Howard E. Gendelman, M.D. | |
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Born | March 18, 1954 Philadelphia, Pennsylvania, U.S. |
Alma mater | Muhlenberg College (B.S.) Pennsylvania State University College of Medicine (M.D.) |
Known for | HIV research, Parkinson's research, neuroimmune-pharmacology |
Awards | Startup of the Year 2022 UNeMed; Nebraska Coalition for Lifesaving Cures' 2022 Life Saver Award; 2018 Jewish Federation of Omaha Humanitarian of the Year Award; 2017 Society on NeuroImmune Pharmacology Lifetime Achievement Award; International Society for NeuroVirology's 2016 Pioneer in NeuroVirology; 2000 J. William Fulbright Research Scholar; and others |
Scientific career | |
Fields | Virology, neuroimmunology, neuroscience, pharmacology, therapeutics |
Institutions | Current: University of Nebraska Medical Center Previous: Henry M. Jackson Foundation for the Advancement in Military Medicine Walter Reed Army Institute of Research Uniformed Services University of the Health Sciences Center Johns Hopkins University Albert Einstein College of Medicine |
Website | https://www.unmc.edu/pharmacology/faculty/primary-faculty/gendelman/ |
Howard E. Gendelman (born March 18, 1954) is an American physician-scientist whose research intersects the disciplines of neuroimmunology, pharmacology, and infectious diseases. Gendelman was born in Philadelphia, Pennsylvania. His research is focused on harnessing immune responses for therapeutic gain in HIV/AIDS and Neurodegenerative disease. [1] He is the Margaret R. Larson Professor of infectious diseases and internal medicine at the University of Nebraska Medical Center (UNMC) in Omaha. [2]
He is married with three children and seven grandchildren. [3]
Gendelman was born in Philadelphia, on March 18, 1954. He attended Muhlenberg College in Allentown, Pennsylvania, where he graduated with a bachelor's degree in Natural Sciences and Russian Studies in 1975. [3] He completed his doctorate of medicine at the Pennsylvania State University-Hershey Medical Center in 1979. [3] He then completed a residency in Internal medicine at Montefiore Hospital, Albert Einstein College of Medicine in 1982, and he was a Clinical and Research Fellow in Neurology and Infectious Diseases at the Johns Hopkins Hospital in Baltimore from 1982 to 1985. [3]
Gendelman worked at the National Institute of Allergy and Infectious Diseases during the height of the HIV/AIDS pandemic. [4] Gendelman also occupied senior faculty and research positions at the Johns Hopkins Medical Institutions, the Uniformed Services University of the Health Sciences Center, the Walter Reed Army Institute of Research, and the Henry M. Jackson Foundation for the Advancement in Military Medicine before joining the faculty of UNMC in March 1993. He retired from the US Army with the rank of Lieutenant Colonel. He established the Center for Neurovirology and Neurodegenerative Disorders at UNMC in 1997, [5] which evolved into UNMC's current Department of Pharmacology and Experimental Neuroscience in 2004. [6] In 2000, he was awarded a Fulbright to do research at the Weizmann Institute of Science in Rehovot, Israel [7] [8]
Gendelman's research explores the role of mononuclear phagocytes (monocytes, macrophages, microglia, and dendritic cells) as viral reservoirs, perpetrators of disease, and depots for nanoformulated drug delivery. His work was foundational to building a field of investigation focused on lentiviral pathogenesis, diagnostics, and therapeutics. These advancements in immune transformation have led to new and effective management of neurodegenerative disease progression. Gendelman and his research team were among the first to develop laboratory assays for establishing viral tropism for mononuclear phagocytes, and they were the first to demonstrate that infected and immune activated mononuclear phagocytes release viral and cellular toxins that damage the nervous system. [9] [10] [11]
Gendelman's group was among the first to reverse HIV-dementia in an infected person using combination antiretroviral therapy (cART), and they developed scores of rodent models to mimic HIV/AIDS end-organ disease. [12] [13] [14] He coined the term long-acting slow effective release ART (LASER ART). These works led to polymer discovery, targeted drug delivery to viral reservoirs, and reduction of residual virus in lymphoid organs. His Nebraska-based research group, along with a team at Temple University, was also the first to combine HIV reservoir-targeted LASER ART and CRISPR-Cas9 to eliminate chronic viral infection from infected animals. [15] This curative approach (published in Nature Communications, 2019) received considerable attention in establishing a novel translational pathway for HIV eradication. [16] [17] [18] This work followed the first ultra-long acting nanocrystal prodrug and the world's first HIV vaccine mimetic [19] [20] (in Nature Materials, 2020). His work with cell-based drug delivery born out of nanoparticle-mononuclear phagocyte interactions has inspired broad pharmaceutical interest; in turn, Gendelman led the establishment of the Nebraska Nanomedicine Production Plant, [21] a biotechnology good manufacturing practices (cGMP) initiative, to position research for clinical translation in the development of long acting nanoformulated ART at UNMC. He also co-founded Exavir Therapeutics, Inc., [22] a biotechnology company developing therapies towards and cure for HIV/AIDS.
Gendelman was the first to pharmacologically transform effector into regulatory T cells to halt the progression of Parkinson's disease. [23] [24] Phase II investigation began in early 2021 after successful phase I investigations [25]
Gendelman has written or edited 17 books and monographs (including multiple editions of the textbooks The Neurology of AIDS [26] and Neuroimmune Pharmacology [27] ). He was the founding Editor-in-Chief of the Journal of Neuroimmune Pharmacology.
The human immunodeficiency viruses (HIV) are two species of Lentivirus that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment, the average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype.
Inflammation is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function.
Macrophages are a type of white blood cell of the innate immune system that engulf and digest pathogens, such as cancer cells, microbes, cellular debris, and foreign substances, which do not have proteins that are specific to healthy body cells on their surface. This process is called phagocytosis, which acts to defend the host against infection and injury.
Kupffer cells, also known as stellate macrophages and Kupffer–Browicz cells, are specialized cells localized in the liver within the lumen of the liver sinusoids and are adhesive to their endothelial cells which make up the blood vessel walls. Kupffer cells comprise the largest population of tissue-resident macrophages in the body. Gut bacteria, bacterial endotoxins, and microbial debris transported to the liver from the gastrointestinal tract via the portal vein will first come in contact with Kupffer cells, the first immune cells in the liver. It is because of this that any change to Kupffer cell functions can be connected to various liver diseases such as alcoholic liver disease, viral hepatitis, intrahepatic cholestasis, steatohepatitis, activation or rejection of the liver during liver transplantation and liver fibrosis. They form part of the mononuclear phagocyte system.
Microglia are a type of neuroglia located throughout the brain and spinal cord. Microglia account for about 10-15% of cells found within the brain. As the resident macrophage cells, they act as the first and main form of active immune defense in the central nervous system (CNS). Microglia originate in the yolk sac under a tightly regulated molecular process. These cells are distributed in large non-overlapping regions throughout the CNS. Microglia are key cells in overall brain maintenance—they are constantly scavenging the CNS for plaques, damaged or unnecessary neurons and synapses, and infectious agents. Since these processes must be efficient to prevent potentially fatal damage, microglia are extremely sensitive to even small pathological changes in the CNS. This sensitivity is achieved in part by the presence of unique potassium channels that respond to even small changes in extracellular potassium. Recent evidence shows that microglia are also key players in the sustainment of normal brain functions under healthy conditions. Microglia also constantly monitor neuronal functions through direct somatic contacts and exert neuroprotective effects when needed.
Following infection with HIV-1, the rate of clinical disease progression varies between individuals. Factors such as host susceptibility, genetics and immune function, health care and co-infections as well as viral genetic variability may affect the rate of progression to the point of needing to take medication in order not to develop AIDS.
HIV-associated neurocognitive disorders (HAND) are neurological disorders associated with HIV infection and AIDS. It is a syndrome of progressive deterioration of memory, cognition, behavior, and motor function in HIV-infected individuals during the late stages of the disease, when immunodeficiency is severe. HAND may include neurological disorders of various severity. HIV-associated neurocognitive disorders are associated with a metabolic encephalopathy induced by HIV infection and fueled by immune activation of macrophages and microglia. These cells are actively infected with HIV and secrete neurotoxins of both host and viral origin. The essential features of HIV-associated dementia (HAD) are disabling cognitive impairment accompanied by motor dysfunction, speech problems and behavioral change. Cognitive impairment is characterised by mental slowness, trouble with memory and poor concentration. Motor symptoms include a loss of fine motor control leading to clumsiness, poor balance and tremors. Behavioral changes may include apathy, lethargy and diminished emotional responses and spontaneity. Histopathologically, it is identified by the infiltration of monocytes and macrophages into the central nervous system (CNS), gliosis, pallor of myelin sheaths, abnormalities of dendritic processes and neuronal loss.
Neuroimmunology is a field combining neuroscience, the study of the nervous system, and immunology, the study of the immune system. Neuroimmunologists seek to better understand the interactions of these two complex systems during development, homeostasis, and response to injuries. A long-term goal of this rapidly developing research area is to further develop our understanding of the pathology of certain neurological diseases, some of which have no clear etiology. In doing so, neuroimmunology contributes to development of new pharmacological treatments for several neurological conditions. Many types of interactions involve both the nervous and immune systems including the physiological functioning of the two systems in health and disease, malfunction of either and or both systems that leads to disorders, and the physical, chemical, and environmental stressors that affect the two systems on a daily basis.
The neuroimmune system is a system of structures and processes involving the biochemical and electrophysiological interactions between the nervous system and immune system which protect neurons from pathogens. It serves to protect neurons against disease by maintaining selectively permeable barriers, mediating neuroinflammation and wound healing in damaged neurons, and mobilizing host defenses against pathogens.
CX3C motif chemokine receptor 1 (CX3CR1), also known as the fractalkine receptor or G-protein coupled receptor 13 (GPR13), is a transmembrane protein of the G protein-coupled receptor 1 (GPCR1) family and the only known member of the CX3C chemokine receptor subfamily.
Epithelioid cells are derivatives of activated macrophages resembling epithelial cells.
The central nervous system (CNS) controls most of the functions of the body and mind. It comprises the brain, spinal cord and the nerve fibers that branch off to all parts of the body. The CNS viral diseases are caused by viruses that attack the CNS. Existing and emerging viral CNS infections are major sources of human morbidity and mortality.
Leishmania donovani is a species of intracellular parasites belonging to the genus Leishmania, a group of haemoflagellate kinetoplastids that cause the disease leishmaniasis. It is a human blood parasite responsible for visceral leishmaniasis or kala-azar, the most severe form of leishmaniasis. It infects the mononuclear phagocyte system including spleen, liver and bone marrow. Infection is transmitted by species of sandfly belonging to the genus Phlebotomus in Old World and Lutzomyia in New World. The species complex it represents is prevalent throughout tropical and temperate regions including Africa, China, India, Nepal, southern Europe, Russia and South America. The species complex is responsible for thousands of deaths every year and has spread to 88 countries, with 350 million people at constant risk of infection and 0.5 million new cases in a year.
Janice Ellen Clements is vice dean for faculty at the Johns Hopkins School of Medicine and the Mary Wallace Stanton Professor of Faculty Affairs. She is a professor in the departments of Molecular and Comparative Pathobiology, Neurology, and Pathology, and has a joint appointment in molecular biology and genetics. Her molecular biology and virology research examines lentiviruses and how they cause neurological diseases.
HIV/AIDS research includes all medical research that attempts to prevent, treat, or cure HIV/AIDS, as well as fundamental research about the nature of HIV as an infectious agent and AIDS as the disease caused by HIV.
Kalipada Pahan is a professor of Neurological Sciences, Biochemistry and Pharmacology, and the Floyd A. Davis, M.D., Endowed Chair in Neurology at the Rush University Medical Center. He is also a research career scientist at the Department of Veterans Affairs, Jesse Brown VA Medical Center. He is an eminent Indian American neuroscientist involved in translational research on multiple sclerosis, Parkinson's disease, Alzheimer's disease, dementia, and Batten disease. He is well known for his research on statins, cholesterol-lowering drugs. He first explored the application of statins in suppressing the inflammatory events in microglia, astroglia and macrophages. This finding has revolutionized the research on statin drugs. Later, his lab has shown that statins may be beneficial in protecting neurons and improving locomotor activities in Parkinson's disease by suppressing the activation of p21/Ras. His lab is also famous for research on cinnamon where they have described that this commonly-used natural spice may be beneficial for different brain disorders including improving memory and learning of poor learners. Recently his lab has delineated a unique crosstalk between fat and memory in which the lipid-lowering transcription factor PPARalpha controls the formation of hippocampal memory via transcriptional regulation of CREB, suggesting a possible reason for the connection between excess belly fat and memory loss.
Neuroinflammation is inflammation of the nervous tissue. It may be initiated in response to a variety of cues, including infection, traumatic brain injury, toxic metabolites, or autoimmunity. In the central nervous system (CNS), including the brain and spinal cord, microglia are the resident innate immune cells that are activated in response to these cues. The CNS is typically an immunologically privileged site because peripheral immune cells are generally blocked by the blood–brain barrier (BBB), a specialized structure composed of astrocytes and endothelial cells. However, circulating peripheral immune cells may surpass a compromised BBB and encounter neurons and glial cells expressing major histocompatibility complex molecules, perpetuating the immune response. Although the response is initiated to protect the central nervous system from the infectious agent, the effect may be toxic and widespread inflammation as well as further migration of leukocytes through the blood–brain barrier may occur.
Sharon Ruth Lewin, FRACP, FAHMS is a leading infectious diseases expert who is the inaugural Director of The Peter Doherty Institute for Infection and Immunity and the Cumming Global Centre for Pandemic Therapeutics. She is also a Melbourne Laureate Professor of Medicine at The University of Melbourne, and the current President of the International AIDS Society (IAS).
Georgette D. Kanmogne is a Cameroonian American geneticist and molecular virologist and a full professor and vice chair for resource allocation and faculty development within the Department of Pharmacology and Experimental Neurosciences at the University of Nebraska Medical Center in Omaha, Nebraska. Kanmogne's research program focuses on exploring the pathogenesis of neuroAIDS by deciphering the mechanisms underlying blood brain barrier dysfunction and viral entry into the central nervous system. Her research also addresses the lack of HIV therapies that cross the blood brain barrier (BBB) and has played a critical role in the development of nanoparticles encapsulating HIV-drugs that can cross the BBB to prevent viral-mediated neuron death in the brain. Kanmogne collaborates with clinical and basic researchers across America, Cameroon, and West Africa, spanning disciplines from hematology to psychiatry, to explore how viral genetic diversity is correlated with the neurological impact of HIV.
Amanda Brown is an American immunologist and microbiologist as well as an associate professor of neurology and neuroscience at Johns Hopkins University School of Medicine in Baltimore, Maryland. Brown is notable for cloning one of the first recombinant HIV viruses and developing a novel method to visualize HIV infected cells using GFP fluorescence.