NYU LANGONE NYU HEALTH FALL 2017 A Battle Plan for Pancreatic Cancer MAGAZINE Blue in the Face (and Everywhere Else) A Medical Mystery The World’s Heaviest Medical Textbook For patients with severe inflammatory FALL 2017 FALL bowel disease, doctors at NYU Langone Health are redefining what’s possible. Help Us Make Dreams Come True EVERY ASPIRING PHYSICIAN DREAMS OF THE DAY SOMEONE WILL MAKE A GIFT ONLINE CALL HIM OR HER “DOCTOR” FOR THE FIRST TIME. But getting there Please visit takes a lot more than hard work and dedication—it takes resources. nyulangone.org/give/funds/ By contributing to NYU School of Medicine students, you help ensure that scholarships our next generation of physicians will have access to the best teaching and research, along with a competitive financial assistance package. To discuss special giving opportunities, contact When you make a gift, you help us guarantee that all of our students will Diana Robertson at have the means to complete our rigorous education. One day, you may 212-404-3510 even have the privilege of addressing them yourself as “Doctor.” or [email protected] Thank you for your generosity. What’s in a Name? Message from the Dean and CEO In 2008, a year after I became dean and CEO, our institution was renamed the NYU Elaine A. and Kenneth G. Langone Medical Center, in honor of our chairman of the Board, Kenneth G. Langone and his wife Elaine, whose $200 million gift was the largest in the institution’s history. Back then, I would never have imagined that I would preside over another name change, and yet I find myself doing so. As of July 20, we are now NYU Langone Health. To re- flect our new identity, and the core of our mission, we have also renamed this magazine, formerly NYU Physician. Many people resist change, but I’ve always been one to embrace it. To me, change signifies growth, development—progress—and it’s only possible at organizations that are forward thinking, nimble, and dynamic. Our new name is important for several reasons. First, it adds a vital new di- mension that reflects the essence of our role: to help people maintain or regain their well-being. We’re about health first and foremost. Second, the name more aptly reflects the future of healthcare, as we continue to expand beyond the walls of our hospitals and deliver a broader range of clinical services closer to where our patients live and work. Finally, it captures the collaborative spirit that brings forth the brightest ideas and allows us to provide the best possible care to our patients. What will not change, however—what will never change—is our commit- ment to excellence in patient care, medical education, and scientific research. This issue spotlights shining examples of each, including a surgeon who does what others cannot—or will not—do to treat the most dire cases of inflamma- tory bowel disease; a researcher who illuminates the enduring and daunting genetic puzzle of adaptive immunity; and a graduate, born and raised in one of the world’s poorest countries, who came to NYU School of Medicine to fulfill his dream of becoming a doctor—and did it in just three years. “What’s in a name?” Shakespeare famously asked. Plenty. Robert I. Grossman, MD, Saul J. Farber Dean and CEO PHOTO CREDIT PHOTO CARNETT JOHN FALL 2017 NYU LANGONE HEALTH ... 1 FALL 2017 A Battle Plan for Pancreatic Cancer Blue in the Face (and Everywhere Else). A Medical Mystery The World’s Heaviest Medical Textbook Contents For patients with severe inflammatory bowel disease, doctors at NYU Langone Health are redefining what’s possible. NEW YORK UNIVERSITY William R. Berkley Chair, Board of Trustees Andrew D. Hamilton President NYU LANGONE HEALTH Kenneth G. Langone Chair, Board of Trustees Robert I. Grossman, MD Saul J. Farber Dean and CEO Kathy Lewis Senior Vice President, Communications and Marketing NYU LANGONE HEALTH MAGAZINE Steven B. Abramson, MD Editor, Science and Medicine Nicole Dyer Director of Publications Thomas A. Ranieri Contributing Editor Larisa Manouilovitch “PATIENTS, INCLUDING YOUNG GIRLS, FACE DEVASTATING CHOICES Print Production Coordinator AS THEY TRY TO BALANCE CANCER TREATMENT AGAINST THEIR ABILITY TO HAVE CHILDREN IN THE FUTURE. WE NEED BETTER OPTIONS.” Modus Operandi Design Art Direction KARA GOLDMAN, MD ON THE COVER: Departments Illustration by Chad Hagen 01 Dean’s Letter 38 Post 48 Anatomy of a Leader What’s in a Name? NEW PEOPLE, PLACES, Life Lessons from AND PROJECTS Steven B. Abramson, MD 04 Scope Faculty Conversation 38 NEWS FROM MEDICINE Q & A with surgeon-scientist Diane Simeone, MD, head of Can an experimental cancer the new Pancreatic Cancer drug protect fertility? 06 Center How the cold sore virus sidesteps PLUS the immune system 10 The Science Building A gold-standard reference for Opens 42 psychiatrists celebrates its golden anniversary 12 Highest Honors from the NIH 44 The quest for liquid biopsies 13 In Memoriam: Steven H. Ferris, PhD 47 CHAD HAGEN LUONG TONY BEN BAKER; KOZOWYK; JONATHAN TOP: FROM CLOCKWISE 2 ... NYU LANGONE HEALTH FALL 2017 Features 14 GUT INSTINCTS Feza Remzi, MD, the new director of NYU Langone’s Inflammatory Bowel Disease Center, has a singular focus: alleviating human suffering. BY ADAM PIORE 22 THE CONTORTIONIST Jane Skok, PhD, studies a fantastical world of looping DNA to crack the secrets of autoimmune disease and blood cancer. BY JOSIE GLAUSIUSZ 30 WHY SO BLUE? How a team of clinical sleuths uncovered the mysterious condition that discolored a young woman’s skin—and threatened her life. BY KENNETH MILLER CHAD HAGEN LUONG TONY BEN BAKER; KOZOWYK; JONATHAN TOP: FROM CLOCKWISE FALL 2017 NYU LANGONE HEALTH ... 3 “Patients, including young girls, face devastating choices as they try to balance cancer treatment against their ability to have children in the future. We need more options.” PHOTO CREDIT PHOTO CREDIT PHOTO 4 ... NYU LANGONE HEALTH FALL 2017 news from medicine — fall 2017 “Patients, including young girls, face devastating choices as they try to balance cancer treatment against their ability to have children in the future. We need more options.” PHOTO CREDIT PHOTO CREDIT PHOTO FALL 2017 NYU LANGONE HEALTH ... 5 Scope New Clues to an Ovarian Fountain of Youth An experimental cancer drug shown to protect egg cells from the ravages of chemotherapy could extend women’s reproductive window. By Karen Hopkin Each year, an estimated 13,000 Amer- about 50 percent of the time,” says of these primordial follicles begins to ican women under the age of 40 are study coauthor David Keefe, MD, the develop “like a faucet set on trickle,” diagnosed with breast cancer. It’s an Stanley H. Kaplan Professor of Ob- explains Dr. Keefe. One of the matur- age when worries of survival are com- stetrics and Gynecology, chair of the ing follicles will release its egg during pounded by worries of reproductive Department of Obstetrics and Gyne- ovulation, and the others will degen- survival, because while cancer treat- cology, and professor of cell biology at erate. Chemotherapy agents, which ments can save lives, they can also NYU Langone. “So a patient can lay kill rapidly dividing tumor cells, also leave women permanently infertile. out $15,000 and undergo six weeks destroy these actively growing fol- That heartbreaking reality inspired of extensive exposure to hormones licles. The ovaries overcompensate reproductive endocrinologist Kara to find it didn’t work.” Many women “so the trickle of follicles becomes a Goldman, MD, to pursue a solution in can’t afford the procedure—or the gush,” adds Dr. Keefe. That overre- 2014, during a research fellowship at delay in treating their cancer. action can lead to infertility by pre- NYU Langone Health. “Patients, in- Chemotherapy attacks a woman’s Many young maturely depleting a woman’s ovarian cluding young girls, face devastating reserve of eggs on two fronts. Women women with reserve—an effect dubbed “follicular choices as they try to balance cancer are born with a finite number of oo- cancer can’t burnout.” treatment against their ability to have cytes—1 million to 2 million, each en- afford the A 2008 study from the Karolinska expense of egg children in the future,” says Dr. Gold- cased in a protective follicle. By pu- freezing—or the Institute revealed that this follicular man, assistant professor of obstetrics berty, about 300,000 remain. During delay in treat- activation is regulated by a signal- and gynecology, who treats patients each menstrual cycle, a small clutch ment. ing pathway known as mTOR, which at the NYU Langone Fertility Center. helps direct cellular growth. Blocking “We need more options.” that pathway with an mTOR inhibitor Working with an interdisciplinary like everolimus, the investigators rea- team of investigators, Dr. Goldman has soned, should dampen this follicular plucked hope from an unlikely source: overreaction and thereby block the an immunosuppressant drug used to adverse effects of chemotherapy. prevent organ rejection in transplant That’s where Robert Schneider, PhD, patients and even treat some cancers. comes in. Dr. Schneider, the Albert B. Using female mice as a model, the re- Sabin Professor of Microbiology and searchers have shown that administer- Molecular Pathogenesis, professor of ing a drug called everolimus alongside radiation oncology, and associate dean chemotherapy protects the animals’ for therapeutics alliances at NYU Lan- ovaries and preserves their fertility. gone, has spent years studying the role The study appears in Proceedings of the mTOR plays in breast cancer, and he National Academy of Sciences. was keen to explore whether the path- Currently, women diagnosed with way could help preserve fertility. cancer can elect to freeze their eggs or “Our protocol was aligned as close- embryos prior to starting chemother- ly as possible with those used to treat apy.