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PCCM diversity grant recipient looks to inhibit platelet endothelial interactions via NEDD9 to improve acute lung injury


 

In February, The American College of Chest Physicians (CHEST), the American Thoracic Society, and the American Lung Association announced a partnership with the prestigious Harold Amos Medical Faculty Development Program (AMFDP), a Robert Wood Johnson Foundation initiative, to sponsor a scholar in pulmonary and critical care medicine. The recipient of the grant was announced recently, and CHEST spoke with him about his background and the project that earned him the award.

George Alba, MD, is a pulmonary and critical care physician investigator at Massachusetts General Hospital. Dr. Alba studied English Literature and Biology as an undergraduate at Washington University in St. Louis, where he worked in a developmental biology laboratory; earned his MD at the Mount Sinai School of Medicine, where he graduated AOA with Distinction in Medical Education; and then completed both Internal Medicine and Pulmonary and Critical Care Medicine training at Massachusetts General Hospital.

CHEST

Dr. George Alba

During his fellowship, Dr. Alba specialized in pulmonary and critical care medicine because he appreciated the variety that comes with working in the intensive care unit.

“I love the medical complexity, the physiology, and the decision-making,” said Dr. Alba. “I’ve always enjoyed all aspects of clinical medicine, so it was hard to choose a path, but the benefit of the ICU is that it allows me to take care of a spectrum of medical illness across all subspecialties.”

He continued, “What I loved about pulmonary, specifically, was that I could see patients in the hospital and in the ICU, perform procedures, and still have a longitudinal relationship with patients in the clinic, which gave me a very flexible, wide grasp of medicine.”

Growing up in a close-knit Cuban family and community, Dr. Alba was raised speaking Spanish at home and learned English primarily in school. Being bilingual helped him in medicine greatly: in clinic, in the hospital, and in the ICU, he is able to communicate directly with Spanish-speaking patients and their families. This became critically important during the COVID-19 pandemic when Chelsea, a primarily Hispanic community in Boston, was disproportionately impacted. The patients greatly benefited from Spanish-speaking clinicians to communicate with their family members who were unable to visit due to the infection control policies in place.

As an instructor of medicine at Harvard Medical School and pulmonary and critical care physician at Massachusetts General, Dr. Alba is actively engaged in clinical care, teaching, and research focusing primarily on mechanisms of pulmonary vascular dysfunction in lung disease.

Dr. Alba’s AMFDP award project is titled “Pulmonary Endothelial NEDD9 and Acute Lung Injury,” and through the proposed scientific aims, he looks to advance NEDD9 antagonism as a potential therapeutic target in acute respiratory distress syndrome (ARDS.) He is being co-mentored by Bradley Maron, MD, a pulmonary vascular disease researcher at Brigham and Women’s Hospital, and Eric Schmidt, MD, an endothelial biologist and expert in animal models of acute lung injury at Massachusetts General Hospital.

This is especially relevant research during the COVID-19 pandemic, as patients with severe lung injury frequently develop clotting in the lung blood vessels. Dr. Alba’s prior work demonstrated that NEDD9 is a pulmonary endothelial protein that is upregulated by hypoxia, that it binds to activated platelets to promote platelet adhesion and clotting, and that inhibition of NEDD9-platelet interactions with a custom antibody can decrease clotting in the lungs of animals. He recently showed that pulmonary endothelial NEDD9 is increased in patients with ARDS who demonstrate blood vessel clotting.

Now, Dr. Alba seeks to use a custom-made anti-NEDD9 antibody to block platelet adhesion in animal models of ARDS to decrease the extent of lung injury. While aspirin and anticoagulants have been unhelpful in treating ARDS in prior trials, Dr. Alba believes that circulating pulmonary endothelial protein NEDD9 can serve as a biomarker to identify subgroups of ARDS who may benefit from earlier targeted antithrombotic therapy.

Dr. Alba hopes that one day the anti-NEDD9 antibody may become one such therapeutic option for patients. The AMFDP will help support his ongoing work.

“Growing up, I saw through my father’s example how education unlocks opportunities. Our community came together to help him on this path. Now a retired doctor of osteopathy in neonatology, he inspired me to pursue a career in medicine,” said Dr. Alba. “This award comes at a critical time in my junior faculty career: It allows me to continue pursuing my research in a meaningful way while also gaining new skills that will be critical for my ongoing career development.”

Dr. Alba continued, “Programs like the Robert Wood Johnson Foundation initiative that specifically try to increase the number of individuals traditionally underrepresented in academia are key and would not be possible without the support of groups like CHEST, the American Lung Association, and the American Thoracic Society.

These programs help folks who may have other external barriers to being in academia, including socioeconomic pressures, lack of resources – financial or otherwise – or simply not knowing what opportunities are available to them. Programs [like AMFDP] that can alleviate some of these additional pressures go a long way to improve the diversity of the medical workforce.”

Dr. Alba is also committed to paying it forward: “I want to ensure that the type of invested mentorship I experienced to help get me this far is not a matter of serendipity for the fortunate few, but rather a standard for all students and trainees, especially those from underrepresented backgrounds.”

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