UT-Houston Faculty Member Wins National Physician-Scientist Award

From the clinic to the laboratory, Dr. Dianna Milewicz strives to take the mystery out of a class of cardiovascular disorders that, left undetected, launch a swift and lethal surprise attack on their victims.

Dr. Milewicz, who is also professor of medical genetics and an expert in the genetics of cardiovascular disease, is one of seven physician-scientists nationally to receive the 2001 Doris Duke Distinguished Clinical Scientist Award announced last month by the Doris Duke Charitable Foundation in New York.

The award, a national foundation grant to the vice chairman of the internal medicine department at The University of Texas Medical School at Houston, both honors and supports three of Dr. Milewicz’s longstanding professional interests: recognizing disorders of the aorta and preventing their catastrophic development in patients; tracking down the molecular basis for those disorders; and helping other physicians conduct genetic clinical research.

"Dr. Dianna Milewicz is a most fitting recipient of the Doris Duke Distinguished Clinical Scientist Award," UT-Houston Medical School Dean Dr. L. Maximilian Buja said. "Her pioneering research on the genetic basis for the clinical spectrum of Marfan’s disease and other vascular diseases is a model for excellent translational research, taking information from the research laboratory and applying it to the understanding of human disease and the care of patients."

The $1.5 million grant will advance Dr. Milewicz’s research on the genetic basis of disorders of the aorta, the trunk of the network of arteries that carries blood from the heart throughout the body.

Aortic aneurysm, enlargement of the aorta that ultimately ruptures, is the 13th leading cause of death in the United States, killing nearly 15,000 people each year.

"When we identify aortic aneurysms early, they can be monitored, treated with beta blockers, and, finally, repaired surgically. Left untreated, aneurysms can cause premature death," Dr. Milewicz said.

One key to early identification is understanding the genetics involved. Between 10 and 20 percent of patients who die from aortic aneurysm have a genetic predisposition for the disease. Dr. Milewicz has tracked a major genetic culprit to a portion of chromosome 5. In collaboration with colleagues at Cornell University, a second gene has been identified, and her laboratory is actively searching for a third gene. Duke Foundation funds will support work to fully identify the gene on chromosome 5 and define how it works, which will help physicians identify people who are at risk and develop new treatments.

While Dr. Milewicz said she is gratified to receive Duke Foundation support for her research, she said she is equally committed to one of the foundation’s main purposes: encouraging physicians to engage in research. A variety of factors in the last few decades, most of them financial, are steadily reducing the number of doctors who have the time and the funding to conduct research.

"This is important because it’s the physicians who take research back to the patients, back to the bedside," Dr. Milewicz said. "Physicians closely observe the course of a disease and gain insight into such issues as how patients respond to medication. They provide a perspective that even the best-trained Ph.D.s might miss."

Duke Foundation funding will support the core genetics laboratory that the medical school established and Dr. Milewicz leads in the University Clinical Research Center at Memorial Hermann Hospital. Dr. Milewicz also is interim director of the UCRC.

Having a core genetics lab helps junior faculty and fellows pursue genetic research on their patients in the clinic and the hospital. For example, Dr. Milewicz’s lab supports the work of Dr. Frank Laws, a cardiology fellow who is exploring the genetics of restenosis – the re-clogging of a coronary artery after it has been reopened with a stent or other procedure. Assistant Professor of Neurosurgery Dr. Dong Kim is searching for genetic variation connected to cerebral aneurysms, also with Dr. Milewicz’s support.

"The Duke award is also a recognition of the commitment of UT-Houston to fostering the careers of physician-scientists and clinical research," Dr. Buja said.

The medical school in recent years has established a formal mentoring program for junior faculty, and started the Center for Clinical Research and Evidence-Based Medicine. Dr. Jon Tyson, Bain Distinguished Professor of Medicine and Public Health, a national leader in clinical research regarding low-birthweight infants, was hired to lead the center. Dr. Tyson earned National Institutes of Health funding to launch a program with M.D. Anderson that teaches junior faculty how to conduct clinical research.

As director of the M.D./Ph.D. degree program at UT-Houston and The University of Texas M.D. Anderson Cancer Center, Dr. Milewicz leads a program that trains physician-scientists in disease-oriented research. Most other M.D./Ph.D. programs instead nurture "basic scientists who happen to be physicians," she said.

Dr. Milewicz notes that women still lag behind their male colleagues in obtaining research grants, tenure, promotion and leadership positions in academic medicine, despite their increased presence among medical school classes since the 1980s. This disparity will be yet another focus of her Duke Foundation support.

"Women continue to have problems advancing in academic medicine," she said. "I want to look at establishing some intense mentoring for women faculty, particularly new assistant professors."

The Duke award is the latest in a series of honors for Dr. Milewicz, including the March of Dimes Basil O’Conner Award, the American Heart Association Established Investigator Award, the 1999 Antoine Marfan Award from the National Marfan Foundation, and membership in the American Society of Clinical Investigation.

Established in 1999, the Doris Duke Foundation Distinguished Clinical Scientist Award goes to physician-scientists who demonstrate excellence in clinical research, professional leadership, and a commitment to research combating human disease. Nonprofit medical institutions nationwide are invited to submit two applicants in two of the four disease areas awarded: cancer, AIDS, cardiovascular disease and blood disorders.

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