Category: Faculty and staff news
VCU team explores epigenetics as cause of adverse drug reactions in elderly
Director of Communications
VCU School of Pharmacy
A VCU School of Pharmacy research team is studying how aging affects the ways drugs interact with the body. The results may help doctors better manage medications in older patients.
The aim is to better understand why older people seem to metabolize drugs more slowly, with the goal of someday seeing fewer adverse drug reactions and hospitalizations among the elderly, said the principal investigator, Joseph McClay, Ph.D., an assistant professor in the VCU School of Pharmacy’s Department of Pharmacotherapy and Outcomes Science.
Older patients are almost seven times as likely to be hospitalized for adverse drug reactions than younger ones, according to a 2006 study in the Journal of the American Medical Association. A separate study in the United Kingdom found that adverse drug reactions contributed to 6.5% of hospital admissions and primarily occurred in older patients.
The causes for these disparities are not well known, McClay said.
The study, supported by a $454,000 grant from the National Institute on Aging, will explore how genetic factors that are turned on and off by the body — a process known as epigenetics — affect how the body interacts with medications as it ages.
The body’s genes, its DNA, do not change over time. But its epigenetics, how the body expresses those genes, does. The VCU team will begin the process of tracking how these epigenetic changes affect the body’s reaction to drugs.
McClay and his colleagues — Elvin Price, Pharm.D./Ph.D., and Matthew Halquist, Ph.D., in the VCU School of Pharmacy and Mikhail Dozmorov, Ph.D., and Patrick Beardsley, Ph.D., in the VCU School of Medicine — and a team of graduate students will begin by mapping age-related changes in key genes using samples of livers from aged mice from the National Institute on Aging.
This map of epigenetic changes, McClay said, will help researchers understand how the liver, the body’s main organ for metabolizing drugs and other outside chemicals, could interact with medicines in older bodies.
Once the mapping is complete, the team plans to focus on a gene known as CYP2E1, which is part of the liver’s system of metabolizing chemicals such as drugs and alcohol and has been shown by the VCU team and others to be expressed differently in older bodies.
In particular, the VCU researchers will study how chlorzoxazone, a drug metabolized by CYP2E1, is affected. If livers from older mice metabolize the drug more slowly, as McClay and his team predict, this could lead to greater understanding of the reasons that older humans are affected differently by medications. and iIn time this could lead to better medication dosing in elderly patients.
“That is the point, in the end,” McClay said. “We want to keep people healthy.”
Price named Yanchick professor and director of geriatric pharmacotherapy
Elvin T. Price, Pharm.D./Ph.D., has been named Victor A. Yanchick professor and director of the Geriatric Pharmacotherapy Program at VCU School of Pharmacy. He takes over the roles from longtime professor Patricia Slattum, who retired earlier this year.
The Yanchick professorship is named for Victor A. Yanchick, dean of the School of Pharmacy from 1996 to 2014, and has the goal of providing sustained leadership for the geriatrics program.
“We are thrilled that Dr. Price has agreed to take on this role and lead the Geriatric Pharmacotherapy Program,” said Joseph T. DiPiro, Archie O. McCalley chair and dean of the School of Pharmacy. “His experience and dedication to improving health among older patients will guide the program into the future of geriatric medicine.”
Price joined VCU School of Pharmacy in 2017 from University of Arkansas for Medical Sciences in the College of Pharmacy, where he was an assistant professor, as an associate professor in the Department of Pharmacotherapy and Outcomes Science. He also is affiliated with VCU’s Institute for Inclusion, Inquiry and Innovation (iCubed), focusing on health and wellness in aging populations.
“Older adults have a special place in my heart,” Price said. “As a child I witnessed several of my older relatives live with, and die from, diabetes and heart diseases. This suffering inspired me to pursue a career studying the impact of genetic variation on aging and how people respond to medications.”
Price earned his doctorate in pharmacy from Florida Agricultural and Mechanical University and his Ph.D. in clinical pharmaceutical sciences and pharmacogenomics from the University of Florida. His published research has focused largely on pharmacogenomics and personalized medicine, as well as on health issues such as diabetes and substance abuse.
Auxiliary Label: Antibiotic stewardship research in a community outpatient setting
By Victoria Hammond
Auxiliary Label Staff
Antibiotic resistance — when bacteria are untreatable by current antibiotics — is a growing public health concern.
To reduce antibiotic resistance, prescribers use antibiotics only when necessary. In hospital settings, experts called antibiotic stewards monitor trends in resistance, prescribing, costs and adverse effects. Prescribing trends are compared to current treatment guidelines.
Stewards in an antibiotic stewardship have a goal to “enhance patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs,” according to the Society of Healthcare Epidemiology of America.
In 2015, about 269 million antibiotic prescriptions were dispensed in outpatient settings — at least 30 percent of which were unnecessary, according to the U.S. Centers for Disease Control. Unnecessary treatment of antibiotics can increase the risk of side effects or opportunistic infections such as C. difficile.
Settings with high volumes of antibiotics being prescribed would benefit from an antibiotic stewardship program to prevent side effects and opportunistic infection.
To improve patient outcomes in outpatient settings, VCU School of Pharmacy faculty members John Bucheit, Pharm.D., Teresa Salgado, M.Pharm., Ph.D., and Amy Pakyz, Pharm.D., Ph.D., have been implementing an antibiotic stewardship program in a free outpatient health clinic in the Richmond area. (They asked that the clinic’s name not be published.)
The faculty members’ first focus targets the prescribing trends of uncomplicated urinary-tract infections, or UTIs. Bucheit, Pakyz and Salgado are developing an antibiogram — a profile of antibiotic susceptibility for a specific practice site — based on prescribing trends from the past two years.
The antibiogram will provide information about which antibiotics are providing beneficial therapy to patients based on the clinic’s antibiotic susceptibility to resistant or nonresistant bacteria. This antibiogram will then be compared with current therapy guidelines to develop clinic specific guidelines for practitioners to use at the clinic. The project was made possible by a grant from the VCU School of Pharmacy’s Center for Pharmacy Practice Innovation.
“We are excited about this project to not only improve patient care at our clinic,” Bucheit said, “but also to provide an example for other outpatient offices interested in improving antibiotic prescribing for uncomplicated UTI.”
After the guideline is developed, Bucheit, Pakyz, Salgado and their team will educate the staff and reevaluate in a year.
The goal of this project is to provide prescriber education and improve patient health outcomes in a setting where high volumes of antibiotics are prescribed.
Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.
VCU receives $2.7M to study use of anti-inflammatory medicine for treatment of heart failure
Hearts that are failing become inflamed and swollen — doctors have known that for years.
But researchers at VCU Pharmacy and VCU Health wondered what would happen to people with failing hearts if they treated the inflammation as a cause of the illness rather than a symptom. Would the patients feel better?
Initial studies seemed to say yes. The results were convincing enough that the National Institutes of Health took the unusual step of funding a larger study directly through a $2.7 million grant over five years.
The grant will fund a clinical trial with 102 heart-disease patients. Researchers will investigate if reducing inflammation in the heart muscle can improve the patients’ health and reduce the need for hospitalization. Researchers expect to begin enrolling patients later this year. (More about this trial and enrollment criteria.)
It is the fourth NIH grant for the research team that is co-led by Benjamin Van Tassell, Pharm.D., vice chair for clinical research and associate professor in the VCU School of Pharmacy Department of Pharmacotherapy and Outcomes Science, and Antonio Abbate, M.D., Ph.D., vice chair of the Division of Cardiology in the VCU School of Medicine. The current study will build on encouraging results from a smaller 2016 study also funded by the NIH.
The researchers are investigating the possibility that inflammation could be a major cause of heart failure, rather than simply a symptom of the condition.
“The heart is a muscle,” Van Tassell said. Like other muscles, when inflamed it becomes swollen and difficult to move. Swelling could have major effects on the heart’s ability to pump blood and could result in heart failure and death.
Heart disease remains the leading cause of death in the United States, according to the Kaiser Family Foundation. The condition is difficult to treat and expensive to manage. Nearly 1 in 4 people hospitalized for heart failure return to the hospital within 30 days of leaving, according to a 2017 study published in the journal Risk Management and Healthcare Policy.
Earlier efforts by scientists to connect heart problems to inflammation have shown inconsistent results, possibly from focusing on the wrong types of inflammation, Van Tassell said. In the past few years, however, Abbate and Van Tassell have led multiple clinical trials using a drug originally developed to treat rheumatoid arthritis to target a specific type of inflammation that is driven by a protein called Interleukin-1.
In the VCU researchers’ 2016 study of 60 heart-failure patients with a recent hospitalization, those who received treatment achieved lower levels of inflammation and were able to exercise longer than patients who did not receive treatment. In the course of six months, only one patient receiving long-term anti-inflammatory treatment went back to the hospital. Nearly one-third of the patients who did not receive the anti-inflammatory treatment were hospitalized in the same period.
Last year, a large-scale study from the pharmaceutical company Novartis used a similar drug to reduce inflammation. The Novartis research found the number of heart attacks was cut by about 15 percent. The VCU study will examine if a similar approach can help people with heart failure.
Promotions for School of Pharmacy faculty
Congratulations to the following faculty members on their promotions, effective July 1st, 2018. The promotions were approved by the VCU Board of Visitors at its most recent meeting.
Dr. Karolina Aberg has been promoted to associate professor in the Department of Pharmaceutics.
Dr. Krista Donohoe has been promoted to associate professor in the Department of Pharmacotherapy and Outcomes Science.
Dr. Keith Ellis has been promoted to associate professor in the Department of Medicinal Chemistry. He has also been awarded tenure.
Dr. Emily Peron has been promoted to associate professor in the Department of Pharmacotherapy and Outcomes Science.
Dr. Masahiro Sakagami has been promoted to professor with tenure in the Department of Pharmaceutics.
Introducing the school’s new development director, Louie Correa
We are pleased that Louie A. Correa is joining us in June as the the school’s senior director of development. He first joined VCU in 2015 as associate director of development for VCUArts. Learn more about him in this Q&A.
Thanks for agreeing to do this! Let’s start with the big picture. What draws you to development as a career?
CORREA: I started in nonprofit management and like most development professionals stumbled into this field. I quickly fell in love with being able to visit with supporters and connect them to the causes they are passionate about. I enjoy hearing about their interests and strategizing to find the place where their interests best serve the institution.
What personal values do you draw on in your life and work? And how do you see those values fitting with those of VCU and the School of Pharmacy?
CORREA: I have a passion for higher education and our students. These are transformative years in their lives and we get to be a part of setting them on a course for future success. I want to do all I can to ensure cost isn’t a barrier to a great education and I want to ensure cost isn’t a barrier for the School of Pharmacy to have the very best faculty and programs. I love the grit I have seen from VCU students. They are often nontraditional, hard-working, self-made type people and I aim to be just as gritty in working to ensure they have the resources they need to receive a great education!
What should people know about your background and what brought you here?
CORREA: I am a Midwesterner, but married a Richmond woman in 2010. We moved here to be closer to family when we decided we wanted to start a family of our own. We have a 2-year-old daughter, Madison, and an 11-year-old puggle named Rex. I got to know a lot of pharmaceutical companies through my work as CEO of The Brandon Marshall Foundation (now called Project 375) where we worked toward promoting positive mental health and de-stigmatizing mental illness. In my spare time (which is confined to my daughter’s sleeping hours) I enjoy exercising, television/film (specifically documentaries), and sports.
Tell us something people might not know about you on the first meeting.
CORREA: I have a robust catalog of dad jokes!
Title: Senior Director of Development
Preferred Name: Louie
Hometown: Chicago, Illinois
Favorite Sport/team/hobby: VCU Rams basketball!
Family members: Erin (owns her own executive coaching practice), Madison (2), Rex (dog, 11)
Augmented reality can revolutionize surgery and data visualization, say VCU researchers
By Leah Small
The practical uses for augmented reality — which superimposes digital information onto real world surroundings — seem endless. Technologists have envisioned futuristic applications such as glasses that allow wearers to visualize turn-by-turn navigation in real time and immersive gaming headsets. Recently, scientists have focused on harnessing the technology for intellectual pursuits.
Virginia Commonwealth University researchers are leading utilization of AR for medical and research purposes. An interdisciplinary team of faculty and students led by Dayanjan “Shanaka” Wijesinghe Ph.D., assistant professor in the department of Pharmacotherapy and Outcomes Sciences in the School of Pharmacy, is developing augmented reality platforms that could improve surgical approaches, refine personalized medicine and serve as a research tool.
The Med-AR program, which is optimized for the Microsoft HoloLens AR platform, renders 3-D models of CT and MRI scans, and allows users to interact digitally. In February, VCU Medical Center surgeons used the application to prepare for two complex cardiac surgeries. Another version of the program is frequently employed to create 3-D models of complex biochemical networks for scientific research.
“Our technology has the capability to democratize medicine across the globe,” Wijesinghe said. “The 3-D surgical and biochemical network models can be shared worldwide for collaborative planning of complex surgeries and research.”
The operating room
In many respects, the AR application surpasses detailed 2-D medical imaging in its ability to offer surgeons realistic presentations of anatomy, said Dan Tang, M.D., the Richard R. Lower professor in cardiovascular surgery in the VCU School of Medicine.
Tang is the surgical director of heart transplantation and mechanical circulatory support. He and his team recently donned headsets to prepare for two surgeries, one to mend a central portion of the heart and the other to repair leaks around two artificial valves.
The surgeons used 3-D reconstructions of CT scans generated by Med-AR to view areas of concern in the way they would appear on the operating table. Programmed verbal commands allowed the surgeons to rotate the models, move them and cause some parts to go transparent to view hidden anatomy.
“It really gives you a sense of where structures lie in relation to other structures while planning operations,” Tang said. “It’s particularly helpful for trainees who are still learning to translate the preoperative screen imaging to the live intraoperative findings.”
Tang expects the technology to improve alongside that of medical imaging and AR hardware.
“Augmented reality represents a leap forward,” Tang said. “When physicians went from plain film X-rays to digitized CT scans, we were provided with more detailed images.”
The majority of this information is still displayed in 2-D slices, and 3-D reconstructions of the images require further development. However, the VCU teams’ interactive, 3-D models present an intuitive imaging platform that surgeons can use to plan operations, and as a tool to educate patients on their disease process.
Wijesinghe envisions more ambitious surgical applications for the technology. His lab is working to develop an experience that is shared in real time between users during surgery and remote users, with the option of video and voice recording. Eventually, he aims to expand the software to overlie scaled 1-to-1 images on top of the operative field to provide supplemental information in real time.
“Being able to overlay the 3-D virtual reconstruction on the patient is akin to providing something like X-ray vision to the surgeons,” Wijesinghe said. “They will be able to see the patient, but also the structure underneath that they need to reach during the operation.”
Wijesinghe and Tang also collaborated with Vig Kasirajan, M.D., the Stuart McGuire professor and VCU Department of Surgery chair; Alex Valadka, M.D., professor and VCU Department of Neurosurgery chair; and the VCU da Vinci Center to perfect the technology.
Rendering biochemical networks
The research initiative stemmed from the need to understand biochemical pathways and interactions. This helps scientists explain and predict cellular functions that impact biological mechanisms such as disease progression and metabolism.
Biochemical networks, which are graphs scientists use to visualize biochemical interactions, provide the key to understanding biochemical pathways.
Data points called nodes represent molecules such as enzymes or metabolites. Lines drawn between the nodes define how the molecules interact.
Biochemical networks allow scientists to see the bigger picture but they take up an enormous amount of space when displayed in 2-D, which makes AR’s 3-D capabilities convenient.
“The issue we were running into is that complete biochemical networks are extremely complex, so no matter how much they are magnified, we cannot even display the data on multiple screens,” Wijesinghe said. “We needed a different technology and it made sense to generate immersive biochemical networks that are not limited to screen space.”
The system has some similarities to existing technologies, Wijesinghe said, but costs much less and is much more portable.
Wijesinghe’s next steps are to apply the AR technology’s biochemical network visualization capabilities to personalized medicine. The goal would be to visualize the effect of drug interactions on biological mechanisms within a patient profile.
For example, a scientist could use the technology to visualize a drug’s ability to improve an individual’s metabolism. Biological indices would be obtained from the patient to create the biochemical network, and drug molecules and metabolites would be represented by nodes. Scientists would use various visual aids, such as affected nodes going dark, to predict drug interactions.
“We solved the problem of visualizing networks,” Wijesinghe said. “Now, what we are working on is visualizing how specific drugs can impact an entire network.”
Service awards to recognize SOP employees on 190 years
If fall is approaching, it must be time to recognize VCU employees for their service to the university! This year, 18 School of Pharmacy employees will be honored for a total of 190 years of service to VCU.
The 20-year employees – Don Brophy, Chris Garland, Mike Hindle, Michelle Rhea and Martin Safo — represent all three of the school’s academic departments as well as the dean’s office.
The 46th annual Service Awards Ceremony and Reception — for VCU faculty and staff with five to 55 years of service (in five-year increments) — will take place 3-5 p.m. Oct. 4 at the Siegel Center, 1200 W. Broad St.
Invitations will be mailed to honorees in late August. For those who wish to attend the ceremony, shuttles will be available from the MCV Campus to the Siegel Center and back (details to come).
Following are the 2017 School of Pharmacy honorees. Some have not been at the school the entire time but previously worked for other university units. Congratulations to all!
Wanda Coffey, Dean’s Office/Office of Experiential Education
Dave Dixon, Department of Pharmacotherapy and Outcomes Science
Adam Hawkridge, Department of Pharmaceutics
Sha-Kim Jackson, Dean’s Office/Office of Research and Graduate Studies
MaryPeace McRae, Department of Pharmacotherapy and Outcomes Science
Marjorie Nesmith, Dean’s Office/Business Office
K.C. Ogbonna, Dean’s Office/Office of Admissions and Student Services
Emily Peron, Department of Pharmacotherapy and Outcomes Science
LaQuanda Ruben, Dean’s Office/Office of Admissions and Student Services
Chanda Diep, Department of Pharmacotherapy and Outcomes Science
Evan Sisson, Department of Pharmacotherapy and Outcomes Science
Janet Wooten, Dean’s Office
Laura Morgan, Department of Pharmacotherapy and Outcomes Science
Don Brophy, Department of Pharmacotherapy and Outcomes Science
Chris Garland, Dean’s Office/Phartech
Mike Hindle, Department of Pharmarceutics
Michelle Rhea, Department of Pharmacotherapy and Outcomes Science
Martin Safo, Department of Medicinal Chemistry
As an aside … 18 employees universitywide will be recognized this year for an impressive 45 years of service each, including William Dewey (Department of Pharmacology and Toxicology, School of Medicine), with whom many School of Pharmacy faculty have worked over the years.
Pharm.D. and graduate students earn a plethora of year-end awards
SENIOR AWARDS BANQUET
Members of the VCU School of Pharmacy Pharm.D. class of 2017 were honored during the annual Senior Awards Banquet, which took place May 12 at the Hilton Richmond Hotel & Spa at Short Pump.
Awards were presented by Dean Joseph T. DiPiro and K.C. Ogbonna, associate dean for admissions and student services, with the assistance of Ron Ballentine, assistant director of admissions and student services. SOP alumnus Ken Kolb (Pharm.D. ’82), welcomed class members as the school’s newest alumni.
Class of 2017 members of academic honor societies Rho Chi and Phi Lambda Sigma were recognized as well as class and student body leaders.
Preceptor, faculty and staff awards went to:
- Preceptor of the Year: Neil Davis, Sentara Virginia Beach General Hospital
- Faculty Award for Excellence in Teaching: Krista Donohoe, assistant professor, SOP Department of Pharmacotherapy and Outcomes Science. (She is also an SOP alumna, Pharm.D. ’10.)
- Outstanding Employee Recognition Award: Gioia Casso, contract and grant administrator, SOP Office of Research and Graduate Studies
Student awards were as follows:
- Patient Care: Apryl Anderson
- Patient Counseling: Dhania Molina
- Pharmacy Communications: Michelle Edwards
- Research Excellence: Omar Hassan
- Academic Excellence: Kassim Rahawi
- Excellence in Pharmacy: Katie Taylor
- Emswiller Award for Leadership Achievement: Heather Savage
- Outstanding Leadership: Phil Jan
- Community Practice Achievement: Samantha Pande
- Technology Excellence: Sung Lee
- Distinguished Service: Dien Tu
- Outstanding Student: Jeff McKenzie
- MCV Alumni Association Award: Phil Jan
- Academic Excellence in Medicinal Chemistry: Kayla Miller
- Academic Excellence in Pharmacotherapy: Chloe Ko
- Academic Excellence in Pharmacoeconomics and Health Outcomes: Julie Patterson
- Academic Excellence in Pharmaceutics: Kassim Rahawi
- Excellence in the Promotion of Pharmacy: Erin Hickey
- Community Engagement Excellence: Alvin Maraya
- Excellence in Public Health: Arzo Hamidi
- Interprofessional Practice and Collaborative Care Excellence: Ashley Simpson
- Excellence in Advocacy and Health Policy: Kalyann Kauv
- Professionalism: Kathryn Mundi
- Excellence in Public Health Pharmacy Practice: Kalyann Kauv
- Dean’s Award: Skylar White
GRADUATE AWARDS LUNCHEON
The school’s annual Pharmaceutical Sciences Graduate Awards Luncheon took place May 25 at Omni Richmond Hotel. SOP alumna Kellie Schoolar Reynolds (Pharm.D. ’92) addressed “Decision Points on Your Career Path.” She is deputy director of the Division of Clinical Pharmacology IV in the Office of Clinical Pharmacology, Center for Drug Evaluation and Research, FDA.
Aron Lichtman, associate dean for research and graduate students, presented the awards:
- Doyle Smith Award: Daniel Afosah
- John Wood Award: Neha Maharao
- V.A. Yanchick Award: Julie Patterson
- Charles T. Rector and Thomas W. Rorrer Jr. Dean’s Award for Excellence in Graduate Study: Daniel Afosah and Julie Patterson
- Pfizer Consumer Healthcare R&D Leading for Innovation Award: Mandana Azimi
- Blake Putney Award: Daniel Afosah, Hrishikesh Kale and Crystal Leibrand
- Lowenthal Award: Liwei (David) Wang
- PCEU GSA-AAPS Graduate Student Travel Award: Crystal Leibrand and Zaneera Hassan
- Peter Byron Travel Award: Deblina Biswas, Emmanuel Cudjoe, Hebing Liu, Nicole Luzi, Neha Maharao, Piyusha Pagare and Yoshita Paliwal
- Rector and Rorrer Travel Award: Bethany Falls, Zaneera Hassan and Crystal Leibrand
SOP alumna tapped as president of ASCPT
VCU School of Pharmacy alumna Kellie Schoolar Reynolds (Pharm.D. ’92) will be inducted as president of the American Society for Clinical Pharmacology and Therapeutics during its 2017 Annual Meeting March 15-18 in Washington.
ASCPT notes that as deputy director of the Division of Clinical Pharmacology IV at the Food and Drug Administration’s Center for Drug Evaluation and Research, Reynolds plays a leading role in the development and regulatory review of anti-infectives, antivirals, immunosuppressants and ophthalmology drug products as well as counterterrorism drug products. She has long studied the pharmacokinetics and pharmacodynamics of these treatments and their potential for drug interactions.
Reynolds has been with the FDA since 1994. At CDER, she works with the Renal Impairment Working Group, the Antibiotic Drug Development Task Force and the Drug Interaction Working Group. Her research and practical guidance on the management of drug interactions has been published in various peer-reviewed journals and books, and she has made more than 30 presentations at professional meetings. She has worked closely with undergraduate pharmacy students and fellows, particularly in the areas of career development and transition.
An ASCPT member for eight years, she was appointed to its board of directors in 2014. She has been involved in numerous society activities, including its By-Laws Committee, Strategic Planning Task Force, Clinical and Translational Science Steering and Search Committee and Mentoring Task Force. She also has chaired the Drug Development and Regulatory Scientific Section and Scientific Program Committee.
She served as an associate editor for Clinical Pharmacology & Therapeutics for six years and was an editorial board member.
Reynolds earned her bachelor’s degree in biochemistry at Virginia Tech. Following graduation from VCU School of Pharmacy, she completed a clinical pharmacokinetics and drug development fellowship at University of North Carolina at Chapel Hill.
Established in 1900, ASCPT now has more than 2,200 members committed to advancing the science and practice of translational medicine, building on a foundation of clinical pharmacology and therapeutics.