Houston Methodist Methodology Magazine - Summer 2019 by Houston Methodist Professional Publications

METHODOLOGY

The Research and Education Magazine of Houston Methodist Summer 2019

The Heart of Progress Valve Development Advances The DeBakey Legacy

Houston Methodist Institute for Academic Medicine Executive Leadership

FROM THE INSTITUTE FOR ACADEMIC MEDICINE As we enter the second half of our Centennial Year celebration, we reflect on the legacy of research and innovation that is the cornerstone of Houston Methodist. In this issue of Methodology, we highlight stories that illustrate how our legacy of innovation serves as the foundation for

translating discoveries into treatments and cures for our patients. The cover story describes a study by the Houston Methodist DeBakey Heart & Vascular Center’s Michael Reardon, MD, establishing minimally-invasive valve replacement as the new standard of care–upholding Dr. DeBakey’s legacy of transformative heart care. As education is at the

The Heart of Progress

Rogue DNA Fragments 14

Catch a Rising Star 16

New Nanochannels Deliver Immunotherapy 18

Best of Both Worlds

Translational Imaging Center

Cellular Insights in High Cholesterol

Art at the Nanoscale 22

Innovating in Pharmacy 24

A New View of Strep

NEWS HIGHLIGHTS

FEATURES

Q & A: Nestor Esnaola, MD

H. Dirk Sostman, MD, FACR President, Institute for Academic Medicine MD Anderson Foundation Distinguished Chair in Molecular Imaging Houston Methodist Emeritus Professor of Radiology Weill Cornell Medical College

in both medicine and engineering. Department of Nanomedicine Chair Alessandro Grattoni, PhD, collaborated with Department of Radiation Oncology Chair E. Brian Butler, MD, on a direct-to-tumor nanodevice for treating research team members Kaifu Chen, PhD, and Longhou Fang, PhD, made discoveries that

EnMed's First Class 30

News Briefs Endowed Positions Honor Centennial

EnMed’s inaugural class in this issue emphasizing the unique program that offers a degree

triple-negative breast cancer. The DeBakey Heart & Vascular Center’s cardiovascular sciences

Destination Research

heart of everything we do in the Institute for Academic Medicine, there is a snapshot of

resulted in their seminal works recognized for publication in Nature and Science, respectively.

And the newly renovated Translational Imaging Center now houses one of the world’s most powerful MRI machines. As you will read, our tradition of exceptional research and innovation is strongly upheld by our faculty in everything we do, ensuring Houston Methodist’s legacy continues long into the future.

Recruitment & Accolades H. Dirk Sostman, MD, FACR

Upcoming Events

Edward A. Jones President and CEO Houston Methodist Research Institute Senior Vice President Houston Methodist

President, Institute for Academic Medicine MD Anderson Foundation Distinguished Chair in Molecular Imaging Houston Methodist Emeritus Professor of Radiology Weill Cornell Medical College

Board of Directors • Houston Methodist Research Institute

Front cover: Michael Reardon, MD, with the Medtronic EvolutTM PRO TAV

Timothy B. Boone, MD, PhD Director, Education Institute Chair, Department of Urology Houston Methodist

David C. Baggett, Jr.

John P. Cooke, MD, PhD

Gregory V. Nelson

John F. Bookout, Jr.

Martha DeBusk

Mary Eliza Shaper

John F. Bookout, III

Dan O. Dinges

H. Dirk Sostman, MD

Marc L. Boom, MD

Antonio M. Gotto, Jr., MD, DPhil

Douglas E. Swanson, Jr.

Timothy Boone, MD, PhD

Edward A. Jones

Andrew C. von Eschenbach, MD

Carrie L. Byington, MD

Evan H. Katz

Joseph C. "Rusty" Walter, III

Joseph R. "Rod" Canion

Edwin H. Knight

Martha Walton

David Chao

Pastor Kenneth R. Levingston

Elizabeth Wareing

Stephen Chazen

Kevin J. Lilly

Judge Ewing Werlein, Jr.

Augustine M.K. Choi, MD

Steven S. Looke

Ernest D. Cockrell, II

Vidal G. Martinez

Read more online: issuu.com/instituteforacademicmedicine

Houston Methodist Institute for Academic Medicine Executive Leadership

The Heart of Progress

Rogue DNA Fragments 14

Catch a Rising Star 16

New Nanochannels Deliver Immunotherapy 18

Best of Both Worlds

Translational Imaging Center

Cellular Insights in High Cholesterol

Art at the Nanoscale 22

Innovating in Pharmacy 24

A New View of Strep

NEWS HIGHLIGHTS

FEATURES

Q & A: Nestor Esnaola, MD

EnMed's First Class 30

News Briefs Endowed Positions Honor Centennial

EnMed’s inaugural class in this issue emphasizing the unique program that offers a degree

triple-negative breast cancer. The DeBakey Heart & Vascular Center’s cardiovascular sciences

Destination Research

heart of everything we do in the Institute for Academic Medicine, there is a snapshot of

resulted in their seminal works recognized for publication in Nature and Science, respectively.

Recruitment & Accolades H. Dirk Sostman, MD, FACR

Upcoming Events

Edward A. Jones President and CEO Houston Methodist Research Institute Senior Vice President Houston Methodist

President, Institute for Academic Medicine MD Anderson Foundation Distinguished Chair in Molecular Imaging Houston Methodist Emeritus Professor of Radiology Weill Cornell Medical College

Board of Directors • Houston Methodist Research Institute

Front cover: Michael Reardon, MD, with the Medtronic EvolutTM PRO TAV

Timothy B. Boone, MD, PhD Director, Education Institute Chair, Department of Urology Houston Methodist

David C. Baggett, Jr.

John P. Cooke, MD, PhD

Gregory V. Nelson

John F. Bookout, Jr.

Martha DeBusk

Mary Eliza Shaper

John F. Bookout, III

Dan O. Dinges

H. Dirk Sostman, MD

Marc L. Boom, MD

Antonio M. Gotto, Jr., MD, DPhil

Douglas E. Swanson, Jr.

Timothy Boone, MD, PhD

Edward A. Jones

Andrew C. von Eschenbach, MD

Carrie L. Byington, MD

Evan H. Katz

Joseph C. "Rusty" Walter, III

Joseph R. "Rod" Canion

Edwin H. Knight

Martha Walton

David Chao

Pastor Kenneth R. Levingston

Elizabeth Wareing

Stephen Chazen

Kevin J. Lilly

Judge Ewing Werlein, Jr.

Augustine M.K. Choi, MD

Steven S. Looke

Ernest D. Cockrell, II

Vidal G. Martinez

Read more online: issuu.com/instituteforacademicmedicine

FEATURES

The Heart of Progress

Houston Methodist’s doctors never stop

The study, which compared outcomes for transcatheter

to rest on their history-making laurels, and

aortic valve replacement (TAVR) with those of open heart

Stephen Little, MD, is already looking ahead

surgery, indicated that the minimally invasive procedure—

to the next innovation. The John S. Dunn

initially used to help high-risk, older patients avoid open

Chair in Clinical Cardiovascular Research

heart surgery—also offers a safer option for lower-risk,

and Education and associate professor of

younger patients. TAVR is now poised to become the

Innovative valves create a legacy for the future

clinical cardiology has designed a mitral

new normal, pending FDA approval of the procedure

Stephen Little, MD

for low-risk patients.

replacement surgery required by hundreds of thousands of patients annually.

“Transcatheter aortic valve replacement is expected to become the new standard within a few years,” said Michael J. Reardon, MD, Allison Family Distinguished Chair of Cardiovascular Research, Houston Methodist

by LaVonne Carlson

DeBakey Heart & Vascular Center, and professor of cardiovascular surgery. “At that point, procedures will

Houston Methodist is at the forefront of history…again. The cover of April’s Cardiology News proclaimed “Historic Moment: Two trials crown TAVR over surgery” and featured Houston Methodist heart surgeon Michael Reardon, MD, speaking to an audience of thousands of cardiologists at the American College of Cardiology conference. He was sharing results of a highly acclaimed study in The New England Journal of Medicine.

valve better suited to the minimally-invasive

As medical director of the Houston Methodist Valve Clinic, Little studies over 3,000 echocardiograms every year. He knows the distinct challenges posed by trying to replicate all the elements of normal valve function.

probably increase from 60,000 to 100,000 in the

“The currently available surgical valves don’t replicate the function

U.S. annually.”

of the mitral valve we’re born with,” said Little. “To improve outcomes for patients after surgery, we developed a new artificial valve to

More than 1,400 patients in seven countries were enrolled in the study, which used a Medtronic valve for the procedures. Results included the rate of death or stroke after 30 days (0.8% for TAVR compared to

mimic the complex mechanical actions, and couple the valve function to the ventricular function. This innovation aims to improve the quality and efficiency of blood flow after surgical valve replacement.”

2.6% for surgery) and after two years (5.3% for TAVR

With 3D imaging and extensive data, Little collaborated with bioengineer

compared to 6.7% for surgery). Additionally, most patients

Matt Jackson and Stephen Igo, director of the Entrepreneurial

can return home within 48 hours, with recovery taking

Institute at Houston Methodist, to co-invent the specialized valve

about a week. Traditional open heart surgery often

they named the MitraMimicTM. Little has a patent-pending prototype

requires weeks, or months, to recover.

and recently received funding from the Translational Research Initiative for further development. He now aims to find a start-up

Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada, H, O’Hair D, Bajwa

investor, prepare for FDA

T, Heiser JC, Merhi W, Kleiman NS, Askew J, Sorajja P, Rovin J, Chetcuti

testing and begin long-term

SJ, Adams DH, Teirstein PS, Zorn GL, Forrest JK, Tchétché D, Resar J, Walton A, Piazza N, Ramlawi B, Robinson N, Petrossian G, Gleason TG,

preclinical trials.

Oh JK, Boulware MJ, Qiao H, Mugglin AS, Reardon MJ. Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. New England Journal of Medicine: March 16 2019.

1953 Michael DeBakey, MD, performs first successful removal of blockage in the carotid artery, establishing the surgical treatment of stroke

DeBakey performs first aortocoronary artery bypass

1964

1968 DeBakey performs first multiple-organ transplant of a heart, lung and both kidneys from one donor to four recipients

Houston Methodist doctors perform first angioplasty

1980

1987 Houston Methodist recognized as first Medicare-designated heart transplant center in Texas and one of first nationally

Michael Reardon, MD, performs first successful autotransplant for cardiac malignancy

1998

2001 Houston Methodist DeBakey Heart & Vascular Center officially opens

Center is among first to repair a leak surrounding a patient’s mitral valve through a small puncture in the groin

2008

2011 Center launches DeBakey Institute for Cardiovascular Education and Training (DICET), first-of-its-kind in the nation

1,000th transcatheter Texas A&M and aortic valve replacement Houston Methodist announce EnMed (TAVR) performed

2016

2017 1,000th heart transplant, performed in collaboration with J.C. Walter Jr. Transplant Center

FEATURES

The Heart of Progress

Houston Methodist’s doctors never stop

The study, which compared outcomes for transcatheter

to rest on their history-making laurels, and

aortic valve replacement (TAVR) with those of open heart

Stephen Little, MD, is already looking ahead

surgery, indicated that the minimally invasive procedure—

to the next innovation. The John S. Dunn

initially used to help high-risk, older patients avoid open

Chair in Clinical Cardiovascular Research

heart surgery—also offers a safer option for lower-risk,

and Education and associate professor of

younger patients. TAVR is now poised to become the

Innovative valves create a legacy for the future

clinical cardiology has designed a mitral

new normal, pending FDA approval of the procedure

Stephen Little, MD

for low-risk patients.

replacement surgery required by hundreds of thousands of patients annually.

by LaVonne Carlson

DeBakey Heart & Vascular Center, and professor of cardiovascular surgery. “At that point, procedures will

valve better suited to the minimally-invasive

probably increase from 60,000 to 100,000 in the

“The currently available surgical valves don’t replicate the function

U.S. annually.”

of the mitral valve we’re born with,” said Little. “To improve outcomes for patients after surgery, we developed a new artificial valve to

2.6% for surgery) and after two years (5.3% for TAVR

With 3D imaging and extensive data, Little collaborated with bioengineer

compared to 6.7% for surgery). Additionally, most patients

Matt Jackson and Stephen Igo, director of the Entrepreneurial

can return home within 48 hours, with recovery taking

Institute at Houston Methodist, to co-invent the specialized valve

about a week. Traditional open heart surgery often

they named the MitraMimicTM. Little has a patent-pending prototype

requires weeks, or months, to recover.

and recently received funding from the Translational Research Initiative for further development. He now aims to find a start-up

Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada, H, O’Hair D, Bajwa

investor, prepare for FDA

T, Heiser JC, Merhi W, Kleiman NS, Askew J, Sorajja P, Rovin J, Chetcuti

testing and begin long-term

SJ, Adams DH, Teirstein PS, Zorn GL, Forrest JK, Tchétché D, Resar J, Walton A, Piazza N, Ramlawi B, Robinson N, Petrossian G, Gleason TG,

preclinical trials.

Oh JK, Boulware MJ, Qiao H, Mugglin AS, Reardon MJ. Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. New England Journal of Medicine: March 16 2019.

1953 Michael DeBakey, MD, performs first successful removal of blockage in the carotid artery, establishing the surgical treatment of stroke

DeBakey performs first aortocoronary artery bypass

1964

1968 DeBakey performs first multiple-organ transplant of a heart, lung and both kidneys from one donor to four recipients

Houston Methodist doctors perform first angioplasty

1980

1987 Houston Methodist recognized as first Medicare-designated heart transplant center in Texas and one of first nationally

Michael Reardon, MD, performs first successful autotransplant for cardiac malignancy

1998

2001 Houston Methodist DeBakey Heart & Vascular Center officially opens

Center is among first to repair a leak surrounding a patient’s mitral valve through a small puncture in the groin

2008

2011 Center launches DeBakey Institute for Cardiovascular Education and Training (DICET), first-of-its-kind in the nation

1,000th transcatheter Texas A&M and aortic valve replacement Houston Methodist announce EnMed (TAVR) performed

2016

2017 1,000th heart transplant, performed in collaboration with J.C. Walter Jr. Transplant Center

FEATURES

The Best of Both Worlds Applying design thinking to surgical devices

VALKYRIE Valkyrie

The Valkyrie is a non-invasive, wearable diagnostic device

After seeing the effect on patients, Hansen began exploring

that monitors blood flow in the lower extremities. It was

alternatives, which led to the invention of the Valkyrie.

designed for trauma patients who run the risk of compartment

He is now working with Houston Methodist surgeon

syndrome, a dangerous condition that can cause permanent

Maham Rahimi, MD, to validate the device.

nerve damage. Traditional treatment relies on physicians

by LaVonne Carlson

using subjective palpation methods that require constant reassessment coupled with invasive needle injections

Maham Rahimi, MD, PhD, RPVI, has found the perfect place to

to monitor muscle compartment pressure. This leads to

pursue his passion: combining engineering and medicine to bring

syndrome, resulting in nerve damage, muscle decay,

the best clinical care to patients. As a cardiovascular surgeon at Houston Methodist Surgery Associates, he faces some of

amputation and even death. Odin Technologies’ Steven Hansen identified the need for the Valkyrie when working as a rehabilitation specialist

the most intricate surgical challenges, while he applies the

in sports medicine at Purdue University. Hansen, a

thought processes of an engineer to explore new technologies

Northwestern University, was working with patients who

for transforming treatments.

Rahimi received a PhD in biomedical engineering from the

devices designed to improve patient outcomes. One device

University of Texas Southwestern Medical Center before earning

benefitting from his guidance is Odin Technologies’ Valkyrie, which

his medical degree at Texas Tech University, followed by a residency

Rahimi can see has potential for powerful applications in multiple

at the University of Cincinnati. He was drawn to Houston Methodist

specialties.

when, as a third-year visiting vascular surgery fellow at the Houston Methodist DeBakey Heart & Vascular Center, he discovered the translational resources available to internal investigators. Now, as a member of the Center, where he teaches the next generation of vascular surgery fellows, he faces the challenge shared by many of Houston Methodist’s inventive physicians: not having enough time in the day. “I am busy on a high-volume team, also teaching residents and medical students, but I am establishing myself as an academic vascular surgeon,” said Rahimi, who was appointed assistant professor of cardiovascular surgery in June. “It is challenging but doable.” While his schedule doesn’t allow time to engineer products, Rahimi is a key opinion leader who provides clinical expertise on surgical

patients getting a delayed diagnosis for compartment

certified athletic trainer with a masters of science from underwent traditional palpation methods that sometimes required insertion of a 16-gauge needle multiple times.

Odin Technologies won first place at Insight's 2018 Health Tech Startup Competition, the people’s choice award at Health Tech Austin Startup Summit, and first place in the diagnostic track at the MedCity Invest Competition in Chicago, IL. Odin Technologies was one of only 23 companies selected to participate in the TMCx four-month program in fall of 2018. “My experience with the Houston Methodist Research Institute has been phenomenal. Since working with Dr. Rahimi, the business has really taken off. Houston Methodist strives to facilitate our needs and provide us with the expertise necessary to produce a product that the end user wants—something designed by health care providers, for health care providers,” said Hansen.

Rahimi’s collaboration on the Valkyrie came out of a TMCx event in August 2018, when he met Steven Hansen, CEO and co-founder of Odin Technologies. By mid-February, Hansen had an agreement with Houston Methodist and early experiments with the device were underway. Currently, the Valkyrie is being tested in preclinical models in the Comparative Medicine Program. The availability of translational resources has helped it progress quickly through the cycle of development. “I moved to Houston right before Harvey hit, and thought ‘Wow! Houston! What did I do?’ Then it got much better,” said Rahimi. “I love Houston: It’s fascinating when you go out and hear so many languages and see different cultures. But the best part is the people at Houston Methodist."

Steven Hansen of Odin Technologies, holding the wearable diagnostic device that monitors blood flow in a trauma patient’s lower extremities

FEATURES

The Best of Both Worlds Applying design thinking to surgical devices

VALKYRIE Valkyrie

The Valkyrie is a non-invasive, wearable diagnostic device

After seeing the effect on patients, Hansen began exploring

that monitors blood flow in the lower extremities. It was

alternatives, which led to the invention of the Valkyrie.

designed for trauma patients who run the risk of compartment

He is now working with Houston Methodist surgeon

syndrome, a dangerous condition that can cause permanent

Maham Rahimi, MD, to validate the device.

nerve damage. Traditional treatment relies on physicians

by LaVonne Carlson

using subjective palpation methods that require constant reassessment coupled with invasive needle injections

Maham Rahimi, MD, PhD, RPVI, has found the perfect place to

to monitor muscle compartment pressure. This leads to

pursue his passion: combining engineering and medicine to bring

syndrome, resulting in nerve damage, muscle decay,

the best clinical care to patients. As a cardiovascular surgeon at Houston Methodist Surgery Associates, he faces some of

amputation and even death. Odin Technologies’ Steven Hansen identified the need for the Valkyrie when working as a rehabilitation specialist

the most intricate surgical challenges, while he applies the

in sports medicine at Purdue University. Hansen, a

thought processes of an engineer to explore new technologies

Northwestern University, was working with patients who

for transforming treatments.

Rahimi received a PhD in biomedical engineering from the

devices designed to improve patient outcomes. One device

University of Texas Southwestern Medical Center before earning

benefitting from his guidance is Odin Technologies’ Valkyrie, which

his medical degree at Texas Tech University, followed by a residency

Rahimi can see has potential for powerful applications in multiple

at the University of Cincinnati. He was drawn to Houston Methodist

specialties.

patients getting a delayed diagnosis for compartment

certified athletic trainer with a masters of science from underwent traditional palpation methods that sometimes required insertion of a 16-gauge needle multiple times.

Steven Hansen of Odin Technologies, holding the wearable diagnostic device that monitors blood flow in a trauma patient’s lower extremities

FEATURES

Cellular Insights in

High Cholesterol & Cardiovascular Disease Long-term goals hold promise for treatment of blood disorders and bone marrow regeneration

ANNUAL FACTS Additionally, Fang says finding this new pathway that controls the generation of HSPCs could be useful for treating blood disorders, such as leukemia and anemia in the future. For instance, he says could possibly be repurposed to mitigate the progression of leukemia. Even further down the line, he said this also holds promise for bone marrow regeneration using patient-derived hematopoietic stem cells, which would eliminate the need to find a donor.

been cited by Nature Reviews Cardiology, and an editorial in

by Lisa Merkl

The New England Journal of Medicine states, “The most notable

In a landmark study, scientists at the Houston Methodist Research

aspect of the study… is the implication of ‘cholesterol metabolism’

Institute discovered what makes white blood cell counts spike in

genes in the biologic makeup of HSPCs. These findings provide

individuals who have high cholesterol, possibly leading to new

of inflammation in cardiovascular disease.”

therapies for heart disease.

Fang and his colleagues say their next steps are to continue

support for the hypothesis that cholesterol metabolism is a driver

exploring the role of cholesterol metabolism in hematopoiesis, Longhou Fang, PhD

saying that their findings bring them one step closer to their

Qilin Gu, PhD

ultimate goal of generating patient-oriented HSPCs, which

“

Led by Longhou Fang, PhD, and postdoctoral fellow Qilin Gu,

They identified a new regulatory mechanism responsible for

will be essential for the progress of regenerative and precision

PhD, in the Center for Cardiovascular Regeneration, the team

this increase in white blood cells typically seen in people

medicine.

looked at hypercholesterolemia, the type of high cholesterol

with these high LDL levels, which increase a person’s risk

that causes very high levels of low density lipoprotein (LDL)–

for cardiovascular disease, the leading cause of morbidity

the so-called “bad” cholesterol–to circulate in the blood.

and mortality in the U.S. and globally.

The mechanism we identified activates a protein called SREBP2 that in turn leads to the development of more hematopoietic stem cells (HSPCs), which are the precursors to white blood cells and the process by which all mature blood cells are produced. We were able to show that targeting this protein using its antagonist can reduce the HSPC counts to bring down the white blood cell counts. This insight may lead to a new strategy to treat atherosclerotic cardiovascular disease.

”

– Longhou Fang, PhD Associate Professor of Cardiovascular Sciences Center for Cardiovascular Regeneration Houston Methodist

the plant-derived drug betulin, which is an SREBP2 inhibitor,

Initially appearing in the journal Science, the study has since by Lisa Merkl

HOUSTON METHODIST

2,312

Operating beds

1.3 M

Patient encounters

540,000 $141 M $55.3 M

“

Hospitals

1,261 51

Sq.ft. research space

Research expenditures

Extramural funding

Clinical protocols

GME programs

29,408

Total learners

23,669

Employees

6,973

Dave B, Gonzalez DD, Liu ZB, Li X, Wong H, Granados S, et. al. Role of RPL39 in Metaplastic Breast Cancer. J Natl Cancer Inst. 2016 Physicians Dec 31;109(6)

Gu Q, Yang X, Lv J, Zhang J, Xia B, Kim JD, Wang R, Xiong F, Meng S, Clements TP, Tandon B, Wagner DS, Diaz MF, Wenzel PL, Miller YI, Traver D, Cooke JP, Li W, Zon LI, Chen K, Bai Y & Fang L. AIBP-mediated cholesterol efflux instructs hematopoietic stem and progenitor cell fate. 2019 Mar 08, Science, Vol. 363, Issue 6431, pp. 1085-1088. The work was supported by grants from the National Heart, Lung and Blood Institute (HL114734, HL132155, HL135737, HL133254), the American Heart Association (16BGIA27790081, 18TPA34250009, 17POST33410671), the National Institutes of Health (HL04880, DK49216, K01DK092365, R01DK111599, CA204468, GM125632), and the Cancer Prevention and Research Institute of Texas (RP110776, RR160083, RP120348, RP170002).

1,435

Trainees-in-residence

1,960

Credentialed researchers

681

Faculty

– Jenny Chang, M.D. Emily Herrmann Chair in Cancer Research & Director, Houston Methodist Cancer Center As of February 2019

FEATURES

Cellular Insights in

High Cholesterol & Cardiovascular Disease Long-term goals hold promise for treatment of blood disorders and bone marrow regeneration

been cited by Nature Reviews Cardiology, and an editorial in

by Lisa Merkl

The New England Journal of Medicine states, “The most notable

In a landmark study, scientists at the Houston Methodist Research

aspect of the study… is the implication of ‘cholesterol metabolism’

Institute discovered what makes white blood cell counts spike in

genes in the biologic makeup of HSPCs. These findings provide

individuals who have high cholesterol, possibly leading to new

of inflammation in cardiovascular disease.”

therapies for heart disease.

Fang and his colleagues say their next steps are to continue

support for the hypothesis that cholesterol metabolism is a driver

exploring the role of cholesterol metabolism in hematopoiesis, Longhou Fang, PhD

saying that their findings bring them one step closer to their

Qilin Gu, PhD

ultimate goal of generating patient-oriented HSPCs, which

“

Led by Longhou Fang, PhD, and postdoctoral fellow Qilin Gu,

They identified a new regulatory mechanism responsible for

will be essential for the progress of regenerative and precision

PhD, in the Center for Cardiovascular Regeneration, the team

this increase in white blood cells typically seen in people

medicine.

looked at hypercholesterolemia, the type of high cholesterol

with these high LDL levels, which increase a person’s risk

that causes very high levels of low density lipoprotein (LDL)–

for cardiovascular disease, the leading cause of morbidity

the so-called “bad” cholesterol–to circulate in the blood.

and mortality in the U.S. and globally.

”

– Longhou Fang, PhD Associate Professor of Cardiovascular Sciences Center for Cardiovascular Regeneration Houston Methodist

the plant-derived drug betulin, which is an SREBP2 inhibitor,

Initially appearing in the journal Science, the study has since by Lisa Merkl

HOUSTON METHODIST

2,312

Operating beds

1.3 M

Patient encounters

540,000 $141 M $55.3 M

“

Hospitals

1,261 51

Sq.ft. research space

Research expenditures

Extramural funding

Clinical protocols

GME programs

29,408

Total learners

23,669

Employees

6,973

Dave B, Gonzalez DD, Liu ZB, Li X, Wong H, Granados S, et. al. Role of RPL39 in Metaplastic Breast Cancer. J Natl Cancer Inst. 2016 Physicians Dec 31;109(6)

1,435

Trainees-in-residence

1,960

Credentialed researchers

681

Faculty

– Jenny Chang, M.D. Emily Herrmann Chair in Cancer Research & Director, Houston Methodist Cancer Center As of February 2019

QA FEATURES

Leading Cancer Prevention and Control with Strong Public Health Focus

A conversation with Nestor Esnaola, MD, MPH, MBA Associate Director of Cancer Control and Population Science

Q: What will be your main areas of focus during the first five years of the program?

A: Under the direction of Jenny Chang, MD, Houston Methodist is strengthening its cancer research programs and the focus on a more population-based approach to cancer prevention across the Houston region. Our goal is for Houston Methodist to become a National Institutes of Health National Cancer Institute (NCI) within the next five years. There are currently 70 NCI-Designated Cancer Centers across the U.S., which inform national policy and strategy for studying and controlling cancer.

Houston Methodist and lead the Cancer Center’s efforts in cancer prevention and control and community outreach and engagement, while also addressing cancer health disparities,

I have extensive experience with stomach, pancreatic, gallbladder, bile duct, small bowel and colorectal cancers,

A new strategic focus is differentiating the

liver metastases, peritoneal malignancies, and extremity and retroperitoneal sarcomas. My research focus includes

Houston Methodist Cancer Center from

racial and ethnic disparities in cancer care and outcomes,

other cancer treatment providers within

implementation of evidence-based interventions.

the Texas Medical Center and beyond. Envisioning a new direction for research, the Center's director, Jenny Chang, MD, brought Nestor Esnaola, MD, MPH, MBA,

as well as cancer care delivery and dissemination and

Q: How does Houston Methodist's cancer patient population differ from the two NCI-designated centers, Baylor College of Medicine and the University of Texas MD Anderson Cancer Center?

A: Houston Methodist’s catchment area – the area from

to Houston Methodist from Fox Chase

which we attract our patient population for cancer treatment

Cancer Center last year as division

While MD Anderson serves a broader national and

chief of surgical oncology in the

cancer education and outreach to increase enrollment in cancer screenings and clinical trials for pioneering drugs and therapies in cancer treatment through collaboration with the Houston Methodist Research Institute investigators. We plan to use tools like internal marketing campaigns for cancer-specific clinical trials employing collateral like flyers, banners and digital marketing assets. These assets will be available in multiple languages, especially Spanish, Mandarin and Vietnamese, and will demonstrate the diverse and inclusive patient population we see. We hope to engage actual patients as the face of our internal marketing campaign.

My role is to help optimize surgical cancer care across

and population science research. by Laura Niles

region. This includes innovative, targeted approaches to

– is the 10-county region along the Gulf Coast of Texas. international population and Baylor serves the more immediate Houston area, Houston Methodist is laser

Department of Surgery. Here, Esnaola

focused on the population in the southeast region of

shares his objectives for leading the

it is very important that we provide our investigators with

Texas. As Houston Methodist seeks NCI designation,

new Cancer Control and Population

tools that demonstrate our thorough knowledge of the

Science program.

proposals. This includes the socioeconomic data of our

patient population we serve to inform all future funding catchment area and the cancer burden therein.

Q: How will you increase efforts to engage the regional patient population?

A: We have extensive plans for increased community

Q: What role does patient education play in cancer prevention and treatment?

A: This is incredibly important in building a network of trust among our patients, our physicians and our investigators. We plan to enhance patient support services to optimize patient engagement. In the past, one initiative I've been involved with includes helping other institutions build patient-to-patient networks. We also will provide educators who have been trained to engage patients in their care. Having a robust patient support network will be instrumental in helping advance our cancer treatment goals within the Cancer Center.

Q: As part of the NCI-designation goal for the Cancer Center, there is an increased focus on clinical trial enrollment. Given your research focus on racial and ethnic disparities in cancer care and outcomes, how does that impact clinical trial enrollment?

A: As part of a recent article in the Journal of Oncology Practice (April 2019), my research colleagues and I discuss best practices to promote diversity in clinical trials. Using in-depth interviews with leaders from U.S. cancer centers with above average recruitment of racial and ethnic minority groups into clinical trials, we indicate that leadership, patient engagement, and community engagement practices are crucial to increasing enrollment of racial and ethnic minorities in cancer trials. According to the National Institute on Minority Health and Health Disparities, approximately 10% of the minority population in the U.S. participates in clinical trials. Clinical trials for new therapies and devices like those created within our own research institute must represent the diverse population that we serve and that will ultimately use them.

engagement across the 10-county Houston Gulf Coast

QA FEATURES

Leading Cancer Prevention and Control with Strong Public Health Focus

A conversation with Nestor Esnaola, MD, MPH, MBA Associate Director of Cancer Control and Population Science

Q: What will be your main areas of focus during the first five years of the program?

Houston Methodist and lead the Cancer Center’s efforts in cancer prevention and control and community outreach and engagement, while also addressing cancer health disparities,

I have extensive experience with stomach, pancreatic, gallbladder, bile duct, small bowel and colorectal cancers,

A new strategic focus is differentiating the

liver metastases, peritoneal malignancies, and extremity and retroperitoneal sarcomas. My research focus includes

Houston Methodist Cancer Center from

racial and ethnic disparities in cancer care and outcomes,

other cancer treatment providers within

implementation of evidence-based interventions.

the Texas Medical Center and beyond. Envisioning a new direction for research, the Center's director, Jenny Chang, MD, brought Nestor Esnaola, MD, MPH, MBA,

as well as cancer care delivery and dissemination and

Q: How does Houston Methodist's cancer patient population differ from the two NCI-designated centers, Baylor College of Medicine and the University of Texas MD Anderson Cancer Center?

A: Houston Methodist’s catchment area – the area from

to Houston Methodist from Fox Chase

which we attract our patient population for cancer treatment

Cancer Center last year as division

While MD Anderson serves a broader national and

chief of surgical oncology in the

My role is to help optimize surgical cancer care across

and population science research. by Laura Niles

region. This includes innovative, targeted approaches to

– is the 10-county region along the Gulf Coast of Texas. international population and Baylor serves the more immediate Houston area, Houston Methodist is laser

Department of Surgery. Here, Esnaola

focused on the population in the southeast region of

shares his objectives for leading the

it is very important that we provide our investigators with

Texas. As Houston Methodist seeks NCI designation,

new Cancer Control and Population

tools that demonstrate our thorough knowledge of the

Science program.

proposals. This includes the socioeconomic data of our

patient population we serve to inform all future funding catchment area and the cancer burden therein.

Q: How will you increase efforts to engage the regional patient population?

A: We have extensive plans for increased community

Q: What role does patient education play in cancer prevention and treatment?

engagement across the 10-county Houston Gulf Coast

FEATURES

Rogue DNA Fragments Create genomic instability common in cancer by Laura Niles

While evaluating a key mechanism that assists in DNA repair, a team of researchers confirmed a key mechanism for disruptive DNA insertion. Baylor College of Medicine’s Grzegorz Ira, PhD, and Yang Yu, PhD, and Houston Methodist’s Kaifu Chen, PhD, and Bo Xia, PhD, collaborated with researchers from the University of Texas MD Anderson Cancer Kaifu Chen, PhD

Bo Xia, PhD

Center and Weill Cornell Medical College to make a discovery that led to publication in December 2018’s Nature. They found that when the mechanism—the enzyme Dna2—is absent, the genetic material of a cell, the genome, becomes unstable and results in breaks in DNA.

Picture the double helix of a DNA strand, then imagine both

DNA. Without Dna2 as a repair mechanism, the rogue DNA

strands are broken and one of the tools that typically repairs

fragments can come from almost anywhere in the chromosome

it is missing. Now the cell is threatened. Without the Dna2

and insert themselves into the DNA break. This research may

repair tool evaluated in this study, excess pieces of DNA

have significance on a larger scale, relating to cardiovascular

produced during cell replication can insert themselves and

medicine as well as cancer.

alter the genome, often negatively impacting a cell. Inserted

“

Our analysis of yeast cells deficient in Dna2 led our research team to propose that Dna2 prevents DNA insertions into the genome,

DNA fragments are often duplications of an existing DNA

“It was recently shown that genomic insertions in hematopoietic

sequence that are released and subsequently integrated

stem cells–immature cells that can develop into all blood cell

into areas of double strand DNA breaks. Importantly, DNA

types, like white and red blood cells–may lead to clones that

insertions also play a role in the mechanisms for antibody

increase the white blood cell count and increase major adverse

diversification, which can help protect humans from pathogens.

cardiovascular events,” said John Cooke, MD, PhD, Joseph C.

relate to what occurs in cancer cells, but more

“Rusty” Walter and Carole Walter Looke Presidential Distinguished

information is needed to know if similar DNA

Chen and his team analyzed the significance of deleting

Chair in Cardiovascular Disease Research.

which helps protect against alteration of the genetic code. These implications

Dna2 in yeast cells. The mutant, Dna2-deficient cells

insertions occur in malignant cells that show

revealed frequent insertions of DNA fragments into breaks in

a Dna2 deficiency. Yu Y, Pham N, Xia B, Papusha A, Wang G, Yan Z, Peng G, Chen K & Ira G. Dna2 nuclease deficiency results in large and complex DNA insertions at chromosomal

”

– Kaifu Chen, PhD Director of the Center for Bioinformatics and Computational Biology Associate Professor of Cardiovascular Sciences Houston Methodist

breaks. 2018, Nature, vol. 564, no. 7735, pp. 287-290.

FEATURES

Rogue DNA Fragments Create genomic instability common in cancer by Laura Niles

Bo Xia, PhD

Picture the double helix of a DNA strand, then imagine both

DNA. Without Dna2 as a repair mechanism, the rogue DNA

strands are broken and one of the tools that typically repairs

fragments can come from almost anywhere in the chromosome

it is missing. Now the cell is threatened. Without the Dna2

and insert themselves into the DNA break. This research may

repair tool evaluated in this study, excess pieces of DNA

have significance on a larger scale, relating to cardiovascular

produced during cell replication can insert themselves and

medicine as well as cancer.

alter the genome, often negatively impacting a cell. Inserted

“

Our analysis of yeast cells deficient in Dna2 led our research team to propose that Dna2 prevents DNA insertions into the genome,

DNA fragments are often duplications of an existing DNA

“It was recently shown that genomic insertions in hematopoietic

sequence that are released and subsequently integrated

stem cells–immature cells that can develop into all blood cell

into areas of double strand DNA breaks. Importantly, DNA

types, like white and red blood cells–may lead to clones that

insertions also play a role in the mechanisms for antibody

increase the white blood cell count and increase major adverse

diversification, which can help protect humans from pathogens.

cardiovascular events,” said John Cooke, MD, PhD, Joseph C.

relate to what occurs in cancer cells, but more

“Rusty” Walter and Carole Walter Looke Presidential Distinguished

information is needed to know if similar DNA

Chen and his team analyzed the significance of deleting

Chair in Cardiovascular Disease Research.

which helps protect against alteration of the genetic code. These implications

Dna2 in yeast cells. The mutant, Dna2-deficient cells

insertions occur in malignant cells that show

revealed frequent insertions of DNA fragments into breaks in

a Dna2 deficiency. Yu Y, Pham N, Xia B, Papusha A, Wang G, Yan Z, Peng G, Chen K & Ira G. Dna2 nuclease deficiency results in large and complex DNA insertions at chromosomal

”

– Kaifu Chen, PhD Director of the Center for Bioinformatics and Computational Biology Associate Professor of Cardiovascular Sciences Houston Methodist

breaks. 2018, Nature, vol. 564, no. 7735, pp. 287-290.

FEATURES

Manuela Sushnitha

Ashley Holder, MD, surgical oncologist and

Kyuson Yun, PhD, assistant professor

Fransisca Leonard, PhD, instructor in

Manuela Sushnitha, Houston Methodist

assistant professor of surgery, Department

of neurosurgery, Kenneth R. Peak Brain

nanomedicine, was awarded a 2018

fellow and Rice bioengineering graduate

of Surgery and Department of Nanomedicine,

and Pituitary Tumor Treatment Center,

METAvivor Early Career Investigator Award

student, was selected for a 2018 Ruth L.

received a Cancer Prevention and Research

Department of Neurosurgery, received a

for her work on "CRISPR-nanoparticle for

Kirschstein National Research Service

Institute of Texas award of $199,998 in the

Cancer Prevention and Research Institute

Macrophage Reprogramming: New Therapeutic

Award by the National Cancer Institute to

High-Impact/High-Risk category for her work

of Texas award of $199,700 in the High-

Strategy for Breast Cancer Liver Metastasis."

develop a biomimetic nanotherapy that

on “Nanoparticle-Mediated Hyperthermia to

Impact/High-Risk category for her work

The award provided $50,000 to support

Improve Chemotherapeutic Efficacy in HIPEC."

on “Developing a Clinically Relevant Drug

development of treatment strategies to

The CPRIT High-Impact/High-Risk Awards

Testing Platform.” Yun’s Brain Cancer

category focuses on short-term funding to explore the feasibility of high-risk projects that, if successful, would contribute major new insights into cancer.

Research Lab focuses on understanding the mechanisms that regulate self-renewal, transformation and therapy resistance in brain cancer stem cells from glioblastoma and medulloblastoma.

activate a patient’s own immune system to fight cancer cells, ultimately aiming to enable faster drug development for improved patient outcomes. Leonard came to Houston Methodist as a postdoctoral fellow in the lab of Biana Godin, PhD, MScPharm.

Fransisca Leonard, PhD

Kyuson Yun, PhD

Ashley Holder, MD

attacks cancer stem cells. She is evaluating the success of the drug delivery system and its ability to overcome the body’s immune system barriers in triple-negative breast cancer. Sushnitha is advised by Ennio Tasciotti, PhD, director of the Center for Musculoskeletal Regeneration, and Omid Veiseh, PhD, assistant professor of Bioengineering at Rice University, with Jenny Chang, MD, director of the Houston Methodist Cancer Center.

Manuela Sushnitha

Catch a Rising Star

Meet the Houston Methodist Cancer Center’s award-winning early career investigators

FEATURES

Manuela Sushnitha

Ashley Holder, MD, surgical oncologist and

Kyuson Yun, PhD, assistant professor

Fransisca Leonard, PhD, instructor in

Manuela Sushnitha, Houston Methodist

assistant professor of surgery, Department

of neurosurgery, Kenneth R. Peak Brain

nanomedicine, was awarded a 2018

fellow and Rice bioengineering graduate

of Surgery and Department of Nanomedicine,

and Pituitary Tumor Treatment Center,

METAvivor Early Career Investigator Award

student, was selected for a 2018 Ruth L.

received a Cancer Prevention and Research

Department of Neurosurgery, received a

for her work on "CRISPR-nanoparticle for

Kirschstein National Research Service

Institute of Texas award of $199,998 in the

Cancer Prevention and Research Institute

Macrophage Reprogramming: New Therapeutic

Award by the National Cancer Institute to

High-Impact/High-Risk category for her work

of Texas award of $199,700 in the High-

Strategy for Breast Cancer Liver Metastasis."

develop a biomimetic nanotherapy that

on “Nanoparticle-Mediated Hyperthermia to

Impact/High-Risk category for her work

The award provided $50,000 to support

Improve Chemotherapeutic Efficacy in HIPEC."

on “Developing a Clinically Relevant Drug

development of treatment strategies to

The CPRIT High-Impact/High-Risk Awards

Testing Platform.” Yun’s Brain Cancer

category focuses on short-term funding to explore the feasibility of high-risk projects that, if successful, would contribute major new insights into cancer.

Research Lab focuses on understanding the mechanisms that regulate self-renewal, transformation and therapy resistance in brain cancer stem cells from glioblastoma and medulloblastoma.

Fransisca Leonard, PhD

Kyuson Yun, PhD

Ashley Holder, MD

Manuela Sushnitha

Catch a Rising Star

Meet the Houston Methodist Cancer Center’s award-winning early career investigators

FEATURES

“

New Nanochannels Deliver Immunotherapy

Our implant releases the drug in a constant manner until the entire amount is completely gone from the reservoir. Since it can deliver the immunotherapy by itself for weeks to potentially months, we would only need to place the device inside the

Direct-to-tumor nanodevice offers hope for treating triple-negative breast cancer

tumor once and then the drug would be released autonomously for that long period of time.

by Lisa Merkl

”

– Alessandro Grattoni, PhD Chair, Department of Nanomedicine Professor of Nanomedicine Houston Methodist

Houston Methodist scientists have developed a nanodevice to deliver immunotherapy to treat triple-negative breast cancer without side effects. Alessandro Grattoni, PhD, chair of the Department of Nanomedicine, and E. Brian Butler, MD, chair of the Department of Radiation Oncology, collaborated with a team from the University of Texas MD Anderson to establish a novel strategy to deliver immunotherapy directly into a tumor. They are exploring whether the new path to nanodelivery could be more effective, with less side effects, compared to conventional immunotherapy, which is administered to the patient’s entire body. This new approach places the implantable nanodevice inside the tumor very accurately, using just one, simple procedure. Once implanted, the device is able to sustain delivery of the immunotherapy over a prolonged period of time without requiring the patient to return for numerous treatments. “Timing of the release may be extremely important,” said Butler. “These immunotherapy payloads come in a tiny metal device with nanochannels that release the medication at a constant rate in a controlled way for extended periods of time.” This platform technology can be applied to many different types of cancer, but the team chose to work on triple-negative breast cancer for its dearth of treatment options. An added benefit beyond the sustained release system is that the implantable device can be placed

While the nanodelivery system has proven as effective as systemic delivery of immunotherapy, the next phase of preclinical trials will explore whether combining the device with radiation therapy can improve on the current effectiveness each achieves singly.

Butler and Grattoni discuss the delivery device in a video explaining their collaboration. A tiny nanodevice (about the size of a grain of rice) is being filled with immunological medication that will be delivered directly to cancer cells when the device is implanted into a patient’s tumor.

“Using Dr. Grattoni’s nanodevice in conjunction with our clinic, we hope to create a very robust immunological response, by putting the immunotherapy directly into the tumor, which is where all the information is,” Butler

The work was supported by grants from Golfers Against Cancer, the Nancy Owens Breast Cancer Foundation, and start-up funds from the Houston Methodist Research Institute.

said. “This may harness the full power of a person’s

Chua CYX, Jain P, Susnjar A, Rhudy J, Folci M, Ballerini A, Gilbert A, Singh S, Bruno G,

immune system to destroy the cancer, offering the

Filgueira CS, Yee C, Butler EB, Grattoni A. Nanofluidic drug-eluting seed for sustained

opportunity to get the systemic response, while treating

intratumoral immunotherapy in triple negative breast cancer. Journal of Controlled Release. 2018 Sept 10: 285: 23-34

locally, without all the side effects.” See Grattoni and Butler explain their research in this video: vimeo.com/292933967

inside the tumor with high accuracy, which also serves as a fiducial marker to facilitate precise delivery for image-guided radiation.

FEATURES

“

New Nanochannels Deliver Immunotherapy

Direct-to-tumor nanodevice offers hope for treating triple-negative breast cancer

tumor once and then the drug would be released autonomously for that long period of time.

by Lisa Merkl

”

– Alessandro Grattoni, PhD Chair, Department of Nanomedicine Professor of Nanomedicine Houston Methodist

The work was supported by grants from Golfers Against Cancer, the Nancy Owens Breast Cancer Foundation, and start-up funds from the Houston Methodist Research Institute.

said. “This may harness the full power of a person’s

Chua CYX, Jain P, Susnjar A, Rhudy J, Folci M, Ballerini A, Gilbert A, Singh S, Bruno G,

immune system to destroy the cancer, offering the

Filgueira CS, Yee C, Butler EB, Grattoni A. Nanofluidic drug-eluting seed for sustained

opportunity to get the systemic response, while treating

intratumoral immunotherapy in triple negative breast cancer. Journal of Controlled Release. 2018 Sept 10: 285: 23-34

locally, without all the side effects.” See Grattoni and Butler explain their research in this video: vimeo.com/292933967

inside the tumor with high accuracy, which also serves as a fiducial marker to facilitate precise delivery for image-guided radiation.

FEATURES

Translational Imaging Center Revamps for revolutionary 7T MRI by Laura Niles

Made possible through a Siemens Healthineers and Houston

generation PET/CT in close proximity to a cyclotron, the

Methodist multi-year consortium agreement, the 7T will

Houston Methodist Translational Imaging Center underwent

facilitate collaboration among clinicians and scientists from

major renovations over the past year. The size of the equipment

across the Texas Medical Center and Houston-area institutions,

required significant logistical support to move the machinery

including The University of Texas Health Science Center at

into the Houston Methodist Research Institute, including

Houston, The University of Texas Medical Branch in Galveston,

removal of the building's front glass panels.

the University of Houston, Baylor College of Medicine, Texas A&M University and Rice University.

With these new capabilities, the Translational Imaging Center provides a unique setting for clinical imaging as well as clinical

"The Siemens 7T Terra is a new generation MRI scanner

and translational research, putting Houston Methodist at the

capable of displaying anatomical structures with unprecedented

forefront of leading medical imaging. New research capabilities

clarity and contrast. Through research applications in collaboration

include better identifying seizure foci; visualizing veins in brain

with members of the consortium and Siemens Healthineers,

lesions caused by multiple sclerosis; providing more detailed

we will push the boundaries of MRI for new applications that

localizing of brain activation using functional MRI for presurgical

benefit our patients," said Christof Karmonik, PhD, associate

planning; and aid in developing an improved surgical approach

research professor of translational imaging and scientific

for implanting deep brain stimulation electrodes. This may have

director of the Translational Imaging Center.

significant impact on diseases and disorders like epilepsy, multiple sclerosis and cancer.

To make way for the 7T, along with a new 3 Tesla MRI Siemens Vida installed in December 2018 and a new

One of the world’s most powerful magnetic resonance imaging (MRI) machines – the Siemens 7 Tesla (7T) MAGNETOM Terra – is now up and running in the Houston Methodist Research Institute. Activated on March 18, it is the first Siemens

7T MRI Brain Scan

3T MRI Brain Scan

A ribbon cutting ceremony to celebrate the new imaging center and its capabilities was held on June 26. Leaders from Houston Methodist, Siemens and across the Texas Medical Center enjoyed tours and demonstrations of the most advanced, high-performance equipment for imaging research and innovation.

7 Tesla (7T) MAGNETOM Terra approved for clinical use in the U.S. and the first and only FDA-approved 7T in Texas.

FEATURES

Translational Imaging Center Revamps for revolutionary 7T MRI by Laura Niles

Made possible through a Siemens Healthineers and Houston

generation PET/CT in close proximity to a cyclotron, the

Methodist multi-year consortium agreement, the 7T will

Houston Methodist Translational Imaging Center underwent

facilitate collaboration among clinicians and scientists from

major renovations over the past year. The size of the equipment

across the Texas Medical Center and Houston-area institutions,

required significant logistical support to move the machinery

including The University of Texas Health Science Center at

into the Houston Methodist Research Institute, including

Houston, The University of Texas Medical Branch in Galveston,

removal of the building's front glass panels.

the University of Houston, Baylor College of Medicine, Texas A&M University and Rice University.

With these new capabilities, the Translational Imaging Center provides a unique setting for clinical imaging as well as clinical

"The Siemens 7T Terra is a new generation MRI scanner

and translational research, putting Houston Methodist at the

capable of displaying anatomical structures with unprecedented

forefront of leading medical imaging. New research capabilities

clarity and contrast. Through research applications in collaboration

include better identifying seizure foci; visualizing veins in brain

with members of the consortium and Siemens Healthineers,

lesions caused by multiple sclerosis; providing more detailed

we will push the boundaries of MRI for new applications that

localizing of brain activation using functional MRI for presurgical

benefit our patients," said Christof Karmonik, PhD, associate

planning; and aid in developing an improved surgical approach

research professor of translational imaging and scientific

for implanting deep brain stimulation electrodes. This may have

director of the Translational Imaging Center.

significant impact on diseases and disorders like epilepsy, multiple sclerosis and cancer.

To make way for the 7T, along with a new 3 Tesla MRI Siemens Vida installed in December 2018 and a new

7T MRI Brain Scan

3T MRI Brain Scan

7 Tesla (7T) MAGNETOM Terra approved for clinical use in the U.S. and the first and only FDA-approved 7T in Texas.

FEATURES

Art at the

Nanoscale by Laura Niles

Artist-in-residence orchestrates “Nanostrings”

“ I want to create intimacy between the viewer and the art and

have the viewer slow down a bit, let their eyes adjust and look at the detail of the work. My work has a certain ‘aboutness’ to it in which I want the viewer to contemplate.

”

to create multi-dimensional masterpieces

– Joseph Cohen Artist and scientist

While the impressionists created works to be admired from

the visual spectrum, both below in the ultraviolet and above

afar, Joseph Cohen’s canvasses are altogether opposite,

in the infrared. Inspired by the German concept of dasein,

inviting the viewer to look closely, view differently, and most

or “being present,” Cohen manipulated paint with the novel

importantly, slow down, observe and think for oneself.

nanomaterials to evoke that idea.

The Weill Cornell Medicine (WCM)/Memorial Sloan Kettering

In 2016, Cohen became an artist-in-residence in Heller’s lab

Cancer Center (MSKCC) and Houston Methodist Center

and began connecting with nanoscience researchers

for Performing Arts Medicine artist-in-residence started on

at other institutions, including Bruce Weisman, PhD, and

this path four years ago. While the artist was mounting a

James Tour, PhD, at Rice University. With Tour, Cohen

solo-exhibition in New York, he gave a talk to a group of

created a laser-induced graphene, which Cohen included in

research scientists from WCM and MSKCC about the overlap

an article published in April's ACS Applied Nano Materials.

between artists and scientists from the Renaissance to today. He connected with cancer nanomedicine researcher Daniel

Through his nano networks, Cohen sources nanomaterials,

Heller, PhD, at WCM/MSKCC, who works with carbon

then suspends the carbon nanotubes in a surfactant, and uses

nanotubes for biosensing and biodelivery.

a probe-sonicator and an ultra-centrifuge to begin purifying the material for later steps. He ultimately uses the nanotubes to

Heller took Cohen under his wing and supplied Cohen with

create his paint at the molecular level, a paint that has optimal

carbon nanotubes, an allotrope of carbon in a tubular form

fluorescence in the near infrared.

that has unique optical and physical properties, which are Cohen’s work was exhibited at “Looking

useful in nanotechnology and biotechnology, among other

Cohen’s distinctive artistic method may one day offer therapeutic

fields of materials science.

benefit. He explains that the same shortwave infrared capabilities used in his paintings could be adapted as a diagnostic tool.

at a Flower, Chapter 3” at Houston’s Winston

Cohen was inspired to make paint from carbon nanotubes

This, like his artwork, takes the relationship between art and

Gallery in April.

because of the nanomaterial’s unparalleled durability and

science beyond normal perceptions.

Several of his works

optical uniqueness; the material allows the artist to create

Contemporary Art

were displayed in a dark room, where a

works that fluoresce at multiple wavelengths beyond the

handheld light source

visible spectrum. The artist’s paintings are “multiple spectrum

emitted a glow from the purified phosphorescent and fluorescent paints.

paintings,” and give viewers access to what is beyond the limits of their physical makeup. These works operate outside

Chyan Y, Cohen J, Wang W, Zhang C, Tour J. Graphene Art. ACS Appl. Nano Materials, April 23, 2019. 3007-3011.

FEATURES

Art at the

Nanoscale by Laura Niles

Artist-in-residence orchestrates “Nanostrings”

“ I want to create intimacy between the viewer and the art and

have the viewer slow down a bit, let their eyes adjust and look at the detail of the work. My work has a certain ‘aboutness’ to it in which I want the viewer to contemplate.

”

to create multi-dimensional masterpieces

– Joseph Cohen Artist and scientist

While the impressionists created works to be admired from

the visual spectrum, both below in the ultraviolet and above

afar, Joseph Cohen’s canvasses are altogether opposite,

in the infrared. Inspired by the German concept of dasein,

inviting the viewer to look closely, view differently, and most

or “being present,” Cohen manipulated paint with the novel

importantly, slow down, observe and think for oneself.

nanomaterials to evoke that idea.

The Weill Cornell Medicine (WCM)/Memorial Sloan Kettering

In 2016, Cohen became an artist-in-residence in Heller’s lab

Cancer Center (MSKCC) and Houston Methodist Center

and began connecting with nanoscience researchers

for Performing Arts Medicine artist-in-residence started on

at other institutions, including Bruce Weisman, PhD, and

this path four years ago. While the artist was mounting a

James Tour, PhD, at Rice University. With Tour, Cohen

solo-exhibition in New York, he gave a talk to a group of

created a laser-induced graphene, which Cohen included in

research scientists from WCM and MSKCC about the overlap

an article published in April's ACS Applied Nano Materials.

between artists and scientists from the Renaissance to today. He connected with cancer nanomedicine researcher Daniel

Through his nano networks, Cohen sources nanomaterials,

Heller, PhD, at WCM/MSKCC, who works with carbon

then suspends the carbon nanotubes in a surfactant, and uses

nanotubes for biosensing and biodelivery.

a probe-sonicator and an ultra-centrifuge to begin purifying the material for later steps. He ultimately uses the nanotubes to

Heller took Cohen under his wing and supplied Cohen with

create his paint at the molecular level, a paint that has optimal

carbon nanotubes, an allotrope of carbon in a tubular form

fluorescence in the near infrared.

that has unique optical and physical properties, which are Cohen’s work was exhibited at “Looking

useful in nanotechnology and biotechnology, among other

Cohen’s distinctive artistic method may one day offer therapeutic

fields of materials science.

benefit. He explains that the same shortwave infrared capabilities used in his paintings could be adapted as a diagnostic tool.

at a Flower, Chapter 3” at Houston’s Winston

Cohen was inspired to make paint from carbon nanotubes

This, like his artwork, takes the relationship between art and

Gallery in April.

because of the nanomaterial’s unparalleled durability and

science beyond normal perceptions.

Several of his works

optical uniqueness; the material allows the artist to create

Contemporary Art

were displayed in a dark room, where a

works that fluoresce at multiple wavelengths beyond the

handheld light source

visible spectrum. The artist’s paintings are “multiple spectrum

emitted a glow from the purified phosphorescent and fluorescent paints.

paintings,” and give viewers access to what is beyond the limits of their physical makeup. These works operate outside

Chyan Y, Cohen J, Wang W, Zhang C, Tour J. Graphene Art. ACS Appl. Nano Materials, April 23, 2019. 3007-3011.

FEATURES

g n i t a v o n In acy

at Houston Methodist are national leaders for “ Pharmacists medication safety and quality of care. They are implementing key innovations that place them at the forefront of their field.

– Michael Liebl, PharmD Director, System Clinical Pharmacy Services Houston Methodist

m r a Ph b

arlso

ne C

on y LaV

Joshua T. Swan, PharmD, MPH,

Brian Parrish, PharmD,

assistant professor of Allied Health

cardiology clinical specialist, is

Sciences, established a Clinical

addressing a national issue at

Pharmacy Fellowship in Outcomes

the other end of the spectrum—

Research to optimize health care

medication errors. A report by

through research projects that are

Martin Makary, MD, at Johns

supported by external grant funding.

Hopkins, entitled “Medical Errors:

This fellowship is one of only a few programs in the country

The Third Leading Cause of Death in the U.S.,” published

that provide highly-customized research training to develop

in The British Medical Journal in May 2016, claims that

independent clinical pharmacist scientists. In 2018, Swan

medical errors may be the third highest cause of death in

initiated the Houston Methodist Opioid Stewardship Program

the U.S., with medication errors costing $21 billion annually.

that aims to optimize safe opioid use and pain management

To address this, Parrish is developing a software system

in the hospital and emergency department settings.

called the Medication Administration Protection System, or MAPS, that will detect and prevent medication

Inspiring a new standard of patient care

errors in order to optimize care and, ultimately, improve

Elsie Rizk, PharmD,

outcomes for patients. It is designed to pull from two databases—one, from a patient’s electronic health

a clinical pharmacy fellow,

record (EHR) and the other, from pharmacological

collaborated with pharmacy,

literature—to send a signal when specific medications

quality, nurses and the medical

are appropriate for each individual patient. Currently,

past 30 days according to a report in MedPage Today on May 12. As medication

staff to develop a list of 19 valid

the project is in a provisional patent status and will be

and feasible quality indicators

usage increases, pharmacists become integral members of the health care

presented for TRI funding in August. The prototype

for opioid stewardship based

will be designed to dovetail with EPIC, and thus can

An estimated 46% of Americans have taken prescription medications in the

team, optimizing medication selection, monitoring, dispensing and preparation. At Houston Methodist, they take it to an entirely new level of innovation.

”

on literature review, survey of stakeholders, and expert

be used for pilot testing with Houston Methodist’s EHR.

panel consensus that was published in American

But the beauty of the concept is that it can dovetail

Journal of Health-System Pharmacy in February 2019.

with any system and thus can be applied nationwide

This innovative research program led by pharmacists

and internationally.

made Houston Methodist the first health care institution to develop and publish quality indicators for opioid stewardship in the hospital and emergency department settings. Rizk, E, Swan, JT, Cheon, O, Colavecchia, AC, Bui, LN, Kash, BA, Chokshi, SP, Chen, H, Johnson, ML, Liebl, MG & Fink, E. Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. 2019, American Journal of Health-System Pharmacy, vol. 76, no. 4, pp. 225-235.

FEATURES

g n i t a v o n In acy

at Houston Methodist are national leaders for “ Pharmacists medication safety and quality of care. They are implementing key innovations that place them at the forefront of their field.

– Michael Liebl, PharmD Director, System Clinical Pharmacy Services Houston Methodist

m r a Ph b

arlso

ne C

on y LaV

Joshua T. Swan, PharmD, MPH,

Brian Parrish, PharmD,

assistant professor of Allied Health

cardiology clinical specialist, is

Sciences, established a Clinical

addressing a national issue at

Pharmacy Fellowship in Outcomes

the other end of the spectrum—

Research to optimize health care

medication errors. A report by

through research projects that are

Martin Makary, MD, at Johns

supported by external grant funding.

Hopkins, entitled “Medical Errors:

This fellowship is one of only a few programs in the country

The Third Leading Cause of Death in the U.S.,” published

that provide highly-customized research training to develop

in The British Medical Journal in May 2016, claims that

independent clinical pharmacist scientists. In 2018, Swan

medical errors may be the third highest cause of death in

initiated the Houston Methodist Opioid Stewardship Program

the U.S., with medication errors costing $21 billion annually.

that aims to optimize safe opioid use and pain management

To address this, Parrish is developing a software system

in the hospital and emergency department settings.

called the Medication Administration Protection System, or MAPS, that will detect and prevent medication

Inspiring a new standard of patient care

errors in order to optimize care and, ultimately, improve

Elsie Rizk, PharmD,

outcomes for patients. It is designed to pull from two databases—one, from a patient’s electronic health

a clinical pharmacy fellow,

record (EHR) and the other, from pharmacological

collaborated with pharmacy,

literature—to send a signal when specific medications

quality, nurses and the medical

are appropriate for each individual patient. Currently,

past 30 days according to a report in MedPage Today on May 12. As medication

staff to develop a list of 19 valid

the project is in a provisional patent status and will be

and feasible quality indicators

usage increases, pharmacists become integral members of the health care

presented for TRI funding in August. The prototype

for opioid stewardship based

will be designed to dovetail with EPIC, and thus can

An estimated 46% of Americans have taken prescription medications in the

team, optimizing medication selection, monitoring, dispensing and preparation. At Houston Methodist, they take it to an entirely new level of innovation.

”

on literature review, survey of stakeholders, and expert

be used for pilot testing with Houston Methodist’s EHR.

panel consensus that was published in American

But the beauty of the concept is that it can dovetail

Journal of Health-System Pharmacy in February 2019.

with any system and thus can be applied nationwide

This innovative research program led by pharmacists

and internationally.

FEATURES

A New View of Strep

Two unprecedented studies explore deadly strep infections by Lisa Merkl

James M. Musser, MD, PhD

Early 2019 brought welcome news from

such a large scale. By looking at the interplay between three

Houston Methodist—with media coverage

separate entities (the genome, transcriptome and virulence),

that reached audiences of 148 million

they generated massive amounts of data requiring the use

spanning 19 nations—about group A

of artificial intelligence for analysis and made an unexpected

streptococcus, the organism that causes

discovery about how group A strep causes human infections.

700 million cases of human infection

They found the trigger that determines whether group A strep

globally every year. While it typically

acts as a “normal” pathogen, or a really angry flesh-eating

leads to strep throat, the organism

pathogen. The results may eventually lead to a vaccine,

also can turn nasty, causing severe

treatment or diagnostics for childbed fever.

invasive diseases such as childbed fever, which strikes moms and their newborns.

In another study published in January’s Journal of Clinical Investigation, Musser’s team repurposed a technique called

“About 10% of all women who get puerperal sepsis, or childbed

TraDIS, a powerful genetic tool first developed for strep throat

fever, will end up dying. It’s devastating and also may cause

in horses. It allowed them to learn precisely how group A strep

the child to die,” said James M. Musser, MD, PhD, corresponding

causes flesh-eating disease while living deep within muscle.

author on a paper that appeared in Nature Genetics in February.

The team identified 72 genes to target for vaccine and antibiotic development.

In the highly publicized study, Musser and his team were the first in the field of bacteria research to study group A strep on

and others have been “ We studying this problem for over 100 years. With these new types of analyses, we’re

Kachroo P, Eraso JM, Beres SB, Olsen RJ, L. Zhu, Nasser W, Bernard PE, Cantu CC, Saavedra MO, Arredondo MJ, Strope B, Do H, Kumaraswami M, Vuopio J, Gröndahl-Yli Hannuksela K, Kristinsson KG, Gottfredsson M, Pesonen M, Pensar J, Davenport ER, Clark AG, Corander J, Caugant DA, Gaini S, Magnussen MD,

making an important step

Kubiak SL, Nguyen HAT, Long SW, Porter AR, DeLeo FR and

toward ultimately having an

and virulence provides novel insights into Streptococcus

effective vaccine to eradicate group A strep from the face of the earth.

”

– James M. Musser, MD, PhD Fondren Presidential Distinguished Chair Chair, Department of Pathology and Genomic Medicine Director, Center for Molecular and Translational Human Infectious Diseases Research

Musser JM. Integrated analysis of population genomics, transcriptomics pyogenes pathogenesis. Nature Genetics. 2019 Feb 18: 51, 548–559. The work was supported by grants from the Fondren Foundation, Houston Methodist Hospital, the Houston Methodist Research Institute, the Academy of Finland (255636), European Research Council (742158), the UK Biotechnology and Biological Sciences Research Council (1503883), National Institutes of Health (1R01AI109096-01A1) and the NIH Intramural Research Program of the National Institute of Allergy and Infectious Disease. Zhu L, Olsen RJ, Beres BS, Eraso JM, Saavedra MO, Kubiak SL, Cantu CC and Jenkins L, Charbonneau ARL, Waller AS and Musser JM. Gene fitness landscape of group A streptococcus during necrotizing myositis. Journal of Clinical Investigation. 2019 Jan 22: 129(2):887-901.

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