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recalls Dr. Schmidt, the Dr. Iven Young Professor of Endocrinology and Professor of Medicine, Biochemistry and Molecular Pharmacology, and Pathology at NYU School of Medicine. “Those patients are the ones I think about on a daily basis. They’re the reason I keep pushing ahead with my research, trying to give back, to find a better solution.” FOLLOWING THE SCIENCE A world-renowned diabetes researcher, Dr. Schmidt has dedicated her life to medical science. She earned her BA in biology and history from NYU, and she is a graduate of the NYU School of Medicine, where she also completed her medical residency and a fellowship in hematology and medical oncology. Her Bellevue experience has shaped her career and her professional focus. After completing her fellowship, she spent nearly two decades in academia at Columbia University—where she discovered the protein called RAGE (receptor for advanced glycation end products) that has proven to promote inflammation and to be a key player in diabetic complications. Dr. Schmidt found that giving 14 | NYU SCHOOL OF MEDICINE mice a RAGE inhibitor or genetically deleting the animals’ receptor protected them from diabetic complications. The animals had less atherosclerosis and considerably less nerve, retinal, and kidney damage. “It was a wonderful example of what I continue to tell people in the lab: Just follow the science,” Dr. Schmidt says. Today, while still steering NYU’s diabetes research program, Dr. Schmidt is expanding her scope to help stop one of the most dangerous and complex epidemics facing humanity: obesity. Over the past year, she and a multidisciplinary team of physicians, scientists, and economists at NYU Langone have been collaborating on a project they believe can result in novel therapeutic interventions and prevention. OBESITY’S HARSH REALITY Obesity plays a role in 86 percent of annual healthcare spending, according to a recent report from McKinsey. Two-thirds of adults in the U.S. are overweight or obese, and one out of three children will develop diabetes. Half of the world’s population is projected to be overweight by 2030. At $2 trillion a year, obesity has roughly the same economic impact as smoking or armed conflict. NYU Langone is committed to changing this harsh reality, and has been recruiting faculty who prioritize innovation and collaboration. In March 2017, in recognition of NYU’s efforts, the American Heart Association (AHA) awarded a $4 million grant to Dr. Schmidt’s research lab, “NYU IGNITION” (InvestiGating Novel obesIty soluTIONs), with support from the recently launched NYU Comprehensive Program on Obesity, to evaluate the anti-obesity effects of blocking RAGE. The initiative, which makes NYU part of the national AHA Obesity Research Network, is breaking new ground by bringing together faculty spanning basic science, clinical medicine, and population health. Leading the basic science research team, Dr. Schmidt is studying new models in mice to determine the role of RAGE-dependent inflammation and adipocyte (fat cell) biology in energy expenditure and weight loss. “We’ve already discovered that mice that have no RAGE whatsoever are largely protected from high fat diet–induced obesity,” Dr. Schmidt says. “When they eat high-fat food, unlike their RAGE-expressing counterparts, they do not become obese. So, we believe that if we antagonize the receptor pharmacologically, we might be able to improve the metabolic effects. Right now, we’re doing our tests in mice, but we’re optimistic that this will ultimately also work with people.” To begin making those human connections, Ira J. Goldberg, MD, director of the NYU Division of Endocrinology, Diabetes, and Metabolism, and the center’s deputy director, along with Jose Aleman, MD, PhD, assistant professor of medicine, will manage IGNITION’s clinical team. Their groups will assess the involvement of the RAGE signaling pathway as well as novel, yet-to-be-identified pathways, and perform an unbiased analysis to determine the inflammatory pathways activated within people who are obese, and how these are changed with surgical and dietary weight reduction. A COMPREHENSIVE PLAN NYU IGNITION’s comprehensive scope will be rounded out by the work of Mary Ann Sevick, ScD, professor of population health and co-investigator with Eran Segal, PhD, of the Weizmann Institute in Israel. In a community-based clinical trial, Drs. Sevick and Segal will compare two behavioral weight loss interventions delivered using mobile technology: a one-size-fits-all calorie- and fat-restricted “WHEN IT COMES TO COMPLEX DISEASES LIKE OBESITY, TRANSFORMATIVE THINGS TAKE TIME.” Ann Marie Schmidt ’83 A nurse teaching a patient how to use an insulin pump without tubing, managed with an electronic control unit ADULTS is obese 1IN 3 2IN 3 are overweight or obese CHILDREN is overweight or obese 1IN 3 86% 1IN 3 will develop diabetes Obesity is one of the biggest drivers of preventable chronic disease, which accounts for 86% of annual healthcare spending Adapted from data available on the Centers for Disease Control and Prevention (CDC) website and in a 2014 report on obesity published by McKinsey & Company Photo: BSIP SA / Alamy 15 | GRAPEVINE ALUMNI MAGAZINE SPRING 2018 diet, versus a calorie-restricted diet plus personalized feedback to reduce glycemic response to
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