Addressing key questions about HIV

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{***Amie Montemurro***}

Coming up on Harvard Chan: This Week in Health…

Meet the graduates

{***Pedro Lamothe-Molina Soundbite***}

(I’ve always enjoyed science and knowing things, but also wanted to do something that has an impact and helps people)

This week we share the first of two profiles of who are wrapping up PhD programs this year. You’ll meet Pedro Lamothe-Molina, an aspiring physician-scientist who has spent the last five years exploring a critical question about HIV.

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{***Amie Montemurro***}

Hello and welcome to Harvard Chan: This Week in Health. It’s Thursday, May 18, 2017. I’m Amie Montemurro.

{***Noah Leavitt***}

And I’m Noah Leavitt.

Commencement here is just a week away, and to mark the occasion we’ll be sharing profiles of two of our graduates this week and next week.

{***Amie***}

First is Pedro Lamothe-Molina, who is graduating with his PhD in Biological Sciences in Public Health.

He’s an aspiring physician-scientist, an HIV researcher, and an accomplished triathlete.

{***Noah***}

You’ll hear about all of that as I share part of my conversation with him. And at times you’ll hear me and Amie share a little more context about Pedro and his work.

And to give you a sense of just how accomplished he is…consider that Pedro applied to medical school when he was just *12 years old.

NOAH LEAVITT: I want to start off by asking you about this great story. You applied to medical school when you were 12, which I think is a really, kind of, fun story. What inspired you to apply at the age of 12? And then, what actually happened when you applied?

PEDRO LAMONTHE-MOLINA: Most of these things weren’t very planned. They just, like, happened. So, I grew up in a family where there were several physicians in the family. So, that’s something I’ve always looked up to. So, I wanted to be a physician from very early on. And I was interested in science, and especially biological sciences. And medicine was one of the– I don’t know, the bigger plans for my career, very early on.

So, I had the opportunity to advance faster during the first years of school. So, suddenly I ended up having finished high school. And in Mexico, as in many other countries, you can apply to medical school as an undergraduate. So, instead of being a four-year program as a graduate program, it’s a six-year program, but it starts right after high school. So, when I finished high school, I had to decide where and what to apply to. And that was, as I said, not very planned. So, I was just there, and I wanted to apply to medicine. And that’s what happened.

NOAH LEAVITT: You got to the interview stage, right? So you applied– I mean, you had kind of had academic success at a young age. So, you eventually got to an interview stage, and that’s– is that when they kind of figured out that you were maybe a little too young?

PEDRO LAMONTHE-MOLINA: So, I did apply. And I had a– actually it was a phone interview with the head of admissions from the university. So, he said that he had reservations whether I would do good or not, being at that young age. So, yeah. That’s what, kind of, like, happened. He said that I was academically qualified enough to be a medical student, but he said that maybe emotionally it would be difficult for me to go along the path of medicine at that age.

NOAH LEAVITT: And so, you mentioned kind of having– kind of being in a family of doctors, so was– and you eventually did end up going to medical school. So, was this something that you kind of always felt drawn to? Working in medicine, working in public health, doing something kind of in the health field?

PEDRO LAMONTHE-MOLINA: Yes. So, I think it was a little bit of two things. I’ve always enjoyed science and knowing things, but also wanted to do something that has an impact and helps people.

{***Noah***}

Pedro did eventually graduate from the Mexican School of Medicine at the Universidad La Salle.

But first he actually made a detour into engineering.

{***Amie***}

At the slightly older age of 17, Pedro graduated from the Monterey Institute of Technology and Higher Education.

While there he focused on engineering projects related to biology. One invention was an electronic device that could measure and record patients’ vital signs.

{***Noah***}

While Pedro didn’t pursue engineering as a career, he did tell me that what he learned in school has been valuable as a public health researcher.

He says that engineering has helped him in learning how to design complex projects.

{***Amie***}

An example of a complex project: Pedro’s dissertation, which looked at a type of white blood cell called a CD8-T cell.

It’s particularly good at fighting infections—especially viruses—in people with HIV.

Pedro helped identify a unique mechanism through which these T cells recognize HIV-infected cells, and showed that this process is linked with certain people’s ability to control the virus.

{***Noah***}

The research is helping to shed light on a lingering question among HIV researchers: Why do some people with HIV never get sick?

I asked Pedro about that, but first he explained why he was drawn to HIV research in the first place.

PEDRO LAMONTHE-MOLINA: So early on in medicine I was fascinated by the coevolution race between pathogens and the immune system. I just found that very, very interesting. And HIV is a very unique disease. I think it’s a very new disease. It’s not been in the humans for very long. But it has grown a lot, and it’s a very, very important global health problem.

We know a lot about the disease. If you read any textbook of medicine or biology, you see there’s a lot that we know about the disease and the virus itself, but it’s just not enough to be able to win against that particular virus. So, I think it’s both an intellectual challenge, but also a very important global health program that we desperately need to fight.

NOAH LEAVITT: And so, I know one of the specific things you touched on a second ago is this immune response, and, kind of, I guess, specifically, this idea that there are people who can get HIV, but they may not necessarily become sex. Is that is that something that’s relatively common? Or, what do we kind of know about that?

PEDRO LAMONTHE-MOLINA: No, that’s a great question. So, everybody responds differently to the virus infection. Some people respond better and have a stronger immune response, a more robust immune response. And they can control the virus for longer. So, when somebody gets infected, sometimes it takes a couple of years or a few years before they develop clinical AIDS. And some people develop clinical symptoms much faster than others.

 

And there are people who have been infected for very long periods of time, and they have been able to suppress the virus long term and be able to prevent those clinical symptoms. So, there are a few people, between 1 and 100 to 1 in 300, that are able to suppress, almost completely, the virus replication below the levels of detection by most of the assays that we have in the clinic. And they’ve been able to control the virus for long.

So, we have a very interesting large cohort of those individuals that my advisor, Bruce Walker, got along the years. And we’ve been trying to understand what is particular about those individuals, and the immune responses that they mount against the virus, in trying to understand what is an effective immune response– what is an immune response that is effective looks like, and if there is something that we can use to replicate this as a potential therapeutic.

NOAH LEAVITT: So, in a sense, kind of where you’re looking at is, if you can take lessons from those people who naturally have an immune response to HIV, and that can be used in people who don’t, almost as a treatment method?

PEDRO LAMONTHE-MOLINA: Yeah, exactly. I think that’s the ultimate goal. I think there are many steps that have to be gone from one side to the other, but that’s the ultimate goal. I think it’s first trying to understand what an effective immune response looks like, and see if there are anything that we can use that– to build therapeutics, further down the line.

NOAH LEAVITT: So, I think what’s interesting is that you’re working kind of on the research side, which as you mentioned, you know a lot of steps, can be kind of a long process, but also kind of on the patient, the medical side. So, I guess, how important is it for you to have exposure to both sides, the research side, but also kind of working with patients one-one-one?

PEDRO LAMONTHE-MOLINA: I think it’s great. It gives you a broad perspective. And I think it gives you a broad, but also a clear perspective. When you’re in the lab and trying to design things, you know what– you have a better idea of what can be applicable, and what would work in a patient if that were to succeed. And the other way as well, if you are in the clinic and see some interesting cases or interesting findings, then you can have ideas of what to do or what to study in the lab.

NOAH LEAVITT: And so, you mentioned working with Bruce Walker. When you were looking at schools of public health, was there– I guess, was there something specific that drew you here? Did you know you specifically wanted to work with him? What kind of brought you up to Boston?

PEDRO LAMONTHE-MOLINA: So, one of the things that was very appealing was this particular program that I applied to, and ended up doing my PhD in, which is the biological science and public health. So, I wanted to apply to a program, and I wanted it to work in something that– it was a basic science, trying to understand the basic mechanisms– but, in something that was not far away from having an application.

And I think– so, that’s what drew me to this particular program. So, I think that’s really unique and great. Once I was in a program, I was interested in immunology, and especially HIV immunology. And Bruce Walker is one of the leading scientists in T-cell immunology against HIV. And he has been for a number of years. So, and being himself a physician and a clinician, I think it was a good fit for me because I wanted to work in basic science, but something that had a potential application.

NOAH LEAVITT: So, I wanted to ask about that. You talked about this idea of being a physician and a clinician. For people listening who may not be familiar with that, what does that really mean when you’re a physician-scientist?

PEDRO LAMONTHE-MOLINA: It depends. There are people who work more– work in the clinic, see patients, and take care of patients. And they do some clinical research with those patients, and try to understand how things work. And some others do more basic science. where they’re trying to understand the cellular or molecular mechanisms of certain diseases. And I think that’s the particular side of a physician-scientist, where you provide care to patients. That you use the knowledge you acquire from taking care of patients to get ideas, to do research, and do research projects in the lab. And the other way around, every research project that you try to set up in the lab has the idea of a potential application that you can carry back into the clinic.

{***Noah***}

So when Pedro isn’t in the lab or the clinic…he relaxes by competing in triathlons and running marathons.

{***Amie***}

He’s completed about 20 triathlons—several of which have been Ironman length.

{***Noah***}

In case you’re not familiar: Athletes in those grueling races swim 2.4 miles, bike 112 miles, and then run a marathon.

I asked Pedro about finding the time to compete in these races…and how he first got started in the sport.

NOAH LEAVITT: So, kind of a fun question. We talked you know about triathlons. So, I’d be interested. I mean, you’re kind of focused on research, I’m guessing on data. How does that affect your triathlon training? Are you like a data geek, and you’re–

PEDRO LAMONTHE-MOLINA: I am, yeah.

NOAH LEAVITT: Always analyzing yourself?

PEDRO LAMONTHE-MOLINA: Yeah. Yeah, a little bit.

NOAH LEAVITT: And so, how do you balance triathlon training with all the work you’re doing in the lab? Is that a difficult challenge for you?

PEDRO LAMONTHE-MOLINA: It’s really hard. It’s really hard. There are times where I don’t have time to train at all. And there are blocks of training where I’m doing a lot of training. Or, and try to do it when things in the lab are not as busy. But, yeah, it’s hard. It’s not easy to do both things, for sure.

NOAH LEAVITT: Are there other moments in a triathlon where you’re just regretting the decision entirely to do a triathlon?

PEDRO LAMONTHE-MOLINA: Oh, yeah, yeah. Every time. Every time. Every time. There is always a point in a particular race where you’re not feeling great, and you’re questioning why am I doing this? But eventually, you finish and then it’s like, oh, this is why I was doing it, so.

NOAH LEAVITT: You mentioned before the interview that you started off as a runner. So, what inspired you to pursue triathlons? Was it just kind of the next natural step? Was it just a challenge?

PEDRO LAMONTHE-MOLINA: No, it was actually almost 11 years ago. It was my birthday in March, and my uncle– he is a very well-established triathlete, and he had done more than 10 marathons, and a half Ironman. And he was training for a full Ironman then. And I started doing a couple of 5K races and 10K races.

And it was during my birthday, he said, oh, there’s a triathlon in May. Why didn’t you sign up for that? It was like, well, I don’t own a proper bike. I have a mountain bike that has been in the basement for five years, and I haven’t used it. And I don’t know how to swim. And so, like, oh, you just do a sprint. It’s fine. You’ll do fine.

So, I actually went to my local gym in Mexico, and kind of like got some lessons from a swimming instructor, and read a couple of books about swimming technique, and watched YouTube videos of how to properly swim. And then, I took my bike out of the basement. It was a mountain bike. So, I just did that triathlon, which is a sprint triathlon. And I just fell in love with the sport. And said, like, well, this is the last sport I’ll ever do. And this is sport I want to do until I’m 80 years old. And, a funny story, this event was actually where I met my wife.

NOAH LEAVITT: So, is she a triathlete as well?

PEDRO LAMONTHE-MOLINA: She is. She is, yeah.

NOAH LEAVITT: So, you basically taught yourself how to swim?

PEDRO LAMONTHE-MOLINA: Well, I–

NOAH LEAVITT: From YouTube?

PEDRO LAMONTHE-MOLINA: Yeah, I couple of lessons from an instructor. He was just telling me, oh, do this, or do that. And then, I had a friend from medical school in Mexico who was a really great swimmer. And then, we went together to training and he taught me a lot about the technique, and got considerably better with his help.

{***Noah***}

As you hear Pedro talk you can tell that family is incredibly important to him—both when it comes to triathlons and his career.

{***Amie***}

And as he talked about at the beginning he does come from a family of doctors and scientists.

Pedro said that his father not only came up to Boston to attend his dissertation defense…but served as a strong support system throughout the writing process, offering suggestions and edits along the way.

{***Noah***}

After graduation, Pedro will head down to Atlanta and Emory University where he’ll begin his medical residency.

He’s still unsure of his long-term plans, but he’ll be doing his residency in internal medicine.

{***Amie***}

And as we mentioned at the beginning of this episode, this is the first of two profiles of our students we’ll be sharing as we approach Commencement.

Next week, you’ll hear the story of Deepali Ravel, who has been working to shed light on the biology behind the malaria parasite, while also serving as an advocate for the importance of science education.

{***Noah***}

That’s all for this week’s episode.

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