- Email: [email protected]
The Resident Retreat for Future Academicians
commentary
was IL-10. Tregs from IL-10-deficient mice did affect the sensitizing ability of the hapten-coupled DCs. Cell-to-cell contact was required—the authors suggest that the Tregs must be activated by the DCs to release IL-10. But perhaps the most interesting observation is that, when the DCs that had been incubated with the Tregs were injected into a naïve mouse, not only did they fail to induce contact hypersensitivity in that mouse but there was activation of more Tregs in the recipient animal. These findings indicate that Tregs, via the release of IL-10, both suppress antigen-presenting cell function (a well-known consequence of IL-10 on DC function) and change their phenotype from immunostimulatory to immunoregulatory. Furthermore, these regulatory DCs can then induce the activation of more Tregs in the naïve recipients, thus amplifying their immunosuppressive function. Although we generally associate UV-induced immunosuppression with a negative consequence (the induction of skin cancer), there are many situations in which clinicians want to turn off an unwanted immune response in an antigen-specific fashion (e.g., in cases of autoimmunity, allergy, and transplant rejection). It is conceivable that the ability of Tregs to influence DC function will make it possible to achieve this aim. For more than 10 years, immunologists have used DC vaccines to treat melanoma, so the technology and experience needed to prepare patientquality DCs are available (Ueno et al., 2010); the challenge will be to generate the Tregs. Schwarz and Schwarz (2010, this issue) isolated Tregs from the lymph nodes of UV-irradiated mice, so it is difficult to see how this can be adapted to the clinic. But it should be noted that human Tregs have been induced to proliferate and expand in vitro (Strauss et al., 2007), so it is conceivable that an in vitro culture system using CD4+CD25+ Tregs and antigen-pulsed DCs may provide a way to generate immunomodulatory DCs. Although simple injection of Tregs would probably achieve this end, it is natural for DCs to come in contact with and activate many T cells in vivo; therefore, it is conceivable that injecting properly “educated” DCs may be a better way to amplify the
immunosuppressive loop. Thus, the data presented by Schwarz and Schwarz confirm the role that T cells play in DC function/differentiation. Furthermore, they point out that Tregs transmit information to DCs that profoundly alters their function, indicating that the traffic flow on the bridge between the innate and adaptive immune response is indeed two-way. CONFLICT OF INTEREST
The author states no conflict of interest.
References
Elmets CA, Bergstresser PR, Tigelaar RE et al. (1983) Analysis of the mechanism of unresponsiveness produced by haptens painted on skin exposed to low dose UV radiation. J Exp Med 158:781–94 Fisher MS, Kripke ML (1982) Suppressor T lymphocytes control the development of primary skin cancers in ultraviolet-irradiated mice. Science 216:1133–4 Moodycliffe AM, Shreedhar V, Ullrich SE et al. (2000) CD40–CD40 ligand interactions
in vivo regulate migration of antigen-bearing dendritic cells from the skin to draining lymph nodes. J Exp Med 191:2011–20 Sakaguchi S, Wing K, Miyara M (2007) Regulatory T cells—a brief history and perspective. Eur J Immunol 37(Suppl 1):S116–23 Schwarz A, Schwarz T (2010) UVR-induced regulatory T cells switch antigen-presenting cells from a stimulatory to a regulatory phenotype. J Invest Dermatol 130:1914–21 Shreedhar V, Moodycliffe AM, Ullrich SE et al. (1999) Dendritic cells require T cells for functional maturation in vivo. Immunity 11:625–36 Strauss L, Whiteside TL, Knights A et al. (2007) Selective survival of naturally occurring human CD4+CD25+Foxp3+ regulatory T cells cultured with rapamycin. J Immunol 178:320–9 Ueno H, Schmitt N, Klechevsky E et al. (2010) Harnessing human dendritic cell subsets for medicine. Immunol Rev 234:199–212 Wong BR, Josien R, Lee SY et al. (1997) TRANCE (tumor necrosis factor [TNF]-related activation-induced cytokine), a new TNF family member predominantly expressed in T cells, is a dendritic cell-specific survival factor. J Exp Med 186:2075–80
See related article on pg 1931
The Resident Retreat for Future Academicians Donna A. Culton1, David S. Rubenstein1 and Luis A. Diaz1 The first Resident Retreat for Future Academicians was held in 2001 with the goal of recruiting and encouraging talented residents interested in careers in academia. In this issue of the JID, Hill et al. present findings to suggest that the retreat has indeed fulfilled its goal. It is our hope that the retreat, which is now in its tenth year, will continue to enlist the future leaders of our specialty. Journal of Investigative Dermatology (2010) 130, 1775–1777. doi:10.1038/jid.2010.133
As incoming President of the Society of Investigative Dermatology (SID) in 2000, I (LAD) recognized four problems facing our Society: a decrease in membership, a decrease in the number of manuscripts submitted by US authors to the Journal of Investigative Dermatology, a fading interest of clinicians in research issues, and
a shrinking pool of young dermatologists interested in biomedical research. I decided to work on the last problem with the approval of the SID Board of Directors. With the support and advice of incoming SID President Jouni Uitto, SID Secretary Paul R. Bergstresser, Barbara A. Gilchrest, Alice P. Pentland, Richard L. Edelson,
Department of Dermatology, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
1
Correspondence: Luis A. Diaz, Department of Dermatology, University of North Carolina–Chapel Hill, Suite 3100 Thurston-Bowles Building, CB 7287, Chapel Hill, North Carolina 27599, USA. E-mail: [email protected]
www.jidonline.org 1775
commentary
program (e.g., debt repayment) once the candidate finishes his or her fellowship training and begins his or her faculty appointment.”
Figure 1. Participants in the first SID Resident Retreat. In attendance were 14 chairs of dermatology departments, (Dr. I. Freedberg is not shown), 11 senior faculty (“Old Turks”), 11 junior faculty (“Young Turks”) and 26 resident physicians. Keynote speakers were Drs. Stephen Katz and Richard Klausner from the NIH.
Kim B. Yancey, Wright Caughman, Amy Paller, Thomas Kupper, L.A. Goldsmith, I.M. Freedberg, and David R. Bickers, we began planning the first Resident Retreat for Future Physician Scientists in Dermatology. The following rationale was used in the R13 Application that was submitted to the National Institutes of Health for sponsorship of the meeting: “We wish to focus our efforts in testing one hypothesis: that early exposure of our young trainees to leading national research figures and diffusion of information about research careers may have a positive influence in their career decisions. If this early exposure is coupled with a future postdoctoral fellowship program and a possible faculty appointment we may stimulate the interest of these young prospects. For this purpose we are proposing a two-day meeting (weekend) in a secluded resource (Gordon conference like) for a selected group of first year residents. Leaders of the SID, NIH, DF, and patient’s coalition groups will be available to our residents in this meeting. Interested individuals will be introduced to a list of all research-training programs
supported by the NIH in the USA. In addition, the selected residents will be able to interact with a selected group of junior physician-scientists already on the path of a successful career in dermatological research (i.e., assistant professors). “We believe that this effort is worth pursuing. If 10% of the incoming residents pursue research and/ or academic careers these efforts will be well rewarded. If successful, the resident retreat may become a recurring event (annually, or biannually) which might facilitate the job of training grant directors and chiefs of dermatology services interested in hiring potential fellows and future faculty members. Ideally, the resident retreat could become “the annual or biannual draft” of talented physicians by academic dermatology departments. A potential candidate may select, and be accepted to, a particular training program for his or her fellowship. In a parallel process, he or she may meet dermatology chairs interested in hiring junior faculty members. It is feasible that the interested dermatology chair may be willing to negotiate a package that includes an incentive
1776 Journal of Investigative Dermatology (2010), Volume 130
The first resident retreat was supported by the Herzog Foundation with the instrumental assistance of George Hambrick, the National Institutes of Health–National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Dermatology Foundation, grants from industry (Galderma and Biogen), and the SID. In addition, US departments of dermatology contributed indirectly to the retreat. The event— held at the Arlie Center in Warrenton, VA, on 15–17 June 2001—was attended by national SID leaders and the first cadre of dermatology residents (Figure 1). The physical setting for the initial—and most of the ensuing— meetings contributed to the collegial atmosphere by promoting close interaction among attendees. In addition to the formal sessions at the retreat, many impromptu discussions occurred during meals and breakout sessions, and after hours when faculty and residents congregated socially at the onsite pub. The rural setting encouraged attendees to remain on site as opposed to meetings in large cities where fivestar restaurants and cultural attractions are often too tempting to forgo. In this issue of JID, Hill et al. (2010) present an analysis of data collected from 167 of 209 resident attendees of the annual retreats held from 2002 to 2006. One of the aims of the study was to determine factors influencing the career decisions of US graduating dermatology residents (n = 288) who attended the retreat (23%, n = 66) as compared with those who did not attend (77%, n = 222). Residents attending the retreat were 4.6 times more likely to enter a career in academics than residents who did not attend. Moreover, 89.5% of those entering private practice found that the retreat was also helpful in their career decision. Importantly, both groups of young professionals identified “time with the family” and location of their future job as important factors influencing their decision, whereas age, gender, marital status, and debt amount were
commentary
not predictors of entering academics. The authors found a significant role for mentorship in individuals entering academic careers. Although this may represent ascertainment bias, it also suggests that the resident retreat positively reinforces the decision of resident attendees to pursue academic careers.
|
The Annual Retreat has aided residents’ decisions about academic versus private practice.
The coauthors of this Commentary represent three generations of academicians: senior (LAD), mid-career (DSR), and entering an academic career (DAC). Each has attended the retreat in different roles and shared, like others in their generation, the purpose of serving our dermatology specialty. It was our experience that information about the secrets of success and the difficulties encountered in an academic career was well received by retreat attendees. Midcareer academicians were reinforced
in their decision to remain in academic dermatology, and the young resident attendees found that the experience aided their decision to enter into academic or private practice activities. Although Hill et al. (2010) report on the first 5 years of the retreat, it is worth noting that the retreat is now in its tenth year. Additional data could be collected to determine how the retreat impacts success in academics. Other topics that might be addressed with ongoing data collection include (i) effectiveness at promoting retention (i.e., are academic dermatologists who participate in this program more likely to stay in academics?); (ii) effectiveness in promoting career success (i.e., compared with academic dermatologists who have not attended the retreat, how successful are academic dermatologists who participate in this program at securing funding for research, publishing, and attaining promotion and tenure?); (iii) whether trainees become mentors, and whether they are better prepared to be mentors; and (iv) whether the proportion of academicians has increased over time as the program and initiative have gained momentum. Finally, it is important to address the future of the retreat, which in the past
5 years has increased the breadth of attendees by including clinician-educators. Because the organization and administration of the retreat represent an investment in the future of our specialty, the SID must find partners—e.g., the American Academy of Dermatology, the Association of Professors of Dermatology, and the American Dermatological Association—to ensure the future of the program. The end result, as shown by Hill and colleagues’ study, is that young residents identified as future leaders of dermatology by their residency directors will be making rational decisions when pursuing careers in academics and private practice. It is certain that both groups of individuals will be guarding the future of our specialty. CONFLICT OF INTEREST
The authors state no conflict of interest.
ACKNOWLEDGMENTS
This work was supported by NIH grants RO1-AI49427 (DSR) and R01-AR30281, RO1AR32599, and T32-AR07369 (LAD).
REFERENCE
Hill ND, DeLong LK, Pennie ML et al. (2010) Factors affecting resident career decisions: the first five years of the Society for Investigative Dermatology Resident Retreat. J Invest Dermatol 130:1931–4
www.jidonline.org 1777
Copyright of Journal of Investigative Dermatology is the property of Nature Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
was IL-10. Tregs from IL-10-deficient mice did affect the sensitizing ability of the hapten-coupled DCs. Cell-to-cell contact was required—the authors suggest that the Tregs must be activated by the DCs to release IL-10. But perhaps the most interesting observation is that, when the DCs that had been incubated with the Tregs were injected into a naïve mouse, not only did they fail to induce contact hypersensitivity in that mouse but there was activation of more Tregs in the recipient animal. These findings indicate that Tregs, via the release of IL-10, both suppress antigen-presenting cell function (a well-known consequence of IL-10 on DC function) and change their phenotype from immunostimulatory to immunoregulatory. Furthermore, these regulatory DCs can then induce the activation of more Tregs in the naïve recipients, thus amplifying their immunosuppressive function. Although we generally associate UV-induced immunosuppression with a negative consequence (the induction of skin cancer), there are many situations in which clinicians want to turn off an unwanted immune response in an antigen-specific fashion (e.g., in cases of autoimmunity, allergy, and transplant rejection). It is conceivable that the ability of Tregs to influence DC function will make it possible to achieve this aim. For more than 10 years, immunologists have used DC vaccines to treat melanoma, so the technology and experience needed to prepare patientquality DCs are available (Ueno et al., 2010); the challenge will be to generate the Tregs. Schwarz and Schwarz (2010, this issue) isolated Tregs from the lymph nodes of UV-irradiated mice, so it is difficult to see how this can be adapted to the clinic. But it should be noted that human Tregs have been induced to proliferate and expand in vitro (Strauss et al., 2007), so it is conceivable that an in vitro culture system using CD4+CD25+ Tregs and antigen-pulsed DCs may provide a way to generate immunomodulatory DCs. Although simple injection of Tregs would probably achieve this end, it is natural for DCs to come in contact with and activate many T cells in vivo; therefore, it is conceivable that injecting properly “educated” DCs may be a better way to amplify the
immunosuppressive loop. Thus, the data presented by Schwarz and Schwarz confirm the role that T cells play in DC function/differentiation. Furthermore, they point out that Tregs transmit information to DCs that profoundly alters their function, indicating that the traffic flow on the bridge between the innate and adaptive immune response is indeed two-way. CONFLICT OF INTEREST
The author states no conflict of interest.
References
Elmets CA, Bergstresser PR, Tigelaar RE et al. (1983) Analysis of the mechanism of unresponsiveness produced by haptens painted on skin exposed to low dose UV radiation. J Exp Med 158:781–94 Fisher MS, Kripke ML (1982) Suppressor T lymphocytes control the development of primary skin cancers in ultraviolet-irradiated mice. Science 216:1133–4 Moodycliffe AM, Shreedhar V, Ullrich SE et al. (2000) CD40–CD40 ligand interactions
in vivo regulate migration of antigen-bearing dendritic cells from the skin to draining lymph nodes. J Exp Med 191:2011–20 Sakaguchi S, Wing K, Miyara M (2007) Regulatory T cells—a brief history and perspective. Eur J Immunol 37(Suppl 1):S116–23 Schwarz A, Schwarz T (2010) UVR-induced regulatory T cells switch antigen-presenting cells from a stimulatory to a regulatory phenotype. J Invest Dermatol 130:1914–21 Shreedhar V, Moodycliffe AM, Ullrich SE et al. (1999) Dendritic cells require T cells for functional maturation in vivo. Immunity 11:625–36 Strauss L, Whiteside TL, Knights A et al. (2007) Selective survival of naturally occurring human CD4+CD25+Foxp3+ regulatory T cells cultured with rapamycin. J Immunol 178:320–9 Ueno H, Schmitt N, Klechevsky E et al. (2010) Harnessing human dendritic cell subsets for medicine. Immunol Rev 234:199–212 Wong BR, Josien R, Lee SY et al. (1997) TRANCE (tumor necrosis factor [TNF]-related activation-induced cytokine), a new TNF family member predominantly expressed in T cells, is a dendritic cell-specific survival factor. J Exp Med 186:2075–80
See related article on pg 1931
The Resident Retreat for Future Academicians Donna A. Culton1, David S. Rubenstein1 and Luis A. Diaz1 The first Resident Retreat for Future Academicians was held in 2001 with the goal of recruiting and encouraging talented residents interested in careers in academia. In this issue of the JID, Hill et al. present findings to suggest that the retreat has indeed fulfilled its goal. It is our hope that the retreat, which is now in its tenth year, will continue to enlist the future leaders of our specialty. Journal of Investigative Dermatology (2010) 130, 1775–1777. doi:10.1038/jid.2010.133
As incoming President of the Society of Investigative Dermatology (SID) in 2000, I (LAD) recognized four problems facing our Society: a decrease in membership, a decrease in the number of manuscripts submitted by US authors to the Journal of Investigative Dermatology, a fading interest of clinicians in research issues, and
a shrinking pool of young dermatologists interested in biomedical research. I decided to work on the last problem with the approval of the SID Board of Directors. With the support and advice of incoming SID President Jouni Uitto, SID Secretary Paul R. Bergstresser, Barbara A. Gilchrest, Alice P. Pentland, Richard L. Edelson,
Department of Dermatology, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
1
Correspondence: Luis A. Diaz, Department of Dermatology, University of North Carolina–Chapel Hill, Suite 3100 Thurston-Bowles Building, CB 7287, Chapel Hill, North Carolina 27599, USA. E-mail: [email protected]
www.jidonline.org 1775
commentary
program (e.g., debt repayment) once the candidate finishes his or her fellowship training and begins his or her faculty appointment.”
Figure 1. Participants in the first SID Resident Retreat. In attendance were 14 chairs of dermatology departments, (Dr. I. Freedberg is not shown), 11 senior faculty (“Old Turks”), 11 junior faculty (“Young Turks”) and 26 resident physicians. Keynote speakers were Drs. Stephen Katz and Richard Klausner from the NIH.
Kim B. Yancey, Wright Caughman, Amy Paller, Thomas Kupper, L.A. Goldsmith, I.M. Freedberg, and David R. Bickers, we began planning the first Resident Retreat for Future Physician Scientists in Dermatology. The following rationale was used in the R13 Application that was submitted to the National Institutes of Health for sponsorship of the meeting: “We wish to focus our efforts in testing one hypothesis: that early exposure of our young trainees to leading national research figures and diffusion of information about research careers may have a positive influence in their career decisions. If this early exposure is coupled with a future postdoctoral fellowship program and a possible faculty appointment we may stimulate the interest of these young prospects. For this purpose we are proposing a two-day meeting (weekend) in a secluded resource (Gordon conference like) for a selected group of first year residents. Leaders of the SID, NIH, DF, and patient’s coalition groups will be available to our residents in this meeting. Interested individuals will be introduced to a list of all research-training programs
supported by the NIH in the USA. In addition, the selected residents will be able to interact with a selected group of junior physician-scientists already on the path of a successful career in dermatological research (i.e., assistant professors). “We believe that this effort is worth pursuing. If 10% of the incoming residents pursue research and/ or academic careers these efforts will be well rewarded. If successful, the resident retreat may become a recurring event (annually, or biannually) which might facilitate the job of training grant directors and chiefs of dermatology services interested in hiring potential fellows and future faculty members. Ideally, the resident retreat could become “the annual or biannual draft” of talented physicians by academic dermatology departments. A potential candidate may select, and be accepted to, a particular training program for his or her fellowship. In a parallel process, he or she may meet dermatology chairs interested in hiring junior faculty members. It is feasible that the interested dermatology chair may be willing to negotiate a package that includes an incentive
1776 Journal of Investigative Dermatology (2010), Volume 130
The first resident retreat was supported by the Herzog Foundation with the instrumental assistance of George Hambrick, the National Institutes of Health–National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Dermatology Foundation, grants from industry (Galderma and Biogen), and the SID. In addition, US departments of dermatology contributed indirectly to the retreat. The event— held at the Arlie Center in Warrenton, VA, on 15–17 June 2001—was attended by national SID leaders and the first cadre of dermatology residents (Figure 1). The physical setting for the initial—and most of the ensuing— meetings contributed to the collegial atmosphere by promoting close interaction among attendees. In addition to the formal sessions at the retreat, many impromptu discussions occurred during meals and breakout sessions, and after hours when faculty and residents congregated socially at the onsite pub. The rural setting encouraged attendees to remain on site as opposed to meetings in large cities where fivestar restaurants and cultural attractions are often too tempting to forgo. In this issue of JID, Hill et al. (2010) present an analysis of data collected from 167 of 209 resident attendees of the annual retreats held from 2002 to 2006. One of the aims of the study was to determine factors influencing the career decisions of US graduating dermatology residents (n = 288) who attended the retreat (23%, n = 66) as compared with those who did not attend (77%, n = 222). Residents attending the retreat were 4.6 times more likely to enter a career in academics than residents who did not attend. Moreover, 89.5% of those entering private practice found that the retreat was also helpful in their career decision. Importantly, both groups of young professionals identified “time with the family” and location of their future job as important factors influencing their decision, whereas age, gender, marital status, and debt amount were
commentary
not predictors of entering academics. The authors found a significant role for mentorship in individuals entering academic careers. Although this may represent ascertainment bias, it also suggests that the resident retreat positively reinforces the decision of resident attendees to pursue academic careers.
|
The Annual Retreat has aided residents’ decisions about academic versus private practice.
The coauthors of this Commentary represent three generations of academicians: senior (LAD), mid-career (DSR), and entering an academic career (DAC). Each has attended the retreat in different roles and shared, like others in their generation, the purpose of serving our dermatology specialty. It was our experience that information about the secrets of success and the difficulties encountered in an academic career was well received by retreat attendees. Midcareer academicians were reinforced
in their decision to remain in academic dermatology, and the young resident attendees found that the experience aided their decision to enter into academic or private practice activities. Although Hill et al. (2010) report on the first 5 years of the retreat, it is worth noting that the retreat is now in its tenth year. Additional data could be collected to determine how the retreat impacts success in academics. Other topics that might be addressed with ongoing data collection include (i) effectiveness at promoting retention (i.e., are academic dermatologists who participate in this program more likely to stay in academics?); (ii) effectiveness in promoting career success (i.e., compared with academic dermatologists who have not attended the retreat, how successful are academic dermatologists who participate in this program at securing funding for research, publishing, and attaining promotion and tenure?); (iii) whether trainees become mentors, and whether they are better prepared to be mentors; and (iv) whether the proportion of academicians has increased over time as the program and initiative have gained momentum. Finally, it is important to address the future of the retreat, which in the past
5 years has increased the breadth of attendees by including clinician-educators. Because the organization and administration of the retreat represent an investment in the future of our specialty, the SID must find partners—e.g., the American Academy of Dermatology, the Association of Professors of Dermatology, and the American Dermatological Association—to ensure the future of the program. The end result, as shown by Hill and colleagues’ study, is that young residents identified as future leaders of dermatology by their residency directors will be making rational decisions when pursuing careers in academics and private practice. It is certain that both groups of individuals will be guarding the future of our specialty. CONFLICT OF INTEREST
The authors state no conflict of interest.
ACKNOWLEDGMENTS
This work was supported by NIH grants RO1-AI49427 (DSR) and R01-AR30281, RO1AR32599, and T32-AR07369 (LAD).
REFERENCE
Hill ND, DeLong LK, Pennie ML et al. (2010) Factors affecting resident career decisions: the first five years of the Society for Investigative Dermatology Resident Retreat. J Invest Dermatol 130:1931–4
www.jidonline.org 1777
Copyright of Journal of Investigative Dermatology is the property of Nature Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.