By SUSAN JONES
Sometime soon, Dr. Arthur Levine’s work will focus on just one question, instead of the thousands of things he’s been dealing with for the past 20 years as senior vice chancellor for health sciences and dean of the Pitt School of Medicine.
Levine, who announced in January that he will transition out of those positions when his replacement is found, is ready to tackle one of the bigger questions in medicine — how to prevent Alzheimer’s disease.
His varied career — from a pediatrician to scientific director of the NIH’s National Institute of Child Health and Human Development to Pitt — has all been influenced by his roles as a molecular biologist and as a physician scientist, “but it’s in the context of my sensitivity to and appreciation for the biology of our species,” Levine says.
The 82-year-old Levine says he decided to step down now because, “I am a physician, and I know that life becomes a little less predictable, and a little more gradual as one reaches my part of the age spectrum, and I would never want to leave the University in the lurch.”
A lasting legacy
Levine’s impact will be felt at Pitt for years to come. He was instrumental in hiring all but three of the department chairs in the School of Medicine, which includes 10 in academic departments started during his tenure. All five other deans in the health sciences have been appointed since Levine started as SVC, and Pitt has launched a number of multidisciplinary research centers and institutes, include the Brain Institute, Drug Discovery Institute, Center for Vaccine Research and Institute for Personalized Medicine.
But his greatest impact, many say, is taking Pitt from a good clinical and teaching school to a leading research institution.
“There’s the old adage, the old curse, may you live in interesting times — Art has lived in interesting times,” says Chancellor Patrick Gallagher. “He’s had a really interesting period for this university, and the results are really remarkable.”
From the late 1990s until today, the United States decided to make the “largest investment in scientific research in any one area of science that any country has ever made in human history, by doubling NIH and then more than sustaining that investment over multiple decades,” Gallagher says. “And no university in the United States rose higher or faster than Pitt. It turns out it’s really difficult to move up in these rankings, particularly these research rankings, because it’s all peer reviews, peer competition.”
Research support, Levine says, has been one of his biggest accomplishments.
“I, together with my colleagues, created a culture and a context in which I have had a catalytic function that has increased our funding for biomedical and behavioral research, quite remarkably given how difficult it is accomplished,” he says. “To do that, I’ve had to recruit a galaxy of remarkable human beings who have, each in his or her own way, contributed to that remarkable success.
“But it’s not the number of dollars that comes. It’s what those dollars mean in a nationally competitive objective sense, … what we’ve contributed to the science of biomedical and behavioral research. The ultimate goal of which is to better the human condition.”
Gallagher also cited Pitt’s fruitful relationship with UPMC as one of Levine’s legacies. “(UPMC is) the largest health care system in the United States that is affiliated with an academic medical center,” he says. “(It’s been) a unique and very productive partnership. A lot of universities are at war with their hospital providers. Both sides need each other; it’s very symbiotic.”
George K. Michalopoulos, chair of the Department of Pathology, was interim dean of the School of Medicine for a few years before Levine was hired. He says Levine came to Pitt at a time of turbulence among School of Medicine faculty, who were upset with a proposal to unify their practice plans under UPMC.
Michalopoulos and former Chancellor Mark Nordenberg had worked together to combine the positions of dean and SVC for health sciences, and to get a contract signed with UPMC that provided money and support for the School of Medicine.
“(Levine) received a lot of stuff from UPMC and he put it to good use. He grew the basic sciences enormously and the basic sciences work with the clinical departments,” Michalopouls says. “And everything now has grown to the point where we’re No. 5 in NIH funding in the country. This is a major, major achievement. We were like No. 32 when he first came.
“That growth took place because he found the right people to bring in, he’s spent money for the recruitment, he monitors the new chairs and he put together collaboration efforts between all these departments.”
Levine put people in charge of clinical departments who knew clinical work and the science behind it, Michalopoulos says. Now, scientific support of clinical medicine has grown so much that is difficult for smaller hospitals to build their own laboratories, he says, particularly ones that rival those at Pitt.
“By growing this scientific support in the clinical wards, Dr. Levine made it possible to convince these other hospitals that you don’t have to build these laboratories, you don’t have to do all that kind of stuff,” Michalopoulos says. “We’ll provide it from here. And all of this helped UPMC grow and the basic science departments to grow.
“So that in a summary is his legacy, he really did something that many other deans and senior vice chancellors … in the country have not been able to do.”
In addition, Gallagher says Levine has been very wise in “teaching a generation that’s going to face a very different health care environment than any doctors, nurses, dentists have faced before.”
“That all happen with a lot of effort, a lot of support, and a lot of push from him and holding together and making sure that everybody did their job,” Gallagher says. “Every year, there’s an evaluation of every chair, how they’re doing in regard to science and clinical at the same time. … He maintained great collaboration with UPMC. … and everything worked together to build what we are today.”
Future of health sciences schools
Levine doesn’t hesitate when asked the biggest challenge the schools of the health sciences face in the future — “financial support.”
“The only two things you need in this business is money and the right aesthetic with which to spend it,” he says.
“There have been some proposals to split the positions again. I think it would be a big mistake,” Michalopoulos says. “I remember the dean of the School of Medicine at that time — George Bernier Jr. — feeling very frustrated because nobody would go to him, just straight up to the senior vice chancellor, who controls budgets and everything. The dean became a cosmetic presence. … And then if you have deans in every school of the health sciences, just deans, they all start defending their own interests.
“Right now, having the two (positions) together, very important decisions have been made by one person looking at the whole thing,” says Michalopoulos, who thinks the next senior vice chancellor should have both a scientific and clinical background.
“They should be looking for a senior vice chancellor and dean that will not only sustain the remarkable trajectory that the health science schools have been on over the past 20 years but will in fact take the schools even further,” Levine says.
Gallagher says the new SVC/dean will face a very different health care field than Levine did in 1997. Health care is one of the largest expenses we have as a country, but it’s not as effective as we want it to be, which is not sustainable, Gallagher says.
“The other interesting set of problems that I think his successor will face are the problems of success,” Gallagher says. “We now have — unlike when Art got here — a very large and mature biomedical science complex. Those are expensive, they’re complex, they’re evolving, and he or she, whoever that is that comes in, is going to be facing an $800 million a year research enterprise, and complicated teaching and a very rapidly evolving health care provider system in UPMC. Those are all high-quality problems to have, great ones that come from success, but they’re going to be a big challenge too.”
In a nod to the “War on Cancer,” Levine and his group are calling their research the “Assault on Alzheimer’s.”
Already he’s recruited Afonso Silva from the NIH, who will help set up a new animal model for the study of Alzheimer’s, and Amantha Thathiah, whose research is on cellular and molecular pathogenesis in Alzheimer’s disease. Levine plans to recruit 10 more for his new lab in the Brain Institute and provide seed grants to people already at Pitt who “are very smart but may never have worked on Alzheimer’s. If we can give enough money to take advantage of their creativity and their intelligence, we’ll be off and running.”
While Pitt already has the Alzheimer’s Disease Research Center, its focus has been on diagnosing and curing the disease. Levine and his group are hoping to find a way to prevent it, possibly through a drug, antibody or a vaccine.
“(Alzheimer’s) isn’t any different than any other disease. … It was a lot cheaper and more effective to develop the Salk polio vaccine than to put children in iron lungs for the rest of their lives,” Levine says. “In fact, I can’t think of very many diseases we’re not better off preventing than treating.”
Levine says more and more money is going into Alzheimer’s research as people recognize “the expense of Alzheimer’s disease, not only the human expense but the fiscal expense for the nation’s health care economy.”
“I think the nation, Congress, the NIH, the foundations all recognize that we have an aging population in this country, and the more people age — and age having been free of cancer and heart disease — the more likely it is that we’ll see Alzheimer’s disease,” he says.
The only significant breakthrough in Alzheimer’s research was done at Pitt by Drs. Bill Klunk and Chester Mathis, who discovered Pittsburgh Compound B, which made it possible for researchers to view Alzheimer’s disease in a living brain. The compound binds to beta amyloid, which seems to be an early trigger for the disease or at least present at the beginning of the disease.
Levine says the disease can be present for 15 to 20 years before a patient starts to show symptoms. His hope is that they can identify people who are susceptible to the disease because of genetics. And he encourages people to sign up for the All of Us human genome project, which allows researchers to have a large genetic sampling to study.
He says we already know the genetics of the early onset version of the disease, which starts in the 30s and ends in the 40s.
“We know that the trajectory of that disease is identical to the much far more common sporadic age-related form of the disease. The two curves look identical. It’s the same 12-year period,” Levine says. “Whatever we can do to prevent the early onset form — and we can identify that theoretically at birth because we know the mutations — we should be able to also do in the common form.”
Susan Jones is editor of the University Times. Reach her at firstname.lastname@example.org or 412-648-4294.