Updated on Jun 30, 2022 | Featured
Denisse Rojas Marquez
Growing up as an undocumented immigrant in Fremont, California, had a profound impact on Denisse Rojas Marquez and shaped her belief that access to higher education and quality health care should be available to all. In 2012, she gained relief from deportation through President Barack Obama’s Deferred Action for Childhood Arrivals program and in 2015 gained acceptance to the Icahn School of Medicine at Mount Sinai. Her achievements earned her the prestigious Paul & Daisy Soros Fellowship for New Americans award.
Now, Ms. Marquez can add another accomplishment to her impressive resume. She was named to the Forbes 30 Under 30 list of young achievers, which appeared in the magazine’s January 24, 2017, issue. Her work in cofounding Pre-Health Dreamers (PHD), a growing network of more than 800 undocumented students from 42 states who are interested in pursuing careers in science and health care, was cited by Forbes in its inclusion of Ms. Marquez. PHD provides resources and advocates for progressive institutional and governmental policies. Ms. Marquez’s inspiration for PHD is based on her experiences as a student who had to navigate her own educational and career aspirations with limited resources.
“Denisse embodies all of the best values and highest aspirations of a true physician-advocate,” says David Muller, MD, Dean for Medical Education at the Icahn School of Medicine at Mount Sinai, and the Marietta and Charles C. Morchand Chair for Medical Education. “I have great respect for the work she has done and the lives she’s changed as a result of her accomplishments.”
Updated on Jun 30, 2022 | Featured, Research
A population of cells in early development may give rise to the ventricular chambers of the heart, but not the atria, according to a study led by researchers from the Mindich Child Health and Development Institute at the Icahn School of Medicine at Mount Sinai and published in Nature Communications.
Feb 6, 2017 | Community, Featured, Seaver Autism Center
As part of an outreach program created by the Seaver Autism Center for Research and Treatment, children with autism have an opportunity to visit the American Museum of Natural History.
One Saturday morning each month, the American Museum of Natural History in New York City opens its doors an hour early to welcome a special group of visitors: children with autism and their families. What they experience is more than a simple stroll through the museum’s labyrinthine exhibition halls. Specialists at the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai have taught museum tour guides and volunteers how to engage and interact with children with autism spectrum disorder (ASD). The Seaver Autism Center has also developed social stories, visual cues, and prompt cards for these visits and has chosen to tour specific halls (Dinosaurs, North American Mammals, Planet Earth, and Ocean Life) based on their ability to meet the children’s sensory needs.
The three-year-old program has been “hugely successful,” says Michelle Gorenstein-Holtzman, PsyD, Assistant Professor of Psychiatry at the Mount Sinai Health System and Director of Community Outreach for the Seaver Autism Center for Research and Treatment. Specialized tours of the museum are continually booked, and exhibits are being added to keep up with the program’s popularity.
“I think you’re going to see more and more museums adopt specialized programs such as this, due to the growing demand,” says Dr. Gorenstein-Holtzman. She is helping the Long Island Children’s Museum—where she is an advisory board member—develop such a program.
The museum connection is a natural fit for the Seaver Center, which uses community outreach to share its knowledge and resources with patients and families across the tri-state area. Supported by a grant from the UJA Federation of New York, Dr. Gorenstein-Holtzman develops evidence-based social skills programming for children, adolescents, and young adults with ASD. The children’s lessons focus on play and conversational skills, while the newly developed young adult curriculum focuses on employment-based social skills.
Citywide outreach also takes the form of a Community Lecture Series held at schools and local meeting halls and a Distinguished Lecturer Series that shares the latest autism research in areas such as epidemiology, genetics, and early detection that are relevant to caregivers and professionals. “What’s unique about the Seaver Center is that we don’t confine our research to the lab,” says Dr. Gorenstein-Holtzman. “We’re continually disseminating our findings to the community so that they have greater meaning.”
In addition, the Seaver Center is translating its materials into Spanish and offering its services to Spanish-speaking families. Pilar Trelles, MD, a child psychiatrist and Seaver Clinical Fellow, is the principal investigator on a research project that partners Latino families of children who are newly diagnosed with autism with “peer advocates” in their community. The peer advocates are actively engaged parents with special-needs children themselves, who have received training from the state. They help newcomers navigate the system, which can often seem complex and overwhelming.
“One of the things that’s important to us is reaching out to minority families who have little idea what we do or how to access the programs we provide,” says Dr. Trelles. “Peer advocates understand what these families are going through and can relate to them in ways that others can’t. They’re able to give them hope that things are going to get better and that their children are going to get the help they need.”
Updated on Jun 30, 2022 | Featured, Research
Manish Arora, PhD, MPH, is known for his work on biomarkers—using human teeth to reconstruct the timing of exposure to harmful chemicals and essential nutrients.
Manish Arora, PhD, MPH, Vice Chair of the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, has been named a recipient of the Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed by the U.S. government on science and engineering professionals in the first 10 years of their independent research careers.
“Dr. Arora’s research is one of those rare paradigm shifts in science,” says Robert O. Wright, MD, MPH, Ethel H. Wise Professor of Community Medicine and Chair, Department of Environmental Medicine and Public Health, and Director, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory at the Icahn School of Medicine. “I first met him 10 years ago when he was a trainee with a big idea. When he explained the concept of using teeth to measure exposure to lead in pregnancy—to assign a date to an event that happened years ago—it felt like science fiction, but he was able to make it happen, which is a testament to both his intellect and perseverance.”
Dr. Arora, an environmental epidemiologist and exposure biologist with a clinical background in dentistry, has long been passionate about the environment and inventing. He earned a PhD analytical chemistry, and nuclear beam methods from the University of Sydney in Australia. He had a joint appointment at that university and at Harvard University’s School of Public Health before being recruited by Dr. Wright to Mount Sinai in 2013. But he credits a source close to home for his current success: his late mother. “She was a big proponent of generating new knowledge,” Dr. Arora says, but as a young girl in India, her education ended in middle school. “So she always valued education, much more than most people do, because it was not easily attainable to many of her generation.”
Dr. Arora focuses his research, which is funded by the National Institute of Environmental Health Sciences, on the effects of prenatal and early childhood chemical exposures on lifelong health. In the same way that trees have growth rings, he says, “we have growth rings in teeth, and because those start forming before you are born, we can actually go back in time and figure out, for example, what you were exposed to in the second or third trimester.”
A baby tooth being prepared for analysis by a laser.
Dr. Arora and his team collect teeth donated by families and dentists all over the world. To study the teeth, they invented novel techniques and equipment, including a robot that cuts, or “micro-dissects,” samples the width of a human hair. The samples are then analyzed for thousands of chemicals the donors may have been exposed to at different times of their development.
“There are two big findings: One is that it’s not just how much you are exposed to, it’s also when you get exposed to it,” Dr. Arora says. “That is what we are finding for diseases like Lou Gehrig’s disease (ALS), in which you become symptomatic at age 50, 60, 70. But the initial exposure—what altered your trajectory—may have occurred early in life. We are also discovering this is true for autism and schizophrenia.” Dr. Arora says the second finding is that a single chemical is not always the key. “What happens when you get exposed to a mixture of chemicals is not the same as when you get any single component. Previously, the technology to study these mixtures of chemicals didn’t exist, but the methods we are developing allow measurement with novel precision. We now have an NIH laboratory hub for this new technology.”
For this work, Dr. Arora received a New Innovator Award in 2014, which included $2.2 million from the NIH. Dr. Arora is now seeing results in the search for metal and organic risk factors. “The next phase will be finding approaches to mitigate the risk, both at a clinical level, with the goal of personalized environmental medicine, and also at a population level, to support public health and policy development,” Dr. Arora says. “The idea is that as clinicians we can treat people one-on-one, but taking broader action like getting rid of lead in gasoline helps all of us.”
Updated on Jun 30, 2022 | Featured, Patient Stories
“Doing Phenomenally Well”
Kaitlyn Crutchlow and dad Ross visit Anna Nowak-Wegrzyn, MD.
After birth, Kaitlyn Crutchlow seemed headed down the same high-risk road as her two brothers, who counted 30 allergies between them. At 4 weeks, she already had body-wide eczema and tested positive for milk and egg allergies. And blood and skin tests at the Elliot and Roslyn Jaffe Food Allergy Institute at Mount Sinai also showed a negative reaction to peanut, which prompted her physician, Anna Nowak-Wegrzyn, MD, Associate Professor of Pediatrics (Allergy and Immunology) at the Icahn School of Medicine at Mount Sinai, to start the infant at 6 months on a slurry of peanut butter and hot water through an eye dropper. “The idea of giving a potentially highly allergic food to an infant unable to verbalize was kind of nerve-racking,” admits Kaitlyn’s mother, Jenny Crutchlow.
Now, at 16 months of age, Kaitlyn is “doing phenomenally well,” reports her mom. A small rash around her mouth and some hives on the torso caused concern initially, but they disappeared after a month and now she consumes peanut-containing foods every day without any reaction. And that has given Ms. Crutchlow the luxury to think about a world free of the constant threat of allergic reactions. “Imagine your child being able to go to birthday parties without worrying about her having a piece of cake,” she says, “or eating at a restaurant without fear that anaphylaxis—a potentially fatal reaction to allergy—is around the corner.”
“Hopeful and Relieved”
Chia Kuo with son Ander
“I think many parents of kids with allergies have this level of guilt that they could have done something differently,” says Chia Kuo, whose 4-year-old twin daughters have food allergies, one of whom has a severe allergy to peanut. So, when her son, Ander, was born, Ms. Kuo was determined to give him an advantage her daughters did not have. She brought him to the Jaffe Food Allergy Institute for testing at 4 months and, soon after, under physician supervision, began introducing him to peanut-containing food as part of a risk-reduction regimen.
Mount Sinai’s Dr. Nowak-Wegrzyn has treated Ander’s older sisters for nearly five years. Dr. Nowak-Wegrzyn started Ander on small doses of diluted peanut butter even though his allergies were considered mild. After passing this initial “food challenge” at the Jaffe Institute, Ander was cleared for increasing amounts of the mixture at home, three to four times a week.
The prognosis for Ander at 10 months is encouraging. The eczema he has had since birth has remained stable, and Ms. Kuo has been advised her son’s chances of developing a peanut allergy are slim. “I’m hopeful and relieved,” she says. “If not for the treatment, there’s a good chance Ander may have wound up with severe allergies, just as one of my daughters did.”
Updated on Jun 30, 2022 | Featured, Research
Scott H. Sicherer, MD, left, and Hugh A. Sampson, MD
In a significant departure from past medical practice, new guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) call on parents to introduce peanut containing foods to infants as young as 4 to 6 months as a way to prevent potentially life-threatening peanut allergy. The guidelines, issued in January, were developed by an expert national panel that included two allergist-immunologists from the renowned Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai.
“About 4 million babies are born each year in the United States, and we know that two to two-and-a-half percent will develop peanut allergy,” says Hugh A. Sampson, MD, Director of the Jaffe Food Allergy Institute and the Kurt Hirschhorn Professor of Pediatrics. “We are not going to eradicate peanut allergy, but our goal with the new guidelines is to get the number of affected children down to about one percent.” Dr. Sampson was a member of the NIAID panel along with Scott H. Sicherer, MD, the Elliot and Roslyn Jaffe Professor of Pediatrics and Chief of the Division of Pediatric Allergy and Immunology.
Peanut allergy has grown alarmingly in recent years. According to a Mount Sinai study, allergy from peanut affected 1 in 250 children in the United States in 1997. By 2002, the incidence had jumped to 1 in 125 children, and to 1 in 70 children by 2008. The advocacy group Food Allergy Research and Education reports that food allergies result in 200,000 emergency room visits each year. “Peanut allergy tends to be severe, is potentially fatal, and is usually lifelong,” says Dr. Sicherer, “so having a strategy to prevent it, particularly one that is inexpensive to implement, offers tremendous benefits.”
For decades, allergists recommended that high-risk infants avoid exposure to peanuts through the first three years, but a landmark international allergy study, first published in 2015, proved to be a game-changer, showing that early introduction to peanut-containing food among allergy-prone infants reduced their chance of developing a peanut allergy by up to 80 percent.
The new guidelines, which were based largely on these findings, define which infants are at high, moderate, and low risk for developing peanut allergy and recommend to allergists and caregivers how to proceed with the introduction of peanut-containing food based upon risk and age. The guidelines also caution parents not to give whole peanuts to infants, and they offer peanut-containing food suggestions and methods to introduce these foods. To learn more about the guidelines, visit niaid.nih.gov.
