ICE/ENDO 2014 Day 1: Shock and Awe

A very long and fun day 1 is in the books for ICE/ENDO 2014. Here’s a sampling of what I learned and experienced:

The plenary session started with a “Year in Review” for the Endocrine Society from Society President Teresa Woodruff. I loved her analogy of the Society as the endocrine system. The idea that an organization needs to be able to respond to changes in their environment to maintain “homeostasis”, or stay on course for their goals, is something universal that any group or company should take into consideration. I find things always make more sense when explained to me in my language, so this analogy made perfect sense. Verbatim it may not resonate as well at IBM or Google, but the idea is cool. I was especially impressed with Dr. Woodruff’s explanation of the new logo. I hadn’t realized how much thought went into the logo design. I just thought it looked sharp, but it actually is both stylish and functional. I hope they put the full description of the planning of the new logo somewhere on the website so people who are interested can learn more about it.

After Dr. Woodruff we heard from Dr. Robert Lefkowitz, Nobel laureate and and giant in the field of G protein coupled receptors. I heard him speak at EB last year and I was excited to hear him speak again. I was not disappointed. I’m not sure the clinicians were able to appreciate the basic science as much as I did (disclaimer: I study a GPCR in my lab, the human FSH receptor) but I thought he put into context the importance of studying the basic science to develop new therapeutic interventions. This is a message I try to give my students every chance I get, so I was glad to hear Dr. Lefkowitz sharing the same ideas. Among the most amazing parts of the talk was the negative stain electron microscopy imaging of arrestin with the beta 2 adrenergic receptor. The levels of detail they were able to get with EM was amazing, and combined with known information about the crystal structures of the individual proteins, they were able to build “low” resolution (28-30 Angstroms, low resolution in the world of structural biology, but unbelievably high for the rest of the world) structural models of the receptor docked with arrestin. I came away with a new appreciation of the relative sizes of the receptor and arrestin- the way the cartoons are traditionally drawn it looks like the receptors are so much bigger than arrestin, but in reality you can see how arrestin docking blocks g protein reassociation when viewed in context.

The follow up to Dr. Lefkowitz was Dr. C. Ronald Kahn, who spoke about an example of the other major class of membrane hormone receptors, the tyrosine kinase receptors, using the insulin receptor as a model. I was amazed when he described how 3 steps- receptor, phosphotidylinositol-3-kinase, and target kinase AKT, there are 1800 possible combinations. Because there are so many forms of PI3K and AKT there are a lot of options and possibilities. This echoed another point that I often make to my students: the complexity of receptor signaling makes it so that every time you think you know what is going on, there are new levels of complexity to understand. The other complicating factor that I learned about in this talk: glyppican 4, an insulin receptor interacting protein that modulates insulin receptor function. Now its not just the receptor and the intracellular targets, but other factors influence function as well. I was particularly intrigued by this because glypican 4 was found to be low in visceral fat and high in subcutaneous fat and as patient BMI increased and insulin sensitivity decreased, so did the level of glypican 4 in the subcutaneous fat. My first thought: does cortisol regulate it? I have always been fascinated by the role of cortisol in insulin sensitivity of adipose tissue; the possibility that either GPC4 increases 11 beta-hydroxysteroid dehydrogenase, leading to increased cortisol and lower insulin sensitivity or increased 11 beta-HSD increases local cortisol and downregulates GPC4 leading to decreased insulin sensitivity is very cool.

The hardest part of a meeting like this is choosing where to go during the many fascinating conflicting sessions. I chose fertility preservation cancer treatment because it touched on 2 classes I teach: Endocrinology (BIO370) and Understanding Cancer (BIO094). The first talk from Dr. Karla Hutt was a fascinating look at the mechanisms that regulate apoptosis in primordial follicles in response to radiation and chemotherapy. It will be a great day when women don’t have to choose between the best courses of treatment and potentially sacrificing their future plans for a family. Dr. Hutt’s research focused on p63 as a regulator of apoptosis and identifying the proteins that regulate p63 activation. One topic that was particularly interesting to me was the idea of ovarian “burnout” where the loss of the mature follicles causes loss of repression and overrecruitment of primordial follicles. Although Dr. Hutt commented that only a few follicles were required to maintain fertility, I wonder if some kind of secondary intervention to suppress recruitment will be needed to compliment the antiapoptotic approaches.

I made the poor decision then to try to book it across the convention center to get to Dr. Ricardo Azziz’s presentation on adipose tissue dysfunction in PCOS. I missed the beginning, but I did learn that I need to revisit my understanding of the relationship between PCOS and BMI- Dr. Azziz showed pretty convincingly the lack of association between the 2, which is the opposite of my understanding before this talk.

Suddenly it was time to hit the Endo EXPO, always a highlight! Collecting swag is part mission, part sport and my student who is here with me (more on Jordan later) took to it with zeal. Of course I always feel the need to chat with the exhibitors as I am taking their pens, magnets, literature, food, etc which slows me down, but I made it all the way through. I am planning to revisit everyone today. One of the coolest exhibits was Biospace and their InBody instrument. I really liked getting the report, especially because of my weight loss in the last year (more on that later).

Suddenly, it was time to man my research poster. The downside to the EXPO is that I got sucked in and missed a few sessions, but the EXPO was also a chance to learn, so I think it was okay. I had a poster (SAT-007) with my student Jordan Pereira ’14. As an educator, there is something really satisfying about seeing your student present their research and Jordan handled it like a pro. Even though he is (was? he graduated last Sunday) an undergraduate, Jordan demonstrated great poise and confidence explaining our research to people who visited our poster. It gave me a chance to visit some posters and colleagues. One of the things that I love is meeting people whose papers I have been reading for years but never had a chance to talk to, although it is a little intimidating for me. It’s also a chance to find people I might be able to bring to campus to share their research. I’m looking forward to inviting Patty Hinkle (University of Rochester) to come talk and also Dan Castracane (Texas Tech University). I had met Dan before as he was a friend of a former Union College colleague, George Butterstein. It was great to catch up with Dan and I am looking forward to having him come to Union soon as well.

After posters, it was off to meet the professor sessions. Again, the choices were overwhelming, but I went with ones near and dear to me. The first, on complications following bariatric surgery was purely selfish: I am 1 year post op from my own RNY gastric bypass. Dr. Caroline Apovian described both the effectiveness of various bariatric procedures and the possible short term and long term complications. Fortunately, I have had nothing but success so far, but I can see where patient compliance plays a large role in success of the procedures. One of the big takeaways for me from a teaching stand point is the endocrine effects of some of the surgeries. I did manage to incorporate some of that into my lectures this year, but I should definitely beef that up for next year.

The second meet the professor I went to was Dr. Andre Lacroix talking about bilateral macronodular adrenal hyperplasia. Again this had a personal tie for me- my mother had Cushing’s Syndrome. Cushing’s and the effects of cortisol were my fist true loves in science and Dr. Lacroix’s work on aberrant GPCR expression in the development of BMAH is something I teach about in both Molecular Biology (BIO225) and Endocrinology (BIO370). I really enjoyed his ability to draw the audience into the conversation. I was hoping to get to “meet the professor” but he was swamped with questions after the session.

Between seeing some of the biggest names in their respective fields and realizing how much I have yet to learn and how much we as a field have yet to learn, “shock and awe” is definitely how I felt after day 1. I am looking forward to another educational and exciting day for day 2!