Positions

Overview

  • 1) Vice Chair for Research:
    As Vice Chair for research, I oversee an extensive research portfolio with physician scientists and PhD’s. The current annual NIH funding level is ~$9 million with a total annual funding of ~$18 million, and a total outstanding research funding of ~$60 million. We have advanced this year from 5th to 3rd place in the Blue Ridge NIH rankings for all Academic Anesthesiology Depts. I have been responsible for making critical strategic decisions including scientist recruitment, bridge funding and support, and planning of Research Retreats, and our Research day (~90 poster presentations in 2016). I have been active in guiding mentors and young faculty. I have also been responsible for initiation of a new and successful internal funding mechanism aimed at investing in both young and established investigators that have or are likely to have a track record of success. This has required establishing an internal Departmental “study section”, as well as an infrastructure for accounting and added grants analysis. I have also advanced an initiative to enhance our philanthropic giving through a partnership with our development team and Alumni. This leadership position has given me not only budget management skills, but also an understanding of what is necessary to maintain and grow a research operation at an academic institution. It has also enhanced my understanding of what is needed to support, promote and grow clinician and PhD scientists.

    2) Division Chief of Cardiac Anesthesia:
    I have just stepped down as the division to focus on my role as Vice Chair for Research after appropriate succession planning and after personally recruiting my successor. I have been the Division chief for the previous 5 years. Our group is comprised of 17 uniquely talented faculty with diverse interests and expertise in areas ranging from holistic medicine to the molecular mechanisms and pathobiology of cardiovascular disease such as pulmonary hypertension. We provide anesthesia and transesophageal echocardiographic services for approximately 1500 open cardiac surgery procedures in 4 new cardiac suites, over 250 TAVRs in a hybrid suite, and as well as a numerous interventional electrophysiology procedures in 6 interventional suites, all located in close proximity. Our group alone has over $1.5M of annual funding with over 50 publications / year. I have recruited 5 new faculty to our division as well as my successor from an outside institution. I have streamlined and improved efficiency in operations, and supported increased procedure numbers through communication, negotiation, and co-ordination with cardiac surgeons and cardiologists. I have re-visited and improved call coverage, and matched compensation with work, a process that has enhanced morale amongst our divisional faculty. The most important legacy of my tenure has been the creation of highly trained electrophysiology cohort of CRNAs which now provide over 95% of all anesthetics for EP procedures in 5 EP labs. We have also introduced new technology into the EP Labs including jet ventilation and trans-cutaneous CO2 monitoring, and the level of satisfaction with our service from our cardiologists and patients is extremely high. Additionally, we have initiated research and quality improvement programs in this CRNA cohort. This experience has allowed me to manage, educate, integrate, collaborate with CRNAs who provide a critical role in the anesthesia team of any modern anesthesia dept. It has also allowed me to work with cardiologists who are now critically important in the new minimally invasive/ hybrid model of cardiac intervention which will inevitably become the backbone of our cardiovascular anesthesia work.

    3) Director, Integrated Vascular Biology Research Laboratory:
    I have been the director of an integrated cardiovascular biology laboratory conducting both basic and translational research for over 18 years. I have been continuously funded by the NIH (NIA and NHLBI), NASA (through the National Space Biomedical Research Institute), the American Heart Association or FAER, as well as other foundations (for the scope of research activities see RESEARCH section). I believe this has given me a keen sense of what is required to be successful in securing funding from diverse sources. It has also taught me fiscal responsibility in the context of grant financial management. Additionally, it has highlighted for me the importance of mentoring- a key to continuity. Most importantly, I understand what is needed to be successful as a researcher, and how important it is to invest in, and commit resources to the right young people early in their careers.

    4) Johns Hopkins International, ARAMCO Health Care Cardiovascular Team:
    I have been an integral member of the Johns Hopkins Aramco Health Care Cardiovascular Team which launched a new Cardiac Surgery Program on April 16th of this year at the Hopkins/Aramco hospital in Dhahran, Eastern Province, Saudi Arabia. This project has spanned almost 3 years and included an initial visit and comprehensive assessment of feasibility, planning, training, recruitment and observerships for cardiac surgeons and cardiac anesthesia colleagues. This process has taught me cultural sensitivity, complexity of organization in international environments, and the importance of persistence and focus toward a goal in the face of headwinds and potential barriers.

    5) Entrepreneurship, Intellectual Property and Commercialization:
    I have been the Scientific co-founder of the biotechnology startup company “Arginetix” (then “Corridor Pharmaceuticals”) that raised close to $28million for the development of a novel class of drugs, arginase inhibitors, for the treatment of diseases in which endothelial dysfunction is a significant component (acquired by Astra-Zeneca 2014). This experience has given me insights into the world of biotechnology, venture funding, and entrepreneurship. Additionally, it has taught me the critical importance of leveraging the most important “asset” that one has in academic medicine: Intellectual Property. I now have a greater understanding of the importance of utilizing this resource to translate our research and potentially fund our discoveries for the future.

    6) Associate Team Leader of the Cardiovascular Alterations Team, National Space Biomedical Research Institute (NSBRI):
    As the Associate team lead for NSBRI from 2010 to 2013, I was an integral part of the NASA and space research community. This experience of directing focused research and priority setting has taught me to manage a group of disparate researchers working outside of their institutions, coordinating and focusing their efforts toward the common goal of improving astronaut cardiovascular health.

    7) Cardiac Anesthesia Fellowship Program Director:
    We have seen our fellowship grow to one of the flagship programs in the country currently with 6 ACGME slots, a robust TEE (and 100% pass rate in the APTE exam) and general didactic program. Moreover, our fellows are integrally involved in presentations at our associated societies such as the SCA and IARS. Many of our past fellows are now successful academic anesthesiologists both at Hopkins and other institutions.

    8) Other Leadership training opportunities:
    In 2011 I was selected for the Johns Hopkins leadership program, facilitated by the Hopkins Talent Managements group. In 2015, I was given the opportunity to be a part of the “Serving Leader Program” (Managed by “Third River Partners”, Pittsburgh PA) in our Department. I have been a member of the Johns Hopkins University conflict of interest committee, and have recently been a part of a number of professorial promotions committees. As Vice Chair for Research of the Dept., I sit on the Medical Research Council of Johns Hopkins School of Medicine. These important leadership opportunities and committees have given me insights into the complex workings of academic research medical institutions.
  • Selected Publications

    Research Overview

  • Basic and Translational Research:
    My laboratory has been studying the mechanisms contributing to the pathobiology of vascular dysfunction in diseases such as age related systolic hypertension, atherosclerosis, radiation and pulmonary hypertension for the last 17 years. This integrated vascular biology laboratory has been continuously funded for 13 years by the NIH, as well as the American Heart Association and NASA through the National Space Biomedical Research Institute. Our vascular research program has attracted undergraduates, from the Johns Hopkins Homewood campus as a result of my joint appointment in the Dept. of Biomedical Engineering. We have also been fortunate to attract and train both Masters and PhD students. and train both MD and PhD Post-doctoral fellows, from the Departments of Anesthesiology, Cardiology and Pulmonary Medicine at Hopkins, and from around the country and the world. Many of the graduate and post-doctoral fellows have received funding through foundations such as the AHA and the Foundation for Anesthesia Education and Research (FAER). The majority of mentees have gone on to productive and successful careers in academic medicine, basic and translational science, and industry. It is our goal to continue to train the best academicians in cardiovascular biology such that this next generation of clinician and basic scientists will be able to address the medical needs and challenges of the rising cardiovascular burden. Our major contributions to science include 1) Arginase 1 and its contribution to age-related endothelial dysfunction and vascular stiffness. We were the first to demonstrate that arginase in endothelial cells reciprocally regulates nitric oxide production leading to eNOS uncoupling and endothelial dysfunction and vascular disease. This has led to the emergence of a robust literature on arginase upregulation and vascular disease. It has also led to the development of small molecule inhibitors of arginase for therapy of diseases in which endothelial dysfunction is a significant component. 2) Arginase 2 as a novel target in atherosclerosis: As with age-related endothelial dysfunction we described the mechanisms by which upregulation of arginase 2 by atherogenic stimuli such a as OxLDL through the Lox-1 receptor contributes to atherosclerosis. 3) Radiation induced vascular dysfunction: With funding from NASA and the National Space Biomedical Research Institution (through NASA) to explore the role of Galactic cosmic radiation in the context of space flight beyond low earth orbit, we explored the mechanisms of radiation induced endothelial injury and potential countermeasures to attenuate it. Using both conventional gamma radiation and high linear energy transfer radiation (using the NASA Research laboratory beamline at Brookhaven National Labs, Long Island) we determined the importance of Xanthine oxidase as a producer of radiation -induced oxidative stress and dysfunction in the endothelium. 4) Role of tissue transglutaminase (TG2) and other cross-linking matrix enzymes in Age-related vascular stiffness: Vascular stiffness and resultant age-dependent systolic hypertension remains an independent risk factor in cardiovascular disease. The molecular mechanisms underlying vascular stiffness remain incompletely understood. We have identified impaired nitric oxide bioavailability as an important contributor to vascular stiffness. Nitric oxide not only regulates vascular function through alterations in vascular tone but modifies the function of enzymes and other proteins by redox-dependent modification, S-nitrosylation. We have demonstrated that impaired NO bioavailability enhance the activity of the cross-linking enzyme tissue transglutaminase (TG2) which in turn contributes to increases in vascular stiffness. Using a secretome proteomic approach we have identified other enzymes that might contribute to age-related vascular stiffness: 5) Role of Opsins in the regulation of photorelaxation and vascular function: Classic sensory receptors in extrasensory sites and their roles in signal transduction: In a serendipitous finding we have discovered a light activated non-visual opsin, melanopsin (opsin 4 (Opn4))-dependent vasorelaxant pathway which in the presence of a beta adrenergic receptor kinase 1 (ARK 1 or GRK2) inhibitor is profoundly amplified. We have thus characterized an endogenous opsin-mediated, light-activated molecular switch for vasorelaxation that can be targeted for therapy in all diseases in which altered vasoreactivity is a significant pathophysiologic contributor.
    All of these contribution have been or are funded by independent R01’s except for the radiation work which was funded by NASA and the National Space Biomedical Research Institution.


    Clinical Research:
    1) Age-related vascular stiffness and outcomes: As we age, our large conduit vessels (aorta) become stiffer, a process that leads to systolic hypertension. This vascular stiffness is and independent predictor of MACE. While this has been show in the context of patients following MI, stroke and renal dysfunction, the role of vascular stiffness as a predictor of peri-operative outcome has not been explored. Moreover, while chronologic age is immutable, vascular age is modifiable. Using newly developed devices and technique we continue to study the role of vascular stiffness in peri-operative outcomes and explore interventions that might improve vascular “age” and thus peri-operative outcomes.
    2) Red cell health and transfusion: While transfusion is associated with adverse outcomes, the mechanisms underpinning is incompletely understood. Using multiple measures of erythrocyte health including RBC deformability, oxidative stress, NO we continue to explore the effect of storage duration on these metrics.
  • Education And Training

  • Coronation Hospital, Internship
  • Long Island Jewish Medical Center, Internship
  • Duke Medical Center Anesthesia, Residency
  • Duke Medical Center Cardiac Anesthesia, Postdoctoral Fellowship
  • Long Island Jewish Medical Center Microbiology, Postdoctoral Fellowship
  • South African Institute for Medical Research, Postdoctoral Fellowship
  • Bachelor of Medicine & Surgery (MBBS), University of the Witwatersrand 1984
  • Full Name

  • Dan Berkowitz