Matthew Brown was spending his first year of college studying cell biology and neuroscience and exploring the full breadth of academic opportunities when his grandfather passed away from an aggressive form of lung cancer.
“That drove me toward the field of cancer biology and immunotherapy,” Mr. Brown says. “I became interested in the potential of translational studies to improve patient treatment.”
It was an interest that led Mr. Brown to the Master of Science in Clinical Research program at the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai.
He knew that Mount Sinai had a robust immunotherapy program and was a highly collaborative environment for research—not just internally but with other academic institutions and organizations across New York City.
“The potential to have a significant impact in improving patient outcomes and expanding the range of therapeutic options available to patients is what excites me.”
Once enrolled, he was drawn to the lab of Nina Bhardwaj, MD, PhD, who has made seminal contributions to human dendritic cell biology, studying their crucial function as sentinels of the immune system and their application in vaccine design. Mr. Brown planned to conduct research evaluating adaptive immune responses to new tumor antigens until the COVID-19 pandemic became New York City’s—and the world’s—most significant public health threat.
Mr. Brown quickly shifted his research focus to explore adaptive immune responses in the context of SARS-CoV-2, the virus that causes COVID-19. Specifically, his research is primarily focused on viral epitopes, the part of the antigen that is recognized by T cell and B cell receptors following exposure to SARS-CoV-2 and how this viral recognition is replicated in the context of vaccination.
“In doing these high-sensitivity mapping studies, we began to identify the shared and highly dominant epitopes that may provide the foundation for monitoring people after exposure and vaccination to assess their immunity and how that is sustained,” says Mr. Brown. “These mapping studies also allowed us to consider the impact of SARS-CoV-2 variants on immune recognition and identify potential targets for next-generation coronavirus vaccines.”
Mr. Brown, who graduated from the Clinical Research program in 2021, envisions using the same tools to identify shared and highly dominant epitopes on tumor antigens to enhance vaccine design in the context of cancer immunotherapy. He is now enrolled in the PhD in Biomedical Sciences Program at the Graduate School to continue his translational immunology training.
“My ultimate goal is to start my own lab to conduct translational research on therapeutics and vaccines in the context of cancer,” he says. “The potential to have a significant impact in improving patient outcomes and expanding the range of therapeutic options available to patients is what excites me.”
After years dedicated to raising her family and working 12-hour nursing shifts, Rosemary Espinal, BSN, RN, decided that January 2020 was the right time to return to school and take her health care career to the next level.
She enrolled in the Master of Science in Health Care Delivery Leadership program at Mount Sinai’s Graduate School of Biomedical Sciences, excited at the opportunity to drive innovation, address challenges, and elevate patient care. But then, the COVID-19 pandemic hit New York City.
Faced with the unknowns and the risk of exposing her family to the disease, Ms. Espinal, a cardiac intensive care unit (CICU) nurse at The Mount Sinai Hospital, initially thought of leaving both the program and her position—but she stayed. As she continued her studies, and as the CICU was converted to a COVID-19 ICU, she was able to identify real-time opportunities to maintain a cohesive staffing structure for her team and improve delivery of care by applying what she had learned through the program.
“I want to use what I have learned to provide excellent care from a new perspective, address the disparities my mother faced as a non-English-speaking immigrant, and guide the next generation of nurses to high standards of quality and safety for our patients.”
For her capstone project, Ms. Espinal undertook a quality improvement initiative to prevent hospital-acquired pressure injuries—using wound care champions to assess patient risk, incorporating injury prevention into her nursing unit’s daily huddles, and creating innovative applications of dressing foams and padding—with considerable success. She estimates there has been a 10 percent decrease in hospital-acquired pressure injuries. In November 2021, she started a new position as a quality manager for Mount Sinai’s Institute for Critical Care Medicine.
Ms. Espinal plans to receive her degree in spring 2022, a milestone achievement: she will be the first person in her immediate family to earn both a bachelor’s and a master’s degree. Her goal is to explore positions in quality management or risk management.
“I want to use what I have learned to provide excellent care from a new perspective, address the disparities my mother faced as a non-English-speaking immigrant, and guide the next generation of nurses to high standards of quality and safety for our patients,” she says. “But I also hope that my daughters will see that it is possible to excel as Hispanic women and to make a difference no matter what life throws your way.”
Brian J. Nickerson, PhD, JD, Senior Associate Dean for Masters Programs, says: “Rosemary’s story is an inspiring illustration of the kind of resilience, determination, and creativity prevalent in great leaders. We are truly fortunate to have her as student in our Leadership Program and proud to know she represents excellence in patient care.”
Growing up in Gabon, Jeannys Nnemnbeng, MD, RRT, knew she wanted to enter the world of medicine. Her passion was inspired by her father, an orthopedist, and by her own experience after being hospitalized with a pulmonary abscess.
But as she began her journey to become a clinician, Dr. Nnemnbeng discovered that studies of treatment efficacy among African populations are hard to find.
“It is not because there is a lack of brilliant minds,” says Dr. Nnemnbeng. “I believe it is because of a lack of training in clinical research methodology. I wanted to change that.”
That led Dr. Nnemnbeng to the Master of Science in Clinical Research program (MSCR) at the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai.
“I was looking for a program with a very specific focus on clinical research, and I knew Mount Sinai was top-notch, which meant I would have a very strong foundation for achieving my goal of becoming a physician-scientist in internal medicine.”
Dr. Nnemnbeng, who has expertise in respiratory therapy, started the MSCR program as the COVID-19 pandemic was about to ravage New York City hospitals. Recognizing that intensive care units urgently needed to determine best practices for patients put on mechanical ventilators after a combined diagnosis of COVID-19 and acute respiratory distress syndrome, Dr. Nnemnbeng launched an observational study of those patients who were admitted to Mount Sinai during the first three months of the pandemic and published preliminary results. She intends to publish more studies related to mechanical ventilation and quality improvement through clinical management.
Dr. Nnemnbeng, who graduated from the MSCR program in 2021, is pursuing a PhD in Clinical Research at Mount Sinai and preparing her dissertation under the mentorship of Alex Federman, MD, Professor of Medicine (General Internal Medicine), and Geriatrics and Palliative Medicine. She intends to conduct research evaluating the effect of peer support on chronic obstructive pulmonary disease outcomes in patients of African ancestry.
Eventually, Dr. Nnemnbeng would like to start a nonprofit aimed at mobilizing U.S. medical students to help other medical students and institutions around the world. “I love the idea of students from various countries collaborating to improve patient care, and I would like to do that for countries such as Guadeloupe, and in Gabon and Mali, where I trained,” she says.
An effective COVID-19 vaccine developed by scientists, from left, Florian Krammer, PhD; Adolfo García-Sastre, PhD; and Peter Palese, PhD, could help ease the shortage of vaccines available to low-and-middle-income countries.
The development of a safe, effective, and inexpensive COVID-19 vaccine that can easily be produced and distributed in low- and middle-income countries is underway at the Icahn School of Medicine at Mount Sinai, where early phase 1 clinical testing in Vietnam and Thailand has shown positive results.
The vaccine is the brainchild of three renowned scientists at Mount Sinai—Peter Palese, PhD, Horace W. Goldsmith Professor and Chair of the Department of Microbiology; Adolfo García-Sastre, PhD, Irene and Dr. Arthur M. Fishberg Professor of Medicine and Director of the Global Health and Emerging Pathogens Institute; and Florian Krammer, PhD, Mount Sinai Professor in Vaccinology. By combining their expertise, the scientists—who previously developed a universal influenza vaccine—hope to bring closure to this deadly pandemic by providing less affluent countries with an accessible and cost-effective COVID-19 vaccine they can manufacture themselves.
To date, the World Health Organization has distributed only 90 million vaccine doses to 131 countries, far short of the number needed to stop the spread of SARS-CoV-2, the virus that leads to COVID-19. More contagious variants of the virus will continue to evolve and plague countries around the world as long as their populations remain unvaccinated. “When we protect other countries we protect ourselves, as well,” says Dr. Palese.
Dr. Krammer says, “In North America and Europe many people are getting vaccinated and the virus circulation is going down. But that is not the case in countries in Asia or Latin America, for example. Their COVID-19 case numbers are going up quickly. They need a vaccine and they don’t have access.”
Anticipating this need, Dr. Palese and his colleagues designed Mount Sinai’s COVID-19 vaccine to use the avian Newcastle virus (NDV), and constructed it similarly to an influenza virus vaccine, which can be manufactured in embryonated or fertilized chicken eggs.
Mount Sinai’s COVID-19 vaccine, which would require two doses, could be made using the same influenza vaccine production facilities that many countries already have in place.
The NDV-based vaccine is engineered to express the spike protein of SARS-CoV-2. The construct is injected into an embryonated egg, the virus replicates, and the amplified vaccine virus is then collected, purified, and inactivated. According to Dr. Palese, the resulting vaccine is stable, extraordinarily immunogenic, and induces highly protective immune responses against SARS-CoV-2. Immunogenicity is a measure of the type of immune responses that a vaccine generates and their magnitude over time.
“The beauty of this vaccine is that it can be made using the same influenza vaccine production facilities that many countries already have” in place, Dr. Krammer says. Approximately three billion doses of flu vaccine are produced each year using embryonated eggs.
There are other advantages, as well. Mount Sinai’s Newcastle vector vaccine does not appear to cause any side effects, such as the low-grade fevers, headaches, or pain and swelling at the injection site that are associated with the Moderna and Pfizer-BioNTech mRNA vaccines. The vaccine can also be stored at the same temperature as a home refrigerator, whereas both mRNA vaccines require extra-cold temperatures found only in commercial-grade freezers.
Mount Sinai’s vaccine, says Dr. Palese, can “probably be produced for under one dollar per dose,” and will require two doses spread over 21 days. By comparison, the mRNA vaccines, which also require two doses spread over three to four weeks, cost roughly $50 per dose. To keep costs down, Mount Sinai has agreed to grant licenses for its intellectual property to low- and middle-income countries that produce the vaccine and forgo any royalties on its use.
Dr. Garcia-Sastre says, “Prior to COVID-19, we realized the potential of NDV-based vaccines and for several years optimized this vaccine vector to achieve optimal immunogenicity of the delivered antigen (or toxin). NDV-based vaccines not only have the potential to stop COVID-19 in countries that have no access to the existing SARS-CoV-2 vaccines, but could be easily tailored to stop future pandemics caused by novel pathogens.”
As phase 2 testing for the vaccine ramps up in Thailand and Vietnam, accelerated phase 1 trials are ongoing in Mexico and Brazil. The trial designs used in these countries should lead to rapid phase 3 results. So far, the scientists say they have been pleased with their phase 1 results and with the tests that have been conducted in animal models.
“You can say that in animals, the vaccine protects beautifully,” says Dr. Krammer. “There is preliminary immunogenicity data that suggests the vaccine induces very good neutralizing titers.”
It is not yet clear whether the current vaccine will need to be updated to protect against aggressive new variants, according to Dr. Krammer. “But if it’s needed, we can change and move quickly to a variant vaccine. It would not be complicated.”
With regard to safety, which is top priority in a phase 1 trial, Dr. Palese says, “We are passing with flying colors.”
The Blavatnik Family Women’s Health Research Institute (BFWHRI) congratulates Tracy Layne, PhD, MPH, who was recently awarded the Schneider-Lesser Foundation Fellowship for Junior Faculty. The fellowship is intended to advance the chances of long-term success for promising junior faculty in the Investigator or Clinician-Educator Tracks at the Icahn School of Medicine at Mount Sinai.
Dr. Layne is an Assistant Professor in the Departments of Population Health Science and Policy and Obstetrics, Gynecology and Reproductive Science as well as a faculty member of the Blavatnik Family of Women’s Health Research Institute.
Since joining the BFWHRI in December 2018, Dr. Layne has had the opportunity to join multiple projects, including a study examining whether there are treatment differences among Black and White women with advanced endometrial cancer. A cancer epidemiologist with a background and interest in the multifactorial and often interrelated drivers of racial and ethnic cancer disparities across the cancer continuum, Dr. Layne focuses on the etiology of disparities in endometrial and ovarian cancer risk and mortality. Her research centers on endometrial cancer and is aimed at understanding the elevated risk of aggressive disease among Black women and the contributors that make it the largest Black-White disparity in gynecologic mortality. A critical component of her work is collaborating with faculty across multiple disciplines and institutions on a range of clinical, epidemiological, and socioeconomic issues relevant to narrowing gaps in women’s health disparities research.
In 2020, five fellowships of $20,000 each were awarded to recipients that have demonstrated high impact research accomplishments and have strong potential for an independent scientific career. Dr. Layne will use her support from the Schneider-Lesser Foundation Fellowship for Junior Faculty to develop preliminary data that examines the relationship between vitamin D metabolism and endometrial cancer disparities between Black and White women.
“Black women are virtually missing from the preclinical and observational research examining the relationship between vitamin D activity and endometrial cancer,” says Dr. Layne. “This despite preclinical research suggesting that vitamin D metabolism is altered in endometrial cancer tissue and may be associated with aggressive disease. It is also notable given that Black women have well-established higher rates of both aggressive endometrial cancer and chronically lower circulating vitamin D concentrations compared to their White counterparts. With these factors in mind, this project will use next-generation sequencing to evaluate whether patterns of vitamin D activity, as measured by gene expression and genomic interaction, differs in bio-banked tissue from non-Hispanic Black and non-Hispanic White women with endometrial cancer.”
We look forward to highlighting Dr. Layne’s research findings from this prestigious award in the coming months. Congratulations and well done, Dr. Layne!
The Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai conferred 201 master’s degrees during a ceremony that was held virtually on Friday, June 26, as New York City continued to observe masking and social distance protocols in the midst of the COVID-19 pandemic. The Graduate School now has eight master’s degree-granting programs, including its newest, Biomedical Data Science, which graduated its first student.
“Class of 2020, I applaud your passion, your dedication, and your commitment to hard work,” said Marta Filizola, PhD, in greeting the graduates. Dr. Filizola is Dean of the Graduate School of Biomedical Sciences and the Sharon & Frederick A. Klingenstein/Nathan G. Kase, MD Professor of Pharmacological Sciences, and Neuroscience.
Marta Filizola, PhD
“This has, of course, been an academic year with an unusual conclusion. But even in these times, there is much to be grateful for. In a year when the world is filled with uncertainty, I also feel hope because of all of you,” she continued. “You have seen your studies through, and now, when they are greatly needed, you will be applying your new skills in biomedical sciences, in data science and statistics, in genetic counseling and clinical research, in public health and health care leadership, to meet some of the greatest challenges these fields have ever faced. Whether you continue in academia; pursue careers in biotechnology, pharmaceuticals, or other industries; or even start your own companies and show the world what it has been missing, I hope you will do it with drive, with discipline, with integrity, and with empathy. The world can use your help.”
Presiding over the ceremony was Eric J. Nestler, MD, PhD, Director of The Friedman Brain Institute, Dean for Academic and Scientific Affairs, and Nash Family Professor of Neuroscience. In addressing the graduates, he said: “We were caught flat-footed by COVID-19 and should have responded much better early on, but public health and modern medicine have saved the lives of innumerable people—through medical support, antiviral agents, and mitigation efforts—who otherwise would have died. And how impressive and heartening it has been to see the leadership role played by Mount Sinai and our health care heroes on the front lines in these efforts.”
Eric J. Nestler, MD, PhD
Still, Dr. Nestler cautioned, “As we continue to focus on containment and treatment, we must also now heed warnings on the impact of contagion on our humanity. We have already seen a dramatic increase in depression, post-traumatic stress, suicide, and drug overdoses, and we all expect that this is the tip of the iceberg of people who are hurting emotionally from the stress and fear of themselves or loved ones getting sick, in addition to the toll of social isolation and severe unemployment. We should also keep the toll of COVID-19 in perspective. Before the pandemic, 70,000 Americans died each year of drug overdoses, and 50,000 from suicides; one might argue that addiction, depression, and suicide have been pandemics for years to which our society has not paid nearly enough attention.”
Dr. Nestler introduced Helena Hansen, MD, PhD, Associate Professor of Anthropology and Psychiatry at the Grossman School of Medicine at New York University, who gave the Commencement address. Dr. Hansen also was awarded an honorary Doctor of Science degree for dedicating her “wide-ranging career to studying the intersections of social forces and medicine, identifying opportunities for improving health, and greatly improving access to care for all.”
Helena Hansen, MD, PhD
Dr. Hansen, who began her training at the peak of AIDS activism, challenged the graduates to seek wisdom in new places. “Our turbulent times have placed health inequalities and climate as centerpieces of social justice, at the very center of our society’s future. You, as highly trained scholars and practitioners of public health, are in the eye of the storm,” she said, as she provided the graduates with three principles for positive action. “Look for expertise and leadership from ‘below.’ The power structure of our society will continually belittle the knowledge of those who never had access to college or graduate education. Your job is to go against the grain and redefine knowledge, expertise, and power.”
She continued: “Look up to larger systems for fundamental causes of syndemics and health inequalities—their roots are almost always in policies and institutions. The predictable patterns of overlapping epidemics signal that they are biosocial in nature, that they represent the biological end points of social environmental assaults. Your job will be to continually redefine health problems from problems of individual behaviors to problems of pathological systems. Build communities of practice wherever you go: you will need the affirmation and power of many like-minded people.” Dr. Hansen concluded, “I congratulate you on choosing the eye of the storm for your career, and I look forward to meeting you there.”
Charles Sanky, MPH
Charles Sanky, a dual MD/MPH degree candidate who received a Master of Public Health degree and intends to complete his MD degree in 2021, was the student speaker. “I’d like to talk about muting ourselves,” he began. “It’s something we tend to do out of courtesy on Zoom calls, but we do this in real life, too—stopping ourselves from speaking our truth, taking action, and sharing what we have to offer. Some of us have felt powerless and incapable of meaningfully effecting change without more education, more skills, more experience. ‘If only I get my master’s, then I’ll be able to tackle the big questions. Then, I’ll be able to contribute. Then, I will be heard.’ We muted ourselves instead of realizing that we had a powerful voice all along.”
Mr. Sanky urged the Class of 2020 to not be silent. “Our graduation, this moment, celebrates our ability to raise our voices, to continue in that fight for serving humanity through health care,” he said. “We have the privilege, ability, and the duty to do something more, to push boundaries to reimagine solutions. In this moment, let’s promise ourselves that we will speak up, take action, be creative, and think beyond the structures handed to us. Class of 2020, let’s live our lives off mute.”
