Researchers at the USF Health Morsani College of Medicine were awarded $5.6 million of expected funds for a 4-year study from the U.S. Department of Defense to examine why many people with Friedreich’s Ataxia (FA) go on to also develop heart disease, a major cause of death for those with FA.

Principal investigator for the USF study is Thomas McDonald, MD, professor in the Department of Internal Medicine (Division of Cardiology) and the Department of Molecular Pharmacology and Physiology in the USF Health Morsani College of Medicine. Dr. McDonald is also a researcher in the USF Health Heart Institute and director of the USF Health Cardiogenetics Clinic.

“We still don’t have a full understanding of the genetic mutation for Friedrich’s ataxia to determine why so many patients go on to get heart disease – we need to know,” Dr. McDonald said. “The physiology is not well characterized. This study will help us gain a better understanding of the basic mechanisms of the gene that carries FA, and help identify clinical predictors of the FA-associated heart disease.”

The new study dovetails with current work taking place in Dr. McDonald’s lab, including an R56 grant from the National Institutes of Health, which focuses on the fundamental mechanisms of LMNA-associated heart disease passed from one generation to the next — and what can be done to help prevent disease and its consequences.

This FA-heart disease study will follow FA patients and their parents over four years, and will involve careful clinical monitoring of heart health, examination of biomarkers, whole genome sequencing, stem cell modeling of heart tissue, and mitochondrial function studies.

From left, Dr. Kami Kim, Dr. Aarti Patel, Dr. Thomas McDonald, and Dr. Theresa Zesiewicz. Not pictured is Sami Noujaim, PhD.

Spearheading the work in the DoD study is a multidisciplinary team of USF Health experts representing cardiology, genetics, neurology, molecular pharmacology, cardiac electrophysiology and predictive modeling. The diverse expertise will help distinguish the clinical, genetic, and biological factors that contribute to cardiac disease in FA patients. Data from FA families and basic science models will be integrated with clinical data to identify unique factors in the heart that influence the cardiac phenotype and separate cardiac-specific traits from those influencing the neurological phenotype.

“Study results could lead to tools used in patient care settings to identify those FA families most at risk for cardiomyopathy and allow for potential intervention and treatment that could help delay onset of the heart disease,” Dr. McDonald said.

The USF Health interdisciplinary team for the study includes:

• Thomas McDonald, MD: clinical cardiology, molecular pharmacology and cardiogenetics (Division of Cardiology, Department of Internal Medicine, MCOM)
• Aarti Patel, MD: neurocardiogenetics and cardiac imaging (Division of Cardiology, Department of Internal Medicine, MCOM)
• Sami Noujaim, PhD: molecular pharmacology and cardiac electrophysiology (Department of Molecular Pharmacology and Physiology, MCOM)
• Kami Kim, MD: machine learning and clinical predictive modeling (Division of Infectious Diseases, Department of Internal Medicine, MCOM; Center for Global Health Infectious Diseases Research, COPH)
• Theresa Zesiewicz, MD, clinical neurology (Department of Neurology, MCOM)

Dr. Zesiewicz, professor in MCOM and director of the USF Health Ataxia Research Center, has specialized in clinical research and patient care for ataxias and other movement disorders’ for more than 20 years and is recognized as an international expert and leader in the field of hereditary ataxias. Her movement disorders clinic supports the evaluation of over 3,000 patients per year, likely the busiest in the world.

“Dr. Zesiewicz will play a vital role in recruiting research participant and in overseeing neurological assessments of patients as they are longitudinally followed in this study,” Dr. McDonald said.

The funding for the study came from the DoD through its Congressional Directed Medical Research Programs (CDMRP), a section of DoD that funds novel approaches to biomedical research. Link: https://cdmrp.health.mil/

The team will begin recruiting study participants next month.

Photo by Ryan Rossy, USF Health Communications

Tampa General Hospital continues to be the best hospital in the Tampa Bay area, as today’s release of the 2023-24 rankings by U.S. News & World Report show.

Today’s U.S. News announcement also recognized 11 Tampa General specialties for their strong national reputation and performance, including six in the nation’s top 50 and three in the top 20. Many of the 11 specialties are led or co-led by USF Health faculty physicians.

“Tampa General’s strong showing in this year’s rankings is a testament to the compassionate care and clinical expertise of our primary teaching partner,” said Dr. Charles J. Lockwood, executive vice president of USF Health and dean of USF Health Morsani College of Medicine.

“I’m so proud of our physicians and the leadership they have provided in propelling so many specialties to be among the best in the nation. These rankings translate into saving patients’ lives across Tampa Bay and beyond.”

Dr. Lockwood is also the executive vice president and chief academic officer of Tampa General Hospital.

The six specialties ranked among the top 50 in the nation are:

• Obstetrics and Gynecology – ranked #9 in the U.S. and #1 in Florida
• Gastroenterology and GI Surgery – ranked #19 in the U.S. and #1 in Florida
• Diabetes & Endocrinology – ranked #18 in the U.S. and #2 in Florida
• Ear, Nose & Throat – ranked #39 in the U.S. and #2 in Florida
• Orthopedics – ranked #30 in the U.S. and #2 in Florida
• Urology – ranked #49 in the U.S. and #2 in Florida

In addition, five more specialties were recognized as “high performing” and among the top 10% in the nation:

• Cancer
• Cardiology & Heart Surgery
• Geriatrics
• Neurology & Neurosurgery
• Pulmonology & Lung Surgery

Give credit to your dad’s gene for keeping you safe during those long months in your mother’s womb.

Because without this genetic warrior, you might have succumbed to any number of viral infections that otherwise could be fatal to a fetus. A new paper published this week in the journal Cell Host & Microbe explains the mechanisms behind this anti-viral protection.

Hana Totary-Jain, PhD, associate professor of Molecular Pharmacology and Physiology and Heart Institute at the USF Health Morsani College of Medicine

“What’s unique about this gene is how it produces a form of defense for the baby in the womb,’’ said Hana Totary-Jain, PhD., associate professor of Molecular Pharmacology and Physiology and Heart Institute at the USF Health Morsani College of Medicine and senior author of the paper.

Their research focused on viruses that affect a pregnant mother and consequently her fetus, which are highly vulnerable to infection because their immune systems are immature. Some viruses, including Zika, rubella, and other serious infections, are rarely transmitted from mother to fetus in utero and can cause devastating consequences.

But the biological processes that protect a fetus from most viral infections are less clear. In the new paper, titled “SINE RNA of the imprinted miRNA clusters mediates constitutive type III interferon expression and antiviral protection in hemochorial placentas,’’ Dr. Totary-Jain and her team describe how a certain gene in the placenta is always armed for the battle.

“The placenta, in human and in mouse, is the first organ the fetus develops, and it is constantly exposed to maternal blood. This increases the chances of transmitting viral infections from the mother to the fetus. Therefore, the placenta has evolved robust defense mechanisms to prevent this transmission. We discovered a gene in the placenta that is expressed only from the paternal allele and produces a viral mimicry response. It tricks the placenta into thinking it’s infected and induces a constant state of antiviral defense”, Dr. Totary-Jain explained.

“So when we turned on this gene in other cells, we could protect the cells from several viruses. This is evolution’s way of protecting the baby. Without it, chances are you wouldn’t have made it into childbirth.’’

Ishani Wickramage, a PhD candidate in Dr. Totary-Jain’s laboratory and a lead author of the study added: “This research fills the gap in our knowledge about how many viruses that may infect a pregnant mother, including SARS-CoV-2, only rarely affect the fetus.’’

“Learning more about how the placenta shields the fetus from viruses also has important implications beyond childbirth,” said Dr. Charles Lockwood, MD, MHCM, one of the paper’s authors, who also is dean of the Morsani College of Medicine and executive vice president of USF Health.

“This is a novel placental mechanism that protects the developing fetus from transplacental transmission of most viruses,” Dr. Lockwood said. “This is the kind of knowledge that could lead to the development of new anti-viral medications to fight viruses that can be deadly for fetuses and newborn babies.”

This work was supported by a grant from the National Institutes of Health. Dr. Totary-Jain and a team of researchers at USF spent five years investigating this intriguing phenomenon in collaboration with Dr. Thomas Tuschl’s lab at Rockefeller University, who performed the sRNAseq and bioinformatic analysis, including researcher Klaas Max and Kemel Akat; and Drs. Kimiko Inoue and Atsuo Ogura from RIKEN and University of Tsukuba, Japan, who provided the mouse model that was used to show that the mouse placenta also developed the same mechanism to protect the fetus from viral infections.

Other USF Health members of the research team are: Jeffrey VanWye; John H. Lockhart; Ismet Hortu; Ezinne F. Mong; John Canfield; Hiran M. Lamabadu Warnakulasuriya Patabendige; Ozlem Guzeloglu-Kayisli; and Umit A. Kayisli.

— Story by Kurt Loft for USF Health News

Tossing and turning all night is enough to make you feel tired and cranky the next day – but USF Health researchers say sleep deprivation creates additional problems for your gut, immune, and heart health. Especially when combined with a high-fat diet, lack of sleep may trigger low-grade chronic inflammation that could lead to heart disease.

How’s that for a worry to keep you up at night?

In a new paper published in April in The FASEB Journal, the journal of the Federation of American Societies for Experimental Biology. a team of USF Health researchers address not only the relationship between diet and sleep, but the effect on the body’s defense system, including immune health and the microbiome.

The microbiome is made up of the bacteria, viruses and other microorganisms in the gut. Scientists are just beginning to realize that the makeup of the microbiome – whether it contains “good” or “bad” bacteria and other organisms – is greatly influenced by diet and has far broader impacts on human health than previously realized.

“The combination of a high-fat diet and sleep deprivation messes up the immune system,’’ said Ganesh Halade, Ph.D., lead author of the paper and an associate professor at the USF Health Heart Institute. “And when we review the status of the microbiome, then we have a better understanding of the root cause of chronic inflammation that can fuel cardiac failure.’’

Dr. Ganesh Halade

Researchers also studied the lipidome, which is the fats, oils, and their molecules inside the body.

It is well-known that a lipid-dense diet can lead to weight gain and low-grade chronic inflammation. But sleep also is key, being fundamental to heart health and fitness of the immune system. Because more and more people with “sleep fragmentation’’ are facing cardiovascular and cardiometabolic issues including obesity and diabetes, their condition has become a serious medical issue, the researchers report.

“Diet, sleep, and exercise – It’s all related, fundamental, and integrative,’’ Dr. Halade said. “If diet and sleep aren’t in balance, then you invite the array of diseases.  Low-grade chronic inflammation is a by product of imbalanced lifestyle. We know a lot about eating habits, but the real question we need to know more about is the interaction of sleep with diet and effect on immune and heart health.’’

This question has become increasingly important, given that the COVID-19 pandemic, working from home and long hours in front of computer screens have changed the way millions of people sleep. This has led to “a metabolic public health problem’’ due to the disruption of circadian cycles.

Heart disease has been the No. 1 cause of death in the United States every year since 1950.

Other USF Health researchers who worked on this study were: Yusuf Mat, MD, biological scientist; Shalini Jain, PhD, assistant professor, Department of Neurosurgery and Brain Repair; Hariom Yadav, PhD, associate professor, Internal Medicine and Neurosurgery and director of the USF Center for Microbiome Research; and Vasundhara Kain, PhD, senior researcher.

In their study, the researchers used male mice in randomized groups, with one group consuming a fat-rich diet and experiencing interrupted sleep patterns. Researchers measured the microbiome and lipidome in obese, sleep-deprived mice and analyzed gut germs and lipids. To determine the importance of sleep in the context of obesity, mice ate types of fat present in ultra-processed food products and then stayed awake before experiencing cardiac episodes.

Previous reports from Dr. Halade’s lab confirmed that omega-3 fats (fish oil-derived molecules) helped repair the heart in healthy mice after heart attack injuries, with the immune cells of the spleen, molecules called resolution mediators, making the repairs.  However, production of these molecules failed in the spleens of obese and sleep-deprived mice, and heart repair thus failed.  Furthermore, the researchers noted, omega-6 fats present in processed and packaged food products deplete omega-3 fatty acids in plasma and the heart, which causes low-grade chronic inflammation.

Dr. Halade and the team concluded that obesity and poor sleep patterns can lead to immune suppression and limits the body’s ability to repair a heart under stress or injury because prolonged chronic inflammation interferes with immune host defenses.

Dr. Halade is a cardiovascular research scientist working to better understand how inflammation and immune responsive metabolic dysregulation contributes to ischemic and non-ischemic heart failure. At the USF Health Heart Institute, he collaborates with other researchers, including Drs. Siddabasave Gowda B. Gowda and Shu-Ping Hui from Hokkaido University in Japan, on therapies and potential cures for people with heart problems.

— Story by Kurt Loft for USF Health News 

The Taneja College of Pharmacy has enhanced its foundational, didactic, and experiential curriculum to accommodate the diversity of students entering pharmacy school, many with diverse backgrounds in study, work, and life experiences. The curriculum includes components that allow students to pursue their passions, become workforce-ready, and pursue nontraditional pharmacy career paths.

As the USF Health Taneja College of Pharmacy’s (TCOP) new 30,000-square-foot home in downtown Tampa continues to progress, plans include a Maker Space/Creativity Lounge, a space that will connect students, faculty, and staff with leaders and innovators to promote creativity as part of professional development.

“The key to this vision is the ITEHC Academy (Innovation, Technology, and Entrepreneurship in Healthcare). What originally started as a student-developed organization has grown to become the foundation for initiatives focused on advancing our student’s creativity, innovative and disruptive mindsets. It is now the pinnacle of the pillars and strategic plan of the USF Health Taneja College of Pharmacy,” said Kevin M. Olson, MBA, PharmD, CPh, assistant professor at the USF Health Taneja College of Pharmacy and director of the ITEHC Academy.

To help elevate and advance pharmaceutical education further, the new space will include virtual and augmented reality, a multitaction video wall, CAD drawing software, 3D printing, and holographic technology.

The space will allow various student groups, such as ITEHC, to develop innovative ideas and prototypes for health-related devices.

“Envision a space where students, faculty, staff, and community partners can come together and collaborate, a space where they can discover new ways of creating value that will advance pharmacy practice, differentiate pharmacist career opportunities, and reshape the future of pharmacy and health care,” Dr. Olson said.

Story and video by Ryan Rossy, USF Health Communications and Marketing

Rendering of the Student Commons outside the Creativity Lounge.

Rendering of the Creativity Lounge.

It is a part of the heart that most people have never pondered, let alone heard of, in their lives. But the left atrial appendage – a physical trait that all humans share – is worth knowing about because it is involved in the vast majority of strokes. Now, a prestigious new grant obtained by a team from the USF Health Morsani College of Medicine and Tampa General Hospital could significantly enhance preventive treatments.

Thanks to the innovative work of Dr. Hiram Bezerra, professor at the USF Health Morsani College of Medicine and director of the TGH Interventional Cardiology Center of Excellence, the $460,000 grant could lead to key improvements of an existing procedure to block the opening to the left atrial appendage (LAA) in certain patients who are at high risk for stroke. And it ultimately could deliver safer, faster, and more effective results for patients.

This marks the first time a National Institutes of Health R01 grant – designed to support advanced, hypothesis-driven research projects with strong preliminary data – has been awarded to USF Health’s Division of Cardiology Sciences in the Morsani College of Medicine.

“I think this is reflective of the journey we are on to become a national presence in the forefront of cardiology,” said Dr. Guilherme Oliveira, chief of the division and Ed C. Wright Professor and Chair of Cardiovascular Research, as well as co-director of the USF Heart Institute for Research. Dr. Oliveira also is vice president and chief of the Tampa General Hospital Heart & Vascular Institute.

“This has never been done here before – the ability to get an R01 grant for our division that basically is developing a new technology – with potential clinical applications going all the way from basic pre-clinical engineering of an innovation and taking it all the way to the bedside,” said Dr. Oliveira. “And I think it’s very telling of where we are with the type of talent we’ve been able to attract to USF and Tampa General.”

In this case, the grant, three years in the works, will allow Dr. Bezerra and his team to produce a better, more streamlined approach for dealing with the left atrial appendage – an area in the heart’s left atrium akin to a little pocket. While the structure may help lower pressure in the atrium, it also is possible for blood to pool there in patients with atrial fibrillation, a type of irregular heartbeat, and raises the risk of a clot that could travel to the brain.

“The actual magical aspect of it, and what we are trying to achieve, is a therapy that is offered for stroke prevention,” said Dr. Bezerra. “More than 90 percent of strokes originate from the left atrial appendage chamber. And by occluding the left atrial appendage, you will prevent a stroke in a population prone to have one – the atrial fibrillation, or AFib, population.”

Those suffering from AFib experience an array of symptoms that include an irregular heartbeat, a racing heart, shortness of breath, fatigue and chest pain. People with the condition are some five times more likely to suffer a stroke than those without it – with some 12 million in the U.S. estimated to have AFib by 2030.

“The patients we are targeting have AFib and for some reasons are not a good candidate for the standard preventive therapy of blood thinners,” Dr. Bezerra added. “The next treatment in line is occluding the left atrial appendage. And we are talking about hundreds of thousands of patients in the United States.”

The primary device in the U.S. used to block the left atrial appendage is called the Watchman, manufactured by Boston Scientific, with some doctors employing the Amplatzer Amulet heart device from Abbott. In the current protocol, a patient typically receives a transesophageal echocardiogram two weeks ahead of the procedure to examine the structure and functioning of the heart and evaluate the size of the appendage.

This allows doctors to plan the procedure and select the device. Patients commonly receive general anesthesia for the procedure, which again involves a transesophageal echocardiogram as a real-time guide. In most cases, patients return home the next day.

“But we are pushing to implement a workflow that is less resource intense, and that we believe is actually safer to do,” Bezerra said.

The grant proposed that patients will not have to undergo general anesthesia for the procedure, and a single cardiac MRI would be employed, allowing a patient to just come in once and not have to undergo a separate pre-imaging appointment. The scanner on the day of the procedure would perform the sizing to determine the best device to use. And it would also allow for improved visibility in real-time guidance during the procedure – providing live, higher-resolution images than the current method affords.

“It will all be done with a single modality,” Dr. Bezerra explained. “In addition, the patient is awake. There is no additional cost of the intracardiac echo, or the inconvenience of general anesthesia. And it increases the chances of a patient to go home the same day.”

Dr. Bezerra wrote the grant to be tied specifically to the Watchman because it is more frequently used. But ultimately, replicating the procedure on a different device would not be difficult to achieve. The grant includes a pre-clinical stage at Cleveland’s Case Western University followed by a clinical phase at USF Health and Tampa General. He estimates that it could be available for use on USF Health patients at TGH in three years.

“The plan is for me now to make a few trips to Cleveland, when it’s time for the animal experiments and to help facilitate that,” Dr. Bezerra said. “The next step will be testing for MRI compatibility and starting basic engineering work. A lot of bench and pre-clinical work still needs to take place before we can offer it to patients.”

Dr. Oliveira put it in perspective: “This is the holy grail of grants – where you go, as I said, from a bench concept and have a grant that will support the development of that product all the way to the bedside. It is not easy to do outside of the industry.”

The research also will be a natural fit for work that other physicians, such as Dr. Bibhu Mohanty, already are doing at USF and TGH to advance stroke care, Dr. Bezerra said. Dr. Mohanty, an associate professor in Internal Medicine at the College of Medicine, is an interventional cardiology specialist.

“This grant will complement our very active multidisciplinary neurocardiac program led by Dr. Mohanty in close collaboration with Neurology and Electrophysiology,” Dr. Bezerra said. “With the addition of this translation grant, USF/TGH will continue to be on the very cutting edge of stroke prevention.”

Story by Dave Scheiber for USF Health News.

The USF Health Morsani College of Medicine Academy of Distinguished Educators class of 2022 (Left to right): Eduardo Gonzalez, MD, FAAFP; Andreas Seyfang, PhD; John Armstrong, MD, FACS; Marzenna Wiranowska, PhD, MS; Susan Pross, PhD.

The USF Health Morsani College of Medicine (MCOM) recently celebrated the newest members of the Academy of Distinguished Educators during a small induction ceremony Sept. 20.

Class of 2022 Inductees:

• John Armstrong, MD
• Eduardo Gonzalez, MD, FAAFP
• Susan Pross, PhD
• Andreas Seyfang, PhD
• Marzenna Wiranowska, PhD, MS

“To us falls the high privilege and great responsibility of training the generation of doctors.  If we fail to do our job to perfection, people die needlessly.  Too often this simple truth is forgotten, but each of you never forget.” said Charles J. Lockwood, MD, MHCM, USF Health executive vice president and MCOM dean. All of you are a testament to why MCOM continues to thrive and why our reputation across the nation continues to rise.”

The program was developed as a collaborative effort by MCOM’s Department of Medical Education, Faculty Council, and Office of Faculty Affairs to enhance the practice, quality and scholarship of teaching and learning at the medical school through educational service, consultation and research.   The program honors exemplary educators of all medical students, physicians, physician assistants, physical therapists, athletic trainers and scientists within the faculty by awarding the prestigious title of Distinguished Educator.

Nominees must hold an active appointment at MCOM for at least two years and hold the minimum title of associate professor.  Nominees must have made exceptional contributions to the education mission in one or more of the following ways:

• Research in education.
• Innovations and scholarly approaches in curriculum development, instructional design, or assessment of student learning.
• Mentoring and development of faculty as educators or educational researchers.
• Individual learner mentoring and development.
• Leadership in education.

About the Inductees:

John Armstrong, MD, FACS.

John Armstrong, MD, FACS  is a nationally recognized surgeon and USF Health professor who has held multiple positions within USF Health and the Florida government.  He served as chief medical officer of the Center for Advanced Medical Learning and Simulation (CAMLS), surgical director of the USF Health American Colleges of Surgeons Accredited Education Institute and professor in the MCOM Department of Surgery.  He also served as Surgeon General and Secretary of Health under former Governor Rick Scott from 2012 to 2016.

Eduardo Gonzalez, MD, FAAFP.

Eduardo Gonzalez MD, FAAFP, joined USF Health in 1994.  He  serves as a professor and director in the MCOM Department of Family Medicine, professor in the Taneja College of Pharmacy Department of Pharmacy Practice.  He is co-medical director of the USF Health BRIDGE Clinic, a free student-run clinic that serves uninsured adults from underserved communities.  In 2019, Dr. Gonzalez was named Physician of the Year by the American Academy of Family Physicians.  He is also a two-time USF alum having completed his undergraduate degree in 1987, and medical school in 1991.

Susan Pross, PhD.

Susan Pross, PhD has been part of the Morsani College of Medicine since 1975.  She is a professor in the MCOM Department of Molecular Medicine and director of the MCOM Office of Research Innovation and Scholar Endeavors Scholarly Concentrations Program, where she helps to develop and assess elective opportunities for student scholarship.   She is a trained immunologist and microbiologist  with research interests in allergy, immunology, and infectious disease.

Andreas Seyfang, PhD.

Andreas Seyfang, PhD is an expert in medical microbiology and parasitology.  He holds several professor positions throughout the USF Health colleges to include the Morsani College of Medicine, College of Public Health and School of Physical Therapy and Rehabilitation Sciences.  He’s earned multiple outstanding instructor and teaching awards that are voted on by students.  He is the director of the Seyfang laboratory that focuses on membrane permeases as target for drug delivery, and cytochrome b5 reductase as enzymatic drug target in opportunistic microbial pathogens including protozoan parasites and nosocomial and neuro-pathogenic fungi.

Marzenna Wiranowska, PhD, MS.

Marzenna Wiranowska, PhD, MS is an international expert in microbiology and immunology.  She joined the USF Health staff in 1982 where she started as a research associate in the Immunopharmacology Program at MCOM and currently serves as an associate professor in the Department of Pathology and Cell Biology.  She leads the Medical Humanities elective of the Scholarly Concentrations Program.  Dr. Wiranowska has earned many awards as an educator of medical students including the Most Outstanding Pre-Clinical Professor Award voted on by the MCOM class of 2019.

Story by Freddie Coleman.  Photos by Ryan Rossy

USF Health doctors are among the best and listed as such in the Top Doctor® list by Castle Connolly.

The list, released earlier this year, includes over 400 local physicians among 55 medical specialties – 82 of them are with USF Health.

USF Health Neurologist Dr. Theresa Zesiewicz.

For more than 25 years, Castle Connolly has conducted the survey that provides the Top Doctors list.

The annual survey involves nominations from peer physicians, who are asked “Where would you go if you needed care?” The process is anonymous and confidential, and doctors cannot nominate themselves. The resulting list, based on merit and inclusion cannot be bought, provides a collection of trusted resources for quality health care.

On this year’s list, 82 physicians on the list are with USF Health. The following list is of USF Health faculty physicians currently practicing medicine within nearly three dozen clinical sites, specialty care centers and affiliated hospitals throughout the region.

Allergy & Immunulogy
Mark C Glaum, MD, PhD
Richard F Lockey, MD
Mandel R Sher, MD
Jolan E Walter, MD/PhD

Cardiac Electrophysiology
Bengt Herweg, MD

Child Neurology
Sagarika Nallu, MD

Colon & Rectal Surgery
Jorge E Marcet, MD
Jaime E Sanchez, MD

Dermatology
Basil S Cherpelis, MD
Nishit S Patel, MD

Endocrinology, Diabetes & Metabolism
Madeline Candelario-Cosme, MD
Yevgeniya Kushchayeva, MD

Family Medicine
Eric E Coris, MD
Eduardo C Gonzalez, MD
Kira K Zwygart, MD

Gasterenterology
Patrick G Brady, MD
John W Jacobs Jr, MD
Jay J Mamel, MD
Joel E Richter, MD
Pushpak Taunk, MD

Gynecology Oncology
Diana Peta-Gay English, MD
Thomas J Rutherford, MD, PhD

Infectious Disease
Sally Fathi Alrabaa, MD
Beata C Casanas, DO
Ambika Eranki, MD
Charurut Somboonwit, MD

Internal Medicine
Nathan A Brinn, MD
Denise K Edwards, MD
Lucy Guerra, MD
John D McCormick, MD
Hugo J Narvarte, MD
Kevin E O’Brien, MD

Interventional Cardiology
Fadi Matar, MD

Maternal & Fetal Medicine
Jan M Lanouette, MD
Charles J Lockwood, MD
Judette M Louis, MD
Stephanie Teresa Ros, MD

Neurological Surgery
Thomas B Freeman, MD
Donald A Smith, MD
Harry R Van Loveren, MD

Neurology
William Scott Burgin, MD
Rossitza I Chichkova, MD
Clifton Gooch, MD
Robert A Hauser, MD
Juan R Sanchez-Ramos, MD
Tuan H Vu, MD
Theresa A Zesiewicz, MD

Obstetrics & Gynecology
Shelly W Holmstrom, MD
Catherine M Lynch, MD
Dawn Palaszewski, MD
Odalis Sijin, MD

Ophthalmology
Ramesh S Ayyala, MD
Mitchell Drucker, MD
Lewis Groden, MD

Orthopaedic Surgery
Roy W Sanders, MD

Otolaryngology
Mark H Tabor, MD

Pediatric Endocrinology
Ellen Verena Jorgensen, MD
Henry Rodriguez, MD
Dorothy Shulman, MD

Pediatric Infectious Disease
Carina A Rodriguez, MD

Pediatric Nephrology
Valerie M Panzarino MD

Pediatrics
Sharon Dabrow, MD
Carol M Lilly, MD
Jennifer C Takagishi, MD

Physical Medicine & Rehabilitation
Naomi A Abel, MD

Plastic Surgery
C. Wayne Cruse, MD
Michael Harrington, MD
Nicholas J Panetta, MD
David J Smith Jr, MD
Paul D Smith, MD

Psychiatry
Jean Fils, MD
Amanda G Smith, MD

Pulmonary Disease
Kapilkumar N Patel, MD
Ricardo Restrepo-Jaramillo, MD

Rheumatology
John D Carter, MD

Surgery
Michael H Albrink, MD
Christopher G DuCoin, MD
Paul C Kuo, MD

Urology
David J Hernandez, MD

Vascular Surgery
Murray L Shames, MD

Colon & Rectal Surgery
Robert D Bennett, MD

Urology
Kevin Heinsimer, MD

USF Health microbiome expert Hariom Yadav, PhD, has received a grant from the National Institute on Aging to help determine if a common medication can restore microbiome diversity in older patients who have a form of heart failure and, thus, prevent the subsequent problems that tend keep these patients inactive and cause their conditions to worsen.

Hariom Yadav, PhD, was recently recruited to lead the USF Microbiome Research Center and his research focuses on the gut-brain connection (gut-brain axis) in relation to cognitive function.

Dr. Yadav, associate professor in the Division of Digestive Diseases and Nutrition for the Department of Neurosurgery and Brain Repair and Internal Medicine in the USF Health Morsani College of Medicine and director of the USF Center for Microbiome Research in the Microbiomes Institute, is a co-principal investigator and is working with co-principal investigator and project lead Dalane Kitzman, MD, at Wake Forest University in Winston-Salem, North Carolina.

The 3-year NIH consortium project research, which will include patients diagnosed with heart failure with preserved ejection fraction (HFpEF), is titled “Repurposing of Metformin for Older Patients with HFpEF.”

Preclinical studies show that gut barriers, including mucin production, are reduced in older gut and cause ‘leaky gut’, which allows certain antigens to diffuse into blood circulation, thus causing systemic inflammation. Preliminary data also suggest that older HFpEF patients have markedly reduced microbiome diversity, including reduced production of beneficial metabolites such as butyrate, which maintain health and gut wall integrity, and may help reduce leaky gut.

Metformin prescription bottle. Metformin is a generic medication name and label was created by photographer.

Metformin is a generic FDA-approved medication used for diabetes. Earlier studies, including research in Dr. Yadav’s lab, shows that metformin decreases leaky gut by improving microbial diversity and increasing intestinal wall mucin production thereby reducing systemic inflammation and improving physical function in lab model studies.

This new study seeks to translate these findings to determine if metformin improves microbiome diversity, reduces leaky gut, and reduces the inflammation associated with HFpEF in patients, a common condition in older people, particular older women.

“Earlier research suggests that metformin can inhibit a root cause of systemic inflammation – leaky gut – and its adverse consequences which are highly relevant to HFpEF, including exercise intolerance, a known barrier for HFpEF patients for staying active,” Dr. Yadav said. “We propose to test repurposing of metformin, a promising medication for improving heart failure outcomes by improving gut leakiness and microbial diversity, and that metformin will restore gut microbiome diversity and increase gut wall mucin, which in turn will reduce leaky gut and systemic inflammation and improve physical function for HFpEF patients.”

This new study is a randomized, blinded, placebo-controlled trial over 20 weeks in 80 non-diabetic HFpEF patients age 60 and older. The Wake Forest and Atrium Health team will coordinate the patients, measuring physical function, provide a quality of life questionnaire, and collect stool and blood samples. The team in Dr. Yadav’s lab will examine the samples and measure microbiome diversity and the key markers of leaky gut and of inflammation.

This study is supported by the National Institute on Aging of the National Institutes of Health under Award Number U01AG076928.

Dr. Yadav is conducting similar research associated with leaky gut and inflammation, including their connections to Alzheimer’s disease and other related dementias.

The USF Health Morsani College of Medicine is the fastest-rising medical school in the country, climbing over the last decade from #80 to #46 in U.S. News & World Report rankings for medical schools for research.

Based on data from U.S. News & World Report Academic Insights, the Morsani College of Medicine has climbed 34 spots in rankings for 2014 to 2023. No other medical school in the data – public or private – has risen as far in rankings as fast as the Morsani College of Medicine.

In the last decade, the USF Health Morsani College of Medicine has made great strides, pushing metrics upward in the college’s three mission areas — education, research and patient care – in an effort to place the college among the best medical schools in the country.

With improved metrics, the college’s placement in the national rankings soared from No. 80 in the 2014 U.S. News list to No. 46 in the recently published 2023 list – a seismic 34 spots.

No other medical school in the country has experienced that same improvement in rankings, making the USF Health Morsani College of Medicine the fastest-rising medical schools in the country.

“Our sustained rise in national rankings reflects the rapidly increasing strength of our educational, research and clinical missions at the USF Health Morsani College of Medicine. We are now competing with the nation’s most storied and respected programs,” said Dr. Charles Lockwood, senior vice president for USF Health and dean of the USF Health Morsani College of Medicine. “These outstanding metrics also position us to attract the highest caliber students and faculty, further advancing our program into the national spotlight for its outstanding education, exceptional research and world class clinical care.”