An illustration of the alveoli in the human lung. Each of us has about 100 million of them that help us breathe.
Profiles in Research
Alan Jobe Honored with Drake Medal
No one had ever asked the question of how much surfactant you had, how it got there, where it was synthesized or how much is secreted.
Alan Jobe, MD, PhD, recently received the Daniel Drake Medal, the highest honor given by the University of Cincinnati College of Medicine.
Jobe is a neonatologist whose pioneering work on the physiology and biochemistry of surfactant helped lead to its approval by the FDA as a safe and effective therapy for preterm infants. He is also five years deep into research on antenatal steroids used as treatment for women at risk of preterm labor—work that promises to be a game-changer for them and their infants.
The Early Years
A California native, Jobe first came to Cincinnati Children’s in 1997. Until then, he hadn’t really been aware of Cincinnati, having spent all his life on the west coast. Born and raised in Los Angeles, he describes himself as an only child who pretty much stayed out of trouble.
During his undergrad years at Stanford, he studied biology and considered going to medical school, but he decided to go for a PhD in cell biology instead.
Then, while in graduate school at the University of California, San Diego, he “drew a really bad draft number during the Vietnam War,” he recalled. “My choices were to move to Canada, be a conscientious objector or go to medical school.” So he chose the latter but continued with his PhD work, earning dual degrees from UC San Diego in 1973.
Building a Legacy
Jobe attributes his career success to multiple factors—self-motivation, a supportive wife and being in the right place at the right time.
“In graduate school, I had worked on the lac operon system, which is a set of genes that encode proteins to break down lactose,” he explained. “This research laid the groundwork for understanding how genes are turned on and off and led to Francois Jacob and Jacques Monod winning the Nobel Prize in Physiology in 1965. It was very early in the days of molecular biology.”
As a fellow, Jobe took the concepts from his PhD work and applied them to the surfactant system in the developing lung. “No one had ever asked the question of how much surfactant you had, how it got there, where it was synthesized or how much is secreted,” he said. “This was at a time when the idea of treating babies with surfactant for respiratory distress syndrome was becoming a hot topic. So, suddenly, my research was very relevant.”
For the next 20 years, Jobe continued his work at Harbor-UCLA, in a small pediatric department with “wonderful people who were supportive of research.” He became the director of the NICU and the Pulmonary Research Library, then was named director of the Perinatal Research Laboratories and the Walter P. Martin Research Center. He also was appointed the Joseph W. St. Geme, Jr. Professor of Pediatrics at the UCLA School of Medicine.
Alan Jobe, MD, PhD
"You should never treat a baby with more drugs than you need to--it's as simple as that."
Shaking Things Up
Jobe’s decision to move to Cincinnati Children’s was prompted by Harbor-UCLA’s shift to a more clinical focus. “I already had grants with Jeff Whitsett, who was a very successful senior researcher here. He discovered most of the proteins in surfactant, while I worked mostly with the lipids,” said Jobe.
“Cincinnati Children’s was a remarkable institution with a tremendous perinatal program that heavily reinvested in their research infrastructure. We probably have the biggest basic research core devoted to lung biology in the world. I felt I could do good work here.”
For the last five years, Jobe has been a consultant to the Bill and Melinda Gates Foundation, researching antenatal steroids and their use in treating women at risk of preterm labor.
“Using antenatal steroids to treat these women has been state-of-the-art for the last 40-50 years,” said Jobe. “But no one had ever formally studied these drugs to determine how they work, how much is needed and how potent they are. Instead, the standard of care was developed empirically.”
Jobe’s research has shown that, while the drugs are effective for babies who are born preterm, they actually cause harm to infants who are born at term—generating chronic conditions in adulthood, like hypertension, stroke and heart disease.
“A recent paper published in 'JAMA' (Journal of American Medical Association) that looked at a cohort of Finnish births over 10 years showed that when women are exposed to antenatal steroids and deliver at term, there’s a significant deficit in the neurodevelopment of their children,” Jobe explained. “I’ve been working to figure out which drugs are the least toxic and what the minimum effective dose is that would reduce the baby’s exposure and still get the maximum benefit.”
The next step is to collaborate with the World Health Organization on clinical trials to confirm research findings. The trials would be conducted in low-resource environments like India and Africa, which is important. Said Jobe, “Just because something works in Cincinnati or Boston doesn’t mean it works in Capetown, where the population is also contending with HIV, TB, malaria and a host of other health issues.”
But these days, Jobe is dealing with his own health issues. Last November, he was diagnosed with a brain tumor and is undergoing chemotherapy. “I’m in remission now and doing okay,” he said, “but I’m the poster child for a bad outcome if I contract COVID-19. So I’m working full-time from home, doing research and teaching, and hoping for a vaccine, like everyone else.”
A Lifetime of Accomplishments
The Drake Medal is the latest addition to Jobe’s impressive stockpile of awards. Other honors include the Virginia Apgar Award from the American Academy of Pediatrics (AAP); the Mary Ellen Avery National Research Award from the American Pediatric Society and the Society for Pediatric Research; the E. Mead Johnson Award for Research in Pediatrics, from the AAP, and the Arvo Yippo Medal from the Pediatric Academic Societies of Finland. He is also an elected member of the National Academy of Medicine (formerly the Institute of Medicine).
“I was lucky to have great mentors like Mel Cohn, Suzanne Bourgeois and Dell Fisher, when I was working on my PhD,” said Jobe. “At Cincinnati Children’s, Jeff Whitsett and Tom Boat have been a great influence on me.”
But passion for his work is what drives and sustains him.
“You have to have the motivation to pursue what you say you want to pursue. I certainly had that motivation, as well as an understanding wife who gave me the support I needed at home to stay late at the lab and be up until all hours of the morning doing experiments,” he said.
“It’s deeply satisfying to know that, through my work on surfactant, antenatal steroids and other projects, I’ve played a role in helping more kids enjoy a longer and better quality of life.”
Just because something works in Cincinnati or Boston doesn’t mean it works in Capetown.