Episode 53: Advancing Biotech at Tulane with Key Opinion Leaders Alexis Ducote and Elaine Hamm

On today's episode, learn about monkeys, mice, the human body, including sperm and poop, drugs, key opinion leaders, and the proper time to use the term doctor.

You're listening to BIO from the Bayou, empowering biotech leaders with the tools, assets, and expertise to improve healthcare outcomes.

Each episode provides insights and information to expand your network, advance your product line, and help your company thrive.

Serving the entire Gulf South, but recorded in the heart of New Orleans.

Welcome back to BIO from the Bayou. I'm your host, James Zanewicz, the Chief I'm Dr. Zanewicz, the Chief Strategy Officer at Tulane Medicine. And today I'm joined by Elaine Hamm and Alexis Dacoti.

Ooh, it's Dr. Dacoti now.

That's right, Dr. Dacoti and Dr. Hamm for just a tad longer, 'cause you're an ingenue.

Well, I only get called doctor when I screw something up, so.

Anyway, you probably already know Elaine, 'cause she is a host of Bio from the Bayou and the Executive in Residence at Tulane and the Executive Director of the AAHH, and, you know, runs a few companies because she is never bored.

Yep.

But Alexis is one of the newest members of our great team, at Tulane Medicine, where he works very closely with Elaine and me on our business development matters, doing a lot of the groundwork for that and driving a lot of strategies forward for us.

Great to be here.

I really like us to talk about some of the exciting things coming out of Tulane or happening at Tulane, in addition to some of the key opinion leaders who are making things happen. Is that OK with you guys?

I'm really jazzed about this. I want to talk about all of it.

Well, as it was your idea, I'm not surprised.

I mean, I'm not going to lie. Of course, I'm going to love this idea. But I mean, I really— that's one of my favorite questions to ask people, of what they're excited about. Right now, in terms of science. And so I think this is a good opportunity for us to talk about what we're excited about.

One of my exciting things is Tuliva. Can we start with that?

Let's start with that.

I know, and I know it's your exciting thing because you guys came up with a name, which is great.

I didn't come up with it, actually. I think it was Alexis, Dr.

Yes, Dakota. Yeah, Dr. Dakota Tuliva.

Tuliva. So yeah, that's a new painkiller that's being developed at Tulane, hence Tuliva. Tulane. I love it, Alexis. It was a really good idea.

He's like, I know, I came up with it.

And there's a little bit of a reason because we talk about opioid painkillers, it's a complicated subject. And if you are attacking it in a different way, you still have that sort of, you know, albatross of an opioid like hanging on your neck. And so by just giving it the name that it deserves of Tuleva, being able to alleviate pain without the challenges of addiction, I think is such a hugely important thing right now. I'm excited about that. I don't know if Alexis, is that one of your Oh, no, absolutely.

I mean, I think this is something that affects our entire country, and it's been growing. And yet we need these for pain management and painkillers. People still have surgeries, people still have chronic pain, but being able to get rid of some of those risks is extremely important. Yeah.

What kinds of pain does it work on?

The investigator, Dr. James Adena, has actually tested on a number of types of pain. So post-operative pain, what you would have after a surgery, inflammation, neuropathic pain, so when there's potentially nerve injury.

And that can be really complicated pain, too, the neuropathic pain. I mean, after surgery, you don't necessarily always have the chance for addiction, but if you have chronic pain, and you need to take something every single day, that obviously increases your risk of becoming addicted to something, but you still need something, and so—

Well, there's often a risk of respiratory depression, which this does not have, as I recall, is that right?

Yeah, they found it to be lower risk. Well, one of the other things that's interesting is, in neuropathic pain and inflammatory pain, traditional opioids, they have limited efficacy there, and one of the issues that you have is, with something like morphine, are oxycodone and some of these, the longer you're on it, it can actually cause sensitivity to pain. So essentially things that would not normally hurt you or bother you now do.

Oh, wow.

You're hypersensitive to these things. And so Taliva has actually, they've shown that this occurs much lower.

It's like you have a PhD in neuroscience.

Something like that.

If he starts drawing things on a board, I'm out.

You didn't bring a board in here, so they can't see it. They deprived me of a whiteboard.

Well, before we move on from Zadina, I do want to point out that we actually have a whole previous episode with Dr. Zadina, episode 34, in which he discusses Tuleba. It's a short, easy listen, but maybe something people want to check out. But now I want to bounce on to another one of my favorite things. It's one of the ones that I was embarrassed that I had not discovered myself in like my first 9 years here. Then Alexa starts and all of a sudden we figure out we have this great asset in Shane Tubbs. Can you guys tell me a little bit about Shane and why I think it's so incredible?

So Shane Tubbs, even in his own words, he puts this as if he's like trying to shepherd a lost or dying art back into the world. You know, he talks about, is anatomy dying? Clinical anatomy. And when we think of clinical anatomy, you know, you start saying, well, people have been looking at the body and doing surgeries and so on for like thousands of years to some extent. Haven't we figured everything out? But he'll get surgeons that come to him and they'll say, hey, in like 95% of my patients, when I go and do this surgery, the vein looks like this.

Mm-hmm.

But in that extra 5%, something different is going on.

Hmm.

And so they'll do these studies to kind of try to sort out these variations in people, to come up with new methods to, like, solve surgical problems. And then surgeons will go back and eventually use those and find out that they're successful. And I just think that's really cool because it's something we think of as basic med school knowledge, and yet there's still so much out there that his team is discovering, and that that's actually useful for keeping people safe, giving them better outcomes during surgeries, or Implantations for drugs and things like that.

Well, and as such, he's now the editor of Grey's Anatomy.

Yeah. Speaking of basic med school knowledge. Yeah.

I mean, that's such a key cornerstone, and I think it's so fascinating that we still don't know so much about it.

You mean the textbook, not the TV show, right?

Well, yeah.

Yeah. Because he will joke about that and say, like, his— what was his grandmother Alexis would watch for him on TV. She's like, you're not on TV. He's like, not gonna be.

Yeah.

All right, moving on. How about Frank Mave Jarvis, who has a brand new center on sex-based precision medicine? We had an episode on this topic about a smaller center he had started before, but now he's got a COBRA grant to really kind of take this on turbo. Can you give us some updates on what this is?

Well, I'll let Alexis talk about the grant part of it, but I, just in general, sex-based medicine is such an important, undervalued part of medicine, especially, you know, I'm coming from a drug development perspective of just For the most part, we have shied away from doing clinical trials in women because it's complicated. I mean, well, women are complicated, and I don't want to hear anything from you over here.

I didn't say anything!

But it's the chance of a patient potentially getting pregnant during a clinical trial is such a huge liability. So we've kept it pretty basic, basic white male as part of our patient population that we would study drugs in. But unfortunately, that means the drugs that we've been developing are really only being tested in them. And so it may not work the same in a woman or an African American. And so we really need to understand those differences. And I think it's such a great value that Tulane has is this understanding, this deep understanding of sex-based differences and as it applies to medicine. And he's been a real leader in this field.

The center is gonna be run by Dr. Frank Movaj Jarvis and Marie Tonette Crosslewood. And so this is an $11.2 million grant from the NIH that will last 5 years. So they wanna, as you said, sort of supercharge the center that they already have. They're gonna be developing training programs to help the newest generation of researchers understand how to incorporate both biological sex and the effects of gender as sort of a social construct that affects our decisions and our environments, and how these affect health and healthcare. Because even accounting for things like estrogen and testosterone, you have differences in presentation of disorders and diseases like heart attack, lupus, rheumatoid arthritis, all of these.

Mm-hmm.

And sort of getting to the bottom of that and understanding how we might treat people differently in terms of healthcare to give them the best outcome is something that would be great that could come out of this.

Yeah.

We'll continue our train of doctors. We have Dr. Suresh Sikka next, who's one of my favorites because he always will present himself, he's like, they call me sperm man. Can y'all tell me why he says that? I mean, seriously, that's how— it's a great way of him breaking the ice and then—

Yeah, I mean, I guess. I mean, just lays it out there. But it's such an important part of medicine too, of understanding, well, one, male fertility, So much we still don't know. And then we think about, you know, the impact of drugs on fertility as it relates to women and men. Being able to understand that prior to doing drug clinical trials is incredibly important. And so he has some deep knowledge and some training and facilities that he uses to help understand the impact of different things on sperm and fertility.

He's worked with pharmaceutical companies before. They have this accredited training program. I think he's trained over like 1,000 technicians.

I think most pharma companies come to him. He's like the go-to person, right?

Right, right.

I guess that's why he's the sperm man.

I mean, you're Poop Lady, he's Sperm Man.

What else?

I don't even—

this is the worst Justice League ever. Sperm Man and Poop Lady. Oh God. I don't even know how to move away from that now.

So, I mean, and it's just so our listeners know, Elaine got her PhD studying diarrhea, which is poop. And that's why we say that. And it's her opening Partyline joke that I've just ruined.

Yeah. Yeah. Now everyone knows my secret. Is there anything else about Dr.

Ziko, we should know before we jump to my next favorite topic?

Oh, what is your next favorite topic?

It is our Tulane National Primate Research Center and some of the CAR-T work going on there to fight HIV-associated neurodegeneration. So I guess it's great that we have a neuroscientist with us, but what's so important about this?

Thank God, because I only play one on TV. He's the actual neuroscientist. So a huge value proposition to Tulane is having this National Primate Center. This is a weird thing to say, but we have a monkey shortage. It's been a really huge challenge for us in the drug development industry to even find monkeys. I mean, the queue to get into a A primate trial is quite long. And so actually, James, I'm going to turn it to you. You know more about the Primate Center here.

Well, we're one of the few— we're one of 7 in the country of the National Primate Research Centers that are actually funded by the NIH. And I'm sure Alexis is going to dig more into this, but I'll say we're one of the only ones that has tremendous capacity to expand. And Alexis and Sam and I recently just went on a tour and saw part of the expansion and heard about more. And I'd love for Alexis to dive in and talk to us a little more about what the Primate Center can do and why it's—

And yeah, what's that entail?

—important to infectious disease.

The Tulane Medical School was founded to combat yellow fever and all of these potential infectious diseases. And so we have this strong background in infectious disease epidemiology and so on. And because primates are much closer to humans than, say, rodent models in terms of how they respond, in terms of, say, how their lungs work, in terms of how they might spread disease, it can help a lot to help us develop treatments for infectious diseases, vaccines, and so on.

Mm-hmm.

They're based in Covington. They have this huge facility.

Well, tell us a little more about— you came back from the Center, from your tour, like, super geeked out about this idea of them being reservoirs for virus.

Right.

I mean, am I wrong in calling you totally geeked out about, you know—

Oh, no, no. I think this one's really cool. So the idea here is that, you know, one of the things that they study a lot is HIV, or human immunodeficiency virus. And we now have antiretroviral therapies that a person can take. It'll reduce their viral titer, and a person with HIV or AIDS down to undetectable. And yet a portion of individuals still exhibit what's called HIV-associated neurocognitive disorder, where they have changes in memory and mood and cognitive processes, motor function. And so this is believed to be because these drugs aren't able to actually cross effectively into the brain.

Mm-hmm.

And so they're not able to get rid of the virus in the brain. And so a certain type of immune cell that sits in the brain is believed to be like a reservoir. So these are macrophages, a type of immune cell, and they're causing sort of chronic inflammation that leads to these cognitive problems.

Huh.

And so there are a number of projects going on at the Primate Center to try to target those cells. One of these is by Dr. Namita Raut, and they are basically trying to take techniques that a lot of times we associate with combating cancer, but you take immune cells out of a person's body and then change them, put them back in, and then they go and attack the cell that you want. And so the idea is to get them to hit these macrophages and Destroy the reservoir, do their job, right? Another one, and this is by Dr. Woongki Kim, he just published a paper today.

Hot off the presses.

Which of course you've already read.

I know, I didn't read the whole thing, but it came up and I was like, oh, I'm about to talk about this. So they're using a drug that actually was initially— has been used to treat ALS and brain cancer, but it can also target these macrophages. And so they show that in these animals, by giving them a dose of this medicine, you actually reduce that viral titer in the brain as well. So potentially long-term, that could be a way to combat these cognitive issues that people with HIV and AIDS exhibit.

Well, it sounds like we do need a whole separate episode on this. Before we get side-eye from our producer, I think we need to move to our last topic so we're on time. He's gonna be like, keep talking. See, I knew it was about to come.

Sorry, Ian.

The final topic I want to touch on is one that we haven't really talked about yet as well, and a tremendous strength at Tulane that we really don't get as much coverage for as we should: research and programs on healthy aging. What should people know about that work going on here, and who do we have working on it?

So I'm partial to this topic because I did my PhD in an aging lab.

Uh-oh, get ready.

Yeah, yeah. I mean, so one of the things we see is that—

Ian's gonna have to cut you off at some point.

Yeah. We see that the human lifespan is expanding. People are able to live longer, and yet what they call the healthspan does not keep pace. There's this sort of those later years where, yes, some people are superagers and they're sharp and they're active right up until the end somehow, but a lot of us You know, we slow down. Even if we don't have dementia, we start having some cognitive issues, memory lapses, and all of these different things. So having the ability to expand that healthspan to keep up with our increasing lifespan is extremely important. And so there are a number of initiatives and researchers going on at Tulane that I think are really important, kind of hitting this from different angles.

One of the aspects that we have in terms of Hedwynn, and we've done a podcast on her, so I don't know if I'll Belabor it too much again because Ian's going to give me the side-eye. Who is Dr. Brooks? Doctor, doctor. Well, I know.

I had dinner with her earlier on.

I had dinner with her last night. I call her Hedwynn. She has incredible research in the area of menopause, and menopause has been one of those things that has kind of been dismissed, to be honest. Hot flashes and cranky women, and that's, you know, deal with it. But she— I mean, it's so much more than that. I mean, Hedwynn has done some— Dr. Brooks has done some incredible research into All of the number of different things that happen during menopause beyond just sort of, oh, you have hot flashes. It also impacts cardiovascular system, the renal system. And she has this incredible mouse model that I didn't even know about. I was actually looking at a mouse model for menopause and was talking to her about it. She's like, you know, that's what I do, right? And so she showed me this new model that she's been developing. And it's absolutely incredible because it's natural menopause models. So they're not removing the ovaries and inducing menopause, but rather that it's an actual menopause mouse model, which I think is very fascinating, and I'm going to use it myself for my drug companies, not for—

Not for Tulane?

Yeah, no.

Well, and one of the main reasons that I got to know Hedwynne is Dr. Sarah Lindsey, who's just down the hall from her, but told me I'd love Hedwynne before I ever interviewed her. And of course, she was right, and I did. But can you guys talk about her work a little bit? Because what she's doing is incredible too.

Yeah, I mean, now we're discovering the impact of estrogen on, on generation of women, where we were told that hormone therapy is such a bad thing for you, it causes all these horrible effects. Horrible study. We now understand it so much better. And there's been a generation of women that have gone through, I mean, honestly, bad health conditions because they're losing estrogen. They weren't put on hormone therapy, and now they're experiencing things like cardiovascular issues, cognitive aging issues. And one of the things that Sarah Lindsey is working on is understanding the impact of estrogen on vasculature system as well as cognitive aging.

So no wonder they collaborate. It makes total sense.

Yeah, 100%. Yep.

And then we have Dr. Qiyang Lisa Zhang, who's deciphering the effect of age on prostate cancer development and prognosis. What else is going on there?

Dr. Qiuyangli Sun Zheng is at the Kettering Cancer Center. So prostate cancer is something that in men, they think— they say like 1 in 8 will get this, and most won't die of it. But it does impact quality of life, and sometimes you have more aggressive forms, right? So she's developed one, a mouse model that works very well in, you know, sort of replicating this prostate cancer spread. But she's also looking at repurposing drugs, finding new drugs to potentially treat this. There's a balance between 2 types of cells that she's found is quite important. And the idea is to sort of tweak that balance to help essentially minimize the spread and risk due to prostate cancer.

The last person I want to bring up is, I'm sure, Alexis's start, because it's Dr. Riccardo Mastani, whose lab you did your work in. So can you just tell us what's important about that? Because if you can't, he's going to come down and retract his recommendation for this job for you.

I have to say it more with less detail than I would. He's going to be like, this is your test. I know. Yeah. So, so when I said I worked in an aging lab, it was a neuroscience aging lab. And we studied both what we call healthy or normal aging, so no dementia models, no Alzheimer's models, and Alzheimer's models. And the idea is, as we said, when you age, even if you don't have dementia, you might have changes in how quickly you can learn things, how quickly you respond to stimuli.

Mm-hmm.

And so what is changing in the brain that causes this? Ricardo's lab, Dr. Mastani's lab, looks at the rate at which new synapses or new connections of the brain are formed or disappear, both sort of at baseline and in response to new learning. The thing that's important here is I think we put a lot of focus on just Alzheimer's, what happens in Alzheimer's or what happens in dementia, but you really need to get the fundamentals of that baseline, like what is happening in the normal aging brain, to see what is actually different in Alzheimer's and how is that changing, parsing out those 2 states.

Yeah.

Look at you making it accessible. I'm so proud of you.

It's like he got his PhD in that.

I know, but that was able to make it accessible to me. In other words, you understood it. I understood it, I know, which is great. But I want to thank you guys so much for coming on. This was super fun. I feel like we should do this more often.

I mean, I love talking about science.

All these great things have so much potential, the assets, the people, the key opinion leaders, to improve the lives of patients, which is what we're all here for. We're developing the future of medicine at Tulane, and I'm excited to hear more updates from the two of you and You're both very good at this. This is fun. Maybe I'll jump through easy.

It's almost like you pay us to do this.

I know.

It's strange how that works out.

But as always, we're gonna have Elaine and now Alexis's contact information and informational links in our show notes. And he's made the mistake of being excessively competent, so he's gonna have to do this from now on.

Yeah, sorry. We should have warned you.

And we'll have more information on the KOLs and research we discussed today, links to previous podcasts for them. And I wanna make sure that everyone knows not to miss out on all these amazing things coming from Tulane. Get into the ground floor with us, and I want to thank everyone for joining us and listening in. Thank you guys for joining us. Thank you. Thanks for joining us for Bio from the Bayou, and we hope you'll join us again.

To never miss the latest updates in biotech, hit the subscribe button now.

We'll catch you on our next episode of Bio from the Bayou.