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October 23, 2020

Meet the Graduate: Tukisa D. Smith, MD, MS
By Editorial Staff

Dr. Tukisa Smith joined the Clinical Scholars program at the Rockefeller University in 2018. Dr. Tukisa Smith received her M.D. from Saint Louis University and completed her internal medicine residency at SUNY Downstate. She completed her Allergy and Immunology fellowship at the Icahn School of Medicine at Mount Sinai and is a diplomate of the American Board of Allergy and Immunology.

 Dr. Smith’s interest in research peaked during her junior year in college. As a double major in business and science, while working as an Organic Chemistry teaching assistant, she realized that the laboratory environment was a welcome contrast from the business school, as it provided an exciting opportunity for exercising precision in experimental design and, execution. There were ritualistic aspects of maintaining a laboratory and the demand for perfection and order was appealing. Her interest in research was further developed when she prepared for experiments that related to the biochemistry of disease mechanism.

 Since Dr. Smith was not a traditional premed or biology major, she was not aware of a career path in which one could become a researcher focused on disease mechanism. Given her deepened interest in research, she joined the NIH Postbaccalaureate Intramural Research Training program at Johns Hopkins in the Division of Infectious Diseases and matriculated into the graduate program in molecular biology with an emphasis in biotechnology. She had a natural knack at bioassay development and was fascinated with microorganism drug resistance mechanisms. She recalls her growing concern about the dangers of antibiotic resistance when she studied the minimal inhibitory concentrations of antibiotics for various bacterial strains isolated from patients. It was at that moment that Dr. Smith knew her career path would be in the field of understanding host immune responses against microorganisms rather than antimicrobial development. It was this pathway that lead her to medical school and subsequently into the field of Allergy and Immunology. Throughout her training she was consistently drawn to translational research focused on understanding disease outcomes in patients with immunodeficiencies and immune dysregulation.

 During her final year in fellowship, her mentor, Dr. Charlotte Cunningham-Rundles at Mount Sinai, encouraged her to think outside of the box and take time off to conduct translational research. Coincidentally, Dr. Barry Coller had sent her an email regarding the KL2 Clinical Scholars program. Dr. Smith applied to the Clinical Scholars program, and after interviewing with various heads of lab, she was invited to join the Laboratory of Biochemical Genetics and Metabolism headed by Dr. Jan Breslow. Dr. Smith was also co-mentored by Dr. Manish Ponda, Assistant Professor in the Breslow Laboratory and a graduate of the Clinical Scholars program. It was a unique opportunity to work with scientists outside of her area of expertise and learn new approaches to understanding immune responses related to the coagulation factor XII contact system, which is a part of the innate immune system with a role in adaptive immune responses.

 Dr. Smith’s research has focused on a rare autosomal dominant disease called Hereditary Angioedema (HAE), clinically characterized by attacks of swelling involving the subcutaneous tissue and mucous membranes. HAE attacks are unpredictable, often extremely painful or disfiguring; when they occur in the neck they can lead to asphyxiation and death. Most patients have either a quantitative or qualitative abnormality in the major inhibitor of the contact system, C1 esterase inhibitor. Dr. Smith is particularly interested in the group of patients with HAE who have normal C1 inhibitor level and function, also known as HAE‐nl‐C1INH, since in most cases, the mechanism is not known. She is also interested in therapeutic development related to the bradykinin pathway, which is involved in HAE, since it is also thought to contribute to various immune mediated diseases.

Her latest research project is focused on understanding whether patients with HAE are at increased risk of COVID-19-related complications, some of which may also involve the bradykinin pathway. Some have speculated that HAE patients who are treated with drugs to counteract the bradykinin pathway may be protected from COVID-19 complications.

 When asked to share her expectation and experiences in the Clinical Scholars, Dr. Smith replied:

“I entered the program expecting that I would learn new skillsets as a clinical researcher. I left the program transformed. I learned the various ways by which I could fashion my career where I can wear multiple hats including that of a physician, translational researcher, biotechnologist and entrepreneur, patient advocate, and policy influencer. I learned the most from my fellow Clinical Scholars, who are some of the greatest minds in a wide range of disciplines. Active dialogue with my colleagues allowed me to become inspired and passionate about my research and I would often gain inspiration from their work, commitment, and drive.

 The best part of the program was the opportunity to engage with world experts in various fields and to hear about their stories and career trajectories. Dining with such individuals was truly a privilege that most are not afforded and those are moments I will always remember. I would describe the program, specifically at Rockefeller University, as one of a kind.”

As a recent graduate of the program and now Assistant Professor of Medicine at the University, San Diego, Dr. Smith was asked for her advice to current Clinical Scholars: “I would say take advantage of all opportunities afforded through the program. Various seminars and workshops might not directly coincide with your research interests; however, you will be surprised how keeping an open mind will impact your research and approach to problem solving. I have taken away many learning points that have equipped me in my present role as a professor, physician, and clinical and translational researcher.”