Early Detection to Halt Spread of COVID-19

A young girl drinking from a small cup, wearing earrings and a pink garment.
Researchers added COVID-19 surveillance to clinical trials treating children in Burkina Faso. This young participant is taking her dose of azithromycin.

Underfunded health clinics, lack of running water, and other public health deficits leave millions of people in sub-Saharan Africa vulnerable to COVID-19. In response, the Proctor Foundation is leveraging two clinical trials underway in Burkina Faso to look for early signs of COVID-19 outbreaks. Led by Catie Oldenburg, MPH, ScD, the trials examine the impact of azithromycin on child mortality and involve 50,000 infants and young children.

Orange badge with a virus symbol and text 'Responding to COVID-19'.

Health workers are now tracking COVID-19 symptoms and influenza-like illnesses in participating clinics. This “syndromic surveillance” method was used to detect an increase in influenza-like illness in New York prior to the first major rise in COVID-19 cases, at a time when the number of lab-confirmed flu cases was declining. With this “early warning system,” the Proctor Foundation aims to empower local governments and health organizations to respond as quickly as possible to stem the spread of the virus.

ACTION Against COVID-19

Orange badge with a virus symbol and text 'Responding to COVID-19'.

Clinical Study of Azithromycin

Premier research teams worldwide are racing to halt the devastation of this novel coronavirus. The Francis I. Proctor Foundation for Research in Ophthalmology quickly joined the fight, using its 20 years of experience with the antibiotic azithromycin to search for solutions.

Two decades ago, That Man May See helped to launch the Proctor Foundation’s research to eliminate the blinding disease trachoma in Ethiopia. The seed-funded pilot study examined the impact of azithromycin on infants and young children. Findings proved that the antibiotic drastically reduced prevalence of the eye disease and saved children’s lives.

 

Leaping into Action

Now, Catie Oldenburg, ScD, MPH, and Thuy Doan, MD, PhD, lead a clinical trial for COVID-19. They have leveraged Proctor Foundation’s deep azithromycin expertise to swiftly initiate a well-designed, nationwide, randomized clinical trial, with support from the Bill & Melinda Gates Foundation. Planning for such rigorous studies often takes months and even years, but the team is already enrolling patients, following a markedly compressed planning period.

The clinical trial is called Azithromycin for COVID-19 Treatment in Outpatients Nationwide (ACTION). The research team, which also includes Ben Arnold, PhD; Travis Porco, PhD; and Tom Lietman, MD; hopes to recruit at least 2,300 patients by the end of the year.

The trial will help researchers understand the potential effect of a single dose of the antibiotic in halting progression of COVID-19 in patients who are not hospitalized. Azithromycin is an antibiotic used to treat many common bacterial infections, and it may have antiviral and anti-inflammatory properties.

The Proctor team collaborates with the Stanford Clinical Virology Lab to recruit newly diagnosed COVID-19 patients. This lab has been performing a high volume of California tests for the virus, known as SARS-CoV-2. COVID-19 patients nationwide are encouraged to participate, and more virology labs will be recruited as well.

 

Inside the Trial

Each participating patient will be sent a single dose of the azithromycin or a look-alike placebo. Because the study is conducted completely via mail and email, patients with proof of a positive SARS-CoV-2 test can enroll from anywhere in the United States within seven days of their positive test result. Participants will then complete five short online questionnaires over the subsequent three weeks.  In addition, Dr. Doan and her lab team will analyze biosamples taken at home by interested participants. Their analysis will provide insight into the precise effects of the azithromycin.

 

Changing Science, Changing World

In the face of this pandemic, the Proctor team is experiencing synergy like never before.

“There’s a level of cooperation across disciplines that was unusual before,” says Dr. Oldenburg. “I feel that the way researchers are working together during the pandemic is going to change how we do science forever.”

Evidence generated by the ACTION trial will serve as a blueprint for future trials. “We don’t think this is the last coronavirus epidemic that we’re going to see,” says Dr. Oldenburg. “What we learn now will allow us to jumpstart effective research practices during future epidemics.”

Dr. Oldenburg stresses the importance of patients stepping forward to participate in gold-standard clinical trials like this one. “To understand and properly evaluate drug treatments,” she says, “the best thing we can do is to conduct and volunteer to take part in randomized controlled trials.”

Five headshots of medical professionals on a blue background.

 

Join the Trial

If you or someone you know tests positive for COVID-19, please consider enrolling in the ACTION study within three days of diagnosis. Learn more: Website: proctor.ucsf.edu/action-trial
Email: Actiontrial@ucsf.edu
Phone: 415.326.3761

That Man May See Leadership Transition

Kathleen Rydar
Kathleen Rydar

After serving as President of That Man May See for the past 16 years, Kathleen Rydar is retiring, effective April 30, and passing the torch on to Deborah Chesky.

Through the Future of Vision campaign, Kathleen ensured that UCSF Ophthalmology would succeed in supporting the new Wayne and Gladys Valley Center for Vision at Mission Bay, a state-of-the art facility that will form the hub of one of the most diverse and productive vision research programs in the world, one of the most successful and innovative teaching programs, and one of the premier clinical care programs in the nation.Kathleen’s passion and from-the-heart altruism has been felt throughout the Bay Area and beyond. In 2005, she was presented with the Hank Rosso Outstanding Fundraising Professional award by the Bay Area Association for Fundraising Professionals. During the span of her tenure, Kathleen has brought in well over $200 million to support the mission of the Department of Ophthalmology and Francis I. Proctor Foundation at UCSF.

Deborah Chesky
Deborah Chesky

Kathleen’s parting gift has been her central role in the recruitment of Deborah, a truly worthy successor as President of That Man May See. With a strong professional history in both health care and philanthropic development in research universities, Deborah started her career as a social work director at Albany Memorial Hospital and then Bellevue Woman’s Hospital in Niskayuna, New York.

She transitioned to Vice President of Marketing and Corporate Development at Bellevue. Deborah moved from philanthropy in health care to research, health, and higher education, ultimately serving as the Senior Advancement Officer for Foundation Relations at Rensselaer Polytechnic Institute in Troy, New York.

Deborah has had an extremely successful tenure at Rensselaer, with productive relationships among many in the sphere of UCSF Ophthalmology—the Bill & Melinda Gates Foundation, the Alfred P. Sloan Foundation, Pew Charitable Trust, Howard Hughes Medical Institute, and the Gordon and Betty Moore Foundation, to name but a few. Deborah is personally committed to issues of health and vision, and the faculty is delighted that she has chosen to bring her skill set to ophthalmology and vision at UCSF, to lead That Man May See’s fulfillment of its mission to save and restore sight in actionable ways.

That Man May See will celebrate its 50th anniversary in 2021. Through Deborah’s passion and commitment, she will continue in its vision to advance the work of a world-class faculty of clinician researchers and basic scientists by engaging the philanthropic community to support research, patient care, and training the next generation of leaders in ophthalmology.

Ophthalmology Department’s Max Nachury, PhD, Receives ARVO’s 2020 Cogan Award

The laboratory research of UCSF Ophthalmology’s Maxence Nachury, PhD, promises to bring great insight to an understanding of photoreceptor degeneration and potential treatment strategies.

The Association for Research in Vision and Ophthalmology (ARVO) has named Dr. Nachury as recipient of its 2020 Cogan Award.

Dr. Nachury studies the primary cilium, a surface-exposed organelle required for vision, olfaction, and developmental signaling. He has published widely in Cell, Science, PNAS, Nature Genetics, Nature Materials and Nature Cell Biology.

The Cogan Award recognizes a “young researcher 45 years of age or younger at the time of application deadline, and who has made important and worthwhile contributions to research in ophthalmology or visual science that are directly related to disorders of the human eye or visual system, and who show substantial promise for future contributions.”

Dr. Nachury’s research is currently funded by the Wayne and Gladys Valley Foundation, Research to Prevent Blindness, That Man May See, National Institute of Health/National Institute of General Medical Sciences, National Institute of Health/National Eye Institute, and the American Diabetes Association.

Halting Retinal Sight Loss

Patients with glaucoma and retinal degenerations need better solutions. Researchers deploy advanced tools to find novel ways to save their sight.

 

Protecting Vulnerable Cells

Photo caption above: To halt glaucoma, Dr. Ou, Dr. Dunn, and Dr. Della Santina investigate novel avenues for preventing damage to retinal nerve cells.

Christie Hastings knows firsthand that glaucoma steals sight. By the time she noticed blurring in her visual field, her sight was irreversibly compromised. Innovative avenues that identify glaucoma earlier and treat it more effectively promise to transform outcomes for patients like Christie.

“Patients need more effective strategies,” says glaucoma specialist Yvonne Ou, MD. To advance novel paradigms to halt the disease, Dr. Ou collaborates with two coinvestigators: physiologist Felice Dunn, PhD, and neuroscientist Luca Della Santina, PhD.

The team uses molecular, anatomical, electrophysiological, and modeling techniques to understand how increased eye pressure, common in glaucoma, affects potentially weaker retinal nerve cells and their neighbors. They also explore how retinal circuits mend themselves and continue functioning even when some cells are damaged.

“Learning how to protect the retinal nerve cells most vulnerable to damage is key to stopping glaucoma,” says Dr. Dunn. “We’re excited to pursue this promising direction.”

 

Altering Genes to Save Sight

Retinitis pigmentosa is a major interest for geneticist Douglas Gould, PhD. Dr. Gould and his team explore how “quality control” mechanisms inside retinal cells try to fix or dispose of mutated proteins.

Headshot of Doug Gould, PhD, with a blue background.

Lorie Hirson is losing her sight to retinitis pigmentosa, but she is hopeful that future generations will be spared. “Vision scientists are getting closer to answers that will change our lives,” she says. “We’re proud to support their research.”

Microscopic cross-section of a biological sample.
Dr. Gould’s team of geneticists explores whether faulty formation of the front of the eye can cause glaucoma. This image shows the anterior segment during development.

In this inherited disease, mutations in a particular protein cause the light-sensitive retinal cells to die off. Dr. Gould’s team will test whether altering this cellular process can preserve vision. If so, treatments to alter this process could potentially preserve sight for patients like Lorie.

 

Prenatal Signs of Glaucoma

Children as young as six months can get glaucoma and its companion, high intraocular pressure. Genetic mutations that lead to the formation of defective ocular cells and tissues in the front of the eye may lead to glaucoma in infancy or later in life.

Dr. Gould uses advanced imaging and molecular techniques to investigate how the front of the eye develops. “By understanding genes that contribute to structural defects, we will open new doors to glaucoma prevention and treatment,” says Dr. Gould.

 

Research support provided by the National Institutes of Health, Research to Prevent Blindness, and friends of That Man May See.

Restore the Retina, Restore Sight

Retinal transplantation will one day allow ophthalmologists to restore sight. To accelerate development of regenerative treatments for blindness, the National Eye Institute has provided funds to five multidisplinary teams nationwide.

 

Retinal specialist Jacque Duncan, MD, leads UCSF research for the initiative, joined by neurobiologist and bio-engineer Deepak Lamba, MD, PhD, and leading scientists at the University of Wisconsin.

To better understand cellular behavior before, during, and after experimental retinal transplantations, Dr. Lamba’s team will use stem cells to develop retinal tissue with many, many cone cells. These are the light-sensitive cells that allow humans to recognize faces and see fine detail in daytime.

“Dr. Duncan’s expertise in patient care, disease progression, and advanced imaging techniques will guide us to look for cellular changes that she has previously recorded from her patients’ retinal cells,” says Dr. Lamba.

The team’s findings will move successful retinal cell transplantations closer to a transformative reality.

 

Photo caption: Dr. Lamba’s team collaborates with clinical researcher Dr. Duncan to advance transplantation of laboratory-grown retinal cells to restore sight.

Welcome New Faculty

Professional headshot of Dr. Catherine Q. Sun.

Dr. Catherine Q. Sun

Q: What do you aim to achieve at UCSF?

A: I look forward to contributing to the growth of our excellent glaucoma division and department. I also want to advance glaucoma clinical care through interdisciplinary research.

Q: Why did you choose glaucoma?

A: I enjoy providing longitudinal care and surgical solutions for patients. Research to improve diagnostic and therapeutic strategies can transform the lives of millions of people facing glaucoma.

 

Q: How has your training shaped your research path?

A: UCSF emphasizes evidence-based medicine. As residents, we were given dedicated research time and presented our projects annually. The innovation was impressive! As a fellow, I used the IRIS Registry (the nation’s largest eye database) to study glaucoma surgical outcomes. Investigation of big data holds so much potential for breakthroughs in care. I’m excited to continue to learn and innovate.

 

Q: Why do you want to initiate “point-of-care” clinical trials?

A:  This promising type of study isembedded into regular medical care. It’s a practical approach that can recruit large numbers of participants quickly and yield data from real-world ophthalmic care, using participants’ electronic medical records. These trials have the potential to accelerate research that benefits eye patients.

 

Q: What sparked your interest in clinical trials?

A: As a medical student, I spent a research year with the Proctor Foundation. Wonderful mentors there taught me the ins and outs of randomized controlled trials, which compare treatment efficacy. In my fellowship, I learned from mentors who conducted some of the pivotal glaucoma trials that guide practice today.

 

Q: How do you unwind?

A: I like good meals with friends, seeing musicals and ballet, traveling, and staying active with dance classes, running, and hiking. I often head to the South Bay on weekends to catch up with old friends and family.

 


Portrait of Dr. Tyson Kim, ophthalmologist.

Dr. Tyson Kim

 

Q: What drew you to ophthalmology?

A: The personal reward in helping a patient regain sight is very high. I love microsurgery and how a procedure can be transformative in a patient’s quality of life. Ophthalmology also aligns with my interests as a scientist and innovator. It is a phenomenal field for translating research and technology into improvements in patient care.

 

Q: How will you grow your research here at UCSF?

A: I will build a research lab that utilizes and develops advanced optical methods to study eye disease. One part of my research program will combine femtosecond laser technologies with transgenic models of disease to observe and alter cellular behavior during abnormal blood vessel development in the living eye. This can be particularly powerful for studying disease processes that are hard to recapitulate outside the body. Another aspect of my research focuses on the development and translation of low-cost and easy-to-use technologies in ophthalmic care.

 

Q: How were you instrumental in creating the RetinaScope?

A: RetinaScope is now a multiinstitutional effort that originally started at UC Berkeley and UCSF. I’m one of the inventors and led several clinical trials validating the technology. The device is an easy-to-use and low-cost way to image the retina. It can effectively detect referral-warranted diabetic retinopathy. We’re seeing how the technology can grow and hope to make it very accessible for places where it’s most needed.

 

Q: How do you enjoy your time outside of medicine?

A: I enjoy the city’s fun food culture and the Northern California outdoors. Music helps keep me balanced, and I like playing the violin. I also enjoy traveling.

 


Portrait of a man with dark hair wearing a light blue shirt, smiling against a yellow background.

Dr. Benjamin F. Arnold

 

Q: What attracted you to the Proctor Foundation?

A: Honestly, I’ve never seen a more dynamic and productive research faculty. They integrate extremely well across disciplines, which is where I think the most creative science tends to happen. A growing part of my research focuses on accelerating the elimination of neglected tropical disease through better surveillance methods. Proctor’s focus on global trachoma elimination is a perfect fit.

Q: What are the big takeaways from your studies on reducing diarrheal disease and malnutrition?

A: These maladies account for an enormous global disease burden. Although public health interventions such as cleaner water and nutritional supplements can prevent them in theory, it has proven difficult to dramatically improve child outcomes in practice. I plan to use lessons from 10-plus years of trials in this area to strengthen Proctor’s efforts to end trachoma and reduce child mortality.

 

Q: What interests you about leading the Data Coordination Center?

A: I’m excited to lead this large team of data scientists. As a methodologist, I think that combining the rich information we collect from study sites around the world with state-of-the-art data science will yield important new insights for eliminating disease. Mentoring junior scientists is one of the best ways to stay abreast of the latest scientific developments – especially in the fast-moving field of data science.

 

Q:  What is your life like outside of medical research?

A: My family and I live a semi-rural existence at the edge of Oakland, complete with three children and a menagerie of horses, honey bees, and chickens. I love mountain biking with my kids on the trails near our house.

 


Smiling woman with short blonde hair in a blue blazer.

Dr. Seanna Grob

 

Q: What did your post-residency faculty year teach you?

A: I learned a lot about patient care for eye trauma, general ophthalmology, and resident education. I discovered that teaching and supervising are skills that require continual refinement. I learned how much I enjoy supporting residents through training and helping patients through challenging times.

Q: What led you to start a mental health clinic side by side with the eye trauma unit there?

A: The primacy of sight and the suddenness of eye trauma and vision loss heighten post-traumatic emotional responses. Patients were very excited to get mental health support. As I set it up, I realized that it could be helpful for many vision specialties. I hope to develop similar collaborations at UCSF.

 

Q: Why did you choose oculoplastic surgery as your specialty?

A: During an oculoplastics sub-internship in medical school, I enjoyed the combination of ophthalmology, head and neck surgery, plastic surgery, and dermatology. My exposure to oculoplastics as a resident and during fellowship furthered my excitement and dedication. My mentors inspired me with their passion for oculoplastics.

 

Q: What motivated you to choose a position at UCSF?

A: I’m joining an amazing group of oculoplastic surgeons and ophthalmologists, and UCSF is a preeminent medical institution with endless opportunities for multidisciplinary research, teaching, and leadership. I’m also excited to establish oculoplastics at the UCSF eye clinic in Berkeley.

 

Q: What did you enjoy about recently sky diving for the first time?

A: Flying over Interlaken, Switzerland, in a helicopter, then 45 seconds of free fall followed by floating down to an absolutely stunning view, was one of the most amazing experiences. As soon as I landed, I wanted to do it again.