George C Tsokos

Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States

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Publications (477)2301.11 Total impact

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    Linda A Lieberman, George C Tsokos
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    ABSTRACT: Systemic lupus erythematosus (SLE) is characterized by multiple cellular abnormalities culminating in the production of autoantibodies and immune complexes, resulting in tissue inflammation and organ damage. Besides active disease, the main cause of morbidity and mortality in SLE patients is infections, including those from opportunistic pathogens. To understand the failure of the immune system to fend off infections in systemic autoimmunity, we infected the lupus-prone murine strains B6.lpr and BXSB with the intracellular parasite Toxoplasma gondii and survival was monitored. Furthermore, mice were sacrificed days post infection and parasite burden and cellular immune responses such as cytokine production and cell activation were assessed. Mice from both strains succumbed to infection acutely and we observed greater susceptibility to infection in older mice. Increased parasite burden and a defective antigen-specific IFN-gamma response were observed in the lupus-prone mice. Furthermore, T cell:dendritic cell co-cultures established the presence of an intrinsic T cell defect responsible for the decreased antigen-specific response. An antigen-specific defect in IFN- gamma production prevents lupus-prone mice from clearing infection effectively. This study reveals the first cellular insight into the origin of increased susceptibility to infections in SLE disease and may guide therapeutic approaches.
    PLoS ONE 10/2014; 9(10):e111382. · 3.53 Impact Factor
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    Journal of Allergy and Clinical Immunology 10/2014; · 11.25 Impact Factor
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    ABSTRACT: The immune-regulatory cytokine IL-10 plays a central role during innate and adaptive immune responses. IL-10 is elevated in the serum and tissues of patients with systemic lupus erythematosus (SLE), an autoimmune disorder characterized by autoantibody production, immune-complex formation, and altered cytokine expression. Because of its B cell-promoting effects, IL-10 may contribute to autoantibody production and tissue damage in SLE. We aimed to determine molecular events governing T cell-derived IL-10 expression in health and disease. We link reduced DNA methylation of the IL10 gene with increased recruitment of Stat family transcription factors. Stat3 and Stat5 recruitment to the IL10 promoter and an intronic enhancer regulate gene expression. Both Stat3 and Stat5 mediate trans-activation and epigenetic remodeling of IL10 through their interaction with the histone acetyltransferase p300. In T cells from SLE patients, activation of Stat3 is increased, resulting in enhanced recruitment to regulatory regions and competitive replacement of Stat5, subsequently promoting IL-10 expression. A complete understanding of the molecular events governing cytokine expression will provide new treatment options in autoimmune disorders, including SLE. The observation that altered activation of Stat3 influences IL-10 expression in T cells from SLE patients offers molecular targets in the search for novel target-directed treatment options.
    Proceedings of the National Academy of Sciences 09/2014; · 9.81 Impact Factor
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    Dataset: cell report
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    ABSTRACT: IL-2, a cytokine with pleiotropic effects, is critical for immune cell activation and peripheral tolerance. Although the therapeutic potential of IL-2 has been previously suggested in autoimmune diseases, the mechanisms whereby IL-2 mitigates autoimmunity and prevents organ damage remain unclear. Using an inducible recombinant adeno-associated virus vector, we investigated the effect of low systemic levels of IL-2 in lupus-prone MRL/Fas(lpr/lpr) (MRL/lpr) mice. Treatment of mice after the onset of disease with IL-2-recombinant adeno-associated virus resulted in reduced mononuclear cell infiltration and pathology of various tissues, including skin, lungs, and kidneys. In parallel, we noted a significant decrease of IL-17-producing CD3(+)CD4(-)CD8(-) double-negative T cells and an increase in CD4(+)CD25(+)Foxp3(+) immunoregulatory T cells (Treg) in the periphery. We also show that IL-2 can drive double-negative (DN) T cell death through an indirect mechanism. Notably, targeted delivery of IL-2 to CD122(+) cytotoxic lymphocytes effectively reduced the number of DN T cells and lymphadenopathy, whereas selective expansion of Treg by IL-2 had no effect on DN T cells. Collectively, our data suggest that administration of IL-2 to lupus-prone mice protects against end-organ damage and suppresses inflammation by dually limiting IL-17-producing DN T cells and expanding Treg.
    The Journal of Immunology 07/2014; · 5.36 Impact Factor
  • Christine Konya, Ziv Paz, George C Tsokos
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    ABSTRACT: To describe our current understanding of the role of T cells in the pathophysiology of systemic lupus erythematosus (SLE).
    Current Opinion in Rheumatology 07/2014; · 5.07 Impact Factor
  • Annals of the Rheumatic Diseases 06/2014; 73(Suppl 2):193-193. · 9.27 Impact Factor
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    ABSTRACT: Abstract Objective: Foxp3(+) regulatory T cells (Treg) are pivotal for the maintenance of peripheral tolerance and prevent development of autoimmune diseases. We have reported that calcium/calmodulin-dependent protein kinase IV (CaMK4) deficient MRL/lpr mice display less disease activity by promoting IL-2 production and increasing the activity of Treg cells. To further define the mechanism of CaMK4 on Treg cells in systemic lupus erythematosus (SLE), we used the Foxp3-GFP reporter mice and treated them with KN-93, an inhibitor of CaMK4. Methods: We generated MRL/lpr Foxp3-GFP mice to record Treg cells; stimulated naïve CD4(+) T cells from MRL/lpr Foxp3-GFP mice under Treg polarizing conditions in the absence or presence of KN-93; evaluated the number of GFP positive cells in lymphoid organs and examined skin and kidney pathology at 16 weeks of age. We also examined the infiltration of cells and recruitment of Treg cells in the kidney. Results: We show that culture of MRL/lpr Foxp3-GFP T cells in the presence of KN-93 promotes Treg differentiation in a dose-dependent manner. Treatment of MRL/lpr Foxp3-GFP mice with KN-93 results in a significant induction of Treg cells in the spleen, peripheral lymph nodes and peripheral blood and this is accompanied by decreased skin and kidney damage. Notably, KN-93 clearly diminishes the accumulation of inflammatory cells along with reciprocally increased Treg cells in target organ. Conclusion: Our results indicate that KN-93 treatment enhances the generation of Treg cells in vitro and in vivo highlighting its potential therapeutic use for the treatment of human autoimmune diseases.
    Autoimmunity 05/2014; · 2.75 Impact Factor
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    ABSTRACT: Abstract Epigenetic events play a central role in the priming, differentiation and subset determination of T lymphocytes. Through their influence on chromatin conformation and DNA-accessibility to transcription factors and RNA polymerases, epigenetic marks allow or prevent gene expression and control cellular functions including cytokine expression. CpG-DNA methylation and post-translational modifications to histone tails are the two most well accepted epigenetic mechanisms. The involvement of epigenetic mechanisms in the pathogenesis of systemic lupus erythematosus (SLE) has been suggested by the development of lupus-like symptoms by individuals who received procainamide or hydralazine treatment resulting in a reduction of CpG-DNA methylation. To date, a growing body of literature indicates that the deregulation of cytokine expression through epigenetic disturbances can result in altered immune responses and autoimmune reactions. Over the past decade, various global and regional epigenetic alterations have been reported in immune cells from patients with SLE and other autoimmune disorders. More recently, the molecular mechanisms that result in epigenetic disturbances have been addressed, and deregulated transcription factor networks have been demonstrated to mediate epigenetic alterations in B and T lymphocytes from SLE patients. A better understanding of the molecular events that contribute to epigenetic alterations and subsequent immune imbalance is essential for the establishment of disease biomarkers and identification of potential therapeutic targets.
    Autoimmunity 04/2014; · 2.75 Impact Factor
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    ABSTRACT: Protein phosphatase 2A (PP2A) is a highly conserved and ubiquitous serine/threonine phosphatase. We have previously shown that PP2A expression is increased in T cells of SLE patients and this increased expression and activity of PP2A plays a central role in the molecular pathogenesis of SLE. Although the control of PP2A expression has been the focus of many studies, many aspects of its regulation still remain poorly understood. In this study, we describe a novel mechanism of PP2A regulation. We propose that the transcription factor Ikaros binds to a variant site in the first intron of PP2A and modulates its expression. Exogenous expression of Ikaros leads to reduced levels of PP2Ac message as well as protein. Conversely, siRNA enabled silencing of Ikaros enhances the expression of PP2A, suggesting that Ikaros acts as a suppressor of PP2A expression. ChIP analysis further proved that Ikaros is recruited to this site in T cells. We also attempt to delineate the mechanism of Ikaros mediated PP2Ac gene suppression. We show that Ikaros mediated suppression of PP2A expression is at least partially dependent on the recruitment of the histone deacetylase HDAC1 to this intronic site. We conclude that the transcription factor Ikaros can regulate the expression of PP2A by binding to a site in the first intron and modulating chromatin modifications at this site via recruitment of HDAC1.
    Journal of Biological Chemistry 04/2014; · 4.60 Impact Factor
  • Katalin Kis-Toth, George C Tsokos
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    ABSTRACT: Signaling lymphocyte activation molecule family (SLAMF)2/CD48 is a coactivator and adhesion molecule on cells with hematopoietic origin. It ligates mainly SLAMF4 on effector/memory CD8(+) T cells and NK cells, suggesting a potential role during viral infection, with SLAMF2 acting as a ligand to activate SLAMF4-bearing cells. The ability of SLAMF2 to signal on its own after it is engaged and the functional consequences are largely unknown. We found that cytosolic DNA-activated dendritic cells (DCs) upregulate the expression of SLAMF2 molecules. Using anti-SLAMF2 Ab and SLAMF4 recombinant protein, we found that SLAMF2 engagement activates immature DCs and, more interestingly, prolongs the survival of DNA-activated DCs by inhibiting IFN-β production and IFN-β-induced apoptosis and promotes the production of the granzyme B inhibitor protease inhibitor-9. Thus, SLAMF2 can serve as a survival molecule for DNA-activated DCs during their interaction with SLAMF4-expressing cytotoxic T cells. Based on our results, we propose that SLAMF2 engagement regulates adaptive immune responses by providing longer access of putative APCs to virus-specific effector T cells by prolonging the time frame of effective stimulation.
    The Journal of Immunology 03/2014; · 5.36 Impact Factor
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    ABSTRACT: Tissue inflammation in several autoimmune diseases, including SLE and MS, has been linked to an imbalance of IL-17-producing Th (Th17) cells and Tregs; however, the factors that promote Th17-driven autoimmunity are unclear. Here, we present evidence that the calcium/calmodulin-dependent protein kinase IV (CaMK4) is increased and required during Th17 cell differentiation. Isolation of naive T cells from a murine model of lupus revealed increased levels of CaMK4 following stimulation with Th17-inducing cytokines but not following Treg, Th1, or Th2 induction. Furthermore, naive T cells from mice lacking CaMK4 did not produce IL-17. Genetic or pharmacologic inhibition of CaMK4 decreased the frequency of IL-17-producing T cells and ameliorated EAE and lupus-like disease in murine models. Inhibition of CaMK4 reduced Il17 transcription through decreased activation of the cAMP response element modulator α (CREM-α) and reduced activation of the AKT/mTOR pathway, which is known to enhance Th17 differentiation. Importantly, silencing CaMK4 in T cells from patients with SLE and healthy individuals inhibited Th17 differentiation through reduction of IL17A and IL17F mRNA. Collectively, our results suggest that CaMK4 inhibition has potential as a therapeutic strategy for Th17-driven autoimmune diseases.
    The Journal of clinical investigation 03/2014; · 15.39 Impact Factor
  • Trevor E. Davis, Katalin Kis‐Toth, George C. Tsokos
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    ABSTRACT: Background/Purpose:MicroRNA (miRNA, miR) are short RNA species (20–23 nt) that act post-transcriptionally modulating messenger RNA (mRNA) translation or stability. They control many biological processes including cell differentiation and homeostasis. Abnormal levels of miRNA have been implicated in cancers and autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. Steroids are first line anti-inflammatory medications that act through transcriptional or posttranscriptional gene regulation. In multiple instances steroids cause mRNA destabilization indicating a potential role for miRNA.Previously, using high-throughput microarray analysis, we found that methylprednisolone (MP) decreased miR-155 expression in CD4+ T cells in vitro. miR-155 is highly expressed in immune cells and influential in cell differentiation. This influence may in part be mediated through suppression of cytokine signaling 1 (SOCS1), a known target of miR-155. SOCS1 inhibits multiple JAK/STAT pathways, which may inhibit cell proliferation and differentiation. Steroids have also been shown to inhibit proliferation, differentiation and the JAK/STAT pathways. Steroids through blocking the IL-12/STAT4 pathway inhibit Th1 differentiation. This pathway is in part controlled by SOCS1, which should be under the control of miR-155. Following our previous work here we explore the potential mechanism of action of miR-155 during MP treatment of T cells.Methods:Total or naive CD4+ T cells were isolated from peripheral blood of healthy donors and activated by anti-CD3/anti-CD28 antibodies for up to 5 days with or without Th1 polarizing conditions (10 nM IL-12 and 5 mM anti-IL-4 neutralizing antibody) and with or without exposure to 10−6 M of methylprednisolone. Some cells were first transfected with mimic miR-155, control mimic miR, anti-miR-155, or control anti-miR by electroporation. Effects on miR-155, SOCS1, STAT phosphorylation, IFNg production and Th1 differentiation were monitored using flow cytometry, RNA quantification by PCR, and protein quantification by ELISA or western blot analysis.Results:Activated T cells treated with MP decrease miR-155 expression and increase SOCS1 expression. In turn, SOCS1 decreases JAK/STAT signaling and inhibits response to cytokines, notably IL-12, resulting in decreased IFNg production by activated T cells.Conclusion:We found that the anti-inflammatory effects of MP, at least in part, act through decreasing miR-155 in T cells by inhibiting JAK/STAT signaling and cytokine production through modulating SOCS1 expression. Based on our findings we propose that miR-155 inhibition could be utilized to suppress inflammation without the myriad of side effects currently inherent in chronic steroid therapy.
    Arthritis & Rheumatology. 03/2014; 66(S11).
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    ABSTRACT: Complement system is activated in patients with trauma. Although complement activation is presumed to contribute to organ damage and constitutional symptoms, little is known about the involved mechanisms. Because complement components may deposit on RBCs, we asked whether complement deposits on the surface of RBC in trauma and whether such deposition alters RBC function. A prospective experimental study. Research laboratory. Blood samples collected from 42 trauma patients and 21 healthy donors. None. RBC and sera were collected from trauma patients and control donors. RBCs from trauma patients (n = 40) were found to display significantly higher amounts of C4d on their surface by flow cytometry compared with RBCs from control (n = 17) (p < 0.01). Increased amounts of iC3b were found in trauma sera (n = 27) (vs 12 controls, p < 0.01) by enzyme-linked immunosorbent assay. Incubation of RBC from universal donors (type O, Rh negative) with trauma sera (n = 10) promoted C4d deposition on their surface (vs six controls, p< 0.05). Complement-decorated RBC (n = 6) displayed limited their deformability (vs six controls, p < 0.05) in two-dimensional microchannel arrays. Incubation of RBC with trauma sera (n = 10) promoted the phosphorylation of band 3, a cytoskeletal protein important for the function of the RBC membrane (vs eight controls, p < 0.05), and also accelerated calcium influx (n = 9) and enhanced nitric oxide production (n = 12) (vs four and eight controls respectively, p < 0.05) in flow cytometry. Our study found the presence of extensive complement activation in trauma patients and presents new evidence in support of the hypothesis that complement activation products deposit on the surface of RBC. Such deposition could limit RBC deformability and promote the production of nitric oxide. Our findings suggest that RBC in trauma patients malfunction, which may explain organ damage and constitutional symptoms that is not accounted for otherwise by previously known pathophysiologic mechanisms.
    Critical care medicine 01/2014; · 6.15 Impact Factor
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    Alexandros P Grammatikos, George C Tsokos
    Edited by MacKay I, Rose N, 01/2014; Springer.
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    ABSTRACT: T cells from patients with SLE exhibit reduced expression of the critical T cell receptor (TCR) associated CD3 zeta signaling chain, and are poor producers of the vital cytokine IL-2. By oligonucleotide pulldown and mass spectrometry discovery approaches, we identified the splicing regulator serine arginine-rich splicing factor (SRSF) 1 or splicing factor 2 / alternative splicing factor (SF2/ASF) to be important in the expression of CD3 zeta chain. Importantly, increases in the expression of SRSF1 rescued IL-2 production in T cells from patients with SLE. In this study, we investigated the regulation of SRSF1 expression in resting and activated human T cells. We found that T cell stimulation induced a rapid and significant increase in mRNA expression of SRSF1, however protein expression levels did not correlate with this increase. Co-engagement of CD28 induced a similar mRNA induction and reduction in protein levels. Proteasomal but not lysosomal degradation was involved in this downregulation as evidenced by blocking with specific inhibitors MG132 and Bafilomycin respectively. Immunoprecipitation studies showed increased ubiquitination of SRSF1 in activated T cells. Interestingly, T cells from patients with SLE showed increased ubiquitination of SRSF1 when compared to those from healthy individuals. Our results demonstrate a novel mechanism of regulation of the splicing factor SRSF1 in human T cells and a potential molecular mechanism that controls its expression in SLE.
    Journal of Biological Chemistry 12/2013; · 4.60 Impact Factor
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    ABSTRACT: Systemic Lupus Erythematosus (SLE) remains a challenging disease to diagnose and follow, as no reliable biomarkers are known to date. We designed a gene expression panel with 40 genes known to play a role in SLE pathogenesis. We found that the combined expression of these genes in SLE T cells can accurately differentiate SLE from healthy individuals and patients with other autoimmune diseases. The accuracy of the test increased further (83%) when only three out of the initial genes (OAS2, CD70 and IL10) were used. A T cell score, calculated from the combined expression levels of these genes, correlated positively with various SLE activity markers in a cross-sectional cohort and in a few patients that were followed prospectively. These data showcase the usefulness of measuring mRNA levels of key molecules in diagnosing and following patients with SLE.
    Clinical Immunology 12/2013; 150(2):192-200. · 3.77 Impact Factor
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    ABSTRACT: TCR-αβ+CD3+CD4-CD8- double negative T cells are expanded in the peripheral blood of patients with systemic lupus erythematosus (SLE) and lupus-prone mice. Double negative T cells have been claimed to derive from CD8+ cells that down-regulate CD8 co-receptors and acquire a distinct effector phenotype that includes the expression of proinflammatory cytokines. This, along with the fact that double negative T cells have been documented in inflamed organs, suggests that they may contribute to disease expression and tissue damage. We recently linked the transcription factor cAMP responsive element modulator (CREM)α, which is expressed at increased levels in T cells from SLE patients and lupus prone MRL/lpr mice, with trans-repression of a region syntenic to the murine CD8b promoter. However, the exact molecular mechanisms that result in a stable silencing of both the CD8A and CD8B genes remain elusive. Here, we demonstrate that CREMα orchestrates epigenetic remodeling of the CD8 cluster through the recruitment of DNA methyltransferase (DNMT)3a and histone methyltransferase G9a. Thus, we propose that CREMα is essential for the expansion of double negative T cells in SLE. CREMα blockade may have therapeutic value in autoimmune disorders with DN T cell expansion.
    Journal of Biological Chemistry 12/2013; · 4.60 Impact Factor
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    ABSTRACT: MicroRNA-155 (miR-155) regulates antibody responses and subsequent B-cell effector functions to exogenous antigens. However, the role of miR-155 in systemic autoimmunity is not known. Using the death receptor deficient (Fas(lpr)) lupus-prone mouse, we show here that ablation of miR-155 reduced autoantibody responses accompanied by a decrease in serum IgG but not IgM anti-dsDNA antibodies and a reduction of kidney inflammation. MiR-155 deletion in Fas(lpr) B cells restored the reduced SH2 domain-containing inositol 5'-phosphatase 1 to normal levels. In addition, coaggregation of the Fc γ receptor IIB with the B-cell receptor in miR-155(-/-)-Fas(lpr) B cells resulted in decreased ERK activation, proliferation, and production of switched antibodies compared with miR-155 sufficient Fas(lpr) B cells. Thus, by controlling the levels of SH2 domain-containing inositol 5'-phosphatase 1, miR-155 in part maintains an activation threshold that allows B cells to respond to antigens.
    Proceedings of the National Academy of Sciences 11/2013; · 9.81 Impact Factor
  • Source
    H K Wong, G M Kammer, G Dennis, G C Tsokos

Publication Stats

10k Citations
2,301.11 Total Impact Points


  • 2007–2014
    • Beth Israel Deaconess Medical Center
      • • Division of Rheumatology
      • • Department of Medicine
      Boston, Massachusetts, United States
    • University of Washington Seattle
      • Department of Immunology
      Seattle, WA, United States
    • Tel Aviv University
      Tell Afif, Tel Aviv, Israel
    • Brigham and Women's Hospital
      • Department of Surgery
      Boston, MA, United States
  • 2007–2013
    • Harvard Medical School
      • • Department of Pathology
      • • Department of Medicine
      Boston, Massachusetts, United States
  • 2012
    • RWTH Aachen University
      Aachen, North Rhine-Westphalia, Germany
    • Boston Children's Hospital
      Boston, Massachusetts, United States
    • Brigham Young University - Provo Main Campus
      • Department of Microbiology and Molecular Biology
      Provo, UT, United States
  • 2011–2012
    • U.S. Army Institute of Surgical Research
      Houston, Texas, United States
  • 2010
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2006–2009
    • University of Münster
      • • Institute of Immunology
      • • Institute of Experimental Pathology
      Münster, North Rhine-Westphalia, Germany
    • Yale University
      • School of Medicine
      New Haven, CT, United States
  • 1996–2009
    • Walter Reed Army Institute of Research
      • Center for Military Psychiatry and Neuroscience Research
      Silver Spring, Maryland, United States
  • 2006–2008
    • Kansas State University
      • Division of Biology
      Manhattan, KS, United States
  • 1992–2008
    • Walter Reed National Military Medical Center
      • • Department of Rheumatology
      • • Department of Surgery
      Washington, Washington, D.C., United States
  • 2006–2007
    • Henry Ford Hospital
      Detroit, Michigan, United States
    • Complutense University of Madrid
      • Facultad de Medicina
      Madrid, Madrid, Spain
  • 2005–2007
    • Universitätsklinikum Münster
      Muenster, North Rhine-Westphalia, Germany
    • National and Kapodistrian University of Athens
      • Division of Propedeutic Medicine I
      Athens, Attiki, Greece
    • University of Patras
      • Department of Internal Medicine
      Ríon, Greece
  • 1987–2007
    • Uniformed Services University of the Health Sciences
      • Department of Medicine
      Maryland, United States
  • 2002–2004
    • Wake Forest School of Medicine
      • • Department of Microbiology and Immunology
      • • Department of Internal Medicine
      Winston-Salem, NC, United States
  • 2003
    • Washington Hospital Center
      Washington, Washington, D.C., United States
  • 2001
    • University of Maryland, College Park
      • Department of Cell Biology & Molecular Genetics
      College Park, MD, United States
  • 1999
    • Henry M Jackson Foundation
      Maryland City, Maryland, United States
  • 1997
    • Universität Heidelberg
      Heidelburg, Baden-Württemberg, Germany
  • 1991–1994
    • Laiko Hospital
      • First Department of Surgery
      Athínai, Attica, Greece
    • National Eye Institute
      Maryland, United States
    • Children's National Medical Center
      Washington, Washington, D.C., United States
  • 1974–1991
    • National Institutes of Health
      • • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
      • • Laboratory of Human Carcinogenesis
      Bethesda, MD, United States
  • 1990
    • State University of New York
      New York City, New York, United States
  • 1986–1990
    • The National Institute of Diabetes and Digestive and Kidney Diseases
      Maryland, United States
    • National Institute of Allergy and Infectious Diseases
      Maryland, United States
  • 1982
    • U.S. Food and Drug Administration
      Washington, Washington, D.C., United States