2022 Annual Meeting Highlights

The Intersectionality of Health Disparities— Pharmacology, Prescribing Bias, and Social Determinants of Health

Submitted by Dr. Margaret E. Gnegy, PhD

As pharmacologists and educators who are training the next generation of scientists and clinicians, we must acknowledge the bias and social determinants of health that impact the health and wellbeing of our country’s citizens.

Jayne S. Reuben, PhD, Associate Professor and Director of Instructional Effectiveness, Texas A&M University College of Dentistry kicked off the Presidential Symposium at the 2022 ASPET Annual Meeting at Experimental Biology.

“We are concerned about the constant use of federal funds to support this most notorious expression of segregation. Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”

In 1966, the Reverend Dr. Martin Luther King, Jr. spoke these words at the second convention of the Medical Committee for Human Rights in Chicago, Ill. These words still ring true today in 2022 as so painfully illustrated by the COVID pandemic that highlighted the differences in morbidity and mortality rates in historically minoritized communities. As pharmacologists and educators who are training the next generation of scientists and clinicians, we must acknowledge the bias and social determinants of health that impact the health and wellbeing of our country’s citizens. To bring these issues front and center, three speakers at EB 2022 unpacked concepts from different frameworks.

Speaker L’Aurelle A. Johnson, PhD, is an Assistant Professor in the Department of Experimental and Clinical Pharmacology at the University of Minnesota, College of Pharmacy. Her presentation explored Activating the DEIA Signaling Pathway through Pharmacology. Dr. Johnson spoke about the regulation of signal transduction pathways, which are complex and requires activation and inactivation of molecular pathways to elicit a desired response (i.e. cell proliferation, synaptic plasticity, long-term potentiation). Similarly, activating the Diversity, Equity, Inclusion, and Accessibility (DEIA) signal transduction pathway is a complex process, especially in the areas of activating people, education, and research. Effective activation of these signal transduction pathways requires: 1) reception, which is the detection and interaction between the signaling molecule or ligand with the specific receptor, 2) transduction, which is when the binding of the ligand to the receptors which initiates a sequential modification to downstream molecules that result in 3) a response, which is the outcome from a specific signal trigger. Dr. Johnson emphasized that people are important to the pharmacology enterprise and that diversity in people is important to ensure the perpetuity of the

pharmacology enterprise. Despite people being the primary ligand to activate its receptor, she explained, there are systemic antagonists of microaggressions - biases, stereotype threats - that prevent people from getting into the enterprise and being successful in the enterprise. However, once people get into the enterprise, there are several factors that result in people being innovative and having increased productivity and purpose in the pharmacology enterprise. Dr. Johnson outlined three key positive regulators—practicing cultural competence, effective conflict management styles, and the enterprise valuing difference and respecting difference.

She also stressed that education is critical to the pharmacology enterprise and is the foundation of accruing and disseminating knowledge to the scholarly communities. Despite education being the primary ligand to activate its receptor there is the systemic antagonist of standardized testing that prevents people from getting into pharmacology graduate education. However, once people get into graduate programs, educators need to practice inclusive teaching, ensure that an anti-racism curriculum is employed and that the program graduates are competent in the disciplines that one chooses to explore. Dr. Johnson noted that positive regulators of this desired response include adapting teaching methodologies to the various learning styles, honoring accommodations and respecting neurodiversity. The absence of these strategies serves as negative regulators of these responses.

Dr. Johnson pointed out that research is how the pharmacology enterprise makes novel discoveries to yield change. Many positive influencers of research, such as collaborations, lab climate and mentorship result in increased publications, research funding, evidence-building innovation and leadership development are important. Conversely, poor experiences in any of these areas may negate the desired response, she explained.

Crosstalk is when one or more of these pathways affects another, Dr. Johnson explained. In activating the DEIA pathway through pharmacology, the receptors of people, education, and research not only affect their individual pathways, but they also affect one another. For example, she said, negative regulators of people, such as microagressions and bias, also serve as negative regulators of education and research. In summary, by using the fundamental concept of signal transduction, we 1) highlighted how pharmacology intersects diversity, equity, inclusion, accessibility (DEIA) 2) explored the process of DEIA reception, transduction, and response in the area of people, graduate education, and research, and 3) explored the benefits/purpose of activating this pathway which fosters a scientific community that is innovative, discipline competent, welcoming and produces the next generations of pharmacology leaders. She asked attendees, “What steps are you going to take ensure that you activate the DEIA pathway People, Education, and Research within your institution?”

Wilson M. Compton, MD, MPE. Deputy Director, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Md., presented Advances in Research in Substance Use Disorders—Ensuring Equity. Substance use disorders are essentially geneticenvironmental-developmental conditions. Influential environmental factors include not only substance exposures themselves, but also characteristics of an individual’s family, neighborhood, school, and cultural contexts, Dr. Compton explained. Evidence regarding these environmental influences arise from both observational and experimental studies. He shared an example of a study done in rural Georgia that found a strong correlation between the number of teen years in poverty and diminishments by the early 20s in volume of brain structures that contribute to academic functioning, social development, learning, memory, mood, and stress reactivity. In contrast, those volumetric declines were not seen in the group whose families had received an experimental family-focused intervention when they were in early adolescence.

Dr. Compton noted that in response to national developments and research, NIDA has launched its Racial Equity Initiative, which focuses on three major domains: 1) enhancing the diversity of the overall addiction scientific workforce, 2) addressing internal inequities within NIDA’s own operations, and 3) health disparities research to ameliorate inequity in prevention and treatment care. One recent research accomplishment is the documentation of perceived racism and discrimination among 10-11-year-old children in the NIH Adolescent Brain Cognitive Development study. Other research has documented disparities in fatal drug overdoses which have disproportionately included American

Indian/Alaska Native persons, especially during the COVID pandemic. Dr. Compton stressed that social environmental factors such as racial and ethnic inequities are key determinants of addictive disorders/outcomes.

Dr. Asa Radix, MD, PhD, MPH. Director of Research and Education, Callen-Lorde Community Health Center, NY and Clinical Associate Professor, Columbia University presented Clinical Practice Guidelines in Transgender Healthcare. Statistics show that more than one million transgender and gender diverse adults live in the U.S. Transgender persons often encounter widespread stigma and discrimination, including in healthcare settings. In addition, Dr. Radix affirmed that access to medical care may be limited as health care providers often lack knowledge of the unique health concerns of this population. Therefore, it is important for healthcare workers to become familiar with the clinical practice guidelines for transgender individuals, including the standards of care for hormonal therapy and other gender-affirming interventions, for those who request them.

Guidelines for practice from the World Professional Association of Transgender Health (WPATH) have been in existence since 1979. Guidelines have also been published by The Endocrine Society. Dr. Radix noted that gender affirming interventions have been shown to improve quality of life, enhance social functioning and reduce rates of gender dysphoria in transgender individuals. The approach to hormone therapy is to recreate the hormonal milieu aligned with gender identity and patient goals, he explained. Although treatment is safe when used according to accepted guidelines, adverse effects may occur, such as venous thromboembolism on estrogen therapy. Individuals should be carefully monitored by knowledgeable health professionals who are aware of hormone-related adverse effects as well as potential drug-drug interactions. Dr. Radix stressed that all healthcare workers should strive to become culturally competent and knowledgeable to ensure that the settings they work in are welcoming and affirming to transgender individuals.

The Guppy Tank Translational Science Pitch Showcase

Submitted by Khalid Garman, MD/PhD and Mohamed Ghonim, PhD

The Guppy Tank Translational Science Showcase is a novel symposium that was first introduced virtually during EB 2021 and held for the first time in front of a live audience during EB 2022. The event was developed and organized by the ASPET Young Scientists Committee (YSC) to provide trainees with an opportunity to craft and deliver captivating pitches that highlight the translational impact and commercial value of their innovative research. Three finalists—Drs. Jia Nong and Subhi Marwari from the University of Pennsylvania and Dr. Mohamed Ghonim from St. Jude Children’s Research Hospital—were selected from a pool of highly competitive applications to compete for the Best Pitch Award. Each finalist was offered travel support and one-on-one mentoring by industry-expert coaches including Dr. Janet Clark (National Institute of Mental Health), Dr. Pamela Hornby (Johnson & Johnson), and Dr. Ross Corriden (Neuron23). Guppy Tank winner Dr. Jia Nong (center) with the keynote speaker, Dr. Nancy Stagliano (left), and one of the judges, Dr. Kyle Palmer (right).

The competitive segment of the event was proceeded by a keynote talk by Dr. Nancy Stagliano (Chief Executive Officer and Chair at Neuron23), who shared her incredibly successful scientific career journey traversing drug development, innovation, and startup biotech venture capital financing. Her talk covered the hallmark components of a translational science pitch and offered practical tips to developing broad audience-tailored presentations. Following the keynote talk, each finalist had 10 minutes to present their pitch in front of a live audience and elite panel of judges including Dr. Kyle Palmer (Opertech Bio), Dr. Frank Leu (Pennovation Center and Thomas Jefferson University), and Dr. Prabha Swayam (Temple University). Each pitch was followed by a five-minute Q&A session. Overall, all the finalists delivered phenomenal pitches and Dr. Jia Nong was selected to receive the Best Pitch Award for her pitch on nanomedicine as a novel therapeutic approach for the treatment of stroke.

Despite being held on the last timeslot of the last day of EB2022, The Guppy Tank Competition was well-attended, and the audience feedback was overwhelmingly positive. The YSC expressed gratitude for the coaches, judges, and the Divisions of Translational and Clinical Pharmacology and Drug Discovery and Development for a successful event. All involved believe the event provided the foundation for future YSC-organized science pitch showcases.

(l to r) The following received the Scientific Achievement Awards at the 2022 ASPET Annual Meeting at Experimental Biology in Philadelphia: Jin Zhang, PhD, FASPET, University of California San Diego, Robert R. Ruffolo Career Achievement Award in Pharmacology; Des R. Richardson, PhD, DSc, Griffith University, Otto Krayer Award in Pharmacology; Morris J. Birnbaum, MD, PhD, Pfizer, Inc., Pharmacia-ASPET Award for Experimental Therapeutics; Krzysztof Palczewski, PhD, University of California, Irvine, Goodman and Gilman Award in Receptor Pharmacology; Margarita L. Dubocovich, PhD, FACNP, FASPET, The State University of New York at Buffalo, Julius Axelrod Award in Pharmacology; Mikel Garcia-Marcos, PhD, Boston University, John J. Abel Award in Pharmacology; Krishnaswami Ramabadran, PhD, E. Leong Way Emeritus Travel Award. ASPET is dedicated to recognizing the best research in, contributions to and accomplishments in all areas of pharmacology. Scientists from all over the world and at all career stages are eligible for ASPET’s various awards. Learn more about the specific eligibility details for each award at http://www.aspet.org/awards.