Research
- Research Faculty
- Boss Lab
- Golomb Lab
- Research Committee
- Mini Grants
I have combined primary care internal medicine with basic laboratory research throughout my career. Although to many physicians this may seem a strange combination, the two areas of work complement each other well. Laboratory work is characterized by delayed gratification, sometimes delayed to the point of wanting to give up, whereas primary care can provide an immediate sense of fulfillment, even though of course many frustrations can arise in delivering high-quality care. Moreover, basic science research should not be the purview of only subspecialists; there is no reason why primary care physicians should not be able to pursue basic laboratory work. It should also be noted that basic science transcends medical specialties and one does not have to be a cardiologist or nephrologist to study signal transduction pathways in cardiomyocytes or renal tubular epithelial cells.
I have worked in different areas from the regulation of carbon flow through the folate pathway to Ras/MAP kinase signaling. I currently have two major research activities. The first is developing the vitamin B12 analog cobinamide as a new therapy for poisoning by multiple toxic chemicals as well as radiation-induced cell damage. Cobinamide has a very high affinity for cyanide and free radicals, and acts as a scavenger of these toxic chemicals. Much of the detrimental effects of radiation are mediated via free radicals. As a vitamin B12 analog, cobinamide is relatively non-toxic, and we have had several pre-Investigators New Drug (IND) meetings with the Food and Drug Administration. We hope to be in clinical trials sometime in 2023.
The second major area of research is studying the regulation of purine nucleotide synthesis by amino acid availability and the phosphatidylinositol 3-kinase/Akt pathway. We have found that amino acids are potent regulators of purine nucleotide synthesis and that Akt phosphorylates transketolase, a key enzyme in the non-oxidative pentose phosphate pathway that supplies ribose sugars for purine synthesis. As part of these studies, the lab has found that purine synthesis is regulated during the cell cycle. This work could lead to novel forms of cancer treatment since purines are required for DNA and RNA synthesis and cellular metabolism.
In my laboratory, there are currently two Project Scientists, two post-doctoral fellows, one graduate student, and two research technicians. In addition, I collaborate closely with another physician-scientist faculty member.
Dr. Chao is interested in applying design thinking to help patients living with diabetes enhance engagement, and thus improve clinical outcomes and quality of life. He leads a study in collaboration with the UCSD Diabetes Design Initiative to refine the onboarding process for those new to using continuous glucose monitors (CGM).
He also serves as the Principal Investigator of clinical trials of new, wearable glucose sensors developed by UCSD Nanoengineer Joseph Wang, DSc and his team. Dr. Chao received funding from an ACTRI Pilot Project grant (NIH CTSA grant: University of California San Diego, NIH Grant UL1TR001442), and two Faculty Development Awards from the UCSD Academy of Clinician Scholars.
Dr. Charat's scholarly interests are in the areas of medical education and in the treatment of chronic pain, opioid use disorder (OUD), and complex persistent opioids dependence within the primary care setting.
In the area of medical education, she has leadership roles in local, regional, and national committees focused on the assessment of clinical skills, particularly through Observed Structured Clinical Examinations (OSCEs.) She is serving as the Chair of the California Consortium for the Assessment of Clinical Competence where she assisted with the implementation of new standard setting protocols for the state-wide OSCE exam. She has also examined clinical assessment in graduate medical education, primary care education curricular development, and resident panel transitions in the continuity clinic setting.
In the area of opioid safety and pain control, she was a co-principle investigator on a grant from the California Association of Family Physicians to promote increased access to care for patients with OUD and increase education for resident learners. She is currently a VA Primary Care Pain Champion, leads the VA San Diego OUD Task Force, and is participating in a regional quality improvement project to improve metrics related to prescribing medications to treat OUD. She is also co-managing a grant from the Veteran's Health Administration Addiction Scholars Program to provide integrated pain management and harm reduction for patients with complex chronic pain, OUD, and complex persistent opioid dependence.
Dr. Golomb's laboratory focuses on intertwined themes: 1. The role of free radicals ("oxidative stress"—i.e. the damage that antioxidants protect against), and cell energy impairment in health, illness, aging, and disease. 2. Areas of interest encompass Gulf War illness and other chronic multi-symptom illnesses (like Chronic Fatigue syndrome); drugs and exposures that mediate harms from these mechanisms (such as statins, fluoroquinolones, pesticides, trans fats, and radiation including non-ionizing radiation); and potentially favorable substances like vitamin D, omega-3s, coenzyme Q10, and chocolate. These mechanisms are also germane to autism, obesity and metabolic syndrome, and neurodegenerative conditions like Lou Gehrig's disease and Parkinson's disease, among other conditions.
A further focus is on research methodology including placebos, “effect modification,” conflict of interest and risk/benefit balance. It is vital to ensure that risks, as well as benefits, are considered for drugs and exposures, particularly for preventive interventions (Studies are typically designed to optimize benefit detection – and for reasons of human subjects protections and cost efficiency, may relatively obviate detection of harm.). Dr. Golomb was the first to propose and defend in the peer-reviewed literature the now leading hypothesis for so-called “Havana Syndrome,” that it is due to pulsed radiofrequency radiation
Dr. Grunvald's research interests focus on many aspects of obesity medicine, ranging from education to bariatric surgery. He has served on the Obesity Medicine Education Collaborative, a national multi-society initiative for developing obesity medicine competencies to guide curricula across US medical schools and training programs. Dr. Grunvald is a principal investigator and collaborator on several projects evaluating predictors and outcomes after bariatric surgery. He also has projects evaluating anti-obesity pharmacotherapy in real-world clinical settings, reducing anti-obesity bias in medical students and residents, and improvement in comorbidities after bariatric surgery. He has partnered with the industry for developing a point-of-care device for the diagnosis of fatty liver disease in clinical settings. Dr. Grunvald is the principal investigator for industry sponsored development of anti-obesity drugs. He is also involved in developing clinical practice guidelines for the use of anti-obesity medications.
Dr. Hose's scholarly focus is on medical education research in the field of musculoskeletal care. Dr. Hose and Dr. Anna Quan of the VA created a YouTube channel with teaching videos on knee and shoulder physical exams titled: "Sdmskproject,".
Dr. Hose is currently working with Dr. Monica Guma from the Department of Rheumatology on several studies. These studies will establish the effectiveness of knee OA rehabilitation of a novel and practical anti-inflammatory diet intervention and set the stage for establishing the scientific basis and biomarkers for most effectively using the diet to improve functional and structural outcomes in OA.
Dr. Sitapati is the Chief Medical Information Officer of Population Health at UC San Diego Health with responsibilities for oversight of more than 150 active EMR based registries, self-service analytics, and predictive analytics. She also has oversight of quality incentive programs including CMS related QIP, AMP, and MSSP ACO. Her research interests include UCSD NIH All of Us, California Integrated Vital Records System, health disparities, digital health and population health. She has interests in integrative care and has been teaching Kelee Meditation in Medicine in the School of Medicine for more than seven years. She is a practicing primary care internist with expertise in HIV care and LGBTQ+ care. She shares dual appointments in the UCSD Division of Biomedical Informatics as well as Division of General Internal Medicine. Her biomedical engineering and medical degrees are from Case Western Reserve University. She has also completed additional training in business administration, clinical research, and lean.
Dr. Wong's scholarly focus is on the Impact of patient generated health data via wearable technology on patient engagement and health outcomes.