Mount Sinai Seminar on Racism and Mental Health Draws an International Audience of Nearly 500 Participants

Mar 11, 2021 | Community, Diversity and Inclusion, Featured, Research


As the COVID-19 pandemic continues to reveal the significant racial disparities that exist in health care access and treatment across the United States, Mount Sinai’s neuroscience community is additionally exploring the profound connections between racism and mental health through a new seminar series.

The first seminar, “The Impact of Racism on Mental Health,” held virtually on Monday, January 25, featured two guest speakers, and drew nearly 500 members of the general public, and researchers and students from 35 universities across eight nations. It was sponsored by The Friedman Brain Institute, as part of its Diversity in Neuroscience initiative known as #DiverseBrains, and the Mount Sinai Office for Diversity and Inclusion. The seminars aim to raise awareness and address the inequities—and amplify the work of researchers studying the various effects of racism on minds and bodies.

The seminar was organized and moderated by Aya Osman, PhD, a third-year postdoctoral fellow at the Seaver Autism Center for Research and Treatment. Dr. Osman is studying the role of the gut microbiome in various neuropsychiatric disorders, including autism and addiction, in the lab of Drew Kiraly, MD, PhD. It was co-moderated by Joseph Simon, a fourth-year PhD neuroscience student studying social influences on decision-making in the laboratory of Erin Rich, MD, PhD, in the Nash Family Department of Neuroscience.

Participants included, clockwise from top left: co-moderator Joseph Simon; speaker Tanja Jovanovic, PhD; Aya Osman, PhD, event organizer and moderator; and speaker Monnica Williams, PhD, ABPP.

The aim of the seminars, said Dr. Osman, is to make research findings more accessible to the public and to increase scientific collaboration with researchers studying similar topics. “We hope this lecture series will open our eyes to the ways racism can be perpetuated and spark dialogue around dismantling structural racism in the mental health field and discuss ways to heal from its impact,” Dr. Osman said.

Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic and Scientific Affairs at the Icahn School of Medicine at Mount Sinai, welcomed the participants. “We launched #DiverseBrains about five and a half years ago to promote diversity and inclusion, and to create an optimal climate throughout The Friedman Brain Institute,” said Dr. Nestler. “And no conversation is more at the heart of our original goals than today’s topic.”

Invited speaker Monnica Williams, PhD, ABPP, Associate Professor, School of Psychology, University of Ottawa, and Canada Research Chair for Mental Health Disparities, gave a presentation on “Racial Trauma and New Directions in Healing,” which drew from existing research data. “We know there are profound connections between racism and mental health,” said Dr. Williams. “We have research over the past 20 years that shows definitive links to just about every major mental illness to experiences of racism and discrimination,” she said, citing post-traumatic stress disorder (PTSD), stress, anxiety, depression, obsessive-compulsive disorder, substance and alcohol abuse, eating disorders, severe psychological distress, psychosis, disability, and suicide.

Dr. Williams also discussed the growing use of medical psychedelics and the research that shows it may hold promise in helping to decrease the negative impact of racial trauma in minority populations. However, she pointed out that her own research has uncovered that minorities are greatly underrepresented in psychedelic medicine studies, with 82.3 percent of the people involved in these studies, as both patients and researchers, being white. “We can now make a strong case that future clinical trials need to examine the efficacy of psychedelics as an adjunct to psychotherapy for individuals with race-based trauma,” Dr. Williams said.

Speaker Tanja Jovanovic, PhD, Professor of Psychiatry and Behavioral Neurosciences, and the David and Patricia Barron Chair for PTSD Neurobiology at Wayne State University in Detroit, addressed the topic of “The Biological Impacts of Racism—Implications for Negative Health Outcomes.” Dr. Jovanovic’s research focuses on the interaction of traumatic experiences, neurophysiology, neuroendocrinology, and genetics in stress-related disorders in adults and children in high-risk populations. In her seminar presentation, she examined racial differences related to neurobiology and how the stressors of racism affect the brain.

“Racism impacts biology and should be treated as an illness,” she said. Dr. Jovanovic presented research showing the biological effects in those experiencing the chronic stress of racial discrimination. Altered physiological measures include higher levels of cell-free mitochondrial DNA, a biomarker associated with stress, aging, inflammatory processes, and cell death. Further, her research shows that racial discrimination may alter the automatic nervous system by increasing the activity of the sympathetic nervous system (increasing startle response, accelerating heart rate, constricting blood vessels, and raising blood pressure), and decreasing the peripheral nervous system, or vagal tone, which is associated with rest and regulation of stress responses.

The Mount Sinai Health System has an ongoing commitment to accelerate efforts to dismantle racism and advance equity through priorities established by the Office for Diversity and Inclusion. The BioMedical Laureates Program, for example, is one of the first in the nation to recruit underrepresented candidates and enhance diversity among senior research faculty. It includes an initiative to recruit and mentor Junior Laureates, those just starting their postdoctoral fellowships. Forming the foundation for these and future efforts is the Mount Sinai Health System Task Force to Address Racism, which was established to make Mount Sinai an anti-racist health care and learning institution that intentionally addresses structural racism.

Participants agreed that much work—at many levels—needs to be done on racism and research. Dr. Osman cited a need for an increase in Black faculty, and diversity training among principal investigators. Said Mr. Simon: “We must continue this dialogue in many different forms, and it’s important that we make this information and this outreach understandable for all.”

Indeed, educating the public is a key component of this effort, said Dr. Osman, who cites a need for solid, clear, science-based information that is understandable by the general public, which is driving her extensive public outreach through social and mass media. As this seminar series continues to invite speakers and discuss this topic, an additional goal is to explore grants that would fund further research into the impact of racism on health, and ways to eradicate it. The second seminar is planned for early spring 2021.

 

 

Artificial Intelligence Tools May Detect Abnormalities that Could Otherwise Be Missed

Mar 2, 2021 | Featured, Research

Mount Sinai radiologists are comparing machine-read patient discharge summaries with original, human-read reports.

A patient’s electronic health record typically contains a trove of information that can be used to help predict and manage their future health needs. But much of that information is often composed of unstructured or fragmented data that first must be translated into language that physicians are able to understand.

A new partnership between the Mount Sinai Health System’s Department of Radiology and an Israel-based start-up, Maverick Medical AI, is exploring how to accomplish that task through the use of artificial intelligence. In a proof-of-concept study, Maverick’s deep learning and natural language processing (NLP) algorithms are being used to accurately identify co-morbidities in 1.5 million patient discharge summaries and radiology reports. If it is successful, Maverick’s program could open the door for its use in an array of medical, research, and business opportunities at Mount Sinai.

David Mendelson, MD

David Mendelson, MD, Vice Chair of Radiology Information Technology at the Icahn School of Medicine at Mount Sinai, is playing a key role in the research. He says one of Maverick’s strengths is its ability to report on secondary abnormalities in nearby organ systems that are sometimes only partially seen or could possibly be overlooked in radiological screenings.

“If someone is screened for lung cancer and the findings are negative, that’s great news for the patient,” says Dr. Mendelson. “But if natural language processing could identify secondary indications like coronary artery calcification or abnormal density of the liver, which might suggest non-alcoholic fatty liver disease, that information could prove very useful to physicians and patients. Physicians might be able to take preventive steps to improve outcomes for patients and ultimately lower health care costs downstream.”

Determining whether Maverick’s propriety algorithm can provide that important information is the responsibility of Pamela Argiriadi, MD, Assistant Professor of Diagnostic, Molecular and Interventional Radiology at Mount Sinai. Dr. Argiriadi and a team of residents are spot-checking secondary co-morbidities extracted by the algorithm from an ocean of radiology reports and discharge summaries to determine how they compare to the original, human-read reports.

“Radiology reports contain a wealth of information and we hope our study will shed light on how key-word phrases in those documents can be mined to provide input into the well-being of patients,” Dr. Argiriadi says. “A major goal of ours is to improve communication with primary care providers by reporting secondary findings to them, which can result in follow-up treatment and preventive medicine.” The software can recognize these findings within the report, extract them, and flag them for the provider.

Yossi Shahak, Co-founder and Chief Executive Officer of Maverick Medical AI, estimates that as much as 80 percent of a patient’s health information remains untapped due to its unstructured format. Translating that raw, fragmented data into medical coding language would provide physicians with actionable clinical insights.

“We are starting with radiology and hope to expand the vocabularies across many medical subspecialties, like cardiology and gastroenterology,” says Mr. Shahak. “That expansion of our data sets could provide Mount Sinai physicians with significant value when they mine it for often overlooked chronic conditions and risk factors. In addition, the conversion from unstructured data into medical coding will help Mount Sinai improve their financial capabilities.”

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Young, Asymptomatic People Can Get Reinfected With COVID-19 and Spread it More Than Once, Study Shows

Updated on Jun 30, 2022 | COVID-19, Featured, Research

A prospective study of 3,249 Marine recruits—who were mostly male and between the ages of 18 and 20—shows a significant risk of reinfection among those who have antibodies to SARS-CoV-2, the virus that leads to COVID-19.

The study, posted on MedRxiv, was led by researchers at the Icahn School of Medicine at Mount Sinai working with the Naval Medical Research Center. It found that the risk of reinfection in those with antibodies was 18 percent of the risk of infection in those without antibodies. Most of the reinfected Marines were asymptomatic, and none required hospitalization. The infections were detected by PCR tests.

The findings support the importance of vaccinating all segments of the population, including individuals who have SARS-CoV-2 antibodies but were never actually diagnosed with COVID-19, and those who were diagnosed, recovered, and think they are now safe from another infection. The study also points to the fact that young people, who are typically asymptomatic, may unknowingly spread the disease to others more than once.

“It is important that we don’t neglect this college-age group of the population,” says the study’s lead author, Stuart Sealfon, MD, the Sara B. and Seth M. Glickenhaus Professor of Neurology, Neuroscience, and Pharmacology and Systems Therapeutics at Icahn Mount Sinai. “They are such an important group in spreading the disease. Many young people have this ‘get it and get over it mentality’ and unfortunately they still have a surprisingly high risk of recontracting it and possibly spreading the virus to others.”

The six-week study was highly controlled. It involved two separate periods of quarantine and multiple tests for COVID-19 before the recruits entered basic training at Marine Corps Recruit Depot, Parris Island, in South Carolina. The study found that among those with antibodies, the reinfected individuals had lower antibody levels and more often lacked detectable levels of the virus-neutralizing antibody activity that blocks infection.

According to Dr. Sealfon, the findings should help resolve any concerns over whether people who have already had COVID-19 should receive the vaccine, particularly in light of current vaccine shortages.

Stuart Sealfon, MD,

“That’s an important take-home message,” says Dr. Sealfon. “Certainly we can show from this study that there’s a fairly high risk of reinfection and not everybody who has had infection will generate effective immunity. So you really want to vaccinate everyone and not worry if they’ve had it or not.”

Why some people fail to generate persistent immunity against reinfection from COVID-19 remains unknown. But highly variable responses to any disease are actually beneficial for evolution.

“When a new disease shows up, individual immune responses are variable to ensure survival at a population level,” says Dr. Sealfon. “People have different genetics that make up their immune systems. They have different previous exposure histories that train the immune system in how to respond to new infections. Immunity uses combinatorial systems to hedge its bets to try and generate the best response it can within an individual and to vary what’s happening across individuals. As a result of individual differences, some people generate more effective long-term immune responses than others.”

In the November 11, 2020, issue of The New England Journal of Medicine, Dr. Sealfon published an earlier study of these marine recruits during their initial supervised quarantine period. He showed that strict public health measures including wearing face masks, social distancing, hand washing, and widespread testing did not completely suppress transmission of SARS-CoV-2.

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Researchers Identify a Promising New Antiviral Drug to Treat COVID-19

Updated on Jun 30, 2022 | COVID-19, Featured, Research

Plitidepsin is derived from Aplidium albicans, a marine organism that typically attaches itself to hard surfaces, such as reefs.

The search for better medical treatments for COVID-19 has led a team of scientists from the Icahn School of Medicine at Mount Sinai, with colleagues in San Francisco, to plitidepsin—a promising small molecule drug derived from a sea organism. When tested in human lung cells, plitidepsin was particularly effective in stopping the replication of SARS-CoV-2, the virus that causes COVID-19. In fact, in pre-clinical trials, plitidepsin was 28-fold more effective than remdesivir—the only antiviral drug currently approved by the U.S. Food and Drug Association (FDA) to treat COVID-19.

Kris M. White, PhD

The research team from Mount Sinai and the University of California at San Francisco recently published their work in Science, revealing one of the most promising efforts to date in identifying an already approved drug that could be successfully repurposed to fight COVID-19. Plitidepsin is approved in Australia—under the name Aplidin—as a treatment for multiple myeloma, a cancer that forms in a group of white blood cells.

One of plitidepsin’s strengths is that it inhibits eEF1A, a host protein within human cells that every variant of SARS-CoV-2 needs to survive. Viruses hijack a human’s cellular machinery in order to thrive and create more copies of themselves, but plitidepsin works by blocking an important pathway that would be used by SARS-CoV-2, its variants, and potentially other respiratory diseases such as respiratory syncytial virus and influenza. In a separate preliminary study in bioRxiv, the research team, and a group of colleagues in England, showed that plitidepsin was effective against b.1.1.7, the newly identified British variant of SARS-CoV-2.

“Aplidin is quite unique in its potency,” says one of the study’s corresponding authors, Kris M. White, PhD, Assistant Professor of Microbiology, and a member of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine. “It is likely going to be able to work against any variant of SARS-CoV-2 and other coronaviruses, including new pandemics that might happen in the future. eEF1A appears to be a broadly used protein for viruses because it has an important role in protein production, making it important for the host cell and also extremely important for the virus. Now we’re looking to test plitidepsin against these other viruses as well.”

Corresponding study author Adolfo García-Sastre, PhD, Professor of Microbiology and Director of the Emerging Pathogens Institute at the Icahn School of Medicine, says, “The ongoing pandemic created the immediate need for us to find antiviral therapeutics that could be moved into the clinic. This led us to screen clinically approved drugs with established data and safety profiles. We found that plitidepsin was a very promising therapeutic candidate.”

Adolfo García-Sastre, PhD

The decision to pursue plitidepsin resulted from research the team conducted last spring, when they identified 332 different host proteins that SARS-CoV-2 interacted with. The scientists looked to see which ones had FDA-approved drugs that targeted the host protein for cancer or other diseases and began following a trail that ultimately led them to Aplidin. Within a week after publishing their work in Nature, the researchers were contacted by PharmaMar, the drug’s small Madrid-based manufacturer.

In October, PharmaMar released the results of a phase 1,2 clinical trial of Aplidin for use against COVID-19, which showed the drug was safe and effective in helping hospitalized patients recover from the disease. By day seven after taking Aplidin, the patients’ viral load was reduced by 50 percent, and by day 15, viral load was reduced by 70 percent. More than 80 percent of patients had been discharged from the hospital on or before day 15.

The results of the clinical trial also confirmed the tolerability of Aplidin for patients with COVID-19. Tolerability had already been observed in studies of approximately 1,300 cancer patients who actually received higher doses of Aplidin than the COVID-19 patients. PharmaMar is currently establishing phase 3 clinical trials.

“The data has shown that it’s worth trying the drug in a phase 3 clinical trial,” says Dr. White. “There’s a good chance we might see efficacy and that it will be well tolerated by the patients at certain doses.” Like remdesivir, plitidepsin would be given intravenously in a hospital setting.

The researchers have proposed that the drug be tested for use alongside remdesivir and also dexamethasone, an anti-inflammatory authorized for use in severely ill COVID-19 patients. As with other antiviral drugs, plitidepsin would work only if given early in the disease cycle, in the active viral replication stage of COVID-19.

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Sixth Annual Mount Sinai Innovation Awards

Updated on Jun 30, 2022 | Community, COVID-19, Featured, Research

The Inventor of the Year team conducted research that led to diagnostic tests for antibodies to COVID-19. (Standing) Florian Krammer, PhD, PhD, Professor of Microbiology, left, and Carlos Cordon-Cardo, MD, PhD, Irene Heinz Given and John LaPorte Given Professor and Chair of Pathology, Molecular and Cell-Based Medicine. (Seated, from left) Daniel Stadlbauer, PhD, Postdoctoral Fellow; Fatima Amanat, Graduate Assistant; Adolfo Firpo-Betancourt, MD, Professor of Pathology, Molecular and Cell Based Medicine; Viviana Simon, MD, PhD, Professor of Microbiology; Ania Wajnberg, MD, Associate Professor of Medicine; and Damodara Rao Mendu, PhD, Director of Chemistry Laboratories, Department of Pathology, Molecular and Cell-Based Medicine.

Individuals and teams from the Mount Sinai Health System were honored for advances in biomedical research, technology, and medicine at the sixth annual Mount Sinai Innovation Awards ceremony, a virtual event held Tuesday, December 8, 2020.

Mount Sinai Innovation Partners (MSIP) presented the award for Inventor of the Year to an eight-member team led by renowned virologists and pathologists, whose efforts led to the development of multiple diagnostic tests for the detection of antibodies against the COVID-19 spike protein—the principal target of neutralizing antibodies.

The Innovation Awards also honored winners of the Faculty Idea Prize, the 4D Technology Development Award; the KiiLN Postdoctoral Entrepreneurship Award; and the Trainee Innovation Idea Award.

The event, which can be viewed here, was hosted by: SINAInnovations, MSIP, the Office of Faculty Development, the Graduate School of Biomedical Sciences, the Department of Medical Education, the Office of Postdoctoral Affairs, the Graduate Medical Education Office, and the Keystone for Incubating Innovation for Life Sciences Network (KiiLN).  

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Mount Sinai Researchers Describe Viral Sanctuaries in the Gastrointestinal Tract of COVID-19 Patients

Updated on Jun 30, 2022 | COVID-19, Featured, Research

A new study published in the journal Nature by researchers at Mount Sinai in collaboration with two other labs at Rockefeller University and co-investigators from the California Institute of Technology and Weill Cornell Medicine describes for the first time a persistence of SARS-CoV-2 in the intestines long after clinical resolution.

The study, entitled “Evolution of antibody immunity to SARS-Cov-2” and published online January 18, 2021, suggests that the memory B cell response to SARS-Cov-2 evolves between 1.3 and 6.2 months after infection in a manner that is consistent with antigen persistence.

Saurabh Mehandru, MD

The authors studied intestinal biopsies obtained from asymptomatic individuals four months after the onset of COVID-19.

Minami Tokuyama, a medical student at the Icahn School of Medicine at Mount Sinai, and other members of the Mehandru Lab at the School of Medicine discovered that SARS-CoV-2 antigens persisted in the lining cells (epithelium) of the intestines long after (3-4 months post infection) resolution of clinical symptoms. The presence of such sanctuary sites could potentially enable continued maturation of the antibody response as was independently discovered by the Nussenzweig Lab at Rockefeller University.

“This finding is significant because it suggests that the memory B cell response does not wane after six months, providing reassurance that those who have previously been infected with the virus will likely mount a vigorous response if they are exposed a second time,” says study author Saurabh Mehandru, MD, Associate Professor of Gastroenterology at the Icahn School of Medicine and Director of the Mehandru Lab.

“Additionally, the presence of viral sanctuaries within the body needs to be better understood in COVID-19 patients with chronic symptoms, or ‘long haulers,’ which could help in identifying novel opportunities for the treatment of this group of patients,” says Dr. Mehandru.

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