 and 200 meter dash, is our Outstanding Young Alumnus. Dr. King will also soon have the distinction of being one of the first faculty members in our new Department of Urology, which officially moves from Division to Department status July 1. I think today’s writings alone make it clear how I cannot help but love what I see at the Medical College of Georgia and how I cannot help but appreciate you all. 

Dr. Lowell Greenbaum passes 

And finally today, I wanted to share with you the passing of another legend, Dr. Lowell Greenbaum. Dr. Greenbaum came to us in 1979 as chair of our Department of Pharmacology and Toxicology. Dr. Greenbaum would be succeeded in that job in 1988 by yet another legend, Dr. Willie Caldwell. Dr. Greenbaum was a pharmacologist, an expert in kinins, proteins that cause inflammation and affect blood pressure, well before inflammation was such a focal point for science and medicine. He was an absolute advocate of research and education who would further pursue both in 1985 when he became the university’s VP for Research and Dean of what was then called the School of Graduate Studies. He was a smart and good man and strategic thinker. We appreciate his service to MCG, to science and to our community. Our thoughts are with his family.

My best to you always,

Dean Hess Signature

David C. Hess, MD

Dean, Medical College of Georgia

Upcoming Events

Apr 28-30 – AU Alumni Weekend, schedule

May 11 – MCG Hooding, 2 p.m., Bell Auditorium

Jun 13 – MCG Faculty Awards Ceremony, 5 p.m., Natalie and Lansing B. Lee Jr. Auditorium

Jun 16 – MCG Faculty Senate Meeting, noon, Natalie and Lansing B. Lee Jr. Auditorium