How UNMC and Nebraska Medicine became the nation’s first responders in the fight against COVID-19.
For 15 years, the University of Nebraska Medical Center and Nebraska Medicine prepared for this moment.
They trained their physicians, nurses and staff to wear personal protective equipment — the heavy hazmat-style layers that protect against dangerous pathogens — perfected medical procedures under the weight of those layers and ran drills on providing care in areas of deadly contamination.
In the wake of 9/11, as the country scrambled to respond to a new, devastating threat, hospitals, universities and state governments were called on to prepare. For what was unclear. The veiled, recondite threat of terrorism meant unknown dangers, including the possibility of biological warfare, thrown into sharp relief by the series of anthrax attacks that followed the World Trade Center’s fall.
Few responded to the call with the diligence of UNMC and Nebraska Medicine. Immediately, their leadership began drawing up plans for a biocontainment unit: a 10-bed facility, the largest of its kind at the time, fitted with negative air flow, a pressurized entrance and decontamination autoclaves, which would provide a safe environment to deal with the world’s worst pathogens.
“We took it seriously,” said Ken Bayles, Ph.D., executive director of basic science research for UNMC’s Global Center for Health Security. “Not only did we stand it up and invest in and build this structure, but we prepared year after year.”
The Nebraska Biocontainment Unit officially opened in 2005. Then it sat empty, as the world waited and attention drifted to other things. But it was never unused. UNMC and Nebraska Medicine continued to prepare — training staff, running drills, learning and getting better.
Then, in 2014, Ebola hit West Africa, and U.S. physicians and a journalist who had been exposed to the deadly virus were flown to the place best equipped to treat them. The “hospital in Omaha” — still without name recognition in the national press — rocketed into the global spotlight.
“Not only were we ready,” said Bayles, “we took on patients, and we did a good job. Then afterwards, we became a leader. We rose to the top pretty clearly. And I think the federal government really took notice of that.”
Two patients were treated and discharged; one, whose disease was advanced by the time he arrived, didn’t make it home. It was a defining experience for the team. It gave them practical knowledge that advanced their understanding of pathogens and how to treat and contain them. It also led to further federal partnerships and the establishment of the National Ebola Training and Education Center (NETEC), which trains health care and public health professionals nationwide to prepare for catastrophic diseases.
It made them even better.
“One thing we learned from taking care of the Ebola patients,” said Cheryl Rand, clinical operations lead of the Nebraska Biocontainment Unit, “is no one got sick. The disease didn’t spread anywhere from here. So we knew we could do that again.”
They continued to prepare. NETEC grew; it has now reached more than 120 hospitals nationwide, and NETEC staff has trained more than 8,000 health care and public health professionals on deadly pathogen preparedness.
“I would say the majority of hospitals in the country in one way or another has benefited from NETEC training,” said James Lawler, M.D., executive director of international programs and innovation at the global center.
Few could have predicted how necessary that training would prove to be — the devastating scale of what was to come. In the months since COVID-19 began spreading throughout the world, it has ravaged communities, touched nearly every country in the world and caused massive shutdowns to curb its spread that have created Great Depression-like economic pain.
But UNMC and Nebraska Medicine’s preparedness and expertise have helped not just Nebraska or even just the U.S. but the whole world battle the pandemic. They treated some of the U.S.’s first COVID-19 patients. They conducted some of the earliest virus tests and clinical treatment trials. Their leadership ran models of the virus’s spread and was critical in informing state and federal policy.
Fifteen years of gathering expertise, running drills over and over and preparing for every scenario put UNMC and Nebraska Medicine in a position to make a substantial difference in one of the world’s most deadly and dramatic crises. They were front and center in the global fight — right here in Nebraska.
We took it seriously. Not only did we stand it up and invest in and build this structure, but we prepared year after year.
Carl Goldman and his wife were sitting at dinner when the captain of the Diamond Princess cruise ship made an announcement. A passenger, who had recently visited Hong Kong, had come down with a new form of coronavirus — the same virus that had led to a lockdown in Wuhan, China, and was slowly drawing the world’s attention. It was Feb. 3. They were docked in Yokohama, Japan, and it was their last night of a trip around Southeast Asia, which Goldman had purchased for his wife as a Christmas present. Goldman, who owns a radio station in Santa Clarita, California, said Japanese officials began working their way through the passengers, taking temperatures and logging their travel histories.
But that was before anyone knew how quickly and easily this virus spread.
By the next day, 10 passengers were reported to have a fever, and everyone was told to go into quarantine in their cabins.
Looking out from his balcony onto the pier at Yokohama, Goldman said it was like a scene out of a movie.
“On the right side were dozens of ambulances and military trucks,” he said. “There were people in hazmat suits. On the left side was media with their cameras and vans … two media helicopters … and a number of media boats circling the ship as well.”
More and more passengers were taken off the ship.
“Each day, the numbers went up,” Goldman said. “So it put us into a definite tense, tense situation.” Goldman kept himself busy blogging his experiences.
By Feb. 11, 135 passengers were infected.
The next day, Lawler, who has a long career working on pandemic preparedness in the administrations of both George W. Bush and Barack Obama and field experience treating Ebola patients in sub-Saharan Africa, was asked to fly immediately to Japan to assist an operation to evacuate every American on board.
“It was a hastily assembled team that went out there to manage a situation that nobody ever had before,” Lawler said.
Lawler’s team, equipped with special helmets and breathing oxygen from portable PAPRs (powered air-purifying respirators) boarded the ship Friday, Feb. 14. They were tasked with locating every American, screening and testing them, and moving them to cargo jets set to arrive two days later.
By 10 p.m. Sunday night, Lawler and the team had tracked down and briefly assessed the more than 400 Americans on board the ship.
They rushed the passengers to the waiting cargo planes. It was a chaotic departure, but Lawler knew if he could just get them to Omaha, they would be safe and UNMC could contain the virus.
Finally on the plane, Goldman, who had fallen asleep after an exhausting few days, woke with a fever of 103. He and the other 12 sick passengers were routed to Omaha, where they landed Feb. 17. A convoy of ambulances and police cars transported them to UNMC.
“We had a motorcade that was longer than President Trump’s or the queen’s,” Goldman said.
It was a hastily assembled team that went out there to manage a situation that nobody ever had before.
Inside the Nebraska Biocontainment Unit, UNMC’s nurses and physicians were ready for the patients to arrive. They waited, encased in full-body suits of impermeable material, three layers of nitrile gloves, knee-length protective boot covers and PAPRs, pulled overhead with clear face shields and tubes pumping in clean air.
“We’ve been training for years and years for all of this,” Rand said. “Our staff was ready.”
Some patients were treated in the BCU; others were taken to the 20-bed National Quarantine Center — the nation’s only federal quarantine facility — which, along with a state-of-the-art simulated biocontainment unit for advanced experiential training, is housed on the ground floor of the Dr. Edwin G. & Dorothy Balbach Davis Global Center.
While the biocontainment unit had been operational since 2005, the quarantine center had opened Jan. 29 — less than three weeks before the first COVID-19 patients arrived.
“We ended up housing people (in the quarantine unit) who needed a relatively significant amount of medical attention,” Lawler said. “The staffing plan had to be reinvented on the fly. And I think it’s a testament to the flexibility and just the quality of our team that our folks are able to do that so quickly.
“It came off as a seamless exercise.”
For the health care workers in the units, the first days were stressful, but the muscle memory ingrained by years of training quickly took over.
“Everybody’s role was important,” said Morgan Shradar, clinical education coordinator for the Nebraska Biocontainment Unit. “It’s been extremely impressive to watch everybody come together and using their knowledge and skill to … counter challenges.”
The staff routinely put in 13-hour shifts or longer, and when they left the hospital, the work never really left them.
“It’s the two o’clock in the morning conversation you’re having with yourself about things that you want to make sure that you get done,” Shradar said.
But they felt privileged to be doing something so important. The challenging days fell away in their memories. Talk to them now, and all they will recall are the high points: the days when patients got to go home and they succeeded in keeping people safe.
“We were here as long as it took,” Shradar said. “I hate to quantify it. It doesn’t matter. We were here.”
Goldman, who spent 10 days in the BCU and 19 more in quarantine, said the nurses and physicians who cared for him were his “angels.”
“They were just unbelievable,” he said. “All of the staff in Nebraska have that Midwest, really wonderful attitude of looking you in the eye and really caring and being sympathetic and compassionate.”
The staff held internal town halls so the patients could talk to each other about their experiences, and they eased their feelings of fear and isolation as much as they could. Goldman spent his 67th birthday in the BCU, and the staff brought him a slice of cake, wrapped in plastic, and a balloon that hung in the corner of the room throughout his stay.
“The whole time I was there, I kept thinking … that if I had to be anywhere in the world, it would be here,” Goldman said. “I ended in the right spot at the right time.”
The whole time I was there, I kept thinking … that if I had to be anywhere in the world, it would be here.
On March 18, the last passenger of the Diamond Princess left quarantine. But by that time, there were 6,520 known cases of COVID-19 in the U.S. and more than 205,000 worldwide. The focus shifted from containing the virus to “flattening the curve.”
UNMC and Nebraska Medicine prepared the hospital and intensive care units for an influx of patients. For the biocontainment team and global center experts, that meant shifting to a training role, not just for other areas of their own hospital, but for hospitals state- and countrywide.
“Our biocontainment unit leaders and team have become extenders for infection prevention and control practice and safety,” said Shelly Schwedhelm, executive director of emergency management and biopreparedness at Nebraska Medicine. “They’ve now turned into consultants on the front lines.”
That meant taking their training on the road to hospitals and essential workplaces, including long-term care facilities and meatpacking plants that stayed open while schools and many other businesses had closed. It also meant turning their attention to testing, treatment and every other aspect of fighting a global pandemic.
Once again, they led the way. The Nebraska Public Health Laboratory, which is partially housed in the biocontainment unit, was one of the first to run COVID-19 tests. UNMC was the first site of a federally sponsored trial, which ultimately expanded to 68 sites, of remdesivir, a promising COVID-19 treatment, which was fast-tracked for approval by the Food and Drug Administration in late April.
“We were the first site in the world to activate that critically important study,” said Chris Kratochvil, M.D., executive director of clinical research for the global center. “Because patients came here for care early in the outbreak, we were teed up for it.”
Meanwhile, Bayles worked with a team in South Dakota to develop virus antibodies, which could be used therapeutically or to protect health care workers. John-Martin Lowe, Ph.D., executive director of training and education at the global center, developed a system to decontaminate health care workers’ safety respirators using ultraviolet light that was a breakthrough with worldwide implications as hospitals everywhere battled with supply shortages. Lawler developed virus models that guided state and federal policies on social distancing and curbing the virus.
“I think it’s clear that the vision of university leadership has always been to create UNMC as an international leader,” Lawler said. “The prescience of that vision is now playing out.”
I think it’s clear that the vision of university leadership has always been to create UNMC as an international leader. The prescience of that vision is now playing out.
As COVID-19 and the vast economic toll it has taken on the world play out, the leadership, physicians, nurses and staff at UNMC and Nebraska Medicine credit teamwork for helping them succeed in this crisis.
“We work together really well,” Bayles said. “I think that’s just sort of innate in our DNA, and that is really paying off in these types of situations.”
“You can’t underestimate the power of a good team,” echoed Kratochvil. “None of what we’ve done could have been done alone.”
Schwedhelm just hopes there is time to take stock of what they’ve learned before the next wave or crisis hits.
“These sorts of scenarios don’t happen in isolation of one another,” she said. “We need to pause, and we need to learn what from what went on, and do that in a big way … to understand what we need to do better next time and try to get things put in place for whatever is the future.”
Because Schwedhelm knows, as everyone does at UNMC and Nebraska Medicine, that whatever comes, they will be there.
On the front lines.
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Radiel Cardentey-Uranga graduated from UNMC in May with high distinction.
UNMC graduate overcomes obstacles to embrace opportunities.
His mom made him look at her hands.
They were swollen, again.
She reminded him how much they ached, day after day, from her job packaging meat at a factory in Columbus, Nebraska.
“She told me, ‘This is the reason you have to go to college. You should get an education. It’s going to help you in the future,’” Radiel Cardentey-Uranga, a recent graduate of the University of Nebraska Medical Center, says.
A few weeks before his graduation, Cardentey-Uranga turned 23. He dreams of a career in radiography, using his hands to help people. He sees that career within his reach now — and maybe, down the road, he’ll become an M.D. or Ph.D. or a physician’s assistant — and he sees himself giving back to the community one day. He knows it’s all thanks to his parents and teachers and all the people who extended their hands to him along the way, pulled him up to where he is today.
To who he is today:
A hardworking, recent college graduate, the first in his family to attend college …
A grateful recipient of two UNMC scholarships: the Charles R. O’Malley Scholarship and the Hermene K. Ferris Scholarship, generous gifts from people who don’t even know him …
A proud citizen of the United States, as of last summer …
And a proud narrator of a very unlikely story. One he can hardly believe himself, he says, as he tells it over the phone from his home in Columbus, Nebraska.
She told me, ‘This is the reason you have to go to college. You should get an education. It’s going to help you in the future.'
Radiel Cardentey-Uranga and UNMC classmates, above, won the 2019 Student Bowl Championship at the Nebraska Society of Radiologic Technology Annual Conference. Cardentey-Uranga, right, became a United States citizen in 2018.
His story began in Cuba. It began even before he was born, when his hardworking dad was thrown in jail for two years for speaking out against the government.
“He just wasn’t in favor of the tyranny or the dictatorship they had,” Cardentey-Uranga says. “He was publicly speaking the truth that the government doesn’t want you to tell.”
When his dad got out of jail, he tried to go back to working in construction. He had a good reputation working with his hands, in masonry. But police were always giving him citations, harassing him, ticketing him. Cardentey-Uranga’s family eventually applied to come to the United States as refugees and was accepted.
Cardentey-Uranga was 16 when he came over with his parents and older brother. After some time in Washington state, his parents split up. Cardentey-Uranga and his mom came to Columbus, where his mom, who had used her hands doing hair and nails out of her home back in Cuba, took on that tough factory job.
Cardentey-Uranga could barely speak or understand English, so he wasn’t much of a student at first at Columbus High School. He’d dropped out of school in Cuba in ninth grade because of his family’s fears that if he kept going, he’d get taken away and thrown into military service, which in Cuba is mandatory.
He struggled because of those years of school he missed, especially in math and physics.
“Basically,” he says, “I had to learn it all from scratch.”
He joined the high school soccer team, which helped because some of the players spoke Spanish. He took a weekend job at an animal shelter, and that helped him learn English. He started to fit in.
A few teachers took him under their wings, encouraged him to try for higher education and pointed him in the direction of Central Community College.
But he didn’t think he was college material. He figured he’d just find a factory job, too, when he graduated.
That’s when his mom made him look at her swollen hands.
“She said, ‘This is the reason you have to go through school. I’m making the sacrifice for you. You should take a chance at the opportunity,’” Cardentey-Uranga says.
He did. He started asking questions about the path to higher education. He took the ACT but scored poorly at first. He started at the community college, way behind the other students. He took evening classes, summer classes. He got to know one of the Spanish instructors there, and she suggested he consider a career in radiography. She told him UNMC had a radiography program he could take right there in Columbus.
Radiography?
He researched it, loved what he saw and applied to the program at UNMC, which has a partnership with a hospital in Columbus. As part of the application process, he was required to do a three-day job-shadowing stint to make sure he really wanted to work in that field.
“I liked the job,” Cardentey-Uranga says. “I felt like it really fit me because I’m using my hands constantly, in different ways. You use the computer sometimes; you’re constantly running around and moving. I like to move. And you get to work with people from all different backgrounds and cultures.”
He applied for scholarships. Then he forgot he’d done so, until one day when he opened an email telling him he’d received the O’Malley and Ferris scholarships. The O’Malley Scholarship was created by the largest gift to benefit UNMC’s College of Allied Health Professions students to date. Besides allowing the college to endow funds for a cohort of “O’Malley Scholars,” the gift provides an additional $500,000 if matched by other allied health donors through 2022. The matching arrangement allows benefactors to endow their own named scholarships, with the benefit of doubling their gift.
“When I got it,” he says. “I got an email telling me and when I read it, I was like, OK, this can’t be real. They probably sent it to the wrong person!”
He laughs.
“But I guess someone realized that I was really working hard to achieve good academic performance. And I got the scholarships, and they truly make a difference. The money helps out with school. But what also really impacts me is the fact that it makes me know there are people out there who are actually invested in your future, who really care about you.
“That’s what impacted me the most — that there are people looking out for me, people who care.”
Cardentey-Uranga graduated from UNMC with a bachelor’s degree in medical imaging and therapeutic science this past May. He will go on to receive a post-baccalaureate certificate in cardiovascular interventional technology through UNMC.
He wrote a thank you letter last May to the people behind the Ferris Scholarship:
I am looking forward to achieving my career goal at UNMC and hopefully someday to be in your shoes and give back to the community in the same way you are doing with me.
He also created a video for the trustees of the O’Malley Trust, telling them his unlikely story and thanking them for their big hand in it.
And promising his story will continue.
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With $90 million in private gifts, new facility will be first of its kind in nation
Children and adults with developmental and intellectual disabilities will benefit from a new facility and all new programs at the Munroe-Meyer Institute in Omaha.
Generous philanthropic support of $90 million is making it possible for the University of Nebraska Medical Center to begin redeveloping a former 220,078 square-foot office building in central Omaha into a state-of-the-art service and health care center.
The facility, located at 6902 Pine St., is adjacent to the University of Nebraska at Omaha Scott Campus and will be more than two times larger than the institute’s current facility located near South 44th and Farnam streets.
Patients, families, university representatives and others came together on Aug. 26, 2019, to celebrate the start of redevelopment. Completion of the new facility is scheduled for fall 2020, and the building will open and begin providing patient services later that year.
As Munroe-Meyer Institute begins its second century of providing services for patients with developmental and intellectual disabilities, its new home will be the first of its kind in the nation, MMI Director Karoly Mirnics, M.D., Ph.D., said. It will be uniquely designed to facilitate integrated care for the individuals and families with these disabilities and complex health care needs that MMI serves across the lifespan, he explained.
“This new facility will not only allow us to provide state-of-the-art care, but it will enable us to recruit and retain top clinicians, educators and researchers to Nebraska,” Mirnics said. “Building on 100 years of service, our vision is for a center that will provide an intimate, convenient care center for our patients while providing us with the talent and facilities to have a global impact in the areas of education and research into intellectual and developmental disabilities.”
Architects consulted with clients and clinicians to create a plan for the building that enhances and simplifies the patient experience, as well as offering an array of services not available elsewhere in the state.
Existing programs will be expanded and enhanced, while new programs and collaborations will be offered. Among the new amenities:
a redesigned and integrated Center for Autism Spectrum Disorders (iCASD), under the leadership of a newly recruited, nationally recognized expert in autism, where MMI professionals will provide interdisciplinary care, pulling together the various services to enhance the patient experience;
a one-bedroom, fully appointed apartment, where occupational therapists can help individuals with intellectual or developmental disabilities learn and practice hands-on life skills;
the Caring For Champions Program, a collaboration with Special Olympics that will provide sustained vision, dental and weight management services; and
a new aquatic center and playground for clients and youth will enhance the experience for youngsters who attend Camp Munroe.
Several benefactors gave to the University of Nebraska Foundation to enable the university to acquire and redevelop the building in response to the exponential growth in the population that needs services.
“Once again, generous individuals and organizations have demonstrated what can be accomplished in Nebraska through giving,” said Brian Hastings, president and CEO of the University of Nebraska Foundation. “It’s because they recognize the need for this vital project that the university is able to move forward. So many people throughout Nebraska and the region will benefit from the expanded facilities, programs and specialized care that will be available at the institute.”
The University of Nebraska Foundation continues to seek contributions to support the programmatic costs associated with the institute.
UNMC Chancellor Jeffrey P. Gold, M.D., called the new building a doorway into the institute’s second century.
“Since its beginnings, Munroe-Meyer Institute has worked to improve the lives of the people and families it serves,” Gold said. “This new home gives it a much larger space and increased versatility and flexibility, but the core of the MMI mission — helping those with intellectual and developmental disabilities to overcome challenges, to live fuller, richer lives — remains the same.
“All of UNMC is excited to see how our colleagues at MMI will continue to grow in their new home to provide even more effective clinical care, education and research, all in the name of enhancing the lives of the people and families they serve.”
Cancer survivor’s generosity benefits UNMC and others who’ve helped him
Steve Sears has been highly successful in his life.
After receiving his undergraduate degree in accounting from the University of Kansas, he went to Northwestern University’s Kellogg School of Management to get his M.B.A. He was hired by PepsiCo shortly after graduating and spent two decades managing the world’s most well-known brands.
He was the chief marketing officer for Frito-Lay in Sidney, Australia, and head of marketing for the Pepsi beverage brands in New York, and he oversaw the acquisition of Stacy’s Pita Chips in Boston.
On his 50th birthday, Steve retired from his marketing career. One month later, he was diagnosed with cancer.
It was Hodgkin lymphoma, stage 4, the most advanced in the disease’s progression. Steve had experienced symptoms for months, but he hadn’t been accurately diagnosed, so the cancer had continued its steady march, coursing through his blood and, ultimately, his organs.
At the time, Steve and his husband were in the process of moving from Boston to Kansas City, where Steve had grown up and his parents still lived. But they decided to stay and seek treatment at Beth Israel Deaconess Medical Center, the teaching hospital of Harvard Medical School, where Steve’s doctor was affiliated. Six months of grueling chemotherapy, and Steve was in full remission.
The move to Kansas City went forward, and Steve’s post-treatment care was set up with the University of Kansas Cancer Center. But at his six-month checkup, Steve was told the cancer was back. It was devastating news.
When cancer, specifically lymphoma or leukemia, returns so quickly, a stem cell transplant is often the best course, and that’s what Steve’s doctor recommended.
Steve quickly educated himself on the procedure and prepared for it. But a week before the transplant, Steve received a call from the cancer center’s finance department. His insurance was not affiliated with KU, and his treatment could not be authorized. It was a sinking feeling, but Steve was told a highly rated facility could take him: the University of Nebraska Medical Center.
The following day, Steve received a call from UNMC saying Julie Vose, M.D., the chief of the division of oncology/ hematology and an internationally known expert on lymphoma, could see him the next day. He drove to Omaha, and from the moment he stepped through the doors and into the waiting room, he felt the warmth of the people who would be his caregivers and life-savers over the next several weeks.
Steve spent five weeks in Omaha, and today, he is six years in remission. When he looks back at the experience, he believes it turned out for the best. Even the fact that the hospital was three hours from home turned out to be a blessing. “My husband and I just kind of sequestered ourselves in Omaha,” he said.
Most importantly, Steve received first-class care, a successful treatment — and kindness.
“You’re so stressed out when you have a life-threatening diagnosis,” he said, “and it’s just so comforting to turn your life over to people who not only do you trust for their technical skills but also who have empathy and just general kindness and humor.”
There were, of course, low points and stressful times during his treatment. But that’s not what Steve remembers. He remembers the people he met, a few in particular: Dr. Vose, his primary physician, Stacy Rooker, his case manager, and a nurse practitioner named Mark Brown.
Mark and Steve had only one interaction, but it came on a difficult day. Steve was feeling frustrated and downhearted, and Mark lifted his spirits. “He spent probably 10 minutes with me,” Steve said, but after Mark walked out, “I felt like a new person, and I never forgot that. It was like he was my angel that day.”
On the fifth anniversary of his transplant, Steve worked with the University of Nebraska Foundation to throw a surprise reception for the three people who had most impacted him during his treatment. He also announced a generous estate gift to support cancer research at UNMC.
UNMC is not the only beneficiary of Steve’s generosity. When planning his estate, he thought about everyone who helped him succeed in his career and find happiness in his personal life.
“It’s been one of my life’s great joys to get that plan together and then have the fun of going around and telling the organizations in the plan that they’re going to receive a gift someday — hopefully many, many years from now — and see the excitement and appreciation that they have.”
Steve has been highly successful in his life. And that has enabled him to give back to the causes that matter to him. But the people who enabled his success saved his life and showed him compassion — those are the ones who inspired him to do so.
University of Nebraska Medical Center collaborates on historic study
PHOTO: Members of the UNMC research team included: Back row (left-right) – James Hilaire, Brady Sillman, Ph.D., Larisa Poluektova, M.D., Ph.D., Santhi Gorantla, Ph.D., Benson Edagwa, Ph.D., and Hang Su; Front row — R. Lee Mosley, Ph.D., JoEllyn McMillan, Ph.D., Howard Gendelman, M.D., Prasanta Dash, Ph.D., Saumi Mathews, Ph.D., Mary Banoub, and Zhiyi Lin. Missing from photo – Aditya Bade, Ph.D. and Nagsen Gautam, Ph.D.
In a major collaborative effort, researchers at the University of Nebraska Medical Center (UNMC) and Temple University Lewis Katz School of Medicine have for the first time eliminated replication-competent HIV-1 DNA — the virus responsible for AIDS — from the genomes of living animals.
The study, reported today in Omaha and in the journal Nature Communications, marks a critical step toward the development of a possible cure for human HIV infection.
“This achievement could not have been possible without an extraordinary team effort that included virologists, immunologists, molecular biologists, pharmacologists, and pharmaceutical experts,” said Howard Gendelman, M.D., Margaret R. Larson Professor of Infectious Diseases and Internal Medicine, chair of the Department of Pharmacology and Experimental Neuroscience and director of the Center for Neurodegenerative Diseases at UNMC. “Only by pooling our resources together were we able to make this groundbreaking discovery.”
“Our study shows that treatment to suppress HIV replication and gene editing therapy, when given sequentially, can eliminate HIV from cells and organs of infected animals,” said Kamel Khalili, Ph.D., Laura H. Carnell Professor and chair of the Department of Neuroscience, director of the Center for Neurovirology, and director of the Comprehensive NeuroAIDS Center at LKSOM.
Drs. Gendelman and Khalili were senior investigators on the new study.
Current HIV treatment centers on the use of antiretroviral therapy (ART). ART suppresses HIV replication but does not eliminate the virus from the body. Therefore, ART is not a cure for HIV, and it requires lifelong use. If it is stopped, HIV rebounds, renewing replication and fueling the development of AIDS. HIV rebound is directly attributed to the ability of the virus to integrate its DNA sequence into the genomes of cells in the immune system, where it lies dormant and beyond the reach of antiretroviral drugs.
In previous work, Dr. Gendelman’s team used a therapeutic strategy known as long-acting slow-effective release (LASER) ART co-developed by Benson Edagwa, Ph.D., assistant professor of pharmacology at UNMC.
Dr. Khalili’s team used CRISPR-Cas9 technology to develop a novel gene editing and gene therapy delivery system aimed at removing HIV DNA from genomes harboring the virus. In rats and mice, they showed that the gene editing system could effectively excise large fragments of HIV DNA from infected cells, significantly impacting viral gene expression. Similar to ART, however, gene editing cannot completely eliminate HIV on its own.
For the present study, Dr. Gendelman and his team led by Prasanta Dash, Ph.D., instructor of pharmacology, combined its LASER ART strategy with the gene editing system.
LASER ART targets viral sanctuaries and maintains HIV replication at low levels for extended periods of time, reducing the frequency of ART administration. The long-lasting medications were made possible by pharmacological changes in the chemical structure of the antiretroviral drugs. The modified drug was packaged into nanocrystals, which readily distribute to tissues where HIV is likely to be lying dormant. From there, the nanocrystals, stored within cells for weeks, slowly release the drug.
Dr. Khalili said, “We wanted to see whether LASER ART could suppress HIV replication long enough for CRISPR-Cas9 to completely rid cells of viral DNA.”
To test their idea, the researchers used mice engineered to produce human T cells susceptible to HIV infection, permitting long-term viral infection and ART-induced latency. Once infection was established, mice were treated with LASER ART and subsequently with CRISPR-Cas9. At the end of the treatment period, mice were examined for viral load. Analyses revealed complete elimination of HIV DNA in about one-third of HIV-infected mice.
“The big message of this work is that it takes both CRISPR-Cas9 and virus suppression through a method such as LASER ART, administered together, to produce a cure for HIV infection,” Drs. Gendelman and Khalili said in a shared statement. “We now have a clear path to move ahead to trials in non-human primates and possibly clinical trials in human patients within the year.”
“The ability to excise HIV-1 DNA from the genomes of infected animals depends on LASER ART’s abilities to maximally restrict ongoing infection. This concept of combining both modalities provides a pathway forward to future studies in humans,” Dr. Gendelman said.
How you may help
While research breakthroughs such as this rely on critical grant funding, private contributions of every amount also make these scientific discoveries possible. Gifts help provide research equipment and instruments, endowed support for faculty, support for fellowships for graduate researchers, program support and much more.
If you are interested in supporting the lifesaving HIV research underway at the University of Nebraska Medical Center, please consider a contribution to the Community Pride and Distinguished Science Research Fund (01087930). Your gift will enable the Department of Pharmacology and Experimental Neuroscience to continue this important work.
You may give online now or send a check made payable to the University of Nebraska Foundation to: University of Nebraska Foundation, PO Box 82555, Lincoln NE 68501-2555. Please include in the memo line of your check the fund number 01087930.
On June 24, 2019, the University of Nebraska Medical Center community gathered to ceremonially break ground on its new campus welcome center — the Wigton Heritage Center — as well as launch the renovation of Wittson Hall and the McGoogan Library.
“Today is a vibrant example of the public-private partnerships that really build the future,” Chancellor Jeffrey P. Gold, M.D., said, noting the caring, generous and visionary philanthropists within Omaha, the state and beyond.
The 10,000-square-foot Wigton Heritage Center will celebrate and memorialize UNMC’s history, while also serving as a campus welcome center.
In addition, the fully privately funded project will replace the existing walkways between Wittson Hall and University Tower and preserve the exterior columns of University Tower. The buildings will be connected through a multi-floor space.
“Beautiful spaces are important,” Dr. Gold said, “but at the end of the day it is always about the people and programs that fill the space.”
The $26 million project includes the $18 million renovation of Wittson Hall, which was supported by the Nebraska Legislature through LB 957 funds.
Private support for the new $8 million Wigton Heritage Center was provided with generous contributions from UNMC historian, alumnus and faculty member Robert Wigton, M.D., and the Leland J. and Dorothy H. Olson Charitable Foundation.
UNMC’s unofficial campus historian, Dr. Wigton is a 1969 alumnus of the College of Medicine who served as professor in internal medicine at UNMC and in several key administrative areas in the College of Medicine, including associate dean for graduate medical education. The Wigton legacy spans three generations with several physicians within the family serving UNMC. For the celebration, Dr. Wigton was joined by his wife, Deborah, and his brother, James Wigton, M.D., class of 1981, and his wife, Judith.
The Olson Foundation was represented at the groundbreaking by the children of the late Leland and Dorothy Olson, including David L. Olson, M.D, a UNMC alumnus and former internal medicine faculty member; Karen Olson, M.D., a UNMC alumna; and Nancy Olson, who holds graduate and undergraduate degrees from both UNL and UNO.
Dr. Gold also thanked the University of Nebraska Board of Regents, the Nebraska Legislature including Sen. Jim Scheer of Norfolk who attended the event, and the University of Nebraska Foundation.
“This is a great day for the McGoogan Library and for the campus,” said Emily McElroy, director of the McGoogan Library, which, next year, celebrates the 50th anniversary of being placed atop Wittson Hall.
The construction project, she said, will enable the library to display its extensive and renowned rare book collection, as well as the artifacts and photos that “tell the legacy of UNMC.” The library’s namesake, Leon S. McGoogan, past chairman of obstetrics and gynecology at UNMC, once dreamed of having 24/7 access and a museum-like archives, she said. “McGoogan would be thrilled with this project.”
Dele Davies, M.D., senior vice chancellor for academic affairs, said the transformational project would “provide a historical anchor.” Wittson Hall, he said, is the heart of the UNMC campus and a major arterial that connects the educational and clinical facets of campus.
The project will include a new faculty commons for collaboration, an interactive e-learning lab, a maker space for printing innovative 3D prototypes, two dozen quiet rooms for students to study and wellness spaces to meditate and de-stress.
The Wittson Hall project will be completed in the second half of 2020; the Wigton Heritage Center will open in 2021.
Group’s total contribution now exceeds $215,000 since 2014
The Fremont Area Alzheimer’s Collaboration (FAAC) has donated a $60,000 pilot grant to go toward Alzheimer’s disease research at the University of Nebraska Medical Center. The donation marks the sixth grant the FAAC has donated to UNMC since 2014 and brings the group’s total contribution to more than $215,000.
Marv Welstead, a 98-year-old Fremont man who lost his wife, Jean, in 2009 after an eight-year battle with Alzheimer’s, is honorary chairperson of the FAAC. On Feb. 21, the Fremont Area Chamber of Commerce inducted Welstead into its Hall of Fame on his 98th birthday.
“Marv has been the driving force behind the FAAC’s success,” said Dan Murman, M.D., professor and vice chair of clinical and translational research in the UNMC Department of Neurological Sciences. “He’s been tremendously supportive. His commitment to the battle against Alzheimer’s disease is truly inspirational.”
The latest FAAC grant will support UNMC’s Alzheimer’s research in two areas – developing screening biomarkers and exploring novel treatment approaches.
Dr. Murman said the screening biomarkers include cerebrovascular measures, retinal measures, and blood and saliva samples. Each of these screening biomarkers is noninvasive and relatively inexpensive, he said. These novel biomarkers would be compared to more traditional biomarkers such as using an MRI scan to measure brain neurodegeneration or a PET scan to determine the amyloid plaque accumulation in the brain.
The grant will provide additional support for several clinical trials at UNMC, Dr. Murman said, including a study of repetitive Transcranial Magnetic Stimulation (r-TMS) as a treatment to improve memory in subjects with very mild Alzheimer’s disease. In addition, the FAAC funding will allow UNMC to recruit subjects for several new clinical trials of promising new medications.
“We can’t thank the FAAC enough for its support,” Dr. Murman said. “The ongoing contributions from the FAAC allow us the flexibility to try new things and seek new advances. We are honored to use their funding to look for answers to this incredibly difficult disease.”
A progressive, degenerative disorder, Alzheimer’s disease is the most common cause of dementia among people 65 years and older. It currently affects more than 35,000 Nebraskans and more than 5 million persons nationwide.
The money raised by the FAAC is donated to the University of Nebraska Foundation, which then distributes it to UNMC as well as the University of Nebraska-Lincoln. It is raised through a variety of channels, including a walk, a golf tournament, a bowling tournament, online gifts and memorials, Welstead said. The FAAC is a component fund of the Fremont Area Community Foundation.
“We’ve received tremendous support from the various groups in Fremont,” Welstead said. “It’s unbelievable. We’ve been getting some very generous memorials from families who have been impacted by Alzheimer’s.”
Welstead acknowledged Dan Kauble, a retired executive from Hormel who has been assisting him in raising money for Alzheimer’s disease. He also saluted Riley Faulkner, president of the FAAC, and Cathi Sampson, vice president of the FAAC.
“We love to raise money locally and then keep the money in Nebraska by giving it to UNMC and UNL,” Welstead said. “We know the University of Nebraska is doing some outstanding research with Alzheimer’s disease.”
Welstead noted that the FAAC will generate more funding through a charity golf tournament on June 23 at Fremont Country Club and a pancake feed sometime in September.
Research support
Funding from the Fremont Area Alzheimer’s Collaboration (FAAC) has assisted numerous investigators in their research. They include:
UNMC:
Daniel Murman, M.D., neurological sciences
Sachin Kedar, M.B.B.S., neurological sciences
David Warren, Ph.D., neurological sciences
Tony Wilson, Ph.D., director of the Magnetoencephalography Laboratory at UNMC/Nebraska Medicine;
Alex Wiesman, Ph.D. candidate who works with Dr. Wilson
UNL:
Greg Bashford, Ph.D., biological systems engineering
Mohammed Alwatban, Ph.D. candidate who works with Dr. Bashford
ABOUT THIS PHOTO: Barney and Vada Oldfield met at the University of Nebraska in Lincoln and enjoyed their life together. Their legacy continues with a number of funds that provide perpetual support to the university, its faculty and students.
For two decades, a research fund has supported the efforts of leading research scientists at the University of Nebraska Medical Center in the pursuit of treatments and a cure for Alzheimer’s disease.
Alzheimer’s disease is a progressive, devastating brain disorder that slowly destroys memory and thinking skills and eventually prevents one’s ability to carry out simple tasks. Experts estimate that more than 5.5 million Americans may have the disease.
Col. A. Barney Oldfield started the fund with a gift to the University of Nebraska Foundation in the 1990s by establishing the Vada Kinman Oldfield Alzheimer’s Research Fund for the UNMC Division of Geriatrics. The permanently endowed fund forever honors his wife, Vada Kinman Oldfield, who suffered from Alzheimer’s for 11 years before her death in 1999.
Later contributions by family members, friends and the Kinman-Oldfield Family Foundation, along with market investment, have increased the endowment to nearly $400,000, ensuring it will support Alzheimer’s research until a cure is found. With foresight typical of the Oldfields, once a cure is found for Alzheimer’s disease the fund will be redirected to battle other disorders associated with aging.
Jane Potter, M.D., professor of internal medicine, geriatrics and palliative medicine at UNMC, said the first 20 years of the Kinman Oldfield Award have helped launch the careers of many successful research scientists.
“For many, this was the first research award that they received,” Potter said. “The award provided support to collect pilot data that then was the seed for applications to other foundations and government funders. It has done what Col. Oldfield intended. He was a great believer in kick-starting careers and setting people in the right direction.”
2019 Kinman Oldfield Alzheimer’s Research Award recipient announced
The Kinman Oldfield Alzheimer’s Research Award is conferred annually as a $10,000 stipend to an individual with promising new ideas in Alzheimer’s disease research.
David E. Warren, Ph.D., assistant professor in UNMC’s Department of Neurological Sciences, is the 2019 recipient of the Kinman Oldfield Award and was recognized during an event on April 22. He researches potential treatment for memory loss in healthy and nonhealthy older adults by combining neuroimaging, neurostimulation and neuropsychology.
A moderate decline in the memory of facts and events is a normal part of aging, Warren said, but amnestic mild cognitive impairment is a severe, clinically relevant type of memory loss that frequently precedes Alzheimer’s disease.
“Loss of memory abilities is devastating for people, but the few treatments available for memory loss provide very limited relief,” said Warren, whose research team includes medical students interested in the field of memory loss treatment.
“We are applying a type of noninvasive brain stimulation that we believe has potential to improve memory abilities among people with mild cognitive impairment who do not yet have Alzheimer’s disease,” he said. “By testing whether this type of stimulation improves their memory abilities more than a placebo, we will determine if it will reliably improve memory. So this study is a key first step that will support our long-term goal of applying the same approach to people with memory loss due to Alzheimer’s disease.”
2019 Reagan Alzheimer’s Scholarship recipients announced
The Kinman-Oldfield Family Foundation also established the Nancy and Ronald Reagan Alzheimer’s Scholarship Fund Award at UNMC to honor Ronald Regan, the late U.S. president who battled Alzheimer’s disease.
The 2019 recipients of the Reagan Alzheimer’s Scholarship are doctor of medicine students Carly Faller, Claire Ferguson and Ran Jing. They each serve on the leadership team for the UNMC Purposes of Aging Interprofessional Group and were honored at an April 22 event.
Faller is a third-year medical student from Lincoln, Nebraska, who’s mentored by Warren. Her research focus is on the effects of targeted transcranial magnetic stimulation on hippocampal-dependent declarative memory in older adults.
Ferguson is a third-year medical student from Omaha, Nebraska, who’s mentored by Natalie Manley, M.D. Her research is focused on a feasibility study regarding virtual reality and dementia in patients.
Jing is a third-year medical student from Shandong, China, who’s also mentored by Warren. Jing’s research focus is on the effects of targeted transcranial magnetic stimulation on memory performance in older adults with amnestic mild cognitive impairment.
New faculty support chair in Alzheimer’s disease announced
The Kinman-Oldfield Family Foundation recently announced its commitment to establish the Kinman Oldfield Chair in Geriatrics at UNMC. Once fully funded, this permanently endowed fund will provide annual support to a renowned faculty member dedicated to Alzheimer’s disease research and teaching.
“The Kinman-Oldfield Family Foundation is pleased to carry on Col. Oldfield’s vision of a cure for, and the eradication of, Alzheimer’s disease,” said Warren Odgers, Kinman-Oldfield Family Foundation trustee. “This commitment to the Kinman Oldfield Chair in Geriatrics also furthers a goal of the foundation to support educational opportunities for Nebraska students.”
The Oldfields, including the family foundation they established to carry on their charitable objectives, have provided philanthropic support to the University of Nebraska for nearly 30 years. In addition to their support for students and faculty at UNMC, the foundation contributed to the new Home Instead Center for Successful Aging, home to UNMC’s geriatrics division and geriatric patient care.
In addition to support of UNMC, the Oldfields also established funds that benefit students at the University of Nebraska–Lincoln, including scholarships for students in the Hixson–Lied College of Fine and Performing Arts, the College of Journalism and Mass Communications and students in the Army ROTC program.
Beginning a life together in Nebraska
Col. A. Barney Oldfield and Vada Kinman met in Lincoln, Nebraska, where they were both studying at the University of Nebraska. The 1933 graduates would go on to be generous supporters of their alma mater through various scholarship funds and programs across the university system.
A native of Tecumseh, Nebraska, Barney Oldfield had a career in the U.S. Air Force as a communications officer and then became a public relations executive for Litton Industries in Woodland Hills, California. Founder of the Nebraska Dollars for Scholars program, he is a legend in the public relations field and counted many celebrities on his list of close, personal friends, including President Ronald Reagan and boxer George Foreman. Oldfield died in 2003, leaving a legacy in educational philanthropy that includes the University of Nebraska and other higher education institutions.
Vada Kinman Oldfield was from Grand Forks, North Dakota. During World War II she enlisted in the Women’s Auxiliary Army Corps, becoming a pioneer in what would become the Women’s Army Corps in 1943. She served in the 12th Air Force Communications Section in Africa and Italy.
In both military and civilian life, the Oldfields made philanthropy their passion, giving generously of their resources and inspiring others to do the same. The Kinman-Oldfield Family Foundation continues their philanthropic legacy today.
