Honoring advances in steroid biology: A conversation with Richard J. Auchus, MD, PhD
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From years spent studying estrogen-metabolizing enzymes to experimenting with recipes in the kitchen, Richard J. Auchus, MD, PhD, has always had a knack for chemistry.
Auchus, professor of pharmacology and internal medicine in the division of metabolism, endocrinology and diabetes at the University of Michigan, said he was lucky to find a mentor early who introduced him to the world of steroid biochemistry, which became a fascination he would go on to pursue in his own research. Today, he is considered one of the leading experts on steroid-related diseases and will receive the outstanding clinical investigator award at this year’s ENDO annual meeting. The award honors an internationally recognized clinical investigator who has contributed significantly to understanding the pathogenesis and therapy of endocrine and metabolic diseases.
Auchus, well known for his pioneering research on steroid hormones, androgen synthesis and conditions such as primary aldosteronism, was also instrumental in revising the Endocrine Society’s clinical practice guideline on congenital adrenal hyperplasia.
Healio spoke with Auchus about what drove him to endocrinology, the advances in steroid biology that will revolutionize research, and his love of multi-sport events.
Healio: What is the defining moment that led you to your field?
Auchus: For me, it goes back to graduate school, when I met my PhD thesis adviser, Douglas F. Covey, PhD, of the department of developmental biology (formerly pharmacology) at Washington University School of Medicine in St. Louis. [Covey] is a steroid chemist, and at the time he was working on aromatase and other estrogen-metabolizing enzymes. He had a project that was just the right background for me — some chemistry, some entomology — but it was about steroid hormones. That was where I got the framework for pursuing a career in steroid biochemistry.
In my last year in the program, people were asking me what I was going to do for my residency. I said, “I don’t want to do that. I want to work in a lab.” But I was told I have to complete a residency. So, I asked, “Who does steroids?” I was told that was endocrinology. I said, “OK, well, I want to do that.” That is how it happened. As I got into endocrinology, I felt it was the most interesting specialty in all of medicine. In subsequent years as a resident, a fellow and as a postdoc, I morphed my interest for steroid biochemistry into my independent research program. But everything goes back to what I did in graduate school.
It was a good decision.
Healio: What area of endocrinology most interests you and why?
Auchus: Limiting this to just one area is difficult, but our most pressing project is to develop better treatments for 21-hydroxylase deficiency, and to make these drugs available to patients soon. There has not been a new class of treatments for this disease in 60 years. People with this disease do not fare well in the long term, so this is a high priority.
In addition to that, adrenal androgens, primary aldosteronism and the biochemical mechanisms that regulate the synthesis of some of these steroids are a close second.
Healio: What advice would you offer a student in medical school today?
Auchus: Do not sell yourself short and do not rush. If you have an attitude that you cannot succeed at something difficult, you already failed. You have to be positive about yourself and what you can do. Life is too short and is about the journey, not the destination. I believe that Chinese proverb. If it takes a few more years to train for something that you really want to do for the rest of your life, then you should invest in that time now. What matters in the end is what I like to call the alarm clock test: When the alarm clock goes off at 6 a.m. 20 years from now, are you going to say, “Another day, I hate this job, but it pays the bills,” or are you going to say, “I can’t wait to get to work, because I love what I do.” That is what really matters. Do what you need to do now to be where you want to be in 20 years.
Healio: What do you think will have the greatest influence on your field in the next 10 years?
Auchus: Two things. One is advances in mass spectrometry, which will enable us to measure smaller and smaller amounts of multiple steroids accurately. That is going to revolutionize the kinds of experiments we will be able to do.
The second is structural biology, such as cryo-electron microscopy and new NMR methods. A lot of the steroid-metabolizing enzymes are hydrophobic and difficult to crystallize. These biophysical techniques are going to give us some insights into these enzymes, into the receptors for the hormones and other things we could not approach by current methods.
Healio: What are your hobbies and interests outside of practicing medicine?
Auchus: I love to fish in the summers and ski in the winters. I enjoy cooking, too; it is like doing chemistry. I train for multi-sport events all year long. I like to compete in open water swimming, triathlons, and running and biking races when I can.
For more information:
Richard J. Auchus, MD, PhD, can be reached at rauchus@med.umich.edu.
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