‘Follow the science and follow your gut’ to make a change in medicine

Key takeaways:

• Emma Guttman-Yassky, MD, PhD, is the recipient of this year’s Paul Ehrlich Award for Experimental Research.
• Guttman-Yassky emphasizes the importance of mentorship and sticking to your beliefs.

Emma Guttman-Yassky, MD, PhD, lives her life in dichotomy. She’s a dermatologist and an immunologist; a researcher and a department chair; and her medical and research experience transcends the globe, from North America to Europe.

Guttman-Yassky, who serves as the Waldman Professor of Dermatology and Immunology and System Chair of the Kimberly and Eric J. Waldman Department of Dermatology at the Icahn School of Medicine at Mount Sinai, is considered one of the world’s leading experts in inflammatory skin diseases, according to a press release from Mount Sinai.

This June, the 2024 European Academy of Allergy & Clinical Immunology awarded Guttman-Yassky with the Paul Ehrlich Award for Experimental Research for her revolutionary efforts in discovering innovative approaches to diagnosis, treatment and prevention in allergy and immunology.

In April, Guttman-Yassky, who also serves as the director of the Eczema Center and Occupational Dermatitis Clinic and of the Laboratory of Inflammatory Skin Diseases at Mount Sinai, earned the first Therapeutic Innovation Award from the American Skin Association (ASA). The ASA selected Guttman-Yassky for this honor for her help in uncovering the molecular and cellular mechanisms that cause inflammatory skin diseases such as atopic dermatitis.

These are only the latest in a long list of accolades Guttman-Yassky has acquired over the course of her career.

When asked, Guttman-Yassky said she is most proud of her involvement in developing new treatments that help patients in need.

“My biggest accomplishments are participating in drug development to potentially identify new targets and helping to co-direct that drug development from an academic side,” she told Healio.

Forming a global perspective

Guttman-Yassky, who also is a member of Healio’s Allergy/Asthma Peer Perspective Board, has herself been a dermatology and allergy patient since childhood.

She has eczema and a significant allergy to dust mites, and she had exercise-induced asthma as a child, she told Healio.

“I was always interested in medicine, and I always thought I would either be a dermatologist or an allergist,” she said, adding that she fell in love with the visual field of dermatology during that rotation in medical school at the Sackler School of Medicine of Tel-Aviv University.

After earning her MD at Sackler school of Medicine at Tel Aviv University, she then had to wait for almost 2 years to begin her first dermatology residency.

“In Israel, it’s very difficult, maybe even more than in the United States, to get accepted to a dermatology residency because there are only seven departments with one spot a year,” Guttman-Yassky told Healio.

During this waiting period, she was introduced to medical research by working with patients with Kaposi sarcoma and embarked on a PhD. During this time, she met Ronit Sarid, PhD, dean of the School of Graduate Studies and professor of the Mina and Everard Goodman Faculty of Life Sciences at Bar-Ilan University, who became her mentor.

“She’s remarkable and an amazing mentor,” Guttman-Yassky said. “I finished that PhD with about 16 publications.”

After she obtained her Israeli Board certification, Guttman-Yassky immigrated to the U.S. and pursued a postdoctoral fellowship at The Rockefeller University as a clinical scholar. She then enrolled in her second dermatology residency at what is now Weill Cornell Medicine.

“The first residency I did in Israel provided me with the European perspective, and then I did another one in the U.S., which gave me the American perspective,” Guttman-Yassky said. “I think in a way it’s beneficial because it gives me more of a global view of dermatology and medicine in general.”

Current research

Guttman-Yassky has researched a variety of topics in the dermatology and allergy fields, including AD, alopecia areata, contact dermatitis and rare skin diseases such as ichthyosis. Her work has allowed for accelerated testing of new pathway-specific immune treatments for AD and improved physician understanding of the pathophysiology of these disorders, according to the press release.

Recently, Guttman-Yassky and colleagues have been investigating tape strips as a minimally invasive way to test children for biomarkers associated with AD as well as serially testing adults in clinical trials with various treatments.

“To really understand the phenotype of skin diseases, the money is actually in the skin,” Guttman-Yassky said. “For quite some time we were scratching our heads, asking, how can we analyze the skin in a way that will be more friendly to the patient and more minimally invasive?

“Lately my lab has spearheaded development of a tape strip approach that gives you a good understanding of the genomic profile of the disease to try to understand drug targets,” she added. “Once you have that, you can follow it up in a smaller number of patients with spatial transcriptomics, single-cell analysis and other techniques that do necessitate biopsies to dive deeper into the disease phenotype.”

Guttman-Yassky also worked on a study to determine if tape strips could identify asthma-specific biomarkers in the skin of children with allergic asthma but without AD, the results of which she said “revolutionized the thinking,” allowing researchers to obtain the phenotype of a disease through the skin in children with no skin disease.

“We discovered that in the skin of children with asthma who don’t have AD, you can identify markers that are linked to their lung severity,” Guttman-Yassky said. “Skin is the largest organ we have, and everything is probably manifested there. And, interestingly, we did not find that much going on in their blood. The skin was a better window into what was happening in the lungs than the blood.

“I'm excited about this, particularly because it’s hard to scope children with asthma and this is a minimally invasive technique,” she added.

Further, Guttman-Yassky helped to conduct a preliminary study that used tape strips to evaluate barrier and immune skin biomarkers in Old Order Mennonite children compared with urban Rochester children.

“The environment plays a very big role in these children,” she said. “We saw that Mennonites are protected from developing atopy. The Rochester children, on the other hand, have much higher predisposition to atopy because of environmental factors.”

Finally, Guttman-Yassky is working on two phase 2 clinical studies that are currently recruiting patients to determine the efficacy of dupilumab (Dupixent; Regeneron, Sanofi) as a treatment for alopecia areata. Study results for children are expected in 2025 and 2029.

“For alopecia areata, the only treatments available are JAK inhibitors, which have a black box warning and cannot be given to children younger than age 12 years,” she said. “I think we can make a difference with dupilumab, maybe not in everybody, but in about half of the patients who also have atopic diseases. We are super excited.”

‘Follow your beliefs’

Guttman-Yassky refuses to let her gender or her immigrant status deter her from achieving her goals and strives to have a positive attitude in the face of adversity.

“I think the way to think about it is in a positive way. When I encounter an obstacle, I think, how can I bypass it? I don't think, ‘Oh, that’s it, I’m stuck, I'll never get there.’ You always need to think that there is no glass ceiling,” she said.

It is also important to not be afraid to ask for help when you need it, Guttman-Yassky said.

“People will usually want to help you and collaborate,” she said.

She also emphasized the role of mentorship in finding success, especially for early-career professionals.

“I think to succeed someone needs a good mentor and you really need people that will champion you. In the beginning of your career, this is really important,” she said.

Sarid, Guttman-Yassky’s first mentor, had a “tremendous” impact on her career trajectory and served as a powerful woman role model.

“She showed me that it’s possible to do it all,” Guttman-Yassky said, adding that Sarid has three children and found time spend time with her family and be an amazing scientist as well.

Guttman-Yassky also spoke on the importance of sticking to your beliefs, even when it means fighting against well-established ideas or dogmas, as this is how new directions and developments arise in medicine.

“It’s hard to change the thinking of people, but if you are 100% convinced by the science, you need to follow your beliefs and propel forward,” she said. “Even if in the beginning it will be hard. Your papers may not get accepted initially in the best journals, but the change will eventually happen. Follow the science and follow your gut.”

References:

• Del Duca E, et al. Allergy. 2024;doi:10.1111/all.16060.
• Emma Guttman-Yassky, MD, PhD, receives high honor at European Academy of Allergy and Clinical Immunology. https://www.mountsinai.org/about/newsroom/2024/emma-guttman-yassky-md-phd-receives-high-honor-at-european-academy-of-allergy-and-clinical-immunology. Published June 4, 2024. Accessed June 28, 2024.
• Rothenberg-Lausell C, et al. Allergy. 2024;doi:10.1111/all.16154.

For more information:

Emma Guttman-Yassky, MD, PhD, can be reached at giselle.singer@mssm.edu; Twitter: @EmmaGuttman.