Curriculum Vitae
`Fatemeh Akhlaghi, Pharm.D., Ph.D.
`
`Summary: I am a pharmaceutical scientist with expertise in clinical pharmacology, translational
`sciences, drug metabolism, pharmacogenomics and pharmacokinetic/pharmacodynamic (PKPD)
`modeling. My research goal is to understand the sources of variability in drug disposition and
`effect specifically in patients with diabetes mellitus or non-alcoholic fatty liver disease (NAFLD).
`The long-term goal is to devise personalized medicine these disease state. I am proficient in design
`and implementation of clinical pharmacokinetic studies, quantification of drug concentration and
`metabolites using LC-MS/MS and data analysis by standard or population pharmacokinetics
`methods. Characterization of expression and activity of drug metabolism enzymes and transporters
`ex vivo or in vitro is another area of research practiced in my laboratory. diabetes mellitus on drug
`disposition, drug development
`in alcoholism and
`therapeutic drug monitoring of
`immunosuppressive agents in organ transplant recipients. In addition, I am the director of the
`graduate program in Pharmaceutics and Pharmacokinetics and Principal Investigator on two NIH
`grants.
`Personal Information
`Date of Birth: November 18th, 1966
`Marital Status: Married with a 24-year old daughter
`Residency Status: Naturalized Citizen of the United States
`Work Address
`Department of Biomedical and Pharmaceutical Sciences
`495A College of Pharmacy, 7 Greenhouse Road
`University of Rhode Island
`Kingston, RI 02881
`Phone: (401) 874 9205 / Fax: (401) 874 5787
`Email: fatemeh@uri.edu
`Departmental Website URI: http://web.uri.edu/pharmacy/research/akhlaghi/
`Laboratory Website URI:
`http://akhlaghilab.com/
`Website Brown University: https://vivo.brown.edu/display/fakhlagh
`Google Scholar:
`https://scholar.google.com/citations?user=wdnBYOAAAAAJ&hl=en
`Linkedin site:
`http://www.linkedin.com/in/akhlaghi
`ORCID ID: orcid.org
`0000-0002-3946-7615
`
`EDUCATION
`
`1984-1990
`Project title:
`Major Professor:
`
`Pharm.D.
`University of Mashhad, Iran
`Use of CD4 to CD8 ratio as a marker for kidney transplant rejection
`Behrouz Nikbin M.D.
`
`1992-1997
`Project title:
`
`Ph.D. in Pharmaceutical Sciences
`University of Sydney, Australia
`Cyclosporine distribution in cardiopulmonary transplant recipients
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`Major Professors: Kenneth F. Brown Ph.D. and Anne M. Keogh M.D.
`
`
`July 2014-
`
`EMPLOYMENT HISTORY
`University of Rhode Island
`
`Ernest Mario Distinguished Chair in
`Pharmaceutics
`
`July 2014-
`Brown University Medical School Adjunct Professor of Medicine
`Full Professor
`
`July 2011-
`University of Rhode Island
`
`July 2010-
`Brown University Medical School Adjunct Associate Professor
`
`2006-2010
`University of Rhode Island
`
`Associate Professor with Tenure
`
`2001-2006
`University of Rhode Island
`
`Assistant Professor (Tenure Tack)
`
`1998-2001
`University of Cambridge, U.K.
`Senior Clinical Scientist
`
`(Advisor: Andrew K. Trull Ph.D.; Funded by Novartis, Roche Laboratories and Papworth
`Hospital Research Trust)
`Post-Doctoral Research Associate
`1996-1998
`
`University of Sydney, Australia
`(Advisors: Kenneth F. Brown Ph.D. and Andrew J McLachlan Ph.D.; Funded by Novartis and
`Janssen Cilag Australia)
`
`FURTHER TRAINING
`
`March 13, 2016
`Design and Analysis of Quantitative Proteomic Experiments: Introduction to Statistical Methods
`and Practical Examples using Skyline, one-day workshop part of Human Proteomics Organization
`meeting in Boston, MA
`
`July 6-10, 2015
`Model-Based Drug Development: Incorporating Population Variability into Mechanistic
`Prediction of PK and Modelling PK-PD
`A course on Simcyp, Certara Corporation
`
`Aug 5-6, 2014
`Transporters in Drug Discovery and Development
`University of Rhode Island
`
`Jan-March, 2013
`Hands on data manipulation using R
`Instructor: Dr. Kaori Ito, Pfizer Groton
`
`May 1-5, 2012
`Fisher / Shafer NONMEM Course
`An Intermediate to Advanced NONMEM course with PLT tools
`Bethesda, MD
`
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`March 19-21, 2012
`The Introductory GastroPlus™ Simulation and Modeling Workshop
`Cambridge, MA.
`
`March 29-31, 2011
`Triple Quadrupole System Training using Analyst® Software for Quantitation
`AB Sciex, Framingham, MA.
`
`October 4, 2009
`Phoenix NLME - A Next Generation Tool for Population PK/PD Analysis
`Instructor: Dan Weiner, Pharsight Corporation.
`
`September 16, 2006
`Course in Pharmacokinetic/Pharmacodynamic Modeling
`Instructors: Drs William J. Jusko and Jogarao Gobburu.
`
`September 12-14, 2005
`A three-day hands-on course on “Wings for NONMEM Population Pharmacokinetics Modeling”;
`Instructors: Drs Nick Holford and Dianne Mould
`Also organized the course with Dr. Sara Rosenbaum.
`July 26-30, 2004
`
` weeklong hands-on course entitled “Molecular Genetic Methodologies for Pharmaceutical
`Scientists”; Department of Pharmaceutical Sciences, University of Buffalo;
`Instructor: Dr. Dan Brazeau.
`
`June 2002
`A three full days hands-on course “Operator’s Training on Sciex API2000 Liquid Chromatography
`Mass Spectrometer” University of Rhode Island, also organized the course.
`Instructor: Dr. Bill Sawyers, Applied Biosystems.
`
`September 27-29, 1999
`Beginning level short course on “Population Pharmacokinetics using NONMEM Computer
`Program”
`Instructors: Drs Lewis Sheiner and Stuart Beal; Uppsala Sweden.
`
`January 9-15, 1999
`“A course in Pharmacokinetic and Pharmacodynamic Modeling using WinNonlin” one credit
`point; Department of Clinical Pharmacology, Karoliniska Institute, Stockholm, Sweden;
`Instructor: Dr. Ole Borga.
`
`December 7-22, 1998
`“A course in Pharmacokinetic and Pharmacodynamic with Clinical Applications”; four credit
`points; Department of Clinical Pharmacology, Karoliniska Institute, Stockholm, Sweden;
`Instructors: Drs Gunnar Alvan, Ole Borga, Johan Gabrielsson, Lars Gustafsson.
`
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`HONORS AND AWARDS
`
`1992
`1993-96
`2002
`2006
`2008
`2010
`
`Levy Maill Pattinson Award, Faculty of Pharmacy, Uni. of Sydney
`Faculty of Pharmacy Postgraduate Scholarship, Uni. of Sydney
`University of Rhode Island New Faculty Development Award
`Outstanding Intellectual Property Award, University of Rhode Island
`Paul-Ehrlich Magic Bullet-Award 2008, Nurnberg Germany
`Outstanding Intellectual Property Award, University of Rhode Island
`
`
`
`PROFESSIONAL SOCIETY MEMBERSHIP
`
`1993-1998
`1997-2001
`1998-2001
`1996-present
`
`1990-present The Medical Council of Iran (Registered Pharmacist)
`1993-1998
`Australasian Society for Clinical and Experimental Pharmacology and Toxicology
`(ASCEPT)
`Australasian Pharmaceutical Science Association (APSA)
`International Society of Heart and Lung transplantation (ISHLT)
`Transplantation Society
`International Association of Therapeutic Drug Monitoring and Clinical Toxicology
`(IATDM&CT)
`1997-present American Association of Pharmaceutical Scientists (AAPS)
`2001-present American Association of Colleges of Pharmacies (AACP)
`2008-present American Society for Clinical Pharmacology and Therapeutics (ASCPT)
`
`
`
`CONSULTING ACTIVITIES
`
`1996
`
`Physicochemical characteristics of ingredients of an antacid suspension,
`consultant for Park Davis Pharmaceuticals in collaboration with Dr. Elizabeth
`Gipps, University of Sydney
`1997-1998 Droplet size determination of nebulized solutions of Salbutamol and Ipratropium
`Bromide using Marple - Miller cascade impactor, in collaborating with Dr. Kim
`Chan, University of Sydney
`2001-2003 Pharmacokinetics of intravenous immunoglobulin (IVIG), I have analyzed the
`pharmacokinetic data from several phase III studies conducted by Bio Products
`Limited, UK
`Member of Mycophenolic Acid TDM Advisory Board (Opticept clinical trial, an
`800 patient trial conducted by Roche Laboratories to evaluate the need for
`mycophenolic acid therapeutic drug monitoring)
`Consulting on a case study conducted at the Department of Emergency Medicine,
`RI hospital on the elimination of carboxy hemoglobin
`2005-2007 Expert witness in a personal injury case involving cyclosporine generic
`substitution and risk of organ rejection
`Expert witness in a patent dispute case between two major pharmaceutical
`companies
`
`2003
`
`2005
`
`2007
`
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`in
`
`2011
`
`2017-
`
`2017-
`
`and pharmacodynamic modeling of bortezomib
`2008-2009 Pharmacokinetic
`cynomongolus monkeys, Millennium Pharmaceuticals
`2007-2010 Pharmacokinetic consultant for a clinical trial on the intra-nasal use of ketamine
`in children with laceration, Department of Emergency Medicine, Hasbro Children
`Hospital, Providence, RI.
`Consultant on concentration–projection of a modified release tablet by two
`different manufacturers.
`Expert witness for a non-infringement trial for two Canadian companies
`2014
`Consultant on bioequivalence studies on a generic versus a brand name drug
`2014
`2016-2017 Consultant on a patent dispute case involving a combination anti-hyperglycemic
`agent
`Consultant on a patent dispute case involving projection of pharmacokinetic
`parameters of controlled release formulations
`Expert witness on a patent dispute involving patent “obviousness”
`
`
`INVITED PRESENTATIONS
`PRESENTATION TITLE/LOCATION
`“Pharmacokinetics of cyclosporine in patients receiving metabolic inhibitors” Invited
`speaker at PKUK99 meeting, Oxford, UK.
`“Clinical pharmacology of immunosuppressive agents” Lecture to the Nephrology
`Residents, Department of Nephrology, Brown University Medical School,
`Providence, RI.
`“Novel strategies for monitoring immunosuppressive agents” invited speaker at the
`Department of Pediatrics Nephrology and Transplantation, the Boston’s Children
`Hospital, University of Harvard Medical School, Boston, MA.
`“Monitoring cardiothoracic transplant recipients” Seminar to the Heart Transplant
`Group, the Brigham and Woman’s Hospital, University of Harvard Medical School,
`Boston, MA.
`“Novel strategies for monitoring immunosuppressive agents” Seminar to Kidney
`Transplantation Services, Rhode Island Hospital, Providence, RI.
`“Pharmacokinetics and pharmacodynamics of immunosuppressive agents” oral
`presentation at RI-BRIN annual retreat, Alton Jones Campus, RI.
`Speaker at the workshop “Hot and alternative research funding” Title: How to Get
`Funding from the Industry, University of Rhode Island, Kingston, RI.
`“Pharmacokinetics of immunosuppressive agents in diabetic patients” Presentation to
`the Transplant Services, RI Hospital, Providence, RI.
`“Pharmacokinetics and –dynamics of immunosuppressive agents” Center for the
`New Stem Cell Biology Visiting Professors Seminar Series, COBRE program, Roger
`Williams Hospital, Providence, RI.
`
`DATE
`Nov
`1999
`Aug 16
`2001
`
`Oct 1
`2001
`
`Oct 23
`2001
`
`Jan 25
`2002
`Jul 11
`2003
`May 20
`2004
`Apr 7
`2005
`Jan 25
`2006
`
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`

`May 24
`2006
`May 31
`2007
`
`Sept 11
`2007
`Oct 2
`2007
`Oct 24
`2007
`
`Jan 2
`2008
`July 25
`2008
`
`Sept 3
`2008
`
`Oct 5
`2008
`
`May 20
`2009
`
`May 2
`2010
`
`Sept 7
`2010
`
`Sept 28
`2010
`
`Dec 14
`2010
`
`Poster Judge at the Joint RI-COBRE symposiums, Providence, RI.
`
`“Review of transplant pharmacology” invited speaker at “Transplant Pharmacology:
`Keys to Medication Management in Organ Transplant Recipients”; Pharmacist CE
`program, Providence, RI.
`Research presentation “pharmacokinetic of immunosuppressive agents in diabetic
`patients” Millennium Pharmaceuticals, Boston, MA.
`“Novel monitoring methods for immunosuppressive agents PKPD” Research
`presentation at College of Pharmacy, University of Kentucky, Lexington, KY.
`“Immunosuppressive agents PK/PD and diabetes mellitus” Visiting professor
`program, Department of Pharmacology and Experimental Therapeutics, Tufts
`University School of Medicine, Boston, MA.
`“Effect of diabetes mellitus on drug metabolism and transporter” Hallett Center for
`Diabetes and Endocrinology Disorders, Brown University, Providence, RI.
`“Pharmacokinetics and –dynamic modeling of bortezomib in cynomonglous
`monkeys” Department of Clinical Pharmacology, Millennium Pharmaceuticals,
`Cambridge, MA.
`“Introduction to pharmacokinetic/pharmacogenomics modeling and application: a
`Velcade® case study” R&D presentation, Millennium Pharmaceuticals, Cambridge,
`MA.
`“Effect of diabetes mellitus on pharmacokinetics and pharmacodynamics of
`immunosuppressive agents: ciclosporin, tacrolimus and mycophenolic acid” Invited
`speaker at EHRLICH II, 2nd World Conference on Magic Bullets, Nurnberg,
`Germany.
`“Application of clinical pharmacology to improve the quality of use of medicines in
`diabetes and transplantation” invited speaker at Division of Clinical Pharmacology,
`Johns Hopkins University, Baltimore, MD.
`“Drug monitoring in distinct patient populations; pharmacokinetic differences
`between transplant recipients of different ethnicities”, invited speaker at Sunrise
`symposium, the American Transplant Congress, May 2010, San Diego, CA.
`“Diabetes, reduced CYP3A4 activity and the possible role of statin lactone in statin
`induced myopathy”; presentation at the department of cardiology, Hartford Hospital,
`Hartford, CT.
`in an FDA workshop on “Pharmacodynamic and
`Invited participant
`Pharmacogenomics biomarkers in solid organ transplantation”, Food and Drug
`Administration, White Oak Campus, MD.
`“Diabetes altering biotransformation and pharmacodynamics of immunosuppressive
`agents”; Invited speaker at the Department of Pharmaceutical Sciences, University of
`Colorado Health Science Center, Anschutz Medical Campus Aurora, CO.
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`

`Mar 23
`2011
`
`8
`
`Oct
`2011
`Aug 28,
`2012
`Oct 22,
`2012
`Aug 8,
`2013
`Nov 18,
`2013
`
`Mar 13,
`2014
`
`Aug 7,
`2014
`
`Mar 12,
`2015
`
`July 13,
`2015
`
`Oct 20,
`2015
`Nov 5,
`2015
`
`Nov 6,
`2015
`
`Feb 2,
`2016
`
`Dec 6,
`2016
`
`Diabetes and side effects of statins, American Heart Association Friends of Heart
`Luncheon, Center for Biotechnology and Life Sciences (CBLS) building, University
`of Rhode Island
`Influence of diabetes mellitus on the disposition of immunosuppressive agents and
`statins, PDM department, Pfizer Center Research, Groton, CT.
`Impact of protein binding on drug disposition and action, College of Pharmacy,
`University of Technology, Sydney, Australia via Video conferencing.
`Altered disposition of xenobiotics by diabetes mellitus, Division of Clinical
`Pharmacology, Johns Hopkins Medical Institute, Baltimore, MD.
`Altered disposition of xenobiotics by diabetes mellitus and fatty liver, College of
`Pharmacy, University of Houston, Tx.
`of
`pharmacodynamics
`and
`Effect
`of
`diabetes
`on
`pharmacokinetics
`immunosuppressive agents, Division of Transplantation, Methodist Hospital,
`Houston, Tx.
`AACP Academic Research Fellows Program; Model of Team Science IV:
`Collaboration between academia, government, industry supported by NCATS;
`Rockville, MD.
`in Biotransformation and
`Invited Speaker at “Pharmacogenomic Interplay
`Pharmacokinetics”; Pharmacokinetic consequences of metabolic syndrome;
`University of Rhode Island
`Invited Speaker at the 30th Annual Seminar by the Sea; Northeast Regional
`Continuing Education Conference for Pharmacists
`“Statin Interactions: Food, Supplements and Other Drugs”
`AACP Academic Research Fellows Program; Model of Team Science IV:
`Collaboration between academia, government, industry supported by NCATS;
`Potomac, MD.
`Presentation of the result of phase 1b of PF-05190457 study in subjects with alcohol
`use disorders; NIH Clinical Center, Bethesda, MD.
`Workshop leader on Mechanisms of Drug-Drug Interactions; International Congress
`of Quality, Safety and Rationale Use of Drugs, University of Mashhad, Mashhad,
`Iran
`“Clinical Pharmacology and Therapeutic Monitoring of Immunosuppressive Agents”
`International Congress of Quality, Safety and Rationale Use of Drugs, University of
`Mashhad, Mashhad, Iran
`Invited speaker in Connecticut Mass Spec Discussion group
`Title: Pharmacokinetic Consequences of Metabolic Syndrome: Challenges and
`Opportunities for Proteomic Mass Spectrometry
`Invited speaker, Pfizer Cambridge
`
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`

`Pharmacokinetics Consequences of Type 2 Diabetes (T2DM) and Non Alcoholic
`Fatty Liver Disease (NAFLD)
`Invited speaker, department of gastroenterology, Beth Israel Deaconess Medical
`Center
`Invited speaker, Diabetes Research Unit, Hamad Hospital Medical Center, Doha,
`Qatar
`Invited speaker, College of Pharmacy, Qatar University, Doha, Qatar
`
`Feb 8,
`2017
`May 7,
`2017
`May 10,
`2017
`
`2001-present
`2003-present
`2003-present
`2002
`2004
`2006-present
`2006-present
`2007-present
`2009
`2009
`2010-present
`2010-
`2011-
`2013-
`2016-
`2016-
`2016-
`2016-
`2016
`
`2013-present
`2015-present
`2014-present
`
`
`2007
`
`
`2009
`
`2013
`2013-present
`
`
`
`
`
`
`
`
`
`AD HOC REVIEWER FOR SCIENTIFIC JOURNALS
`
`British Journal of Clinical Pharmacology
`Clinical Pharmacokinetics
`Journal of Chromatography B
`Pharmacoeconomics
`Transplantation
`Journal of Pharmacology and Experimental Therapeutics (JPET)
`Clinica Chemica Acta
`Clinical Pharmacology and Therapeutics
`European Journal of Clinical Pharmacology
`Liver Transplantation
`British Journal of Pharmacology
`Journal of Pharmaceutical and Biomedical Analysis
`European Journal of Medicinal Chemistry
`Lancet
`New England Journal of Medicine
`Current Drug Metabolism
`Pharmacotherapy
`Alcohol and Alcoholism
`Medical Science Monitor
`
`JOURNAL EDITORIAL BOARD
`
`Clinical Pharmacokinetics
`Journal of Pharmaceutics and Drug Research
`Journal of Research in Pharmacy Practice
`
`
`GRANT REVIEWS
`
`Department of Defense, Chemical and Biological Defense Basic, Research
`Program
`The Czech Science Foundation, Czech Republic (GACR)
`National Science Center, Poland
`Qatar National Research Foundation (QNRF)
`
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`Reviewing 2-3 grants in each grant cycle
`
`
`
`NIAID special emphasis panel; ZAI1 PA-I M1, ad hoc reviewer
`
`2014 April
`XNDA study section, ad hoc reviewer
`
`2014 June
`ZTR1 CI-6 (01) review of NCATS X02 grants
`
`2014 August
`ZTR1 CI-6 (02); Study section for review of NCATS UH2/UH3 grants
`
`2015 March
`CIDO Study section, ad hoc reviewer, Chicago, Illinois
`
`2015 Oct
`ZAI1-BDP-I-M4 study section, mail in reviewer
`
`2016 May
`BCHI study section, mail in reviewer
`
`2016 June
`ZAI1 PA-I (M2) 1 NIAID R34 review study section
`
`2017 Jan
`Nominated to be a standing member of Clinical and Integrative Diabetes
`
`2017 June
`and Obesity [CIDO] Study Section
`
`
`TEACHING RESPONSIBILITIES
`
`
`
`BPS403
`
`Pharmacokinetics I (Basic Pharmacokinetics)
`
`4th year Interactive Learning
`PHC427
`BMS540 Drug metabolism (experimental)
`BPS502 Drug development
`Pharmacokinetics in various phases of drug development
`Pharmacokinetics II (Applied Pharmacokinetics)
`
`BPS504
`
`BPS525
`
`PHP516
`BPS530
`
`PHC597
`
`Experimental techniques in biomedical sciences
`Use of mass spectrometry in quantitative analysis
`Pharmacy practice laboratory II
`Topics in drug metabolism
`Pharmacokinetics and drug-drug interaction studies
`5th year Interactive Learning (1 section)
`
`2002-2004, Team-
`taught (50%)
`2002, Sole instructor
`2003, Team taught
`2005-now, Team taught
`
`2001- now, Sole
`instructor
`2004-now, Team taught
`
`2002-now, Team taught
`2005, 2007, 2011, 2013,
`2015, Team taught
`2003- 2007, 2015, Sole
`Instructor
`2002-2004, 2015-
`
`Graduate seminar
`
`BPS693/
`694
`APS670 Advanced pharmacokinetics
`
`2001, 2003, 2009, 2014,
`2016 Sole instructor
`Average student evaluation of teaching score: 4.5 out of 5 in didactic courses
`
`
`
`SERVICE ACTIVITIES IN THE UNIVERSITY OF RHODE ISLAND
`
`URI sabbatical review committee
`2005
`URI president appointee at the “Intellectual Property Committee (IPC)”
`2008-2011
`2009-current Member of “URI Institutional Review Board (IRB)”
`
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`2014
`
`2009
`2010
`
`2007-2008 Member of search committee for “Assistant Vice President for Research,
`Intellectual Property Management and Commercialization”
`Member of search committee for “Technology Transfer Specialist”
`Member of search committee for biostatistics faculty in the department of
`Computer Science and Statistics
`Member of search committee for biostatistics faculty in the department of
`Computer Science and Statistics
`2015-current Member of faculty Senate, URI
`
`Service Activities in College of Pharmacy (COP) or
`Department of Biomedical and Pharmaceutical Sciences (BPS)
`2006-current Member of research and graduate studies committee, COP
`2010-2013
`Program assessment committee, vice chair, COP
`2007-08
`Member of ad-hoc promotion and tenure standards committee, BPS
`2003, 05, 07 Member of various faculty search committees, BPS
`2010
`Search committee for two pharmaceutics positions, BPS
`2011
`Member of search committee for Pharmacogenomics faculty, BPS
`2010-2011
`Coordinator of INBRE seminar series, college of pharmacy
`2012
`Member of search committee for BPS departmental chair
`2012-
`Coordinator of College of Pharmacy College Wide Seminar series
`2013-
`Chair of liver and metabolic disorders working group, COP
`2013-
`Chair of faculty development committee, BPS
`2013
`Chair of promotion and tenure committee, COP
`2013
`Chair of full professors committee, COP
`2013
`Member of medicinal chemistry search committee, BPS
`2014
`Chair of Pharmaceutics faculty search committee, BPS
`2015
`Member of Pharmacogenomic faculty search committee, BPS
`2016
`Chair of two faculty searches in pharmaceutics
`2017
`Chair of search committee for Assistant/Associate Professor on Pharmaceutics
`
`2012
`
`ORGANIZATION OF SCIENTIFIC CONFERENCES
`Co-chair of 1st International Conference on Frontiers in Pharmaceutical
`Sciences: Global Perspectives; September 28-30, 2012
`Member of organizing committee for Pharmacogenomic Interplay in
`Biotransformation and Pharmacokinetics, August 7th & 8th, 2014
`Member of organizational committee for Boston Society 2016 Applied
`Pharmaceutical Analysis conference
`Sept 14, 2016 Session chair, Non-P450 Metabolism / Electron Pushing / Unusual Metabolism in
`2016 Applied Pharmaceutical Analysis conference
`
`2014
`
`2016
`
`
`
`
`
`STATEMENT OF RESEARCH
`
`My research program is aimed at improving the quality of use of medications by means of
`identifying sources of variability in dose-concentration and concentration-effect relationships.
`Identification of new or improved biomarkers for drug effect is also another aim of this research.
`This type of research is usually identified as a branch of “Clinical/translational Pharmaceutical
`Sciences” within pharmacy schools but also is known as “Clinical Pharmacology” in the medical
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`II.
`
`III.
`
`IV.
`
`schools. During the drug development process (Phase I-III), Food and Drug Administration of
`United States (FDA) and other regulatory agencies avidly scrutinize a new agent for its safety and
`effectiveness; however many aspects of a new drug including side effects or drug-drug interactions
`are only discovered after the new drug is prescribed to a large number of patients. My research
`effort is focused on the evaluation of safety and effectiveness of post-marketed drugs (Phase IV)
`with an emphasis on the immunomodulators. The three main objectives of my research program
`include:
`
`Several projects are currently underway aiming to:
`I.
`To characterize the effect of diabetic mellitus on immunosuppressive agents’ disposition
`and concentration-effect relationship in kidney transplant recipients.
`To study enzyme activity and protein expression for major phase I and phase II drug
`metabolizing enzymes in diabetic and non-diabetic tissues.
`To study the disposition of statin lipid lowering agents in type 2 diabetic patients and to
`identify factors (i.e. CYP3A activity, genetic polymorphism, pro-inflammatory cytokines)
`in predisposing a diabetic patient to statin related myopathy.
`To validate the use of saliva as a non-invasive specimen for therapeutic drug monitoring
`of immunosuppressive agents.
`V. Development of A Novel Compound for Alcoholism Treatment: a Translational Strategy
`
`
`Other research areas include utilization of iodinated contrast media agents for precise assessment
`of kidney function and development of better/alternative dosage forms. I have elaborated on each
`of these areas in the following paragraphs:
`
`(i)
`
`To characterize the effect of diabetic mellitus on immunosuppressive agents’
`disposition and concentration-effect relationship in kidney transplant recipients.
`
`A kidney allograft transplant is the ultimate method of treatment for End Stage Renal Disease
`(ESRD). To prevent rejection, a transplant recipient will remain dependent on a life-long treatment
`with several immunosuppressive agents with unpredictable pharmacokinetics and numerous side
`effects. Approximately 30% of all kidney transplant recipients in the United States are diabetics
`before transplant and 15-20% develop new onset diabetes post-transplant (NoDAT). Data from
`UNOS and USDRS suggest that both graft and patient survival are reduced and the risk of serious
`infections is increased in transplanted diabetics. Although, in the current clinical practice, the
`immunosuppressive therapy is similar between the two groups, data on higher rate of infection
`imply that diabetics may be more immunosuppressed than their non-diabetic counterparts.
`Personalized immunosuppressive therapy, by means of devising appropriate diagnostic methods,
`may therefore reduce the occurrence of unwanted events thereby improving graft and patient
`survival. This project is aimed to estimate specific PK/PD parameters of immunosuppressive
`agents for patients with diabetes type (1 or 2) or with respect to the degree of glucose control. The
`hypothesis is that the effective concentration of some immunosuppressive agent is different
`between diabetic and non-diabetic patients as a function of diabetes type or glucose control. The
`other aim of this project is to evaluate the influence of diabetes type and glucose control on the
`cytochrome P450 3A (CYP3A) activity and metabolism of immunosuppressive agents.
`
`To date, we have observed that diabetes significantly reduced the concentration of some of the
`cyclosporine metabolites (Dostalek et al. 2011), while the exposure to tacrolimus metabolites was
`
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`not affected by diabetes (Chitnis et al. 2012). A clinical PKPD study is underway aiming to
`elucidate the metabolism of sirolimus in diabetic patients (funded by Pfizer). We have also
`observed altered concentrations of mycophenolic acid glucuronidated metabolites in diabetic
`patients (Akhlaghi et al. 2006; Patel et al. 2007), which may indicate an effect of diabetes on phase
`II metabolism or transporters. Altered concentrations of prednisolone and cortisol were also
`observed in diabetic patients (Ionita et al. under review). These observations, have led us to study
`the expression and activity of drug metabolizing enzymes in diabetic livers and kidneys.
`Moreover, diabetes is associated with delayed gastric emptying time and altered GI pH. The effect
`of gastric residence time and GI pH was characterized on the disposition of immunosuppressive
`agents was characterized using an FDA approved system named SmartPill™ technology. The data
`analysis of this study that is funded by Novartis is currently ongoing.
`
`(ii)
`
`To study enzyme activity and protein expression for major phase I and phase II drug
`metabolizing enzymes in diabetic and non-diabetic tissues.
`
`Patients with diabetes mellitus require pharmacotherapy with numerous medications. However,
`the effect of diabetes on drug biotransformation is not well understood in human. This study was
`designed to investigate the effect of diabetes on liver cytochrome P450 3As, the most abundant
`phase I drug-metabolizing enzymes that oxidize numerous clinically, physiologically, and
`toxicologically important compounds. Using liver samples from diabetic and non-diabetic donors
`genotyped for CYP3A4*1B and CYP3A5*3 polymorphism, we have compared cytochrome P450
`3A4, 3A5, and 2E1 mRNA expression, protein level, and enzyme activity between diabetic and
`non-diabetic subjects. The results showed pronouncedly lower P450 CYP3A4 activity in diabetic
`livers, whereas P450 3A5 protein level or mRNA expressions were comparable between the two
`groups. Concurrently, we observed increased P450 2E1 protein level and activity, characterized
`by higher chlorzoxazone 6-hydroxylation, in diabetic HLMs. The manuscript from this study
`(Dostalek et al. 2011) was published at the British Journal of Pharmacology. The result of this
`study also provides mechanistic explanation for reduced metabolite concentration of cyclosporine
`(a CYP3A4 substrate) but not tacrolimus that is also metabolized by CYP3A5. This study was
`funded by American Heart Association.
`
`Moreover, MPA biotransformation and UDP-glucuronosyltransferases (UGTs) expression and
`activity were compared between liver and kidney from diabetic and non-diabetic donors.
`Glucuronidation of MPA as well as the expression and a probe substrate activity of UGTs primarily
`responsible for MPA phenol glucuronide (MPAG) formation (UGT1A1, 1A9), and MPA acyl
`glucuronide (AcMPAG) formation (UGT2B7). We have found both diabetic and non-diabetic
`human liver microsomes (HLM) and kidney microsomes (HKM) formed MPAG with similar
`efficiency; however, AcMPAG formation was significantly lower in diabetic samples. Supporting
`this finding, markedly lower glucuronidation of the UGT2B7 probe 3’-azido-3’-deoxythymidine,
`UGT2B7 protein and UGT2B7 mRNA was observed in diabetic tissues. UGT genetic
`polymorphism did not explain this difference since UGT2B7*2 or *1c genotype were not
`associated with altered microsomal UGT2B7 protein levels or AcMPAG formation. Furthermore,
`mRNA expression and probe activities for UGT1A1 or UGT1A9, both forming MPAG but not
`AcMPAG, were comparable between diabetic and non-diabetic tissues suggesting the effect may
`be specific to UGT2B7 mediated AcMPAG formation. These findings suggest that diabetes
`mellitus is associated with significantly reduced UGT2B7 mRNA expression, protein level, and
`enzymatic activity of human liver and kidney, explaining in part the relatively low circulating
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`concentrations of AcMPAG in diabetic patients. This study is published in Drug metabolism and
`Disposition (Dostalek et al. 2011) and was funded by Novartis.
`
`(iii) To study the disposition of statin lipid lowering agents in type 2 diabetic patients and
`to identify factors (i.e. CYP3A activity, genetic polymorphism, pro-inflammatory
`cytokines) in predisposing a diabetic patient to statin related myopathy.
`
`Adverse drug reactions (ADRs) are the 4th major cause of death in the United States, the cost
`associated with drug-related morbidity, and mortality is estimated to be $136 billion per year. The
`incidence of ADRs is increased exponentially in patients who routinely take 4 for more
`medications. Individuals with diabetes mellitus are an example of such patients, although
`surprisingly, very little is known about the effect of diabetes mellitus on the pharmacokinetics and
`disposition of commonly used drugs. HMG-CoA reductase inhibitors (statins) are commonly used
`lipid lowering agents; however, up to 7% of patients treated with statins exhibit symptoms of
`muscle toxicity and ~0.5 percent develop potentially fatal rhabdomyolysis (severe muscle
`breakdown). Atorvasatin (ATV, Lipitor®, Pfizer) is the most frequently prescribed statin, yet to
`date, its pharmacokinetics has never been studied in diabetic patients. Epidemiological evidence
`suggests that the incidence of ATV induced rhabdomyolysis requiring hospitalization is three
`times higher in diabetic patients. Administered as an acid, ATV is converted to a lipophilic and
`more toxic lactone form. We have recently observed plasma concentration of ATV lactone was
`significantly elevated in diabetic patients, which may explain the higher incidence of ATV related
`side effects in diabetics. The broad long-term objective of this project is to optimize
`pharmacotherapy with statins to the individual need of each diabetic patient. The central
`hypothesis is that down regulation of CPY3A enzymes lead to elevated concentration of ATV-
`lactone. The rationale for this project is to identify patients’ inherent propensity to develop
`myopathy so those patients can be administered statins (such as rosuvastatin) tha