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$12.5 Million Grant to Advance Study of Hormone’s Role in Weight Gain and Bone Loss

Updated on Jun 30, 2022 | Featured, Research, Women's Health

Mone Zaidi, MD, PhD, center, with team members in the Department of Medicine (Endocrinology, Medicine and Bone Disease), from left: Sakshi Gera, PhD, Postdoctoral Fellow; Funda Korkmaz, MD, Associate Researcher; Jameel Iqbal, MD, PhD, Senior Faculty; Olena Hadeliya, Associate Researcher; Daria Lizneva, MD, PhD, Instructor; Anisa Gumerova, MD, PhD, Associate Researcher; Alina Rahimova, MD, Biomedical Informatician; Nanette Fraticelli, Grants Coordinator; and Tony Yuen, PhD. View a video on the FSH project.

Researchers at the Icahn School of Medicine at Mount Sinai have been awarded a $12.5 million grant from the National Institute on Aging for a study seeking to advance the treatment of two public health hazards in older adults—osteoporosis and obesity. The four-part project will focus on follicle-stimulating hormone (FSH), which rises at menopause and could be responsible for the weight gain and bone loss that many women experience in middle age.

FSH was known for years to be an important part of the reproductive system. But the groundbreaking research of Mone Zaidi, MD, PhD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease) at the Icahn School of Medicine at Mount Sinai, and his team showed in a mouse model that FSH also plays a direct role in bone loss and belly-fat gain—and that blocking FSH would reverse those effects. Dr. Zaidi has now developed a “humanized” monoclonal antibody to block FSH signaling, and it will be tested in mice during the new project.

“This next stage will bring us closer to creating an effective therapy with an FSH-blocking antibody aimed at preventing and treating both obesity and osteoporosis,” says Dr. Zaidi, who is principal investigator of the overall project. Targeting and blocking FSH was found in past studies to be effective in male as well as female mice, Dr. Zaidi adds, so its benefits could extend to both genders in people. He will oversee and serve as director for the four new studies, which will be conducted at Mount Sinai and other academic medical centers around the country. Mount Sinai will receive the bulk of the grant—$2 million a year for five years—and will serve as the data center for the project.

The first study, conducted at Mount Sinai, will determine if blocking FSH in mice will change bone mass and body composition across their lifespans, inducing them to live longer. The second study will explore whether the new monoclonal FSH-blocking antibodies can prevent fat gain and bone loss in mice, and if they can also treat existing obesity and osteoporosis. This investigation will be led by Tony Yuen, PhD, Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease) at the Icahn School of Medicine at Mount Sinai, and performed collaboratively with UT Southwestern Medical School. For the third study, also in mice, Mount Sinai will team up with Maine Medical Center Research Institute (MMCRI) to study the effects of FSH on bone marrow fat deposits, which are associated with osteoporosis during aging and in menopause. And the fourth project will study the correlation between FSH, body fat, and fracture risk in people from the AGES-Reykjavik cohort of 12,000 women and men between 66 and 93 years of age. This epidemiology project will be led by scientists at the University of California, San Francisco.

The FSH research builds on a long-term collaboration between Dr. Zaidi, director of The Mount Sinai Bone Program, and Clifford Rosen, MD, senior scientist at MMCRI and co-director of the four projects. The results of their previous work were published in the journal Nature in 2017 and were among the eight “notable advances” in biomedicine named that year by Nature Medicine. Dr. Zaidi is hopeful that his team’s work will progress to clinical trials in humans within two years. “What would be fascinating and incredibly rewarding,” he says, “is if we can actually show a significant increase in lifespan while also regulating obesity and osteoporosis through a single, FSH-blocking agent.”

New Paths at Match Day 2019

Updated on Jun 30, 2022 | Community, Featured

Two future pediatricians hugged in celebration at Match Day 2019. Monica Amoo-Achampong, right, was matched with NewYork-Presbyterian Morgan Stanley Children’s Hospital and Alison Celello with Cincinnati Children’s Hospital. “I love the opportunity to work initially with parents as caregivers and eventually work directly with patients as adolescents and young adults,” Ms. Amoo-Achampong says.

Hopeful and nervous, elated and grateful. These were some of the emotions expressed at Match Day 2019, the celebratory event in which graduating medical students opened an envelope to learn which residency programs they will attend during the next phase of their training. During the event on Friday, March 15, 121 students at the Icahn School of Medicine at Mount Sinai were matched to residency programs throughout the country, including highly competitive ones at NewYork-Presbyterian/Columbia University Irving Medical Center; Massachusetts General Hospital; the University of California, San Francisco Medical Center; and the Hospital of the University of Pennsylvania. Thirty-five students will remain within the Mount Sinai Health System to continue all or part of their graduate training. They were among about 27,000 students around the nation who participated in the Main Residency Match®, the largest so far. The Match is managed by the National Resident Matching Program, a nonprofit organization that uses an algorithm to align the preferences of applicants with those of residency programs.

Ted Pak, who matched with Massachusetts General Hospital (Internal Medicine), with Sonia Jarrett, MD, an ISMMS graduate who is now a pediatrics resident at the Children’s Hospital of Philadelphia. View a video of Match Day 2019.

“Before we send you all to get those envelopes in a massive, rugby-type scrum, let’s take some time for thanks,” said Peter Gliatto, MD, Senior Associate Dean, Undergraduate Medical Education and Student Affairs, Icahn School of Medicine at Mount Sinai. He led the students in a round of applause for the “incredible support” they had received from the faculty, mentors, family, partners, and friends who were gathered in the Annenberg West Lobby. Jasmine Tatum was elated to be matched at Stanford University in Psychiatry. “I feel so privileged to be entering a field where I can help care for the whole person, not just the biological elements, but the psychological and social components as well.” She says she chose Stanford because of its excellent clinical training and emphasis on resident wellness—plus the campus is near family.

Ted Pak was looking forward to the “endless research opportunities” in his match: internal medicine at Massachusetts General Hospital. Mr. Pak, who intends to specialize in infectious diseases, said Mass General was his No. 1 pick because it is “team-oriented, with a great research infrastructure, diverse patients, and a strong teaching culture.”

Syed Haider, right, who matched with Rutgers New Jersey Medical School (General Surgery), was congratulated by Peter Gliatto, MD.

The class members will receive training in 22 specialties, including 23 graduates in Internal Medicine; 12 in Emergency Medicine; 11 each in Pediatrics and Psychiatry; 8 each in Anesthesiology, and Obstetrics and Gynecology; 6 in General Surgery, and others in specialties including Family Medicine, Neurology, and Radiation Oncology. As its graduates were receiving their matches, Mount Sinai was extending offers to students from around the country. The new residents, who will arrive in July, include graduates from 16 of the nation’s top 20 medical schools. “I am thrilled with my match results,” says Giselle Lynch, who will have a residency in Ophthalmology at New York Eye and Ear Infirmary of Mount Sinai (NYEE), after a preliminary year in Internal Medicine at Morristown Medical Center in New Jersey. “After completing a research year in NYEE’s Retinal Imaging Laboratory, I felt connected to their commitment to their patient population and clinical research.”

Syed Haider matched at the General Surgery program at Rutgers New Jersey Medical School. He says his interest in surgery stemmed from his childhood in Pakistan, when a cousin was injured in sectarian violence and saved by emergency surgery. “From very early on, I saw surgery as a force against extremism and surgeons as the heroes in this conflict,” he says. Later, as a medical student, “I learned to dress wounds and suture skin to close incisions, and I observed and felt the deep connection between the surgeons and their patients,” he says. “I feel incredibly blessed and lucky to pursue my dream of becoming a surgeon, and grateful to the Icahn School of Medicine.”

Road to Resilience Episode 10: Resilience Stories (Live!)

Updated on Jun 30, 2022 | Featured, Insights

An anxious woman’s worst fear comes true. A young man grasps for a ladder out of poverty and depression.

In Episode 10 of the Road to Resilience podcast, two resilience stories are told live by two neuroscience PhD students–Ana Efthymiou and Joe Simon–at the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai.

These stories were performed live at the “Studying the Brain” storytelling event hosted by the School of Medicine’s Friedman Brain Institute at El Barrio’s Artspace on March 11, 2019.

Road to Resilience brings you stories and insights to help you thrive in a challenging world. From fighting burnout and trauma, to building resilient families and communities, the podcast explores what’s possible when science meets the human spirit.

Ana Efthymiou, a PhD student at the Graduate School of Biomedical Sciences at the Icahn School of Medicine.

Joe Simon, PhD student at the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai.

The series is based on the well-received book Resilience: The Science of Mastering Life’s Greatest Challenges, co-authored by Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and Steven Southwick, MD, Professor of Psychiatry at Yale University.

Road to Resilience is available on Apple Podcasts, Spotify, Stitcher, and Google Play (link works best in Chrome). New episodes of the series are released on the last Wednesday of each month.

You can find more information on the Icahn School of Medicine website or on the Road to Resilience website.

Listen to Road to Resilience Episode Nine: The Mystery Virus

Research Is Customizing Artificial Pancreas for Pregnancy

Mar 19, 2019 | Featured, Patient Stories, Research

From left: Carol J. Levy, MD; Camilla Levister, NP; Co-Investigator Grenye O’Malley, MD, Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease); and Clinical Research Coordinator Selassie Ogyaadu, MD, MPH.

An artificial pancreas system tailored to the specific, and daunting, challenges faced by pregnant women with type 1 diabetes is the goal of a study to be conducted by a consortium of four leading institutions, including the Icahn School of Medicine at Mount Sinai. The project, funded by the National Institutes of Health, is the first of its kind in the United States.

“Pregnant women with type 1 diabetes typically test their blood sugars seven to eight times per day, and many wear glucose sensors, but they still struggle tremendously to keep their blood sugar levels in target ranges,” says Carol J. Levy, MD, Clinical Director of the Mount Sinai Diabetes Center, and the project’s principal investigator at the Icahn School of Medicine.

If blood sugar levels are too low for a prolonged period of time, a pregnant woman can feel poorly, or pass out, and risks seizures. If levels rise too high, there are risks to her unborn child, including malformations, delayed lung maturity, placental malfunction, or fetal death. “The use of customized technology provides an important opportunity to improve patient and fetal outcomes,” says Dr. Levy, Associate Professor of Medicine (Endocrinology, Diabetes and Bone Disease), Icahn School of Medicine at Mount Sinai. “We are excited to be part of the team evaluating this important area of research designed to improve care and reduce patient burden.”

The clinical trials will be conducted by specialists at three sites: Mount Sinai; the Mayo Clinic in Rochester, Minnesota; and the Sansum Diabetes Research Institute in Santa Barbara, California.

The overall principal investigator is Eyal Dassau, PhD, an expert on algorithm design and Director of the Biomedical Systems Engineering Research Group at Harvard University’s John A. Paulson School of Engineering and Applied Sciences.

Each patient participating in the artificial pancreas portion of the study will wear a Dexcom G6 continuous glucose monitoring device and an insulin pump. Both devices are linked with a software algorithm on a smartphone, which identifies a personalized blood-glucose range and prompts doses of insulin with reduced input from the patient. This is also known as a closed loop system because it uses a customized algorithm to close the decision-making loop between the glucose reading and the delivery of insulin, with the goal of improving blood sugar control.

In the artificial pancreas, or closed loop system, a controller—consisting of a software algorithm on a smartphone—receives readings from a continuous glucose sensor and prompts doses from an insulin pump, with reduced input from the patient.

The only artificial pancreas approved by the U.S. Food and Drug Administration is the Medtronic 670G. But it is designed for blood glucose targets between 120 milligrams/deciliter (mg/dL) and 180 mg/dL, while pregnant women with type 1 diabetes aim for a narrower range—under 90 mg/dL while fasting and 130 to 140 mg/dL one hour after meals.

“This is not easy to do, even for the most meticulous patients,” says Dr. Levy. Another challenge is that hormonal shifts in each trimester change the level of resistance to insulin, making the proper dose “a moving target.”

The first clinical trial in the grant—Longitudinal Observation of Insulin Requirements and Sensor Use in Pregnancy (LOIS-P)—is now enrolling 50 pregnant women with type 1 diabetes and will follow their glycemic outcomes into the postpartum period, providing guidance in refining the algorithm. The trial is named for the late Lois Jovanovic, MD, who was a former director of the Sansum Institute and a role model for many in the study of diabetes, including Dr. Levy. The overall project is intended to progress from a sequence of in-clinic studies to a safe and effective at-home clinical trial.

“I view this work as critical for patients, and I have a personal perspective as well, since I have had type 1 diabetes for 48 years,” Dr. Levy says. “I managed my diabetes with my health care team through two pregnancies, and every day was a challenge. Caring clinicians are important, and any support that people with type 1 diabetes can have provides a huge difference. Every time I enroll a patient in the LOIS-P study, I feel as if we are one step closer to a real answer for many women.”

For more information about the clinical trials, call 212-241-9089.

Changing the Paradigm for Patients With Treatment-Resistant Depression

Mar 14, 2019 | Featured, Psychiatry, Research

Dennis S. Charney, MD

The U.S. Food and Drug Administration on March 5 approved SPRAVATO™ (esketamine) CIII nasal spray for the treatment of treatment-resistant depression. Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, is a co-inventor of a method of treatment, which is patented and part of the drug application for SPRAVATO, a product of the Janssen Pharmaceutical Companies of Johnson & Johnson.

“As a researcher, you strive to come up with new treatments for the patient, especially in terms of finding answers to the most debilitating diseases,” says Dr. Charney, who is also President for Academic Affairs, Mount Sinai Health System. “To know that you oversaw the early development of an approach that can make a difference in the lives of countless individuals is extremely rewarding.”

Esketamine represents the first new mechanism of action in decades to treat major depressive disorder. Delivered in the form of a nasal spray, esketamine works differently than the three classes of antidepressants that are currently on the market. The drug works on the N-methyl-D-aspartate (NMDA) receptor, an ionotropic glutamate receptor in the brain. In contrast, widely used antidepressants target different neurotransmitters—serotonin, serotonin and norepinephrine, and norepinephrine and dopamine—and can take weeks or even months to work.

An estimated 30 percent of people who are treated for depression do not respond to therapies. Treatment-resistant depression (TRD) is a devastating disease that is associated with greater morbidity, higher health care costs, and various comorbid conditions.

“We commend Dr. Charney and his colleagues for their work in changing the paradigm for patients with treatment-resistant depression,” says Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System. “Through his commitment to innovation and science, Dr. Charney has inspired countless researchers to leverage new technologies and create discoveries to benefit the lives of patients around the world—while at the same time leading the Icahn School of Medicine to unparalleled growth and high national rankings.”

In his role as Dean of the Icahn School of Medicine, Dr. Charney says that many younger researchers look to him for advice. “I tell them that in science you’ve got to keep trying, to keep pushing,” he says. “There is a lot to be gained by working in a small group that is engaged in the give and take of scientific interaction. Researchers should understand that failure is going to happen, but they can use that failure as a stepping stone to discovery.”

Conflicts of Interest Disclosure: Dr. Charney is named as co-inventor on patents filed by the Icahn School of Medicine at Mount Sinai (ISMMS) relating to the treatment for treatment-resistant depression, suicidal ideation, and other disorders. ISMMS has entered into a licensing agreement with Janssen Pharmaceuticals, Inc., and it has and will receive payments from Janssen under the license agreement related to these patents for the treatment of treatment-resistant depression and suicidal ideation under this agreement. Consistent with the ISMMS Faculty Handbook, Dr. Charney is entitled to a portion of the payments received by the ISMMS. Since SPRAVATO has received regulatory approval for treatment-resistant depression, ISMMS and thus, through the ISMMS, Dr. Charney will be entitled to additional payments, beyond those already received, under the license agreement.

Continuity of Cardiac Care for South Nassau Patients

Mar 13, 2019 | Featured, Patient Stories

Patient Bill Regan with, from left: Robin Varghese, MD; Pilar Stevens-Haynes, MD; and Jason
Freeman, MD—members of the coordinated team that treated him on Long Island and in Manhattan.

Even before an official partnership was finalized in December 2018, specialists from the Mount Sinai Health System were collaborating with physicians at South Nassau Communities Hospital to provide advanced and coordinated care to Long Island patients. For 67-year-old Bill Regan, a retired financial services executive from Massapequa, this new relationship proved to be life-saving.

It was in March 2018 that Mr. Regan decided to try a new primary care physician—this time, at South Nassau Primary Care at Bellmore. During his first visit to Carolyne McHyman, DO, Mr. Regan provided the details of his medical history, which included a carotid endarterectomy, a surgical procedure to clear blockages in the carotid artery in the neck, and prescriptions for high blood pressure and high cholesterol. The former long-time smoker told Dr. McHyman that he was “generally in good health,” but when he also mentioned some daytime fatigue and left leg discomfort when he walked long distances, she ordered several diagnostic tests.

They included a chest CT scan, as part of The Mount Sinai Hospital’s Early Detection Lung Cancer Screening program; an ultrasound of the abdominal aorta to check circulation and to rule out an aortic aneurysm, an abnormal bulge in the aorta; a consultation to rule out a sleep disorder; and a recommendation to see his cardiologist, Pilar Stevens-Haynes, MD, for an evaluation.

The CT scan of the lungs, while negative for lung cancer, showed calcification in his aorta. The ultrasound of the abdominal aorta also showed narrowing of the left iliac artery in his pelvis, while a magnetic resonance angiography, which provides detailed images of blood vessels in the body, revealed a 90 percent blockage of that artery. “Honestly, I didn’t worry about my health, but these test results blindsided me,” recalls Mr. Regan.

Meanwhile, Dr. Stevens-Haynes recommended a cardiac catheterization to check for any blockages of his coronary arteries. “Bill didn’t have previous symptoms of chest pain, but coronary artery calcification can be associated with major adverse cardiovascular events, and we needed to get to the bottom of it,” says Dr. Stevens-Haynes.

When Jason Freeman, MD, Director of Interventional Cardiology at South Nassau Communities Hospital, performed the cardiac catheterization on April 24, he discovered that Mr. Regan’s left main and circumflex coronary arteries that supply blood to his heart were significantly blocked and could not be treated with stents, expandable tubes used to open clogged arteries. Now, Mr. Regan would need open-heart surgery—a diagnosis that was made immediately by Robin Varghese, MD, Associate Professor of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai, who was at South Nassau that day.

South Nassau’s Center for Cardiovascular Health has long been known for its outstanding care. It is a recipient of Healthgrades’ 2019 Coronary Intervention Excellence Award and five stars for its performance in coronary interventional procedures, placing it among the top 10 percent in the nation; however, it does not perform cardiac surgery.

“When I met with Dr. Varghese, the heart surgeon, I was very anxious, but I came out feeling this is going to be okay,” Mr. Regan says. “He walked me through what the procedure entailed. He had a diagram of the heart and the arteries, and he was positive, calming, and reassuring. He made me feel like ‘we got this and this is what we do every day.’”

Long Island patient Bill Regan was able to receive postoperative care, including cardiac rehabilitation, close to home in South Nassau.

On April 30, Dr. Varghese and his team at The Mount Sinai Hospital performed the three-hour surgery to restore blood flow to Mr. Regan’s heart. “After surgery, we took Bill to our Cardiac Surgery Intensive Care Unit,” says Dr. Varghese, who is also Director of Cardiovascular Critical Care for the Mount Sinai Health System. “He was sitting up in the chair in no time and looking great. He surprised us all.” Within four days, Mr. Regan was released from the hospital and was back home on the South Shore under the supervision of South Nassau’s Homecare program, attending church two days later in Massapequa.

“My entire experience was coordinated and supported by the most wonderful people from South Nassau and Mount Sinai,” says Mr. Regan. “I feel blessed, thankful, and overwhelmed with gratitude to everyone, and I mean everyone, involved in my treatment and recovery at South Nassau and Mount Sinai.”

After he was released from South Nassau’s Homecare program, vascular surgeon Xenophon Xenophontos, MD, performed a successful angioplasty of the left iliac artery. Mr. Regan also participated in South Nassau’s Cardiac Rehabilitation program at South Nassau’s Sports Medicine and Rehabilitation Therapy (SMART) Center in Oceanside, which he completed three months ago. Mr. Regan says he plans to return to the SMART Center this month for additional exercise programs.

Having access to advanced specialty care at The Mount Sinai Hospital while being able to stay close to home for pre- and postoperative care offers many benefits for patients. “Continuity of care is a key component of quality of care, especially when treating patients with multiple conditions,” says Adhi Sharma, MD, Executive Vice President for Clinical and Professional Affairs and Chief Medical Officer at South Nassau. “The care was not only life-saving for Bill, but a seamless journey and patient experience.”

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