Our faculty are always working on advancing research.
Current projects include:
Oral Biofilms: Novel Methods to Control Pathogenesis
Innovative medical devices have enhanced health care and improved the overall quality of life. Although providing significant medical benefits, there are unfortunately a myriad of diseases that can be attributed to the presence of medical devices. Microbes can colonize on a medical device surface and cause infections, and at times can even lead to malfunction of the device. Microbial species are present either as planktonic cells or incorporated into biofilms. Biofilms evolve from the planktonic state and are characterized as dense micro-communities that grow on inert surfaces and encapsulate themselves with secreted polymers. When organisms form a biofilm, they are able to adapt to environmental change by altering their gene expression patterns. The biofilm structure and corresponding change in gene expression can protect the microbes from disinfectant agents or antibiotics. The resultant biofilm can pose a serious public health issue.
While different types of medical devices harbor biofilms, dental prostheses are some of the most pervasive. The majority of the oral microbes are commensal organisms. Those that are pathogenic microbes can result in oral infections, and at times initiate systemic diseases. The physical nature of biofilms and the survival mechanisms they possess, whether phenotypic adaptability or genetic resistance, leave them impervious to antibiotic treatment. Given the lack of response to traditional antimicrobial therapy, biofilm infections currently pose a great challenge to the world of medicine and odontology.
Despite the difficulty of eradicating biofilms, several conventional strategies do exist to control them. Methods to remove the biofilms include mechanical, chemical or biologic. Our studies focus on (a) evaluating the existing chemical methods and identifying novel activities and benefits associated with the chemical methods and (b) the application of novel natural products to elicit unique anti-biofilm activities.
Effect of antibiotics on Pseudomonas aeruginosa biofilm - Biofilm is a structured community of different microorganisms that adhere to a surface and are enclosed in a self-produced polymeric matrix. When encased in a biofilm, bacteria exhibit a high degree of antibiotic resistance compared with their planktonic counterparts, which makes biofilm based bacterial infections very difficult to treat. Pseudomonas aeruginosa (PA) is a gram-negative opportunistic pathogen that causes severe acute and chronic infections at different sites within the body, such as the urinary tract, skin (surgical wounds or burns), and the respiratory tract. These gram-negative bacteria kill thousands of people annually and are responsible for 10% of all hospital-acquired infections caused by drug-resistant strains and biofilm formation. Pseudomonas aeruginosa is increasingly becoming resistant to currently used antibiotics, posing a great threat to patients and healthcare institutions. This phenomenon of resistance is mainly attributed to biofilm formation in the host patient, rendering it difficult for antibiotics to penetrate and kill the bacterial cells. We study analyze the performance of commonly used antibiotics against Pseudomonas aeruginosa PA01 in both the planktonic and biofilm phase to determine their resistance pattern and their effectiveness in inhibiting PA01 biofilm formation and eradication.
Oral and Systemic Health: Impact of Respiratory Microbiota on COPD
The link between oral infection and various respiratory diseases in the dentate population has been the focus of several studies. The increased presence of respiratory pathogens on natural dentition is associated with chronic obstructive pulmonary disease (COPD). Data from the Loewy Laboratory has demonstrated a significant association between COPD and edentulism; an association greater than that of the dentate population. Our clinical studies are focused on characterizing the microbes on the surfaces of dentures and evaluating PCR amplicons for: (a) the presence of respiratory pathogens and (b) DNA sequence variations.
Mechanisms of Penicillin Tolerance in Group B Streptococcus
Group B Streptococcus (GBS) remains a leading cause of neonatal infection despite careful screening and antibiotic treatment guidelines. All pregnant women undergo screening for GBS at 35-37 weeks of gestation, for which the most common treatment is penicillin where resistance has not been reported. GBS infections may be due to penicillin tolerance (PT) in which a treated organism is growth-inhibited, but remains viable for an extended period of time. However, very little is known about this phenotype behavior in GBS, and its underlying mechanisms. The PT phenotype in GBS strain may be caused by underlying structural or stress response differences that may lead to differences in cell wall integrity, cell wall synthesis rate, cell stress response due to PBP inhibition, and/ or autolysins expression. Using a variety of assays, our Group B Streptococcus isolates will be characterized as susceptible or tolerant to Penicillin, respectively. We will be investigating different mechanisms of penicillin tolerance, with current focus on the difference in cell wall construction between penicillin susceptible and tolerant strains.
Study of antimicrobial effect of acid and mechanisms of acid resistance in Eschericia coli
Studying the genes responsible for better survival of the small colony variant IH3 in low pH and mechanism of acid mediated damage in E. coli. We are interested in determination and comparison of the expression of a panel of different genes in the WT E. coli and its acid resistant small colony variant IH3 using RT-PCR to identify the ones responsible for better survival of the latter in low pH. Another part of this project is to look at stress mediated membrane damage using fluorescence microscopy. This work has application in the use of low pH as an alternative antimicrobial therapy.
Loewy, Z.G., Galbut, S., Loewy, E. and Felton, D. (2018) Influence of the oral microbiome on general health. Dx.doi.org/10.5772/intechopen.76213.
Berger, D., Rakhamimiova, A, Pollack, A. and Loewy, Z. (2018) Oral Biofilms: Development, Control and Analysis. High-Throughput 7, 24, doi: 10.3390/ht7030024.
Loewy, Z. (2018) Nature: A Rich Source of Potent Therapeutics. Drug Design Development and Delivery Journal doi: 10.3102/ddddj.20181102.
Offenbacher, S., Barros,S., Bencharit, S., Yu, N., Preisser, J., Moss, K. and Loewy, Z.G. (2018) Differential mucosal gene expression patterns in Candidiasis-associated, chronic oral denture stomatitis. J. Prosthodontics doi:10.1111/JOPR 13007.
Pharmacogenomic testing has been designed to help achieve optimal treatment outcomes. Our clinical research is focused on assessing the impact of pharmacogenomic testing on physicians' choice in prescribing medications. Current clinical areas include pain management and cardiovascular disease.
Medicine today has been challenged by the differential variabilities exhibited in patient response to pharmacotherapy. It is now known that different patients respond differently to the same medication. Moreover, patients respond differently to varying doses of the same medication. The advent of molecular biology has allowed for the identification of risk factors associated with pharmacotherapy. With the advances of molecular biology, predictions regarding clinical outcomes based upon an individual’s unique DNA sequence should be enabled.
The primary objective of the education project is to provide an education vehicle for healthcare professionals, introducing them to pharmacogenomics technology and its applications. Topics include: application of genomic and phenotypic information to personal pharmacotherapy, data integration, reimbursement and clinical examples / case studies in various areas of practice.
Pokotylyuk, I., Kulshrestha, S., Loewy, Z. and Kumar, P. (2018) Clinical relevance of µ-opioid receptor A118G polymorphism in demographically variant populations. Pharmacology and Toxicology 6: 228-236.
Cohen, K., Loewy, Z.G. and Rumore, M. (2018) End-of-Life Care: Law, Ethical Principles and Jewish Medical Ethics. Annals of Long-Term Care 39-45. doi: 10.25270/altc.2018.0400025.
Rabizadeh, B., Wong, S. and Loewy, Z.G. (2018) Traditional and nontraditional careers in pharmacy. STEM Magazine. August 2018.
Our research is primarily focused on determining how cells are programmed to adopt a normal state of differentiation and how this programming is disrupted in cancer. Currently, our research is focused on the maturation of epithelial cells along the crypt-luminal axis of the colon and is centered on three main areas:
Regulation of the Tropomyosin 4 (TPM4) gene and its role in epithelial cell migration
Maturation of colon epithelial cells into differentiated effectors requires their migration from the stem cell compartment at the crypt base toward the lumen. Evidence suggests that early events in colon cancer progression induce transcriptional changes in key genes to inhibit calcium-mediated cytoskeletal protein contractility in colon epithelial cells, thereby suppressing their migration. We hypothesize that these transcriptional changes and subsequently disrupted migration may be early events that prevent differentiation in colon cells and can eventually lead to tumorigenesis.
One protein that may regulate colon epithelial cell migration, and possibly also control the balance between normal differentiation and tumorigenesis, is Tropomyosin 4 (TPM4). TPM4 interacts with nonmuscle myosin and has been implicated in regulating nonmuscle cell motility. Although the role of TPM4 in colon epithelial cells is unknown, we have shown that TPM4 is suppressed at the RNA and protein levels in growth arrested, differentiating (relative to proliferating, undifferentiated) colon epithelial cells. Therefore, we hypothesize that TPM4 modulates human colon epithelial cell migration and that TPM4 overexpression drives colon epithelial cell tumorigenesis.
Our studies are focused on 3 main goals:
1. Identify the mechanisms of TPM4 gene transcription in colon epithelial cells.
2. Determine whether TPM4 plays a role in colon epithelial cell migration.
3. Examine whether TPM4 expression regulates the balance between differentiation and tumorigenesis.
Role of calcium and vitamin D in suppression of colorectal tumor growth
Colorectal cancer is also greatly influenced by nutrient intake. Many studies show that calcium and vitamin D can protect from colorectal tumor progression, but the mechanisms are unclear. We hypothesize that supplemental calcium and vitamin D can prevent malignant progression of colon epithelial cells by increasing expression of genes that enhance colon epithelial cell contractility and motility, thereby reversing the block to colon cell epithelial migration in tumorigenic cells mentioned above.
Our current experiments are aimed at identifying the nuclear proteins that interact with ligand-bound vitamin D receptor (VDR) and promote vitamin D-induced target gene expression in colon epithelial cells by immunoprecipitating endogenous VDR and an overexpressed VDR-GFP construct in colon epithelial cells. We will then use chromatin immunoprecipitation (ChIP) and reporter assays to determine whether these nuclear proteins regulate expression of candidate target genes, including TPM4, to modulate colon epithelial cell contractility and motility. These studies will elucidate how calcium and vitamin D can possibly suppress a premalignant state and prevent colon cancer.
Video microscopy of epithelial cells in culture
Video microscopy can reveal many aspects of epithelial cell biology that are not possible by static imaging alone. We have constructed a simple, low-cost (‹$500) apparatus that maintains a microscope and cell culture vessel at 37 +/- 0.4 degrees Celsius for extended time periods. Using this instrument, we have observed several phenomena in colon epithelial tumor cells, including novel membrane fusion events and aberrant cell divisions, that elucidate many physiological mechanisms utilized by these cells in normal as well as disease states. This apparatus is currently being used to visualize and measure responses, particularly in terms of absorption and migration, of color epithelial cells to vitamin D treatment.
Broad areas: organ toxicology, free radical biology and biochemical pharmacology. Focused areas: Mechanisms of drug and chemical-induced various forms of cell death (apoptosis, necrosis and necraptosis) in in-vivo models. Select expression and interplay of bcl-2, bcl-xl, p53, bad, bax and free radicals during drug induced cell death and their prevention by phytochemicals. Role of oxidative stress, genomic injury/repair and microRNA dynamics during toxic interactions. Exploration of anticancer and antitoxic properties of phytochemicals and nutraceutical mixtures in biological models.
Stohs SJ; Ray SD; Miller H. (2018) Recent Studies Regarding the Safety and Efficacy of Bitter Orange Extract (P-Synephrine). Nutri Food Sci Int J 7(2): NFSIJ.MS.ID.555708.
Ray SD, Black A, Shah S, Stohs SJ. (2018) ADRs, ADEs and SEDs: A Bird’s Eye View. Side Effects of Drugs Annual. Xxvii – xliv.40: 27-44
Fudin HR; Babin JL; Hong LT; Ku J; May AL; Wisner A; Hall S; Ray SD.(2018) Drugs of Abuse. Side Effects of Drugs Annual. 40: 29-89
Keshishyan S; Nguyen H; Alofabi O; Black A; Ray S.D.(2018) Cytostatic Agents. Side Effects of Drugs Annual. 40:569-577
Pittman J, Schalliol LA, Ray SD.(2018) Insulin and other hypoglycemic drugs. Side Effects of Drugs Annual. 40:537-546
Ali A; Kim JJ; Hudgins DK; Wireku M; Pisano ME; Ray SD.(2018) Beta Adrenergic Antagonists and Antianginal Drugs. Side Effects of Drugs Annual. 40:243-252
Rust C, Ford H., Ray SD.(2018) Lithium. Side Effects of Drugs Annual. 40:21-28
Black A; McManus D; Alofabi O; Ray S.D.(2018) Antiprotozoal Agents. Side Effects of Drugs Annual. 40:337-343
Keaton S; Noel Z; Ray SD.(2018) Drugs Acting on the Cerebral and Peripheral Circulations. Side Effects of Drugs Annual. 40: 252-262
Gray JP, Amacher C, Ford C, Ray SD(2018) Metal Antagonists and Metals. Side Effects of Drugs Annual. 40: 279-288
Papetti, M. and Kozlowski, P., “Novel Aspects of Live Intestinal Epithelial Cell Function Revealed Using a Custom Time-Lapse Video Microscopy (TLVM) Apparatus”, Cytometry A 93: 464-471 (2018)
Many drug substances are extracted from natural sources. They may show some potential therapeutic benefits on disease, however, they cannot be delivered to the human body in their isolated state. We need to modify them using various formulation strategies in order to make them more effective and efficient for their target delivery. Formulation strategy is an art which is supported by science and knowledge. Each molecule is unique; we use pharmaceutical and analytical techniques to identify the specific characteristics and create a suitable formulation strategy accordingly.
Areas of Interest:
- Drug-drug interactions
- Protein binding
- Pharmacokinetics of Cannabinoids
- Physicochemical characterization of bactericidal-type antibiotics
- Drug polymorphism and difference in Bioavailability
- Pharmaceutical calculations
Alexander, S, Flores, J, Ofuluozor H., Babayeva M.(2018) Significant Inhibition of Protein Binding of Phenytoin. Journal of Advances in Medicine and Medical Research. Vol.: 25(11) 1-7
Flores, J, Alexander, S, Bababyeva, M (2018) A Novel HPLC Method for Determination of Phenytoin in Human Plasma. Journal of Pharmaceutical Research International, Vol.: 22(6)
Alexander, S., Flores, J., Ofuluozor, H., Babayeva, M (2018) Significant Inhibition of Protein Binding of Phenytoin. Journal of Advances in Medicine and Medical Research. Vol.: 25(11)1-7
Clinical Pharmacy Practice (Drs. Veltri, Wang, Smith, Davis, Liu, Phoenix, Kavanagh, Kim, Fazylov, Friedman-Jakubovics, Cohen, Sharma and Cani)
Dr. Veltri - clinical areas of expertise and research involve several areas of internal medicine pharmacotherapy including infectious disease, cardiology, nephrology, endocrinology, gastroenterology, respiratory disorders and vaccination.
Dr. Wang - primary research interest involves Cardiology and Anticoagulation. Specifically, she is interested in investigating dosing of anticoagulation or medication for cardiovascular diseases in specialty population such as kidney disease, elderly and heart failure.
- Optimal diuretic dosing in heart failure exacerbation
- Chronic positive inotropes in congestive heart failure
- Periprocedural interruption of direct oral anticoagulation for percutaneous coronary intervention
- Dosing of direct oral anticoagulation in borderline renal function
- Nontraditional dose reductions of apixaban for atrial fibrillation
Dr. Smith - Research background is focused on developing our understanding of opioid use and prescribing, and pain management through multimodal Receptor/Channel Targeted Analgesia. He also works on developing programs to decrease risk of death in patients identified with opioid use disorder during their Emergency Department stay.
Dr. Davis - Area of research interests include critically ill patient management, DVT prophylaxis, delirium, and neurocritical care. She is currently conducting research on the appropriate frequency of heparin in the prevention of DVTs in critically ill patients. In the future, Dr. Davis plans to become involved in conducting research on the pharmacologic management of cerebral vasospasm post subarachnoid hemorrhage.
Dr. Liu - area of research interests include polypharmacy, dementia, long-term care, home-based primary care, and transitions of care. She currently has plans to conduct research on the pharmacist’s impact on reducing polypharmacy in the long-term care setting at Rutland Nursing Home in Brooklyn, New York and is involved in preceptorship of the current PGY-2 Geriatrics Pharmacy Resident’s research project at Kingsbrook Jewish Medical Center, which evaluates the management of patients colonized with Candida auris. Prior to coming to Touro College of Pharmacy, Catherine was involved in the following research projects: Management of urinary tract infections and asymptomatic bacteriuria at four Veterans Affairs Community Living Centers; evaluating anticholinergic medications in Veterans with dementia; evaluating the benefit of diclofenac gel in a veteran affairs healthcare system; and evaluating the outpatient management of acute respiratory tract infections at a veteran affairs healthcare system.
Dr. Phoenix - The areas of research that I am most interested in pursuing involves diabetes, lipid, and hypertension management.
Dr. Kavanagh - My clinical research interests primarily include HIV, hepatitis B and C, diabetes mellitus, hypertension, dyslipidemia, COPD/asthma, and smoking cessation management. I am interested in risk reduction and primary prevention of major causes of morbidity, including atherosclerotic cardiovascular disease prevention and obesity management. My educational research interests include ways to optimize learning for students, increase recall, facilitate application of knowledge to patient cases, and increasing student satisfaction with the learning process.
Dr. Kim- Areas of research interest is within provision of drug information. Drug information is one of oldest clinical pharmacy services and a core responsibility of all pharmacists. In the past years, with the development various drug information resources and increased access to electronic drug information resources, the practice has changed significantly from providing simple medication information to supporting evidence-based medicine in health care. As health care system continues to evolve, Dr. Kim is interested in the evolving role of drug information pharmacists and trend and utilization of drug information services in health care systems.
Dr. Fazylov - My research interests are:
2. Antimicrobial stewardship
Veltri K., Olsufka W., (2018) A Unique Case Presentation of Methadone Toxicity without QTc Interval Prolongation despite Patient Risk Factors. J Clin Stud Med Case Rep 2018, 5: 057
Goriacko P., Veltri K. (2018) Safety of direct oral anticoagulants vs warfarin in patients with chronic liver disease and atrial fibrillation. 7 February 2018. Eur J Haematol. 2018;1–6.
Le,C., Gennaro, D., Marshall D., Alaev, O., Bryan, A., Gelfman, A., Wang, Z., (2018) Lemierre's syndrome: One rare disease—Two case studies. Journal of Clinical Pharmacy and Therapeutics. Online: https://doi.org/10.1111/jcpt.12774
Hammond, D., Russell,N., Davis, N., Caballero, J., Garner. S., Sorensen, T., Watchmaker. C., Bookstaver, B(2018) Financial costs of pursuing postgraduate residency. AJHP. Volume 75, Issue 17, 1 September 2018, Pages 1266 -1267, https://academic.oup.com/ajhp/article-abstract/75/17/1266/5139847
Olsufka, W., Cabral D., McArdle. M., Kavanagh, R. (2018) Nortriptyline-induced oral ulceration: A case report. Mental Health Clinician November 2018, Vol. 8, No. 6, pp. 309-312
Nguyen, T., Kavanagh, R. (2018) New Drug Update: Edaravone: a free radical scavenger for treatment of amyotrophic lateral sclerosis (ALS) shown to slow the decline in loss of physical function. ACCP StuNews. ISSUE 35, MARCH 2018
Kim, J. (2018) Choosing Home Hemodialysis: A Critical Review of Patient Outcomes. Blood Purifications. 2018;45:224–229. https://doi.org/10.1159/000485159
Peyko V, Friedman-Jakubovics, ML(2018) Novel approach to vancomycin level monitoring: Impact of a multidisciplinary monitoring system on timing of vancomycin levels. American Journal of Health-System Pharmacy. American Journal of Health-System Pharmacy, Volume 75, Issue 3, 1 February 2018, Pages 121–126, https://academic.oup.com/ajhp/article-abstract/75/3/121/5102031
Friedman-Jakubovics ML, Fazylov R(2018) Diuretics (Peer Reviewed Chapter in Textbook). Side Effects of Drugs Annual (textbook) Volume 40, 2018, Pages 269-278
Cohen K, Loewy Z, Rumore M. (2018) End-of-Life Care: Law, Ethical Principles and Jewish Medical Ethics. Ann Longterm Care. 2018;26(4):25-31.
Arafat S, Campbell T, Yusuff J, Sharma R (2018) Prevalence of and Risk Factors for Prediabetes in Human Immunodeficiency Virus (HIV) Infected Patients. Diabetes Spectrum. 2018 May; 31(2): 139-143. https://doi.org/10.2337/ds17-0009
Cani E, Moussavi F, Sharma R, Eilerston B(2018) Carbapenem-resistant Klebsiella pneumoniae vertebral osteomyelitis in a renal transplant recipient treated with ceftazidime-avibactam. Transplant Infectious Diseases. Apr;20(2):e12837. doi: 10.1111/tid.12837. Epub 2018 Feb 19.
Kim E, KC S, Sharma R (2018) Community-Acquired Pneumonia. Pharmacy Times. JANUARY 23, 2018
Cani.E., (2018) Carbapenem-resistant Klebsiella pneumoniae vertebral osteomyelitis in a renal transplant recipient treated with ceftazidime-avibactam. Transplant of Infectious Diseases. Apr;20(2):e12837. doi: 10.1111/tid.12837. Epub 2018 Feb 19
Healthcare Systems: Medication Use; Adherence; Pharmacoeconomics (Drs. Addo-Attuah, Loh, Wertheimer)
Dr. Addo-Attuah – Research interests:
- Healthcare Systems and services and Health Policies
- Access to healthcare, including medicines, and the outcomes of such access for various population groups.
- Special focus is on access to Antiretroviral Therapy (ART) and outcomes for people living with HIV/AIDS (PLWHA).
- Outcomes research in health and education; use of students’ perception data for ongoing curricular development.
- Public health-related research at the local and global levels
Dr. Loh - Areas of research interest include: medication use, adherence and outcomes in the Medicare population with chronic diseases. The goal of my research is to improve population health by promoting appropriate medication use.
Dr. Wertheimer – Areas of research interest include:
- Pharmacoeconomics and outcomes research.
- Counterfeit drugs
- Off-label drug use
Haak, S., Mazar, I., Carter, R., Addo-Atuah, J., Ryan, M., Salazar Preciado, L., Gonzalez, L., Ralda, L. (2018) Cultural Sensitivity and Global Pharmacy Engagement in Latin America: A Focus on Argentina, Brazil, Ecuador, Guatemala, and Mexico. AJPE. 2018/11/7 pages: ajpe7218
Loh. E., (2018) Diabetes Diagnosis and Management among Insured Adults across Metropolitan Areas in the U.S. Preventive Medicine Reports. Volume 10, June 2018, Pages 227-233