Sarcoidosis Program

The Sarcoidosis Program at the Mount Sinai Medical Center has a long and prominent history.  The Program was established in 1948 when Louis Siltzbach created the Sarcoidosis Clinic. Since then, the Program has grown to become one of the largest in the world. The Program currently consists of the Sarcoidosis Clinic, the Sarcoidosis Support Group, and the out-patient practices at the Mount Sinai-National Jewish Respiratory Institute, a partnership of Mount Sinai’s top-ranked academic medical center in New York with the nation’s leading respiratory hospital based in Denver, CO.  Sarcoidosis patients, many of whom are members of the Sarcoidosis Support Group, receive care at the Clinic and the Institute. 

The Mount Sinai-National Jewish Respiratory Institute is a tertiary referral center for the most complex cases of sarcoidosis. Our physicians have developed a rare level of experience and skill in diagnosing and treating the most challenging forms of this disease. We strive to reverse the disease’s progression, manage symptoms, and provide the tools needed to best cope with the disorder. Through unique diagnostic tests, advanced treatments, and a multidisciplinary approach, we give our patients the resources, support, and care they need to achieve the best possible quality of life.                

I developed clinical and research interests in sarcoidosis during my fellowship training at Johns Hopkins University School of Medicine and was recruited to Mount Sinai in 2007 to enhance the Sarcoidosis Program.  In 2011, I became the Director of Mount Sinai’s Sarcoidosis Clinic.   In 2014, I became Director of Mount Sinai’s Sarcoidosis Program.  As Director of the Program, I oversee the Sarcoidosis Clinic and the Alvin S. Teirstein Sarcoidosis Support Group.  In addition, I care for approximately 500 patients, 90% of whom have sarcoidosis, at the Mount Sinai-National Jewish Respiratory Institute.

The Sarcoidosis Clinic at Mount Sinai is one of the largest of its kind in the world.  Approximately 700 patients visit the Clinic annually.  As Director of the Clinic, I supervise the care of all of the patients who attend the Clinic. 

Mount Sinai’s Sarcoidosis Support Group meets on a monthly basis.  At the meetings, I routinely lecture about topics of interest to sarcoidosis patients and their caregivers.  The meetings allow patients to voice their concerns, share experiences, learn about new diagnoses and therapies, and meet the multidisciplinary staff of pulmonologists, ophthalmologists, and other specialists who participate in their care.

In addition to caring for patients, I am an active member of the national and international academic community of physicians who study sarcoidosis.  I am currently evaluating the use of the drug, KiactaTM, for the treatment of sarcoidosis. (see “Our Research” below).   I am also a reviewer for several journals in the field of pulmonary medicine.  Nearly all of the articles that I review relate to the topic of sarcoidosis.  I am a member of the following pulmonary societies:  American Thoracic Society, American College of Chest physicians, tAmerican Association of Granulomatous Diseases (AASOG) and World Association of Granulomatous Diseases (WASOG).  The WASOG group was recently tasked with the development of a clinical assessment tool for the diagnosis of sarcoidosis.

http://www.mountsinai.org/profiles/adam-morgenthau   

Dr. Morgenthau is the inventor of technology relating to the use of the drug, KiactaTM, for the treatment of sarcoidosis.  Dr. Morgenthau transferred his rights to the technology to the Icahn School of Medicine at Mount Sinai.  Mount Sinai has applied for a provisional patent with respect to the technology and has licensed the technology to Auven Therapeutics, a global private equity company focused on the accelerated development of breakthrough therapeutic drugs.  Dr. Morgenthau has collaborated with Auven to develop a novel Phase II/III clinical trial protocol  to evaluate the safety and efficacy of KiactaTM for the treatment of sarcoidosis. .  A multicenter clinical trial is anticipated in 2017.

While developing the Kiacta study protocol, Dr. Morgenthau collaborated with Transparency Life Sciences (TLS), a drug development company based on open innovation, to utilize crowdsourcing and mobile health technology to develop protocols that are focused on parameters most relevant to clinical decision-makers and patient needs.

In September 2014, TLS launched an online tool to solicit feedback about the protocol, clinical trial design and utilization of mobile health technology intended for use in the clinical trial evaluating Kiacta in sarcoidosis.  The answers to the questions posed in the survey tool were used to fine tune the design of the protocol for the impending clinical trial.  More than 200 researchers, physicians and patients participated in the survey.  The crowdsourcing provided valuable information, which improved the design of the trial and will likely enhance patient participation.   The protocol has been submitted to the FDA for regulatory approval.  A phase 2/3 clinical trial evaluating the safety and efficacy of Kiacta in patients with sarcoidosis is expected in 2017.

Dr. Chandramani-Shivalingappa is evaluating the immunologic mechanisms underlying granuloma formation and maintenance in sarcoidosis, and his work is being funded by a philanthropist named Leslie Maltz.

The goal of Dr. Chandramani-Shivalingappa’s project is to establish and utilize a novel histological assessment method, which has been termed the Granuloma Immune MicroArchitecture in Sarcoidosis (GIMA-S), to better characterize histologic phenotypes of disease, correlate these with clinical phenotypes and to assess treatment responses and prognosticate clinical outcomes.

In collaboration with Dr. Morgenthau, Dr. Chandramani-Shivalingappa is conducting preliminary in vitro assays to evaluate novel therapies for the treatment of sarcoidosis.

Dr. Becker is the principal architect of the project that Dr. Chandranmani-Shivalingappa has begun.  The Granuloma Immune MicroArchitecture in Sarcoidosis (GIMA-S) is a histological method designed to better characterize histologic phenotypes of disease, correlate them with clinical phenotypes and to assess treatment responses and prognosticate clinical outcomes.

Dr. Becker was involved in a project to provide complex immunophenotyping surveillance on patients undergoing a clinical treatment trial with MCSF-Ab.  He developed complex immunophenotyping panels to monitor relevant immune cell subsets at the pharmacodynamically relevant time-point

The WASOG Sarcoidosis Organ Assessment Instrument: An update of a previous clinical tool.
Judson MA, Costabel U, Drent M, Wells A, Maier L, Koth L, Shigemitsu H, Culver DA, Gelfand J, Valeyre D, Sweiss N, Crouser E, Morgenthau AS, Lower EE, Azuma A, Ishihara M, Morimoto S, Tetsuo Yamaguchi T, Shijubo N, Grutters JC, Rosenbach M, Li HP, Rottoli P, Inoue Y, Prasse A, Baughman RP, Organ Assessment Instrument Investigators TW.
Sarcoidosis Vasc Diffuse Lung Dis. 2014 Apr 18;31(1):19-27.

Catheter ablation of atrial arrhythmias in cardiac sarcoidosis.
Willner JM, Viles-Gonzalez JF, Coffey JO, Morgenthau AS, Mehta D.
J Cardiovasc Electrophysiol. 2014 Sep;25(9):958-63. doi: 10.1111/jce.12424. Epub 2014 May 2.

Sarcoidosis of the upper and lower airways.
Morgenthau AS, Teirstein AS.
Expert Rev Respir Med. 2011 Dec;5(6):823-33. doi: 10.1586/ers.11.66. Review.

Recent advances in sarcoidosis.
Morgenthau AS, Iannuzzi MC.
Chest. 2011 Jan;139(1):174-82. doi: 10.1378/chest.10-0188. Review.

"End-stage" pulmonary fibrosis in sarcoidosis.
Teirstein AT, Morgenthau AS.|
Mt Sinai J Med. 2009 Feb;76(1):30-6. doi: 10.1002/msj.20090.

Spectrum of fibrosing diffuse parenchymal lung disease.
Morgenthau AS, Padilla ML.
Mt Sinai J Med. 2009 Feb;76(1):2-23. doi: 10.1002/msj.20087. Review.

Adam Morgenthau, MD, Director of the Sarcoidosis Program
Dr. Morgenthau received his medical degree from the Sackler School of Medicine in Tel Aviv, Israel and completed his residency at North Shore University Hospital in New York. He subsequently completed his fellowship training in Pulmonary and Critical Care Medicine at the John Hopkins University School of Medicine.  While at Johns Hopkins, Dr. Morgenthau developed clinical and research interests in sarcoidosis.  He was recruited to the Sarcoidosis Program at Mount Sinai in 2007.  Dr. Morgenthau is currently the Director of Mount Sinai’s Sarcoidosis Program and the Alvin S. Teirstein Sarcoidosis Support Group. He currently cares for a cohort of approximately 500 patients with sarcoidosis at the Mount Sinai-National Jewish Respiratory Institute.  Dr. Morgenthau is a member of the following societies:   American Thoracic Society, American College of Chest physicians, tAmerican Association of Granulomatous Diseases (AASOG) and World Association of Granulomatous Diseases (WASOG).Dr. Morgenthau’s research efforts are focused on developing new therapies for sarcoidosis.  He is currently evaluating the use of the drug, KiactaTM, for the treatment of sarcoidosis.  In collaboration with Transparency Life Sciences (TLS) a drug development company, he has written a novel study protocol to be used in future clinical trials. He is also currently leading or involved in the following projects: a prospective study evaluating forced oscillation testing in patients with sarcoidosis; and a descriptive study characterizing the differences in clinical features among Hispanic, Caucasian and African American sarcoidosis patients. Finally, in collaboration with Prashanth Chandramani-Shivalingappa, MSc, PhD, Dr. Morgenthau is conducting preliminary in vitro assays to evaluate novel therapies for the treatment of sarcoidosis.

Christian Becker, MD, PhD, Adjunct, Assistant Professor Mount Sinai
Dr. Becker received a combined MD (1999) and PhD degrees (2001, molecular genetics) from Hannover Medical School in Germany. He trained in Internal Medicine in Germany (2000-2002) and subsequently in the US at The Albert Einstein Medical Center in Philadelphia, PA (2002-2005), followed by clinical (2005-2008) and research fellowship training (2008-2009) in Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai. Dr. Becker’s research focus lies in human pulmonary immunology. He developed a translational human immunology focus in pulmonary disease and worked extensively on dendritic cell functional and anatomic diversity in the steady state as well as in sarcoidosis and lung cancer. He has published high impact papers on the functional heterogeneity of dendritic cell subsets in the steady state humanized mouse lung and human lung for both the CD8 and CD4 T cell compartments. Dr. Becker established a very successful multidisciplinary program for the study of human lung diseases at Mount Sinai, which has recruited and characterized over 300 patients with a spectrum of pulmonary conditions to date. Dr. Becker is leading the Pulmonary Disease Group in the Human Immune Monitoring Center (HIMC) at Mount Sinai, where he facilitates and directs the use of multiscale immunophenotyping techniques like mass cytometry (CyTOF) as well as novel immunohistochemical techniques like MICSSS (Multiplexed Immunohistochemistry Consecutive Staining on Single Slide) in the human lung tissue mircro-environment in sarcoidosis. Dr. Becker developed and optimized the methodology and protocols for the study of the Granuloma Immune MicroArchitecture in Sarcoidosis (GIMA-S), which is currently ongoing.

Prashanth Chandramani-Shivalingappa, MSc, PhD, Postdoctoral Fellow
Dr. Chandramani-Shivalingappa received his PhD degree from the University of Hohenheim, Stuttgart, Germany. During this time, he was able to show the responsiveness of chemosensory neurons located in the nasal cavity responds to MHC class I peptides. Later he worked as postdoctoral research associate at Iowa State University, and Central Michigan University. His work has been published in peer reviewed journals, which has recently reached headline news, showing the effect of electronic cigarette vapors in initiating lung disease and aging. Dr. Chandramani-Shivalingappa has come to Mount Sinai to conduct research in order to better understand the inflammation in sarcoidosis and develop an appropriate therapeutic approach.

There are no active clinical trials in sarcoidosis. 

A phase 2/3 clinical trial evaluating the safety and efficacy of KiactaTM in patients with sarcoidosis is expected in 2017.