Dr. Donald A. Glass II Receives the 2024 DF Sanofi and Regeneron Diversity, Equity, and Inclusion Mid-Career Award

Donald A. Glass II, MD, PhD, has received the first 2024 DF Sanofi and Regeneron Diversity, Equity, and Inclusion Mid-Career Award (SRDEI) from the Dermatology Foundation (DF). The award funds research of exceptional mid-career investigators and comes with funding of $100,000 each year for three years to support basic, clinical, or translational research that leads to a better understanding and treatment of skin disorders adversely impacting underrepresented or underserved populations. One of those skin disorders is the focus of Dr. Glass’ research — keloids — which affect as much as 6% of the US population and is 3-7 times more prevalent among African Americans than the general population.

“This award will be pivotal in helping us continue to focus, not just on clinical treatment, but on trying to understand the genetic underpinnings and comorbidities of patients with this condition.”

The award is a collaboration of the DF and the Skin of Color Society, with the generous financial support of Sanofi and Regeneron.

“This award will be pivotal in helping us continue to focus, not just on clinical treatment, but on trying to understand the genetic underpinnings and comorbidities of patients with this condition,” Dr. Glass said. “This should pave the way for better treatments, and better treatment modalities.”

His family instilled an interest in science and medicine. His father was a chemist who also had an MBA, his mother was a registered nurse, and his godfather was a medical doctor. After graduating from high school in the Bahamas, Dr. Glass spent two years at the Lester B. Pearson United World College of the Pacific in Victoria, British Columbia. He then received a BSc in chemistry and did premedical training at the University of Pennsylvania before moving to Houston.

Dr. Glass is associate professor at UT Southwestern Medical Center (UT Southwestern) Department of Dermatology. He earned an MD/PhD from the Medical Scientist Training Program at Baylor College of Medicine (Baylor) in Houston in 2006 where his research focused on the signaling pathways that regulate bone mass. During medical school, his interest pivoted from internal medicine to dermatology. He did a research-track dermatology residency at UT Southwestern where he did his postdoctoral research fellowship with Drs. Helen Hobbs and Jonathan Cohen, mentors who encouraged him to dive right into his passion — keloid research.

“Why is it that a scar in some individuals behaves like a pseudotumor that continues to grow into the normal, unaffected skin?”

“My fascination with skin diseases is not just that they happen, but often times we don’t know why they happen,” he said. “Why is it that a scar in some individuals behaves like a pseudotumor that continues to grow into the normal, unaffected skin?”

Dr. Glass sees patients two and a half days each week, with a half-day in the clinic devoted solely to keloid patients. There, he uses the Keloid Area and Severity Index (KASI), which he co-created, to evaluate keloids (Limmer et al. 2022). Dr. Glass was frustrated that, when he started, treatments were often limited to steroid injections and surgical excision.

Finding targets for future treatments

The higher incidence of keloids in individuals of African ancestry and the fact that the disease runs in some families, usually with an autosomal dominant inheritance pattern, suggests that keloids are the result of genetic changes. His lab is devoted to discovering gene variants linked to keloids and to identify medical disorders associated with the condition. These two lines of research could provide new treatment options and prevention strategies.

The higher incidence of keloids in individuals of African ancestry and the fact that the disease runs in some families, usually with an autosomal dominant inheritance pattern, suggests that keloids are the result of genetic changes.

First, his lab identifies dysregulated gene expression and single nucleotide polymorphisms within certain genes in keloid tissue compared to normal skin that may suggest that specific genes or pathways are involved in keloid formation.

“Our hope is that industry stalwarts and startups can use these findings to develop new medications to target signaling pathways and genes involved in keloid formation,” said Dr. Glass. “There are already some academic labs doing clinical trials with dupilumab, a monoclonal antibody used to treat atopic dermatitis that has shown some promise in the treatment of keloids.”

His second line of research has shown African Americans with keloids are more likely to suffer from comorbid conditions such as atopic dermatitis, hypertension, diabetes, and uterine fibroids compared to those without keloids. This research leverages a keloid registry of patient data using tissue and blood samples from his clinic that Dr. Glass began collecting during his postdoctoral fellowship. DNA analysis of samples, as well as data from the National Institutes of Health’s (NIH’s) All of Us Research Hub and UT Southwestern electronic medical records, will lead to identification of other medical conditions associated with keloids.

Dr. Glass values the types of bridging grants DF provides researchers from underrepresented groups. Beyond NIH or the department of defense there aren’t disease-specific funding mechanisms for keloid research comparable to the National Psoriasis Foundation or the National Eczema Foundation. The SRDEI award broadens the scope of funding for research on this type of disease.

“Having this diversity, equity, and inclusion mid-career award will empower more investigators to pursue research on conditions that either disproportionately affect skin of color individuals or manifest differently depending on skin tone.”

“Having this diversity, equity, and inclusion mid-career award will empower more investigators to pursue research on conditions that either disproportionately affect skin of color individuals or manifest differently depending on skin tone,” he said. “This includes many under-researched conditions more likely to affect individuals who are not of European ancestry, such as scarring alopecia, prurigo nodularis, hidradenitis suppurativa, and melasma.”

DEI and the need for cultural competency

Equity and inclusion are tied to diversity and exist when physicians understand the unique needs of patient populations based on their skin tones. “Dermatologists see all skin types and should be familiar with the pathophysiology of the range of conditions that affect the US population,” said Dr. Glass, who is a former co-chair of the Diversity and Inclusion Committee of the Society for Investigative Dermatology (SID) and a past president of the Skin of Color Society (SOCS). “Dermatology is unique because the diversity of humanity is literally in our face when it comes to these conditions.” However, Dr. Glass believes that clinicians with skin of color should not feel constrained to specialize solely in skin of color conditions, nor should research on these conditions be limited only to investigators with skin of color.

Embracing equity and inclusion also widens the scope of diseases studied, who is studying them, and the number of individuals from various backgrounds who become dermatologists (Horsley et al. 2019; Glass et al. 2020; Desai et al. 2021). NIAMS and the NIH have found that investigators from underrepresented groups have a harder time receiving funding than those of European ancestry (Ginther et al. 2011; Erosheva et al. 2020). This occurs, in part, because those investigators tend to focus on conditions like keloids that traditionally have been understudied and underfunded.

“This creates a perpetual cycle of grant reviewers not understanding the need for research on these diseases, or not understanding that the research is cutting edge for this condition at this point in time,” Dr. Glass said. “Perhaps in 10 years, research funding on these conditions will be closer to what’s traditionally been funded, such as for melanoma, psoriasis, acne, or atopic dermatitis. But it has to be funded today for that to happen.”

Recently, NIAMS has been addressing these funding deficiencies and announced a notification of special interest (NOSI) to accelerate research in understudied skin types (NIAMS 2023) as well as partaking in an NIH-wide effort to support the health-related research of scientists who are also making a significant contribution to diversity, equity, inclusion, and accessibility, which should support those whose research intersects with diversity, equity, inclusion, and advocacy (NIH 2023).

DF bridge funding supports DEI research

“The Foundation has been instrumental in providing funds to new investigators to get the flywheel of success going,” Dr. Glass said. He has received a DF Dermatologist Investigator Research Fellowship and a DF Career Development Award (CDA). He parlayed the CDA into a K award from NIAMS. (The DF also awards DEI Career Development Awards to junior investigators in the early stages of their career.)

Dr. Glass is a member of the DF Leaders Society. “With funding that accompanies this SRDEI award, the Skin of Color Society and the Dermatology Foundation are demonstrating the need to have a mid-career award to help researchers bridge between grants for research on underfunded conditions.

“The Foundation has been very good at reading tea leaves about our specialty, anticipating where research is going or needs to go, and then supporting researchers in those domains. It provides funds directed toward women’s health, cosmetic dermatology, surgical dermatology, and now, this DF DEI mid-career award. This bodes well for the future of DEI in our specialty.”

Apply by December 1 for the 2024 DF Sanofi and Regeneron Diversity, Equity, and Inclusion Mid-Career Award (SRDEI).

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