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Brandon Pham

2017 Gina M. Finzi Memorial Student Fellow

Project Summary:

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder that is significantly more common in females than in males. However, males with SLE tend to develop more severe damage to their organs. The precise reasons for the increased female bias in developing SLE and for the more severe disease in males are still unclear.

This project aims to explain why these sex differences occur. Females and males differ in many biological aspects, such as in hormones and gonads, but their most fundamental difference is that females have two X chromosomes and males have one X and one Y chromosome.

We suspect that these sex chromosomes may contribute to differences in immune responses between males and females. Specifically, we focus on a class of genes, called toll-like receptors, which are located on the X chromosome. These toll-like receptor genes have previously been implicated in the development of SLE.

We want to test if these genes also contribute to sex differences in SLE. We will use an animal model system to test this idea. This particular model system allows us to separate the effects of chromosomes from gonads (sex hormones).

Ultimately, our findings promise to clarify the role of toll-like receptor genes in immune regulation and to provide insight into why females are generally more likely to develop SLE and why males generally develop more severe SLE. The results of this study may pave the road for new research studying sex-specific treatments for males and females based on sex differences.

I am incredibly thankful for the generosity of the Lupus Foundation of American for the Finzi award, which has been at once inspiring and motivational – galvanizing my current work on hydroxychloroquine at Stanford and my career as a future physician and scientist.

Publications and Absractions

  1. Pham BH, Marmor MF. Sequential changes in hydroxychloroquine retinopathy up to 20 years after stopping the drug: implications for mild vs. severe toxicity. Retina. 2019; 39(3):492-501.
  2. Pham BH, de Sisternes LH, Durbin MK, Marmor MF. Topography shows limited ellipsoid zone recovery from mild hydroxychloroquine toxicity. Investigative Ophthalmology & Visual Science. 2019; 60(9):4998.
  3. Marmor MF, Pham BH, Goldberg JL. Photopic negative response (PhNR) waveform measurement independent of baseline (N-wave) for the clinical evaluation of glaucoma. Investigative Ophthalmology & Visual Science. 2019; 60(9):2443.
  4. Mercado C, Pham BH, Beres S, Marmor MF, Lambert SR. Unilateral Retinitis Pigmentosa in Children. Journal of American Association for Pediatric Ophthalmology and Strabismus. 2018; 22(6):457-461.e4.
  5. Pham BH, Marmor MF. Long-term progression of hydroxychloroquine retinopathy off the drug. Investigative Ophthalmology & Visual Science. 2018; 59(9):3162.

Presentations

  1. Marmor MF, Pham BH, de Sisternes L. Topographic optical coherence tomography segmentation shows limited anatomic recovery from early hydroxychloroquine retinopathy. Oral presentation at 42nd Macula Society Annual Meeting in Bonita Springs, Florida on February 13, 2019.
  2. Marmor MF, Pham BH. Continual progression of severe hydroxychloroquine retinopathy. Oral presentation at 51st Annual Retina Society Scientific Meeting in San Francisco, California on September 13, 2018.
  3. Chandramohan A, Lee M, Pham BH, Tao J, Zubair T, Do D. Seeing things differently: satisfaction scores in patients receiving intravitreal injections. Oral presentation at Stanford Ophthalmology Resident’s Day at the Byers Eye Institute at Stanford University on June 2, 2018. 
  4. Pham BH, Marmor MF. Severe hydroxychloroquine retinopathy fails to stabilize up to 20 years after drug cessation. Selected for poster presentation at 35th Annual Stanford Medical Student Research Symposium on May 17, 2018.
  5. Pham BH, Marmor MF. Serial follow-up of long-term hydroxychloroquine toxicity in patients off the drug. Oral presentation at Grand Rounds at Stanford Byers Eye Institute on April 19, 2018.
  6. Mercado C, Pham BH, Beres S, Marmor MF, Lambert SR. Unilateral Retinitis Pigmentosa in Children. Selected for poster presentation at 2018: American Association for Pediatric Ophthalmology and Strabismus (AAPOS) 44th Annual Meeting with ISA in Washington, DC on March 19, 2018.