leading with vision - Diabetes Research Institute
Transcription
leading with vision - Diabetes Research Institute
leading with vision [2009 annual report] [Over the last two years, we have undergone an extensive re-engineering effort to transform the DRI into a cure-focused machine. The goal: to be more efficient than any other research institution in moving promising discoveries from the lab to clinical application.] In this new era of research, the DRI is Leading with Vision by applying fresh thinking, revolutionary ideas, sweeping efficiencies and a steadfast commitment to aggressively pursuing a cure for diabetes. 1 [2009 annual report] About the Diabetes Research Institute 2 Mission and Goals 4 Message from the Scientific Director 6 Research Review 8 Faculty and Staff Listing 26 About the Diabetes Research Institute Foundation 30 Message from the Chairman and President 32 Financial Statement 34 To our Donors 36 The Heritage Society 42 National Board of Directors 43 Honorary and Regional Boards 44 DRI Foundation Staff 45 about [the DRI] The Diabetes Research Institute is a recognized world leader in cure-focused research. Since its inception in the early 1970s, the DRI has made significant contributions to the field of diabetes research, pioneering many of the techniques used in islet transplantation. From innovations in islet isolation and transplant procedures to advances in cell biology and immunology, the DRI is now bridging cell-based therapies with emerging technologies to restore insulin production. [diabetes research institute foundation] 2 The most comprehensive diabetes research center of its kind, the DRI is credited with changing the international research paradigm, ensuring that promising findings in the lab can be translated to patients in the fastest, safest and most efficient way possible. Through this translational process, the DRI bridges research programs in the rapidly evolving fields of pancreatic stem cell development, tissue engineering, transplant immunology, cell transdifferentiation, molecular biology and regenerative medicine, among others, to approach the cure with a true multidisciplinary strategy. Pioneering New Therapies to Restore Insulin Production The Institute is an innovator in several research areas; however its principle focus is the biological replacement of insulin function to restore blood sugar control. Known for its groundbreaking work in islet transplantation resulting in normalized blood sugar levels in study patients, the DRI is now improving transplant processes and addressing the remaining challenges that limit the procedure’s widespread application. Beyond islet transplantation, the DRI is opening new doors to discovery by developing novel approaches to restore natural insulin function. Scientists from a broad range of disciplines are applying their expertise by: • • • • • constructing tissue-engineered barriers and bio-devices generating new, small molecules to eliminate the need for immune suppressing drugs developing sophisticated techniques to assess islet viability and predict long-term function transforming select cells of the body into insulin-producing cells exploring methods to regenerate islets within the native pancreas. The Hub of a Global Research Alliance The DRI has a long history of scientific collaboration, but the most focused and far-reaching initiative to date is the Diabetes Research Institute Federation. Comprised of a dozen medical centers on almost every continent, the DRI Federation is an international network of leading scientists who are sharing knowledge, applying their respective expertise to key research areas, and concentrating solely on curing the disease. The Institute’s open-door philosophy provides opportunities for scientists and biomedical companies around the world to utilize the DRI’s state-of-the-art facilities and expertise to quickly and efficiently evaluate promising new research strategies. Much of this work begins in the DRI’s Fast Track Center for 3 [2009 annual report] Testing, where investigators can access all three of the fundamental phases of research – basic (in the lab), pre-clinical (study models), and clinical (patient studies) – under one roof. This translational approach and structure enables researchers to take potential new therapies begun in the lab and further develop these techniques to benefit those with diabetes. The DRI applies this same collaborative approach as a training center, hosting international conferences and conducting hands-on workshops for visiting scientists. The Institute also facilitates the distribution of its specialized cell processing equipment and other devices to researchers throughout the world. This includes the system that separates healthy insulin-producing islets from a donor pancreas, which was invented by the DRI’s scientific director, Dr. Camillo Ricordi. Consistent Competitive Funding DRI scientists have been awarded competitive federal and state grants for more than 30 consecutive years. The resulting research findings have been published extensively in peer-reviewed journals and the DRI’s many innovations are used in diabetes centers worldwide. As leaders in their fields, the Institute’s faculty serves on numerous national and international committees, scientific review panels and medical associations to provide and interpret scientific data and assist in strategic planning. While competitive research grants are the mainstay of world-class research institutes, the Diabetes Research Institute Foundation provides the DRI with the critical seed funding necessary for developing and pursuing new research initiatives. Supported by private philanthropy, the DRI Foundation also fills the gaps in many stages of the research process that are not covered by grants and other funding sources. A Community Resource A designated Center of Excellence at the University of Miami Miller School of Medicine, the DRI provides informative and practical Continuing Medical Education programs for physicians, health care professionals and industry representatives. For patients and their families, the DRI’s Kosow Diabetes Treatment Center offers an array of diabetes management and education activities, as well as participation in clinical research studies, ensuring the highest standards of health care delivery. The Best Hope for a Cure With an unwavering commitment to cure those now living with diabetes, along with its unique spirit of collaboration and fast track approach to research, the DRI is leading the international effort to cure this disease. For the millions of families affected by diabetes who are looking to the world of science for answers, the DRI is the best hope for a cure. 5 mission [and goals] The Mission of the Diabetes Research Institute: To develop and rapidly apply the most promising research to treat and cure those now living with diabetes. [diabetes research institute foundation] 4 Goals • To foster a dynamic multidisciplinary research team comprised of basic and clinical scientists that conduct innovative diabetes research. • To facilitate the translation of new research findings into novel therapies for patients with diabetes as quickly as possible. • To improve clinical care and enhance the quality of life for all patients with diabetes through professional training and education programs. • To expand collaborative alliances with other leading centers of research, thus creating a global intellectual environment, which streamlines research efforts worldwide and furthers our mission to cure diabetes. • To establish corporate, philanthropic and academic partnerships to share in the costs of research and development, thus accelerating the testing of new approaches and developments to cure diabetes. 7 5 [2009 annual report] from the [scientific director] Curing a disease is no small task. Historically, the conquest and near eradication of major scourges like smallpox and polio have required dedicated resources, creative approaches and scientific insight that was uncommon for the day. At the Diabetes Research Institute (DRI), we bring that same disciplined pursuit of a cure to type 1 diabetes. This dedicated effort, on the part of our entire research team, has enabled us to make great strides toward this goal. [diabetes research institute foundation] 6 In a world of increasing economic challenges, however, we must find ways to work smarter while maintaining our unrelenting focus on a cure. We must ensure that our resources are utilized efficiently, that our creativity is constantly inspired, and that our vision is keenly focused. As the economy began its downward spiral in 2008, the DRI made responsible adjustments to its research plan to ensure that the most important work could continue at full speed and leave no stone unturned in pursuit of a cure. A number of consolidating steps were taken to meet that mandate, and over the last two years, we have undergone an extensive reengineering effort to transform the DRI into an even more resourceful research enterprise. In that line of thought, we have established four primary areas of research, and prioritized the projects within them: 1 Cellular and Molecular Biology of the Endocrine Pancreas 2 Sources of Insulin Producing Cells and Regeneration 3 Nanotechnologies, Encapsulation/Biomaterials and Devices 4 Immunomodulation and Tolerance. Some projects were staggered, others moved to collaborating laboratories that were less affected by the slowing US economy. Our goal: to be more efficient than any other research institution in moving promising discoveries from the lab to clinical application. We’ve re-organized our research program into a tight group of priority areas aimed at asking and answering the most urgent scientific questions: • Can we reprogram some cell types to become insulin producing cell types - and can we do so in large enough numbers to be clinically useful? • How does the immune system attack that precipitates diabetes actually occur, and can that knowledge be tapped to reverse the process? • Can we slow progression of new onset diabetes by following critical biomarkers, and can this knowledge help us eliminate the disease altogether? • How consistently can we push our own stem cells down the path to creation of new insulin-producing cells for our own use? • What are the most efficient and reproducible alternative sources for islets—will it be from cord blood, mesenchymal stem cells, amniotic fluid, or other potential sources newly arrived on the research horizon? • What is the optimal implantation site for replacement cells, and what type of hybrid device or nanoscale semipermeable barrier will work best to protect them? • Once new insulin producing cells are transplanted, how can recurrence of autoimmune attack be prevented? • Can nanoparticles be used to produce tolerance, and thus facilitate the survival of replacement cells in patients? This annual report highlights the paths being explored at the Institute’s many interdisciplinary labs and the most recent achievements we’ve made together with our global network of Federation scientists, who have been brought in to work on the challenge with us. Our one-of-a-kind international network of scientists forms a living, breathing powerhouse of knowledge that is intensely focused on making type 1 diabetes a disease of the past. Join us on the path of groundbreaking discovery and let’s make diabetes history. Camillo Ricordi, M.D. Stacy Joy Goodman Professor of Surgery Distinguished Professor of Medicine Professor of Biomedical Engineering, Microbiology & Immunology Director, Diabetes Research Institute and Cell Transplant Center University of Miami 9 7 [2009 annual report] research [review] Since our inception, the Diabetes Research Institute has been at the forefront of cure-focused research, pioneering many of the approaches to restore natural insulin production in those living with diabetes. Today, building upon almost four decades of expertise, we are defining a new research strategy for the 21st Century that is not typically found in academic medicine. Over the last two years, we have undergone an extensive re-engineering effort to transform the DRI into a cure-focused machine. The goal: to be more efficient than any other research institution in moving promising discoveries from the lab to clinical application. [ The Diabetes Research Institute is committed to moving research from the lab to the patient in the fastest, safest way possible. At our Dr. Denise R. and Thomas D. Stern Fast Track Center for Testing, researchers evaluate promising new technologies and potential therapies in a state-of-the-art environment where we have the ability to advance research exponentially faster than what might be found in a traditional research environment. Read more about it at DiabetesResearch.org [diabetes research institute foundation] 8 We’ve unified the research process in what can best be called a “sequential, integrated” approach to biomedical research. This approach ensures that every improvement made in a basic lab experiment impacts the next level of research as the study moves forward to pre-clinical studies, and finally to clinical trials. This approach has been optimized at the DRI, where unlike other diabetes research centers, all levels of translational research are found under one roof so as to maximize collaborations and cross-fertilization of ideas – from basic to clinical as well as across disciplines. We have organized our research operation into four primary areas, each structured to fast-track research concepts and eliminate wasted time. Information is regularly exchanged among our diverse faculty, whom have expertise in a broad spectrum of disciplines from immunology and stem cell research to molecular biology, engineering and more. We complement our internal expertise by collaborating with other leading researchers throughout the world to reach our goal a cure as fast as humanly possible. In this new era of research, the DRI is Leading with Vision—by applying fresh thinking, revolutionary ideas, sweeping efficiencies and a steadfast commitment to aggressively pursuing a cure for diabetes now. One small step forward in any of these primary research areas can have a huge impact on work being done by others within the DRI's interconnected team. Through this synergy, we’re able to pursue a cure for diabetes from many angles. Cellular and Molecular Biology of the Endocrine Pancreas Understanding cellular function, and dysfunction, is key to finding a cure for diabetes. Our cellular and molecular biology efforts encompass not only the study of cells that produce insulin, but multiple cell types that impact metabolism, transplantation and regeneration. Their similarities and differences, cellular architecture, response to cellular signals, and a host of other molecular characteristics all play a role in furthering the understanding of diabetes and the development of new therapies to restore normal metabolic function. Sources of Insulin Producing Cells and Regeneration We are focusing on a number of strategies to optimize cellular therapies for the treatment of diabetes, including finding alternative cell sources for use in transplantation to bridge the supply gap; transdifferentiating cells (reprogramming one cell type to grow into another); and even working in the area of cell regeneration, which may ultimately replace transplantation altogether. Nanotechnologies, Encapsulation, Biomaterials, Devices and Local Drug Delivery Investigators are using many newly available technologies to enhance traditional cell-based science and, as a result, are creating unparalleled opportunities to treat and cure diseases. Here at the DRI, researchers from such diverse disciplines as engineering, immunology, biomaterials and computer technology are working together as never before, generating cutting-edge ideas to solve the problems of diabetes. Immunomodulation and Tolerance To speed the process of developing and testing promising immune system therapies, we have assembled a specialized research team to focus on designing next-generation drugs. Using highlyefficient computer modeling and advanced drug design methods, we are working to develop small molecules that can be specifically used to overcome the unique immune system challenges posed in type 1 diabetes. 11 9 [2009 annual report] A clear view of a functioning islet (bright gray) transplanted into the anterior chamber of a mouse eye. Researchers are able to observe the development of blood vessels (red) and can monitor immune responses. In this study, T-lymphocytes (labeled green) travel through blood vessels infiltrating the islet - causing the destruction of the insulin-producing cells. This novel “living window” provides vital information on specific immune system mechanisms and targets and will greatly impact strategies to protect islets. [ Visit our web site to hear a podcast on the Living Window from Per-Olof Berggren, Ph.D. DiabetesResearch.org CELLULAR AND MOLECULAR BIOLOGY OF THE ENDOCRINE PANCREAS Our Molecular Biology and Immunogenetics teams study the most basic, essential aspect of diabetes research: the science of cells. By understanding the molecular mechanics of cells, we can begin to answer the fundamental questions about the function, growth and survival of insulin-producing cells. This past year, we pursued a number of projects focused on the study of cellular architecture, response to cellular signals, and a host of other molecular characteristics which all play a role in furthering the understanding of diabetes and the development of new therapies to restore natural insulin production. “Living Window” Allows Scientists to View Cell Activity in Real Time We now have a view into cellular functions like never before. For the first time, our scientists can actually observe insulin-secreting cells inside the living organism. This viewing platform also gives us a way to watch the body’s response to new therapeutic strategies that attempt to save islets from this deadly immune system attack. Measuring Islet Viability with Calcium Signals In 2009, in collaboration with the Karolinska Institute in Stockholm, Sweden, we transplanted islets into the eye of a mouse, and then viewed the islets through the animal’s transparent cornea. Through this “living window,” we watched the islets engraft onto the iris, connect to a network of blood vessels, respond to stimulation and actually reverse diabetes in the animal. One way to measure the health and viability of islets, prior to transplantation, is to track signals sent by calcium within each cell. When glucose reaches a beta cell, a sequence of events is triggered. As part of the sequence, calcium within the cell sends a signal that allows insulin to be released. The stronger the calcium signal, the greater the insulin response. Using this novel, non-invasive technology, we can see how the immune system launches its attack on the islets cells, something that occurs in the natural course of type 1 diabetes onset. We’re now measuring those calcium signals because by doing so, we believe we can identify islets that are the healthiest and are most likely to survive. [diabetes research institute foundation] 10 Nephrin, a known target of immune attack in type 1 diabetes, is expressed in pancreatic beta cells (green). When stimulated by glucose, it acts as a major regulator of insulin release (red) - opening the door for the development of therapeutic strategies targeting nephrin to preserve cell function in diabetes and islet transplantation. Newly-Discovered Pancreatic Molecule Vital to Insulin Secretion Recent findings suggest there might be a link between the development of diabetes and a molecule called nephrin. Nephrin is a substance essential for optimal kidney filtration, which eliminates toxins produced by the body. Although nephrin was once thought to be a kidney-specific molecule, we recently discovered it in the pancreas and are now working to understand the role it plays in diabetes. Our preliminary research, funded through donations made to the Diabetes Research Institute Foundation, shows the nephrin molecule is vital for beta cells to secrete insulin in response to blood sugar. Nephrin may also be a target of immune system attack in persons with type 1 diabetes. With that preliminary data in hand, we secured funding this year from the National Institutes of Health and the American Diabetes Association to continue this promising research. Our goal now is to better understand the connection between nephrin and the function of insulin-producing cells in those with diabetes. Once that connection is clear, the development of drugs targeting nephrin may represent one approach to the treatment of diabetes. A summary of our preliminary research on nephrin was published in October, 2009 in the journal Diabetes. 11 [2009 annual report] Predicting Diabetes Onset Our Immunogenetics and Molecular Biology teams are leading a study of tiny nucleic acid molecules, called MicroRNA, which may be used to predict the onset of diabetes. These molecules regulate key biological processes in our bodies such as cell growth and the development of stem cells into functional adult cells. These MicroRNAs also regulate key immune functions. Our preliminary studies indicate patients with type 1 diabetes have a dramatic increase in one of these regulators, miRNA-7, compared to their family members who do not have the disease. As a biomarker, miRNA-7 may help us detect islet autoimmunity very early, increasing the probability of success in treating or preventing the disease. The study is now recruiting additional families as part of an ancillary study of the National Institutes of Health’s Type 1 Diabetes TrialNet. TrialNet is a consortium of clinical centers with additional collaborating centers in Canada, Italy, Germany, Finland and Australia. The goal of the study is to identify people at risk for developing diabetes and to slow disease progression in people newly diagnosed with the disease. SOURCES OF INSULIN PRODUCING CELLS AND REGENERATION One of the most critical challenges we face is to develop sources of insulinproducing cells. We believe stem cells could be used to alleviate the shortage of insulin-producing cells available for transplant. Stem cells reproduce quickly. They have the potential to become any cell type of the body and are simply waiting for “instructions” to be programmed into one tissue or another. During 2009, much of our research has focused on developing safe, efficient protocols for the use of stem cells; work made possible through the generosity of private donors. But our team of scientists at the DRI is also aggressively pursuing other sources of insulin-producing cells, including the use of adult skin and cord blood cells, transdifferentiation (reprogramming one cell type to grow into another) and regeneration (generating new insulin-producing cells from one’s own tissues). [diabetes research institute foundation] 12 Making Embryonic Stem Cell Use Safer We continue to make progress in our goal to eliminate risk associated with the use of embryonic stem cells as a potential therapy for diabetes. Embryonic stem (ES) cells are immature cells that proliferate at a remarkable rate. Their ability to multiply makes them an ideal candidate to alleviate the shortage of insulin-producing cells in persons with diabetes. When left unchecked, however, wildly dividing ES cells can cause tumors to form. We are working to eliminate that risk by developing safer, more efficient protocols for the use of ES cells. One strategy is to provide ES cells, being cultured in the lab, with high levels of oxygen. We believe the oxygen helps speed the transformation – or differentiation – of the ES cells into insulin-producing cells. Once differentiated, the cells stop dividing. 13 [2009 annual report] A second strategy involves the use of protein transduction technology (PTD) to induce the differentiation. Embryonic stem cells proceed through five developmental stages in order to become insulinproducing cells. At each stage, a “developmental switch” needs to be turned on to drive the cell down the intended path. The key is to insert these developmental switches, or signals, safely into the cell. We are using proteins to deliver these signals and sequentially orchestrate the development of islet cells. This protein therapy is believed to be safer and more efficient than gene therapy – making it a more likely candidate for clinical trials. Reprogramming a Person’s Own Cells Our pioneering efforts in protein transduction technology (PTD) are also being used as a safer method for reprogramming existing adult cells into insulin-producing cells. Research has already demonstrated that a person’s own skin cells, for example, can be returned to an undifferentiated state, similar to that of an embryonic stem cell, then reprogrammed to become an insulinproducing cell. Now, our researchers are studying the use of proteins to induce that transformation more safely than ever. The results of this preliminary work, funded by the Diabetes Research Institute Foundation, were so encouraging, the National Institutes of Health awarded us a grant this year allowing us to further explore the potential of this technology. Cord Blood Cells Umbilical cord blood cells are also showing promise as a potential source of insulin-producing cells. Cord blood stem cells, as the name implies, are derived from newborn umbilical cord blood. Studies have suggested that these cells can be coaxed into becoming cells that have features common to insulin-producing beta cells. At the DRI, we are exploring the true potential of these cells. We have already established the conditions that are necessary to culture these cells with reproducible success. Now, we are working to improve the protocols used to transform, or differentiate, these cells. We are studying the use of protein transduction technology (PTD) to induce the differentiation. Compared to gene therapy, PTD offers a safer and more efficient method to orchestrate the development of a stem cell. We’re also researching the use of various materials, such as bioengineered scaffolds, to provide physical support to the cells as they mature. [diabetes research institute foundation] 14 Mesenchymal Stem Cells Dr. Norma Sue Kenyon, co-director of the Executive Research Council at the Diabetes Research Institute, and her team continue to develop ways to replace insulin-producing cells without the need for life-long anti-rejection drugs. A major research focus is to improve islet survival by preventing the inflammation that occurs when the cells are transplanted and exposed to other environmental factors. Dr. Kenyon and her team are using a population of bone marrow derived mesenchymal stem cells (MSCs) to achieve this. These cells have been instrumental in repairing damaged tissue and have also shown the ability to stimulate the growth of blood vessels as well as significantly reduce inflammation. These are two critical areas needed for successful islet replacement strategies and are the basis for studies involving the co-transplantation of both islets and MSCs. In addition to enhancing graft acceptance and longer term viability of the new cells, MSCs produce factors that help suppress the immune response to transplanted cells and may also support the production of new insulin-producing cells. Transdifferentiation Our researchers are testing the ability to turn cells that have a different function into insulin-producing cells, a process known as transdifferentiation. Our study of transdifferentiation focuses on liver cells. The liver and the pancreas, where insulin-producing islet cells develop naturally, have a lot in common. They start off – in the earliest stages of development – as the same kinds of cells. Some branch off to form the liver; others, the pancreas. To take advantage of the two organs’ developmental similarities, we are working to coax a population of liver cells into insulin-producing cells. We’re partnering on this effort with Lola M. Reid, PhD, professor in biomedical engineering at the University of North Carolina, who has been a leading researcher on liver stem cells for more than 30 years. If successful, this transdifferentiation from liver to pancreatic cells would allow a patient with diabetes to be the donor of his/her own therapeutic tissue. The potential to effectively generate new tissues from our own mature organs would overcome both the shortages in tissue availability and the need for immunosuppression, or anti-rejection drugs. 15 [2009 annual report] Regrowing Our Own Insulin-Producing Cells There is mounting evidence the body may be able to regenerate or “regrow” insulin-producing cells through a natural, self-repairing process. At the Diabetes Research Institute, we’re studying whether this cell regeneration process has the potential to reverse or prevent the onset of type 1 diabetes. Our scientists and their colleagues are testing several methods to stimulate islet regeneration in the native pancreas. These approaches include the use of hepatocyte (HGF) and epidermal growth factors (EGF) along with hormones such as Gastrin, among others. If an abundance of healthy islets can be regenerated early on, then this could eliminate the need for islet transplants altogether. Molecule May Increase Number of Insulin-Producing Cells As we explore new ways to increase the number of insulin-producing cells, our researchers are also studying the properties of molecules called MicroRNA. MicroRNAs are tiny nucleic acid molecules that regulate key, biological processes in our bodies such as cell growth and the development of stem cells into functional, adult cells. A team of researchers here at the DRI identified one such regulator, called miRNA-7, which appears 200 times more frequently in insulin-producing islets than in other non-islet tissue of the pancreas. As a result, miRNA-7 is believed to be involved in expanding the number of islets and increasing insulin production. By better understanding miRNA-7 and the role it may play in promoting cell expansion and regulating insulin production, we may identify new strategies for clinical therapies in the treatment of diabetes. [diabetes research institute foundation] 16 NANOTECHNOLOGIES, ENCAPSULATION, BIOMATERIALS, DEVICES AND LOCAL DRUG DELIVERY Along with the need to develop new sources of insulin-producing cells, we must identify new ways to improve islet transplant technology and the body’s ability to tolerate those transplanted cells. To meet that challenge, we’ve brought together researchers from such diverse disciplines as engineering, immunology, biomaterials and computer technology to work together, and in 2009, these multi-disciplinary teams have made exciting progress that takes our pioneering work in traditional cell-based science to a new level. Biohybrid Devices In a recent study, our researchers designed and implanted a small mesh cylinder under the skin (subcutaneous) to house and protect transplanted cells. Once a network of blood vessels grew in and around the mesh, islet cells were inserted into the cylindrical “biohybrid device” and the alreadyestablished blood vessels were able to immediately deliver oxygen and other vital nutrients to the cells. These self-contained devices act as mini “organs” and have been engineered to provide islet cells with an enhanced ability to thrive. But they offer another benefit. The device gives researchers the opportunity to deliver tiny amounts of anti-rejection drugs precisely where the cells are located; eliminating the systemic drugs used today which cause so many unwanted side effects. As a result, in experimental models, just 1/100th of the amount of anti-rejection drugs was required, minimizing side effects for the transplant recipient. This past year, we began to focus on developing new and improved strategies for the delivery of agents to these implantable devices, to further shield transplanted islets from attack. Moving forward, the goal is to develop an environment that mimics the native pancreas as much as possible so that transplanted insulin-producing cells have the best chance to thrive. 17 [2009 annual report] A strong outer frame protects the islets from physical damage. An open mesh membrane promotes the growth of blood vessels inside the device to nourish the islets with oxygen and nutrients in a highly porous structure shown. [ Visit our web site to hear a podcast on scaffolds from Dr. Cherie Stabler DiabetesResearch.org Bioengineered “Scaffolds” In another example of how we’re applying technology to enhance traditional science, our tissue engineering team is testing new strategies for the use of bioengineered “scaffolds.” Much like the scaffolding you’d see on the outside of a building, these bioengineered scaffolds, developed at the DRI, provide a 3-dimensional framework to protect islet cells. Like the biohybrid devices, the scaffolds help to mimic the native environment of the pancreas by preventing islets from clumping together, allowing oxygen and other nutrients to efficiently reach each cell. Now, we are initiating studies to see if the scaffolds could also be used to deliver beneficial cells or agents that will further increase the viability of transplanted islets. One strategy incorporates an oxygen-generating compound to the scaffolds which has resulted in improved islet viability and glycemic control in study animals. A second strategy involves co-delivering other cells that will accelerate vascularization, the growth of blood vessels in and around the scaffold. The DRI's Dr. Cherie Stabler is one of 10 scientists nationwide who have won the Type 1 Diabetes Pathfinder Award for highly innovative research studies that offer exceptional promise for improving the understanding, prevention, and treatment of type 1 diabetes and its complications. The Pathfinder Award supports creative new investigators who propose innovative research projects that have the potential for unusually high impact in type 1 diabetes. Each award recipient receives $1.5 million to pursue their work over a five-year period. [diabetes research institute foundation] 18 Microscopic Encapsulation Technology Protecting Transplanted Islet Cells In 2009, our researchers continued to report signs of success in the development of nanoencapsulation technology, the newest area of immunoisolation research. Nanoencapsulation is a microscopic layering technique that’s been used for decades in the electronics, optics and sensor industries. By adapting this methodology to cell-based science, researchers are developing biocompatible coatings that serve as a type of “camouflage” for the implanted islets, allowing them to go unnoticed by the body and avoid inflammatory reactions or immune attack. And, because the nanoencapsulation layer is so thin – almost as if it’s “shrink-wrapped” around the islet cells – oxygen and nutrients can easily reach the cells and the islets themselves can efficiently release insulin back into the bloodstream. Additionally, in contrast to previously-used coating methods, nanoencapsulation helps to maintain the actual size of the cell so that more cells can be transplanted into a smaller space. Along with protecting the cell, researchers believe these nanoscale layers can also be made “active.” By attaching anti-inflammatory molecules to their surface, the nanoscale layers actively ward off attacks on the transplanted cell. Because this nanoencapsulation strategy holds such promise, we’ve established a partnership with Dr. Jeffrey Hubbell, professor and director of the Integrative Biosciences Institute, and Professor of the Institute for Chemical Sciences and Engineering at Ecole Polytechnique Fédérale de Lausanne in Switzerland. Dr. Hubbell is world renowned for his work with biomaterials for tissue engineering and drug delivery. 19 [2009 annual report] Bone Marrow as a Site In addition to bioengineering environments that mimic the pancreas, DRI researchers are studying whether other sites within the body may be used to successfully house transplanted cells. For years, the liver was thought to be the optimal environment for transplanted insulin-producing cells to survive. But in the past decade, there has been mounting evidence to the contrary – and researchers are now looking for alternative transplant sites. In preliminary animal studies conducted by the DRI in conjunction with Hospital San Raffaele in Italy, one of the members of the global research collaboration known as the Diabetes Research Institute Federation, islets were infused into the bone marrow of mice. Bone marrow is the soft, spongy tissue found inside bones, where 95 percent of the body’s blood cells are developed and stored. The results show the approach is safe and potentially suited for clinical trials. IMMUNOMODULATION AND TOLERANCE As we continue to develop a supply of insulin-producing cells and identify optimal environments within which they can thrive, scientists still need to re-educate the body to tolerate these cells; to see them as “self” and allow them to exist. Currently, islet transplant recipients must take powerful immunosuppressant drugs for life. These drugs often cause unwanted side effects, including damage to the islets themselves. One area of focus for us during the past year has been to pursue approaches to limit the use of immunosuppressants, to make them less harmful to the recipient, to deliver them only where they’re needed, and to eliminate them altogether. [diabetes research institute foundation] 20 Drug Discovery Program One of the most exciting developments in this area of research during the past year came from our Drug Discovery team, led by Peter Buchwald, Ph.D. The team demonstrated that small molecules might help block a critical pathway used by the immune system when it attacks insulin-producing cells. We’ve been investigating for some time this particular pathway, known as the CD40-CD154 pathway, to determine if we can interfere with the cascade of events that leads to transplant rejection by the recipient's immune system. Previously, we demonstrated that it was possible to block the pathway in pre-clinical models with an antibody to the CD154 molecule, but blood clots developed in 10 percent of the cases and the drug was removed from clinical development. Further research, conducted by the Drug Discovery team during the past year, shows that instead of the antibody, a small molecule may instead be used to block the pathway – and without the blood clot side effects. The team’s research findings were published in the Journal of Molecular Medicine 2009. That Drug Discovery team is also working with our Tissue Engineering group to develop methods to deliver immunosuppression to the local transplant site. Instead of using systemic drugs that affect the entire body, the collaborative team is developing a system to provide safer, low-dose drugs directly into an implanted device containing the insulin-producing islets. 21 [2009 annual report] [ Visit our web site to hear a podcast on T Regulatory Cells by Dr. Thomas Malek DiabetesResearch.org Bioengineering Tolerance with Nanoparticles One of the newest and most quickly evolving fields of bioengineered medicine involves the study and use of nanoparticles, synthetic materials that are microscopic in size; thousands fit inside the width of a single human hair. We are studying whether these microscopic particles can be used to help patients tolerate transplanted insulin-producing cells. Under the direction of Dr. Jeffrey Hubbell, we are developing ways to use nanoparticles to carry tiny amounts of anti-rejection drugs to key parts of the body’s immune system. The belief is that because these nanoparticles are so small, they can be sent precisely to cells in the body that regulate the immune system’s response. By pinpointing the delivery of the drug to a specific cell, we can potentially dampen or modify an immune response that would be triggered by the introduction of foreign tissue and allow patients to tolerate transplanted insulin-producing cells. Using the Body’s Immune System Cells to Achieve Tolerance Along with pursuing tolerance through the development of bioengineered medicine, we are looking for ways to re-educate the body’s immune system to recognize and accept insulin-producing cells. There are cells within our own bodies whose job is to constantly scan and rescan the tissues of the body, evaluating what they see. If these cells notice something foreign or out of balance within the body, they have the capacity to trigger the immune system to respond. And in some cases, they have the capacity to suppress a response. Along with our colleagues at Hospital San Raffaele (DRI Italy), we’ve identified a way to isolate one such cell, the Regulatory T Cell (or TReg), from a patient’s own blood. As the name implies, TRegs regulate the function [diabetes research institute foundation] 22 of the immune system and prevent uncontrolled reactions by suppressing immune responses. In people with type 1 diabetes, there’s an imbalance of these TRegs which leads to the destruction of insulin-producing cells in the pancreas. Our scientists are developing strategies to restore that balance of Regulatory T Cells. Another naturally-occurring cell we’re studying is the Marrow Derived Suppressor Cell, or MDSC. MDSCs accumulate in certain areas of the body and we believe they could be used to teach the body to either tolerate its own insulin-producing cells or tolerate transplanted insulin-producing cells. In 2009, we began to evaluate the effects of MDSCs on autoimmunity and transplant rejection. Hyperbaric Oxygen Therapy There is increasing evidence that oxygen plays a critical role in the development and viability of insulinproducing cells. We are pursuing several strategies to more efficiently deliver oxygen to these cells, including the use of hyperbaric oxygen therapy, or HOT. HOT has been used for decades to deliver pressurized oxygen to scuba divers who suffer complications after being underwater. It is a remarkably simple, non-invasive therapy that is showing early signs of promise in diabetes research. In pre-clinical studies conducted by DRI scientists, animals that received hyperbaric oxygen therapy were 50 percent less likely to develop diabetes than those without HOT. The preliminary data showed such potential our researchers presented their findings at the American Diabetes Association Meeting in May, 2009. Clinical trials are currently underway at the Diabetes Research Institute where patients are being given a combination of oxygen treatments along with infusions of their own bone-marrow derived stem cells. The hope is that the combined treatments will cause the pancreas to either recover or function well enough to allow patients to significantly decrease or stop their medications. Similar trials will take place in Europe, Asia and Latin America as part of the collaborative efforts of the DRI Federation. 23 [2009 annual report] Clinical Trials Our Clinical Cell Transplant Program (CCTP) continues to build on the promising results of a landmark multi-center clinical trial which demonstrated that patients with long-standing diabetes could achieve insulin independence following infusions of insulin-producing islet cells. The results, published in the 2006 American Journal of Medicine, concluded that while nearly 90 percent of the study participants were able to discontinue insulin injections during the first year, over time the transplanted islets lost function, requiring most patients to resume low doses of insulin. Despite needing insulin again, the patients maintained some insulin production from the transplanted islets, allowing for easy-to-manage blood sugars and, most importantly, without experiencing episodes of hypoglycemia. Within the past 24 months, we published a follow up study, “Improved long-term health-related quality of life after islet transplantation.” In that study, 40 islet recipients were followed for seven years and it was concluded that islet transplantation is associated with long-term improvement in quality of life. In other recent developments, our clinical trials have demonstrated: • The improved metabolic control achieved with islet transplantation can restore hypoglycemia awareness in patients with type 1 diabetes, persisting even after islet graft failure. • When combined with islet transplantation, two new drugs, Exenatide and Etanercept, improve engraftment and long-term islet survival and function. • Kidney function remained stable after islet transplantation alone in our studies. Our steady progress in this field justifies a renewed optimism for the potential of cellular therapies in diabetes. As the current limitations of islet transplantation are progressively overcome, the indication for clinical applicability of these strategies will greatly expand to more widely available cellular therapies and regenerative medicine solutions that will eventually be offered as treatment to the majority of patients with insulin-requiring diabetes. In 2009, we reviewed the “Steady Progress and Current Challenges in Clinical Islet Transplantation” in Diabetes Care. We continue to focus on improving the safety and long-term success of cell replacement therapies. The Clinical Cell Transplant Program has several active protocols that will assess the effectiveness of new drugs to prevent rejection, as well as other agents to improve islet engraftment and increase islet mass after transplantation. In addition, the group is identifying markers that indicate early islet loss as a means of developing intervention strategies to sustain islet function. We are actively screening individuals for participation in the islet alone or islet after kidney transplantation studies. For additional information on the trials and/or eligibility criteria, please call 305-243-5321 or visit: DiabetesResearch.org/clinicaltrials. Trial Net Six Diabetes Research Institute investigators assumed leadership roles in 2009 with the Type 1 Diabetes TrialNet. Funded by the National Institutes of Health, TrialNet is a consortium of clinical centers that enables researchers around the world to perform intervention studies aimed at preserving insulin-producing cells in individuals with newly-onset diabetes, or in those at risk of developing the disease. [diabetes research institute foundation] 24 Under the direction of the DRI’s Jay Skyler, M.D., TrialNet national chairman, we’re currently participating in a number of TrialNet studies, which can be found at DiabetesTrialNet.org and patients receive prompt feedback when inquiring about our services. • We’ve developed and implemented an Electronic Data Management System (EDMS) to capture essential demographic, education and clinical outcomes data of patients attending the Diabetes Education Service. We have over 1,200 patients entered into the system and have captured to date over 4,000 education visits. We presented the EDMS at the 2009 American Association of Diabetes Educators National Symposium and plan to export the system to other diabetes health care services in 2010. • We developed 15 Education Factsheets, available in both English and Spanish, as part of our Mastering Your Diabetes program. Mastering Your Diabetes is a five-day intensive insulin management program that is offered four times per year, with a specific program for children held each summer. The program aims to enhance participant knowledge and problem-solving skills across insulin management and blood glucose monitoring to optimize diabetes control and health outcomes. Our new fact sheets are available on the DRI web site and will be provided to our key community referrers and utilized at community health fairs. • We continue to provide and review areas of strength and potential growth across our 13 monthly group education programs. Our group programs, conducted in English and Spanish, cover all key content areas from basic diabetes and nutrition information (Diabetes Made Simple, Domine La Diabetes, Supermarket Shopping) through to insulin management programs (Basal / Bolus Insulin Therapy and Carbohydrate Counting) and advancing to insulin pump therapy and continuous glucose monitoring programs. In 2009, we also published the results of one trial where we concluded the drug rituximab helped to preserve beta cell function over a period of one year in patients with type 1 diabetes. The findings were published in the November 26, 2009 New England Journal of Medicine. Our TrialNet researchers include Dr. Jay Skyler, TrialNet national chairman; Dr. Norma Sue Kenyon, associate chair for immunology; Dr. Jennifer Marks, principal investigator – TrialNet Clinical Center; Lisa Rafkin-Mervis, study co-chairman; Dr. Alberto Pugliese, co-investigator, clinical center and Della Matheson, trial coordinator. Patient Education Service One of the greatest challenges facing people living with diabetes is their ability to gain awareness of and implement the necessary self-management demands expected of this disease. The Diabetes Education Service of the DRI’s Eleanor and Joseph Kosow Diabetes Treatment Center is designed to support that need for timely and effective education. This year, our patient education initiatives were once again awarded the highest standards of recognition with the American Diabetes Association’s Education Recognition Program (ADAERP) certification. We’re proud of our accomplishments over the past 18 months: • We have enhanced communications with referral sources (resulting in an increase of our external referral base from 13 to 51 referrers), created new collaborations and taken steps to make sure referrers 25 [2009 annual report] Throughout 2010 we will continue to focus on existing education programs, the development of new education initiatives to meet patient needs and ongoing team development and diversification. Collaboration, innovation, integration and evaluation will continue to be the driving force of our education service. faculty [and staff listing] [diabetes research institute foundation] 26 Faculty Dr. Camillo Ricordi Dr. Luca Inverardi Stacy Joy Goodman Professor of Surgery Distinguished Professor of Medicine Director, Diabetes Research Institute and Cell Transplant Center Research Professor of Medicine, Microbiology and Immunology Director, Immunobiology of Islet Transplantation Associate Director, Cell Transplant Center Dr. Rodolfo Alejandro Dr. Norma S. Kenyon Professor of Medicine Associate Director of Clinical Research Associate Director, Cell Transplant Center Director, Clinical Cell Transplant Center (CCTP) Martin Kleiman Professor of Surgery, Medicine, Microbiology and Immunology and Biomedical Engineering Director, Wallace H. Coulter Center For Translational Research, University of Miami Dr. Anthony Atala Dr. Livio Luzi Adjunct Professor W.H. Boyce Professor and Director of the Wake Forest Institute for Regenerative Medicine Wake Forest University School of Medicine, Winston-Salem, NC Adjunct Professor Professor of Physiology Director, Amino Acid and Stable Isotopes Laboratory, Nutrition and Metabolism Program University of Milan, San Raffaele Scientific Institute, Milan, Italy Dr. Allison Bayer Dr. Thomas Malek Research Assistant Professor Professor and Vice-Chair of Microbiology and Immunology Dr. Per-Olof Berggren Dr. Luz Prieto-Sanchez Mary Lou Held Visiting Scientist Adjunct Professor of Surgery Head of Cell Biology and Signal Transduction Professor and Head, Experimental Endocrinology at the Karolinksa Institute in Sweden Assistant Professor of Clinical Medicine, Division of Endocrinology, Diabetes and Metabolism Dr. Jennifer Marks Research Associate Professor of Surgery Professor of Medicine Interim Chief, Division of Endocrinology, Diabetes and Metabolism Medical Director of the Miami VA Medical Center Dr. Peter Buchwald Dr. Armando Mendez Assistant Professor Department of Molecular and Cellular Pharmacology Director, Drug Discovery Program Associate Professor of Medicine, Division of Endocrinology, Diabetes and Metabolism Dr. Dora Berman-Weinberg Dr. Luigi Meneghini Dr. Zhibin Chen Assistant Professor, Department of Microbiology and Immunology Associate Professor of Clinical Medicine Director, Eleanor and Joseph Kosow Diabetes Treatment Center Dr. Shari Messinger Dr. Juan Dominguez-Bendala Assistant Professor of Epidemiology and Public Health Research Associate Professor of Surgery Director, Stem Cell Development for Translational Research Dr. Daniel H. Mintz Dr. Sarah Ferber Scientific Director Emeritus Professor of Medicine Visiting Professor Head, Molecular Endocrinology Unit, The Chaim Sheba Medical Center Dr. Bresta Miranda-Palma Assistant Professor of Medicine, Division of Endocrinology, Diabetes, and Metabolism Dr. Alessia Fornoni Assistant Professor of Clinical Medicine, Division of Nephrology and Hypertension Dr. Ronald B. Goldberg Division of Endocrinology, Diabetes and Metabolism Professor of Medicine Director, Lipid Disorders Unit Dr. Robin Nemery Adjunct Professor of Pediatrics Division Head of Pediatric Endocrinology at Joe DiMaggio Children’s Hospital Dr. Rajendra Pahwa Research Associate Professor of Surgery Medical Director, Human Cell Processing (cGMP) Facility Dr. Jeffrey Hubbell Adjunct Professor Professor of Biomedical Engineering Director, Integrative Biosciences Institute Institute for Chemical Sciences and Engineering at Ecole Polytechnique Fédérale de Lausanne, Switzerland Dr. Ricardo Pastori Research Professor of Medicine, Immunology, and Microbiology Director, Molecular Biology Laboratory Dr. Maria del Pilar Solano Assistant Professor of Medicine 27 [2009 annual report] Dr. Antonello Pileggi Research Associate Professor of Surgery Director, Pre-Clinical Cell Processing and Translational Models Dr. Alberto Pugliese Research Professor of Medicine, Immunology and Microbiology Director, Immunogenetics Program Dr. Gennaro Selvaggi Assistant Professor of Clinical Surgery, Liver and Gastrointestinal (GI) Dr. Jay Skyler Professor of Medicine, Pediatrics and Psychology Division of Endocrinology, Diabetes and Metabolism Associate Director of Academic Programs Chairman, NIDDK Type 1 Diabetes TrialNet Study Group Dr. Cherie Stabler Assistant Professor of Biomedical Engineering Director, Tissue Engineering Laboratory CCTP Research and Support Staff Andrea Curry, Advanced Registered Nurse Practitioner Eva Herrada, Manager, Research Alina Cuervo, Sr. Medical Biller John Wilkes, Sr. Regulatory Analyst Vincenzo Lauriola, Research Associate Dr. Karina Bernetti, Post Doctoral Associate Dr. Eduardo Leão M. Peixoto, Post Doctoral Associate Edwin Cintron, Office Manager Yanet Florez, Secretary Alina Cuervo, Sr. Medical Biller Lilian Ali, Data Entry Clerk Cecilia Arana, Data Entry Clerk Tyeisha Burford, Research Laboratory Tech Kyla Zehtab, Research Assistant Clinical Chemistry Dr. Ronald B. Goldberg, Professor of Medicine Espy Perez, Supervisor, Medical Technology Dr. Armando Mendez, Research Associate Professor Rosa Hernandez, Sr. Research Lab Tech Jorge Montelongo, Sr. Cellular Transplant Specialist Dr. Andreas Tzakis Professor and Director, Miami Transplant Institute Director of Microsurgery Core Facility in the Cell Transplant Center Chief of the Division of Liver and Gastrointestinal (GI) Surgery Dr. Keith Webster Clinical Research Center Dr. Luigi Meneghini, Director Dr. Claudia Ardila, Post-Doctoral Associate Ada Konwai, Sr. Patient Clinical Assistant Burlett Masters, Research Support Specialist Diane Sabogal, Sr. Medical Assistant Professor, Molecular and Cellular Pharmacology Administration Dr. Mitra Zehtab, Chief Operating Officer Sabrina Boulazreg, Assistant Operations Manager Mabel Luis, Executive Assistant to Dr. Ricordi Margaret Collado, Chief Financial Officer Anjanette Arzani, Manager, Finance Dora Cardenal, Manager, Accounting Juan Perez-Scholz, Manager, Sponsored Programs Caridad Bassols, Program Coordinator Franlis Alvarez, Bookkeeper Edmundo Caldera, Accounting Assistant Ligia Delgado, Accounting Assistant Marc Friedenthal, Buyer Grace Perez, Sr. Buyer Ilvis Torres, Administrative Assistant Jeanette Shikak, Administrative Assistant Medical Development Gary Kleiman, Sr. Development Director, Major Gifts Aimee Siegel-Harris, Manager, Donor Relations Cell Biology and Signal Transduction Dr. Per-Olof Berggren, Director Dr. Midhat Abdulreda, Research Scholar Dr. Alberto Fachado, Sr. Research Associate Rayner Rodriguez-Diaz, Research Associate Clinical Cell Transplant Program (CCTP) Dr. Rodolfo Alejandro, Director Dr. Livio Luzi, Adjunct Professor of Surgery Dr. Raffaella Poggioli, Assistant Scientist Dr. Gennaro Selvaggi, Assistant Professor of Surgery Diabetes Prevention Program (Type 2) Dr. Ronald B. Goldberg, Director Dr. Hermes Florez, Assistant Professor of Clinical Medicine Jeanette Gonzalez-Calles, Research Associate Juliet Ojito, Nurse Specialist Dr. Sumaya Castillo Florez, Assistant Scientist Wanda Ramirez, Secretary Bertha Veciana, Medical Assistant Drug Discovery Program Dr. Peter Buchwald, Director Dr. Emilio Margolles Clark, Assistant Scientist Eleanor and Joseph Kosow Diabetes Treatment Center Dr. Luigi Meneghini, Director Dr. Ronald B. Goldberg, Professor of Medicine Dr. Jennifer B. Marks, Professor of Medicine Dr. Daniel H. Mintz, Professor of Medicine Dr. Bresta Miranda-Palma, Assistant Professor of Medicine Dr. Luz Prieto-Sanchez, Assistant Professor of Medicine Dr. Anup Sabharwal, Assistant Professor of Medicine Dr. Jay S. Skyler, Professor of Medicine, Pediatrics and Psychology Dr. Maria del Pilar Solano, Assistant Professor of Clinical Medicine Health Care Professionals Ramon Arce, Sr. Registered Nurse Alejandra Cordovez, RD, LD/N, CNSC Kellie Rodriguez, Manager, Nursing Jane Sparrow-Bodenmiller, Registered Nurse Educator Allison Wick, Advanced Registered Nurse Practitioner [diabetes research institute foundation] 28 Clinic Administration Angela Almestica, Patient Clinical Associate Michael Amada, Sr. Staff Assistant Arleen Barreiros, Sr. Administrative Assistant Hariamnys Caceres, Patient Clinical Assistant Odalys Cano, Patient Access Representative Iliana Gonzalez, Patient Access Representative Jannet Fraguela-Yern, Clinic Manager Hector Villagran, Sr. Patient Clinical Assistant Flow Cytometry Facility Dr. Oliver Umland, Associate Scientist Human Cell Processing (cGMP) Facility Dr. Rajendra Pahwa, Medical Director Aisha Khan, Director of Laboratory Services Alejandro Alvarez Garcia, Associate Scientist Dr. Shashidhar Jaggaiahgari, Post-Doctoral Associate Dr. Elina Linetsky, Director, Quality Assurance/Regulatory Affairs Dr. Omaima Malik, Associate Scientist Dr. Joel Szust, Scientist Dr. Xiaojing Wang, Associate Scientist Xiumin Xu, Manager, Cord Blood Program/ Flow Cytometry Clinical Lab Kevin Peterson, Sr. Cellular Transplant Specialist Carmen Castillo, Research Laboratory Technician Judith Molina, Sr. Research Associate Maite Lopez Cabezas, Research Associate Yelena Gadea, Specialist Irayme Labrada, Specialist Elsie Zahr, Sr. Research Associate Pre-Clinical Research and Program Development Dr. Norma S. Kenyon, Director Dr. Dora Berman-Weinberg, Research Associate Professor Waldo Diaz, Manager, Research Laboratory James Geary, Veterinary Tech Dr. Dongmei Han, Scientist Ena Poumian-Ruiz, Supervisor, Research Laboratory Reiner Rodriguez-Lopez, Veterinary Technician Laura Velez, Sr. Administrative Assistant Research Staff Dr. Ana Hernandez, Post-Doctoral Associate Alexander Rabassa, Research Associate Melissa Willman, Senior Research Associate Cellular Medicine Dr. Alessia Fornoni, Assistant Professor of Clinical Medicine Dr. Nancy Jauregui-Aguirre, Post-Doctoral Associate Maria Saenz, Sr. Research Associate Jongmin Jeon, Research Associate Tammy Suwunrut, Sr. Administrative Assistant Stem Cell Development for Translational Research Image Analysis Facility Dr. George McNamara, Scientist Immunobiology of Islet Transplantation Dr. Luca Inverardi, Director Dr. Olakunle Adeegbe, Post-Doctoral Associate Kevin Johnson, Sr. Research Associate Dr. Ryosuke Misawa, Post-Doctoral Associate Dr. Kamalaveni Prabakar, Scientist Dr. Alessia Zoso, Research Associate Rejane Lamazres, Research Associate Immunogenetics Program Dr. Alberto Pugliese, Director Dr. Isaac Snowhite, Sr. Research Associate Gloria Allende, Sr. Research Associate Dr. Francesco Vendrame, Post-Doctoral Associate Dr. Juan Domínguez-Bendala, Director Dr. Sirlene Cechin, Post-Doctoral Associate Dr. Nancy Vargas, Research Associate Silvia Alvarez, Research Associate Microbiology and Immune Tolerance Dr. Tom Malek, Director Dr. Allison Bayer, Assistant Professor Cecilia Cabello, Research Associate Tissue Engineering Dr. Cherie Stabler, Director Dr. Jeffrey Hubbell, Research Professor Chris Fraker, Sr. Research Associate Dr. Kerim Gattas-Asfura, Post-Doctoral Associate Dr. Hernan Rengifo, Post-Doctoral Associate Diabetes TrialNet Molecular Biology Dr. Ricardo Pastori, Director Dr. Dagmar Klein, Scientist Dr. Valia Bravo, Post Doctoral Associate Dr. Margarita Nieto, Post-Doctoral Associate Dr. Samuel Rosero, Associate Scientist Pre-Clinical Cell Processing and Translational Models Dr. Antonello Pileggi, Director Dr. Ann Brady, Post-Doctoral Associate Dr. Carmen Fotino, Post-Doctoral Associate Dr. Gaetano Faleo, Research Associate Dr. Damaris Molano, Scientist 29 [2009 annual report] Dr. Jay Skyler, National Chairman Dr. Norma Sue Kenyon, Associate Chair for Immunology Dr. Jennifer Marks, Principal Investigator –TrialNet Clinical Center Lisa Rafkin-Mervis, Study Co-Chairman Della Matheson, Trial Coordinator Dr. Alberto Pugliese, Co-Investigator, Clinical Center about [drif ] MISSION: To provide the Diabetes Research Institute with the funding necessary to cure diabetes now. [diabetes research institute foundation] 30 The Diabetes Research Institute Foundation was created in 1971 by a small group of parents of children with diabetes who were committed to finding a cure for this devastating disease. Driven by hope and fueled by the need to end their children’s suffering, they banded together to support a promising research program at the University of Miami solely aimed at curing those living with diabetes. This singular goal remains today. The Foundation has evolved into an international coalition of business leaders, celebrities, research scientists, clinicians, families and other concerned individuals who have elevated the importance of cure-focused research and shifted the direction of funding into this critical area. The DRI has become the world leader it is today through the dedication and perseverance of the people involved with the Foundation – those who have a personal stake in the eradication of this disease. Supported by private philanthropy, the DRI Foundation has been and continues to be the organization of choice for those who are serious, passionate and committed to finding a cure for their loved ones and millions of others with diabetes. Over the years, thousands of generous individuals and companies have given of their time and resources to help fulfill the DRI’s mission. One of the Foundation’s most faithful partners is the Building and Construction Trades Department (BCTD) of the AFL-CIO, whose members have raised millions of dollars to construct and equip the DRI facility, dedicated in 1994, and who continue to fund its vast research initiatives. Through a special program called the Blueprint for Cure, which dates back to 1984, the American labor movement pledged its unwavering support of the DRI’s mission to cure this disease. Building upon their decades-long commitment, the BCTD has strengthened their ongoing partnership with the DRI through a new effort called Project Type Zero: The hope for a diabetes-free tomorrow. Thanks to the efforts of thousands of building and construction trade members, millions of dollars have been raised for the Institute's cure-focused research. The leadership of the Foundation has also been instrumental in voicing the plight of those with diabetes in the public arena. 31 [2009 annual report] Together with other leading diabetes advocacy organizations,the DRI Foundation has appeared before Congress to request increased funding for diabetes research, and has made recommendations on the future direction of research appropriations. On an annual basis, the Foundation hosts numerous informational workshops for people with diabetes and their families focusing on the latest advances toward a cure. Additionally, Institute and Foundation faculty and staff participate in a variety of print and broadcast public service programs locally, nationally and internationally, which are designed to educate the community on current research progress and the newest diabetes management techniques. A 501(c)(3) not-for-profit corporation, the Foundation raises funds through individual and corporate donations, memberships, foundation grants, special events, and planned giving, which allows donors to leave a personal legacy by providing a gift in the form of a will, trust or other deferred giving vehicle. The DRI Foundation has thousands of members both in the United States and around the world, and has successfully expanded into various locations, including the opening of regional development offices in New York, Long Island and Washington, D.C. message [chairman and president] This past fall, in conjunction with our Diabetes 2.0 Conference in Florida, we toured a small group of presenters and attendees through the Diabetes Research Institute. This sophisticated group, comprised of members of the diabetes online community and parents of children with diabetes, came prepared to ask a myriad of questions. What they were unprepared for were not only the open and candid responses to their questions, but the passionate determination to find a cure that was palpable throughout their visit. As one visitor wrote in his blog, “…it is obvious that this group of people is obsessively focused on finding a cure for diabetes…I was very impressed with the way the institute is set up with the goal of finding a cure as its core…” And in the words of another, “When you are in the room with these men and women who are working everyday, all day, just to help you…it’s hard not to feel overwhelming[ly] grateful and to think, ‘Wow, I really am not alone in this.’” Those statements ring true. We want to make it perfectly clear that no one with diabetes is alone because the DRI and Foundation are determined to find a universal cure for this disease. Even through the economic and fundraising challenges of the last few years, we have not waivered because tomorrow isn’t soon enough - we are working to find a cure for diabetes now. This past year, we’ve been fortunate to celebrate some successes while also having to make some sacrifices. After several years of substantial growth, we’ve had to adjust to the realities of the economic climate and, like most organizations, reduce our budget and fine-tune our priorities. While the majority of our assets were liquid and unaffected by the financial collapse, we have raised far fewer funds than initially anticipated. This reality forced us to adopt a contingency plan that resulted in a reduction of our financial allocation to the DRI by 25 percent. Fiscal 2010 and 2011 will see continued reductions absent a meaningful increase in fundraising. As you will read in the Research Review section of this report, Dr. Camillo Ricordi and his team have responded to the challenging funding environment by streamlining the scientific agenda to focus on only the most promising initiatives. In doing so, they have further enhanced the efficiency of the DRI’s operation. The DRI’s efforts have been consolidated into four primary research areas represented by nearly 80 projects, a reduction from over 100 projects a few years ago. Coupled with support from the Foundation, peerreviewed grants from the National Institutes of Health and other funding entities comprise a meaningful portion of the Institute’s annual budget. The DRI has always been one of the most highlyfunded diabetes centers given its cure-focused work, however, many of these grants expired in the middle of the year and, due to budgetary constraints, were not renewed. Large grants, in particular, have been the most difficult to secure. It is a difficult time, but it also an exciting time. Our researchers are digging into the deepest depths of creativity, Leading with Vision and moving ahead with determination to accomplish our goal. At the Foundation, our number one focus remains providing our scientists with the funds they need to keep promising research moving forward and maintaining the scientific program at the highest level. We have had to work harder, smarter and more [diabetes research institute foundation] 32 Thomas D. Stern Robert A. Pearlman Chairman President and Chief Executive Officer resourcefully. Hence, we undertook a year-long project to overhaul our website, DiabetesResearch.org, so that we can better provide our visitors with updated information, multimedia content, logical navigation, easier donation and event registration forms, and a new online community, DRInsider, that affords benefits to those who join. Our new website was launched a few months ago and we’re thrilled with the positive feedback we’ve received. We encourage you to visit the site, look around and join our community. Along with the website, we’ve bolstered our Diabetes Diplomats program. Supporters can now create their own fundraising event(s) – either off line or online – and right on our new site. Families and individuals from around the country are spearheading events on our behalf and these dollars have never been more important. Our deepest thanks go to each and every person undertaking an activity to benefit the DRI. In addition to these generous individuals, a number of companies have stepped to the plate to support our efforts. Walgreens of South Florida launched a campaign to help us “Cure Diabetes Now,” through in-store canister collections, plush toy teddy bear sales, and friendly competitions among hundreds of employees in a company-wide softball tournament. Their efforts have raised more than $100,000, to date, with the campaign continuing into next year. Walgreens, together with Johnson & Johnson’s Animus and Lifescan divisions and numerous other companies and families, served as sponsors of our Diabetes 2.0 Conference and their participation was sincerely appreciated by the DRI, the Foundation and all of our attendees. 33 [2009 annual report] Our Conference was but one of numerous events taking place throughout our regions during the past year. The involvement of a growing cadre of dedicated volunteers helped to raise significant funds for the DRI, from golf tournaments and galas to kid-friendly parties and comedy night. All of the individuals who gave of their time and resources should feel particularly proud of what they’ve accomplished for this organization. One of the largest groups raising funds on our behalf is the Building and Construction Trades Department of the AFL-CIO. Well into their new fundraising campaign, Project Type Zero, the men and women of the unions have stood alongside the DRI for almost four decades and their commitment to our cause remains as strong as ever. We are exceptionally grateful for their loyal friendship and longstanding commitment to helping us find a cure for this disease. With thousands of dedicated and passionate people supporting our efforts, we are certainly not alone. As we pursue our mission to find a cure, we hope we can count on your continued support, as it is more important than ever before. Thank you again for the generosity you have shown in the past and for what you will continue to do in the future. Thomas D. Stern Robert A. Pearlman Chairman President and Chief Executive Officer financial [statement] [diabetes research institute foundation] 34 Statement of Activities for the Year ended June 30, 2009 Support and Revenue Contributions Reimbursement Contracts Special Events, net of expenses Investment Income Total Support and Revenue $4,308,011 2,003,723 2,933,878 (1,513,558) 7,732,054 Expenses and Fund Balances Program Services Research provided to the Diabetes Research Institute Community Education 11,984,866 749,024 Total Program Services 12,733,890 Through the support of private philanthropy, the Diabetes Research Institute Foundation has funded six chairs totaling $14 million: The J. Enloe and Eugenia J. Dodson Chair in Diabetes Research, Stacy Joy Goodman Chair in Diabetes Research, Mary Lou Held Chair for Diabetes Research, Martin Kleiman Endowed Investigatorship, Daniel H. Mintz Visiting Professorship, and the Ricordi Family Chair in Transplant Immunobiology. Support Services Administration and General Fundraising 1,183,505 2,215,828 Total Support Services 3,399,333 Change in Net Assets (8,401,169) Net Assets, Beginning of Year 41,081,520 Net Assets, End of Year $32,680,351 Fundraising Percentage Fundraising Expense as a Percentage of Support and Revenue 29% Statement of Activities for the Fiscal Year 2009 Support Diabetes Research Institute Foundation $11,984,866 National Institutes of Health Grants 4,516,953 Kosow Center 2,398,564 Juvenile Diabetes Foundation International Grants 1,799,415 University of Miami 966,959 State of Florida 493,941 Corporate Grants 488,143 American Diabetes Association Grants 19,511 Total Support $22,668,352 Expenditures Research Grants Research & Clinical Support $19,419,295 3,249,057 Total Expenditures $22,668,352 35 [2009 annual report] 53% 20% 11% 8% 4% 2% 2% 0% 100% to our [donors] To our donors with our deepest gratitude… We wish to gratefully acknowledge all of our donors whose continued support has allowed DRI scientists to pursue promising new research avenues, to lead with vision into the most advanced areas of science and to keep hope alive for millions of children and adults who dream of a cure for this devastating disease. Our DRI family continues to grow and many new donors have joined us over this past year. We sincerely appreciate every single gift we receive, no matter the size. We would like to take this opportunity to recognize and thank our highest contributors, whose unwavering dedication and unparalleled generosity has truly helped accelerate progress toward a cure for diabetes. The individuals, families, corporations and foundations listed on the following pages have been the backbone of this organization since our inception almost four decades ago. Their names appear in the corresponding giving levels as of December 31, 2009. Again, we wish to deeply thank all of our donors the world over for your continued support of the Diabetes Research Institute and Foundation. [diabetes research institute foundation] 36 Visionaries - $10,000,000+ Building and Construction Trades/AFL-CIO J. Enloe and Eugenia J. Dodson* Raymond and Russell Johnson* Sylvia and Rowland Schaefer Chairman’s Council - $5,000,000+ Polly and Baron de Hirsch Meyer* Leon J. Simkins Leadership Council - $1,000,000+ Michele Bowman and Joseph Underwood Trudy and Paul Cejas Diabetes Foundation of Florida D.R. Donaldson Family Foundation Randy Dorfman The Esformes Family, Annie and Nate Esformes Foundation for Diabetes Research Inserra Family Foundation International Association of Bridge, Structural and Ornamental and Reinforcing Iron Workers International Association of Heat & Frost Insulators and Asbestos Workers International Brotherhood of Boilermakers, Iron Ship Builders, Blacksmiths, Forgers & Helpers International Brotherhood of Electrical Workers International Brotherhood of Teamsters International Union of Bricklayers & Allied Craftworkers International Union of Elevator Constructors International Union of Operating Engineers International Union of Painters and Allied Trades The Jack Parker Foundation Carole and Barry Kaye Richard H. Kline* Eleanor C. and Joseph* Kosow Laborers’ International Union of North America Alfred P. LaRose* Operative Plasterers’ & Cement Masons’ International Association of the U.S. & Canada Peacock Foundation, Inc. Ricardo Puente William and Deborah Rand Sheet Metal Workers International Association Stacy Joy Goodman Memorial Foundation Dr. Denise R. and Thomas D. Stern United Association of Journeymen & Apprentices of the Plumbing & Pipe Fitting & Sprinkler Fitting Industry of the U.S. & Canada United Brotherhood of Carpenters & Joiners of America 37 [2009 annual report] United Union of Roofers, Waterproofers and Allied Workers Jill and Cliff Viner Governors’ Society - $500,000 + Jeanne and Virgil Christopher* Rose Cohen* Tom Curtis Kelly and Harold Doran E.R.A.S.E. Diabetes Joan and William J. Fishlinger Florida Jaycees Susan and Douglas D. Gallagher Paola and Piero Ludovico Gandini Richard L. Gelb Family Las Vegas Meetings by Harrah's Entertainment Louise K. and Robert T. Held, Sr.* Lola and Donald Jacobson Blanche E. Kroloff* Amy and Alan Meltzer Million Dollar Hole in One Risa and Jeff Pulver Red Apple Group Redfern Foundation Valerie and Camillo Ricordi The Family of Samantha Max Stern Ferne and Daniel Toccin ULLICO Management Company Roberta and Bruce Waller Distinguished Humanitarians $250,000+ Elizabeth M. and Robert W. Bradley* Jane and Bill Burt* Henry E. Caballero* Ivette and Juan Calles Pearl Coulter* Diabetes Research & Wellness Foundation Lloyd and Helen Dilworth Foundation Florida Power & Light Employees Jeanine Forman-Ham Florence Frank Paula N. Freund* Future Leadership Foundation, Inc. Dr. and Mrs. Phillip T. George and Family Linda and Barry Gibb Mary and Jay N. Goldberg Martin Granowitz Jill and Allen Greenwald Fran and Mel Harris The Barbara and Sam Herzberg Family The Holtz Family IBM Foundation and Employees Louis Kaczmarek* Isolde Kaskel* The Martin Kleiman Family Connie and Harvey Krueger Tova Leidesdorf Lions Club International Eleanor Lowe* Francine Lowe Isabel and Sam* May Micki* and Joseph Mele Charlotte and Eugene Milgram The Mostyn Foundation Brenda Novak's Online Auction For Diabetes Fred and Mabel R. Parks Foundation Penny and Robert A. Pearlman Phil Peterson Key West Poker Run, LLC Cristina and Ramon Poo The Seaver Institute Miriam and James J. Sensale Hazel and Marvin Shanken Shapiro-Silverberg Foundation Holly and David Sherr Muriel and Sherman Simon Philanthropic Fund Richard H. Simons Charitable Trust Edith and Martin B. Stein Burton S. and Barbara F. Stern Symonds Family Van Pelt Foundation Ethel J. Vilm* Washington CLUB Rita and Stan Weinstein Westreich Foundation Sally Zak* Sonja Zuckerman Grand Founders - $100,000+ Lisette and Norman* Ackerberg Joseph Alexander Foundation , Inc. Barbara and Philip Altheim American Building Maintenance Co. Arison Family Aurora Foods, Inc. Bankers Life & Casualty Co. Autis H. Barker* The Bastin Family Alan Bauer* Diane and Bernard Beber Margaret and Raymond Berner Buddy Blair* Nancy and Jerry Blair Martha and Tom Blash* The Family of Dr. Adam H. Bloom Boehringer Mannheim Corp. Delores S. and William K. Brehm Sylvia Bruce* Marty B. Bruder Valetta Arlene Byrn* Carnival Cruise Lines Cynthia D. Carr Roberta O. and Harvey R. Chaplin Children with Diabetes Foundation Cohen Family Charitable Foundation for Jake Cohen Brian and Cheryl Coughlin Cushman & Wakefield, Inc. Tom Daly Dotty and George* D’Amato Reva Dauer* Lucille S. Dell* The DeMatteis Family Foundation Jodi and Bob Dickinson Robert E. Dooley The Durst Organization Cindi and Paul Elias Cindy Epstein The Charles Evans Foundation Raymond Falkenstein* Elizabeth and Max Feldberg Fund Eric Feiler* Fidelity National Title Insurance Company First Quality Maintenance LTD. Randy and Mark Fisher Derry and Steven Fishman Michael J. and Katherine E. Franco Foundation Fraternal Order of Eagles Marvin Ross Friedman Sherrie Garfield in Memory of Joseph Garfield* Gibb Family Foundation Glen Cove Police Benevolent Association Nancy and Lawrence E. Glick Esther and Marc S. Goodman Jane and Jerrold F. Goodman Alvin Grabow* Linda and Glenn Greenberg Maurice R. and Corinne P. Greenberg Elizabeth A. Guon* Elizabeth and Gary Hall, Jr. Shirley D. Harris Arthur H. Hertz The Hatz Family Kirsten and Steven Heinemann John W. Henry Judith and Lawrence Howard JAD Corp. of America Lynne and C. Shelton James Paul Tudor Jones The Max and Yetta Karasik Family Foundation Henry A. Keller, Jr. Joan Keller Sue and Norman Kenyon Barbara and Martin P. Klein Priscilla & Ira Kleinberg Foundation Sylvia Kwasha* Ladyzinski Family Foundation Lucrezia and Vito LaForgia Oscar and Vivian Simkins Lasko Barbi and Warren Lazarow Pat and Mac Levitt Sandra and Sidney Levy Robert Mace Anna Machado* Beverly and Mel Marks Julia and Gilbert Merrill Foundation Miami Beach Chapter/NCCH Miccosukee Tribe of Indians of Florida Dottie and Julie Miller Matthew Miller Family Jeffrey Modell Foundation Mutual of America Sheila and William Natbony The Norjana Charitable Foundation Novo Nordisk Pharmaceuticals Olstein Family Foundation for Brooke Goldfarb Onesource Facility Services, Inc. In memory of my wife, Laurie R. Parham, Ted Parham* Jane Parker and Francis Cosentino Feli and Gerd Petrik Carolyn Pflugk in Memory of Peter Pflugk Steven Posner and Kathryn Chesler John Reisman Judith A. and Paul B. Reisman The Retirement Research Foundation Margaret H. Reynolds* Jed Ringel Marion A. Roletti Foundation Sondra Rose The Rose and Burton Kahn Family Foundation Ruth and Albert* Rosenberg Kelly and Charles Royal Madelyn Rubin Mark R. Rubin Charles Sakele* Leslie and Ricardo Salmon Sandoz Research Institute Ruth and Samuel Schwartz* Inge and Maurice Schweizer* Barbara F. Scott Jacci S. and Floyd E. Seskin Shell Key West Challenge The Morton F. Silver Family Freda F. Silvers* Kathy Simkins Barbara and Sheldon Singer S L Green Management LLC Louise B. Soehner* Jana and Steven Sonberg South Florida District Optimists International Spear, Leeds & Kellogg Sportsmen for Charity The Starr Foundation Gerald J. Steinberg* Sandy and Paul Steinberg Frank Strick Foundation Marilyn and Gary Studley Suburban League Jack Taylor Family Foundation Anna and Leonard Thun Tiffany & Co. Turner Construction Company, Anaheim, CA Lois and Joseph Umbach William T. Voigt* Walgreens Barton G. Weiss Dorothy and Jack Weiss James Wenck, Jr.* Lois and Richard Werner Helene Westreich Dr. Jack Widrich Foundation Susan Winberg and Kenneth Shewer Cynthia and Philip Wolman Ann Zorn* Barbara and Martin E. Zweig Founders - $50,000 + Dr. and Mrs. Vincent J. Abbatiello Abbott Diabetes Care ACC Construction Corporation Adco Electrical Corporation Carl J. Althoff* The Jeffrey A. Altman Foundation and Owl Creek Asset Management Ambassador Construction Co., Inc. American Airlines American Fruit & Produce Corp. Americana Manhasset Barbara Annis ATCO Properties & Management, Inc. Lillian Baker* The Bakery, Confectionary, Tobacco Workers and Grain Millers International Union Victor Ballard* Marlene and David Berg Biogen, Inc. Blank Family Foundation, Inc. Belle and Albert* Blanton Esther Blattner* Carol Nudelman Blumberg and Morton Blumberg Boca Group International, Inc. The Linda and Douglas Boyd Family C. Allen Brice Philip Brice Rita and Samuel* Brodie BrookBridge Consulting Services, Inc. Bvlgari C.H. Robinson Company Worldwide, Inc. Camp NYDA Junior Division, Inc. Mary and Stephen Carner The Carrion Family Carrousel Chase Manhattan Bank Tracy and James Ciocia Citigroup Beatrice Clancy Carole and H. L. Clark Collins Building Services, Inc. Terry Cook* Dr. Stephen B. Colvin* and Mrs. Helane Brachfeld-Colvin ConEdison Solutions, Inc. Murray Cornblum Coscan Waterways In Memory of Pat Covelli Arlyn and Stephen Cypen Damon Biotech Gertrude Davenport* Kathleen and Charles Delle Donne Delta Air Lines Gail and Charles DelVecchio Gillian and Elliot* Dinnerstein Charles Domina Gary Dubin Maxine Dubin Betty and Lowell Dunn Durnan Group, Inc. Eli Lilly & Co CB Richard Ellis F.J. Sciame Construction Co., Inc. The Mary Farrell and Stuart Bloomberg Family Chris and Kevin Fee The Milton and Sally Feldman Foundation Doris Felner* Claudia M. Ferero Firequench, Inc. Mary Beth and Bruce Fishbein Valerie and Marc Fishman Shirley Fletcher Fluor Constructors International, Inc. Kathi and Scott Forbes The Foundation for Transplant Research Patricia Frankel Edith and Sol Freedman Jack & Pauline Freeman Foundation Christine M. Frick* Joel S. Friedman and Victoria Agron Milton I. Friedman* John Gallin & Son, Inc. Joan Galison Gladys and Martin Gelb The Genatt Family Herbert and Elaine Gimelstob Becky and Braxton Glasgow Gloria* and Stanley Goldman Moises T. Grayson Amy, Scott, Jonathan & Lexi Greenwald Grossjung Foundation [diabetes research institute foundation] 38 Grubb & Ellis Guardian Service Industries, Inc. Edgar and Frieda Hamm Trust Kenneth Harple Harvard Maintenance, Inc. Sigrid Haukland* Health Foundation of South Florida Hector Family Foundation Lady Monica Heftler Heisman Trophy Trust Roberta and Lawrence Helfant H. Kurtz Henley* Gertrude Hirsch Iacocca Foundation IESI Corporation Insulin-Free World Foundation JDP Mechanical, Inc. Johnson and Johnson Family of Companies Kenny Johnson Mollie Kalman* Reuben Kaplan* Amy Katz Eleanor and Herbert* Katz Helene and Stanley Kellert* Kelly Press, Inc. Patricia and James Kennedy Tammy and Steven Klein Stanley M. Kossoff Burt Kozloff Janie and Ron Kupferman Kenneth A. Lattman Foundation, Inc. Maximilian Lavine* Lehman Brothers Fran and Robert Leichtung Thomas J Lipton, Inc. Ann and James Long Long Island Board of Realtors Joan and Martin Maddaloni Magnus and Petherick Family Mainco Elevator & Electrical Corp. Medimmune Milrose Consultants, Inc. Mitzi and Sol Center Marie G. Morandi MOSAIC M-T-M Printing Co., Inc. Mystic Pointe Neiman Marcus Neocrin Company New York City Transit Authority Judy and J. P. Newell, III Newmark & Company Real Estate, Inc. Kathryn A. Nicolosi The Nieweg Foundation NMAPC, Inc. The Oringer Family Foundation Lisa and James Pappas Louise and Allan Pashcow Perlmart The Picard Family Ruth and Nathan Plaks Platinum Maintenance Service Corp. Louise and Faustino Poo Porsche Ethel C. Posnick The Puntillo Family Quality Building Services Corp. Quality Fire Protection Consultants, Inc. Raymond C. and Diane F. Radigan In memory of my husband John, Lillian Redlich Maria and Eric Reeps Gertrude Reis* Remco Maintenance Corporation Marie and Charles Rizzo 39 [2009 annual report] Blanca I. Rodriguez Helen L. Rossi* Iris and Gene Rothstein Florence and Arnold Rubin* Gloria and Dr. Larry Ruchman Olga and Carlos Saladrigas Roberta Sands Irela and Jose Saumat ScheinMedia Schindler Elevator Corporation Richard Schoninger and The Schoninger Fund Bruce and Mary Jo Schumin The Segel Company, Inc. Mildred and Julius Ser Tom Shanks Sherwood Medical Industries Iris and Milton Shlansky Natasha and Thomas Silver Lenore Toby-Simmons and Dr. Bernard J. Simmons The Simon Foundation Rose Sipocz* Sandra Smith Alan Smurfit Claudine Smurfit Iolanda M. Sobol Donald Soffer Frosene Sonderling* Southern Wine & Spirits of South Florida Abbe and Eric Spar Marilla M. Spear* Joan Spector Stanford Financial Group Debbie and Lou Steiner Structure Tone Inc. Ted Moudis Associates, Inc. To The Point Together Against Diabetes The Torch Foundation Transel Elevator and Electric, Inc. Triangle Services, Inc. Turner Construction Company, New York, NY Unity Electric Co., Inc. Vanguard Construction & Development Co., Inc. VITAZEST Water - Triple A Products, LLC Vivotech The Reverend Ann Walling Rina and Jerrold Weinbrom Laura Weinsoff Anne Weinstock* Laurie and Lawrence Wells Leslie Westreich Rhoda and Donald White Dan Whitney a.k.a. Larry the Cable Guy Marion and Robert S. Wilson The Paula and Tom Wilson Family Josephine Wolf* Wollowick Family Foundation Zwicker Electric Co., Inc. Benefactors - $25,000+ ABM Janitorial-Northwest A.F. Best Securities, Inc. A/R Environetics Group, Inc. Abbey Foundation Jayne and Leonard Abess/City National Bank of Florida Alice and Arthur Adams* Sari and Michael Addicott Adelhardt Construction Corporation Arthur and Shelley Adler Annette and Lee Aerenson AFL-CIO Housing Investment Trust/AFL-CIO Building Investment Trust Ahmuty, Demers & McManus AIG Armando Alejandre Jr. Memorial Foundation Carmen Alexander-Printup* and Michael C. Alexander Allergan Medical Optics Amalgamated Transit Union American Healthcorp., Inc. American Home Products Corp. American International Group A-One-A Produce & Dairy Aragon, LLC Architectural Tile Restoration, LLC Helen M. Aren* Peggy and Joseph Armaly The Artzt Family ASM Mechanical Systems Sallie* and David Balogh Lydia and Paul Balzano George W. Bauer Family Foundation Bay Area Produce Bear, Stearns & Co., Inc David A. Beckerman Foundation Marie Belanger Suzanne and Marc Bell Arvilla and Leo* Berger Ruth and Philip Berman Betagene Incorporated Suzanne and Donald Bezahler Jennifer and Robert C. Bills Biscayne Greyhound Track Blavin & Company, Inc. Bloomberg Ted Bodin* Michele and Peter Bongiorno Boston Properties, LP The Boult Family Foundation Bovis Lend Lease, Inc. Bravo Brands Inc. Bristol-Myers Squibb Company Romero Britto Dorothy and Michael Brumer Buchwald Jewelers Marilyn Cahn Kate Callahan and Peter Benjamin Calvin & Flavia Oak Foundation Canyon Ranch Health Resort Cartier, Inc. Sophia and William J. Casey Foundation CBRE Real Estate Services, Inc. Lee and Sidney Charnin Elizabeth Cheval Deborah Chodrow Edwin S. Chua and Lori Dolce Cilco, Inc. Citrix Systems Karen B. Cohen Mr. and Mrs. Michael Cohen Ralph Cohen* Vivian Cohen* Comet Electric Mabel B. Conklin Gertrude and Jack* Cooper Miller Cooper Lorraine and Sidney Cooperman Cathie and Robert Cornacchia Cornblum Family Corporate Interiors Contracting, Inc. Couts Heating and Cooling Inc. Cure Diabetes Now Jane and Lawrence David Merle M. DeLancey DeLancey Printing Delicious Brands, Inc. Kim and Jordan Dickstein Ann and Norman Didriksen Distillery Wine and Allied Workers Donaldson Acoustics Co., Inc. Amy and William Donner Debbie and John Drury Dudley Foundation Mildred Edelstein* Edmar Cleaning Lola and Gus Efthimiou Sheila Elias Susan and Gerard Elicks Gail E. Ellis and Sandy J. Fox Empire Office, Inc. Chase Enterprises Erectra Construction Corp. ESS & VEE Acoustical Contractors, Inc. Eurohypo AG Rosa and Francis Feeney Iris and David Feldman Mr. and Mrs. Keith Fell Marilyn Fellman Fine Art and Craft Co., Ltd. Pamela and Barry Fingerhut Lillian Fiolic* Fisher Brothers Management Co. FIT USA Foundation Florida Association of Furniture Manufacturers Florida District Kiwanis Florida Mushroom, Inc. Fred Geller Electrical, Inc. Fried, Frank, Harris, Shriver & Jacobson In Loving Memory of Fred Friedland Friends United for Diabetes Research Doree and Malcolm Fromberg Thomas E. Frueh* G.L. Homes of Florida Corporation Anne Gache Mira and Murray* Gaines Gardiner & Theobald Inc. Gina and Peter Gardner Gensler The GEO Group Friends of Robert A. Georgine Suzanne and Thomas* Gerard Niety and Gary Gerson Arnold Gertner Bunchy Gertner Judy and Robert Giaquinto Susan and Arthur Gillin Dalia and Saul Glottmann Marion and Donald Golden Carolyn and Marc Goldfarb Debora and David Goldfarb Goldman Sachs and Company Bella and Lester* Goldstein Lorraine Goldweber* Jennefer and Ian Goodman Nettie Gratkowski* Ellen and Irving Grauer Sylvia Gray George Green Danielle and Troy Gregory James and Betty Guy Susan and Alan Habacht Amy and James Haber Foundation Norma and Herbert* Hackmeyer Patrick and Mary Hall Joseph and Sally Handleman Foundation Trust Daniel J. Hannon Hanover Moving & Storage Co., Inc. Deana and Stephen Hanson Nicki and J. Ira Harris The Headlands Foundation Health Net, Inc. Ellen and Barry Heimlich Christopher and Joie Hein Mr. and Mrs. Robert T. Held, Jr. Mary K. Heller* Marilyn and Carl Hellman Janet and Barrett Hess Madeline and Herbert Hillsberg Louis Hirschfield The Hirshleifers HLW International LLP Hochberg Family Foundation Lee S. Hochwald* The Homan Foundation Home Savings Bank of Florida Hotel Employees and Restaurant Employees International Union Household Credit Card Services Edith and Robert Hudson Peter Huri ICAP Services North America LLC Insignia/ESG, Inc. International Association of Fire Fighters Intracoastal Abstract Co., Inc. J.T. Magen & Company Inc. Myra and Allen Jacobson JC & F Services, Inc. The Joachim Family Jones Lang Lasalle Americas Max D. Josephson* Juvenile Diabetes Research Foundation International K & R Industries Kaback Enterprises, Inc. Charlotte and Louis Kaitz Howard Kane Mr. and Mrs. Michael A. Karsh Marsha and Arthur Katon Joan and Myron Kaufman Beth and Sy Kirshner Klear Electrical Corp. Merrick R. Kleeman Harry Klein* Sheila and Arthur Kline Knight Electrical Services, Corporation Gary Koenig, in Memory of Walter D. Koenig Helene and Marc Kovens Debra and Jerry Kramer Alvia Kreher* Bertha Kubler L & K Partners, Inc. Nancy and Richard Ladd LandAmerica Laurie and William* Landau Brian and Jill Landow Lane Office Furniture, Inc. Laro Service Systems, Inc. Lazard Freres & Co., LLC Lehr Construction Corp. Carole and Marvin Leichtung Jan and Arthur Leichtung Ellen and Joseph Leondis Joan and John Leondis Evelyn C. Levine* Meryl R. Lieberman Lodi Markets, LLC JoAnn B. Long Dr. and Mrs. John Lovecchio Lowenstein Sandler PC The Luebs Family M. Robert Goldman & Company Alice Mace Macklowe Management Co. Inc. Margot Madans Mailboxes, Etc. Jack N. Mandel Diane and Paul Manning Marino Gerazounis & Jaffe Associates, Inc. Lisa and Richard Mattaway Linda and Bill McDonald, Jr. MC Energy Inc. Scott McDonald and Tiffany Schauer McGann Family Lois and Marvin L. Meitus Mercedes Benz of Palm Beach Joseph Messana Metropolitan Steel Industries, Inc. Linda and Thomas Meyer The Milch Family Foundation Dawn Mintz Memorial Fund Marge K. and Dr. Daniel H. Mintz Martha Mishcon Monster Worldwide, Inc. Monterey Fund, Inc. Edward Moss Stephen and Sandy Muss H. Herbert Myers Memorial Foundation National Association of Letter Carriers National Distributing Company National Music Publishers Association, Inc. Dr. Robin Nemery and Barry Hauser Eleanor & Roy Nester Family Foundation Sheldon Neuman* New York Community Bank Foundation New York Elevator Company, Inc. Ann and Jack Norman Northland Cranberries, Inc. Novocell, Inc. Sandra Nowicki Otis Elevator Natalie and Michael* Pelavin Rosalie and Stephen Pandol Parents for the Cure Perry Ellis International Inc. David J. Peterson Ruth Pfeffer Plaza Construction Corporation Simon Portnoy Victor Posner* Hildine and Jerry Potashnick Premier Restoration Technologies, LTD. The Produce Connection Prudential Financial Norma and Luis Quintero Rafa Machinery and Engineering Real Estate Media Rosalind and Daniel Richter Myrna and Norman Ricken Marsha and Barry Ringelheim Heather and Charles A. Ritter Robert Stigwood Organization Joan and Gerald Robins Deborah and Scott Robins Loree Rodkin Helen and James Rosburg [diabetes research institute foundation] 40 Harry & Bessye Rosenberg Charitable Trust Seymour Rosenberg Blanche I. Rosenblatt Mr. and Mrs. Maurice A. Ross Maritere and Jorge Rosso The Rothstein Family Ruth Rubenstein* Adrienne R. and Arnold J. Rubin Alice and Seymour Rubin * S.I.U. of North America Sager Development/Subway Saks Fifth Avenue Salomon Smith Barney Faryl and Jonathan Sandler Gerald P. Schein Jill Schildkraut-Katz Sue Schonfeld Patricia and Leonard Schupak Donna and Marvin Schwartz Beatrice & Samuel A. Seaver Foundation Michele and Norman* Seiden Samantha Shanken and Michael Baker Barbara and Norman Shapiro Sanjiv Sharma and Nadine Allen Louis K. Sher Dana and Andrew Shore Show Management Concession Inc. Sheila and Joseph Shulevitz The Silva Family, in Memory of Barbara Katz Casey and Matt Singer Samuel Singer* Dolly and Mitchell Sirgany Skadden, Arps, Slate, Meagher & Flom LLP Jay Skyler and Mercedes Bach Bernadette and Owen Smith Linda and Frank Smith Standard Drywall, Inc. Starvin Marvin Jewelry Inc. Steelcase Inc. Rhoda Stern Strauss Paper Company, Inc. Stuart Dean Co., Inc. Sugarman Family Partners in Memory of Fred Krutel* Cindy and Michael Sweeney Team FootWorks Temco Service Industries, Inc. Tennessee Valley Authority Rick, Margarita and Steven Tonkinson Top Tomato Company Tropical Shipping U.S. Trust Bank of America Private Wealth Management Union Bank The Union Central Life Insurance Company United Food & Commercial Workers International Union United States Sugar Corp. Vornado Office Management Vornado Realty Judy and Bruce Waldman Thomas J. and Holly C. Weger Carole and Marcus Weinstein Susan Blash Weiss and Gary Weiss Wells Fargo Foothill The Wilfork Family Winn-Dixie Stores, Inc. Marcia and Leon* Winograd Sheila Wohl Laurence G. Wolf Marsha and Fred Wolinsky 41 [2009 annual report] Yates Restoration Group Ltd. In Memory of Lucian Zadrozny Deborah and Jeffrey Zane Althea Brandner Zansler Donna and George Zoley Mary Zuk* *deceased heritage [society] Nancy Barr Bisco E. Diane Beber Thomas and Martha Blash* Michele Bowman and Joseph Underwood Annemarie and Lester Brockman Marty B. Bruder Jane D. Burt* Henry Caballero* Ivette and Juan Elias Calles Jeanette Carmel* Tom Curtis Aldo Del Re* Cindi and Paul Elias Eric Feiler* Carole D. Franklin Sherrie and Joseph* Garfield Stanley J. Garfinkel Dr. and Mrs. Phillip T. George Elizabeth A. Guon* J. Jean Hacker* Kenneth G. Harple Shirley Harris Frances Harrow Larry Hassenbein Don and Diane Holmes Shirley M. Hotto Jill and Thomas Karlya Carole and Barry Kaye Dr. Norman and Sue Kenyon Richard H. Kline* Eleanor Kosow Rose B. Kramer Rebecca Krawitz* Sara Kupchik* Marc D. Levine* Margot Madans Muriel B. Mele* Jill and Gary Miller Howard C. Neumann Kim and Beverly Newlin Eleanor J. and Laurence S. Newman* David Papier In memory of Laurie R. Parham Ruth Plaks Betty Pinto* Barbara C. Popp Hildine and Jerome Potashnick Lori Chadick Randell James and Dr. Wendy Rapaport Lillian Redlich Gertrude Reis* Margaret H. Reynolds* Jo-Ann Rifkind Susan and Neil D. Rosenberg Beatrice and William Sahm Charles Sakele* Arline B. Schaeffer Kimberly Schlom Maurice and Inge Schweizer* Seskin Family Foundation Barbara and Sheldon Singer Elda Bello Spano Emilia M. Stark Gale Goldstein Tucker Ilene and David Vinikoor Simon H. and Sandra F. Waugaman Esther Weingarden* Laura Weinsoff Lori and Lary Weintraub Susan Blash Weiss and Gary Weiss Julius Werbner* Adele Wilson* Sally D. Zak* Morris Zell Don Zipern Ann Zorn* *deceased [diabetes research institute foundation] 42 national [board of directors] Chairman Thomas D. Stern Chairman Emeritus Marc S. Goodman Vice Chairmen William J. Rand, M.D. Charles Rizzo President and CEO Robert A. Pearlman Treasurer Harold G. Doran, Jr. Secretary Barry C. Hauser Directors Mark H. Ayers Bernard Beber, M.D. Diane Beber Marlene Berg Juan Elias Calles Brian Coughlin Nathan J. Esformes William J. Fishlinger Jeanine Forman-Ham Douglas Gallagher Piero Gandini Lawrence E. Glick Jay N. Goldberg Esther Goodman Jerrold Goodman Arthur Hertz Lawrence Howard, M.D. Bonnie Inserra Glenn Kleiman Martin P. Klein 43 [2009 annual report] Eleanor Kosow Harvey M. Krueger Sandra Levy Allan L. Pashcow Ramon Poo Risa Pulver Michelle Robinson Ricardo Salmon Kenneth A. Shewer Kathy Simkins Sheldon L. Singer Steven Sonberg Jill Viner Michael Wallock Sonja Zuckerman honorary & regional [boards] Florida Board of Directors Northeast Board of Directors Long Island Board of Directors Honorary Board of Directors Chairman Chairman Chairman William J. Rand, M.D.* Ricardo Salmon* Allan L. Pashcow* Directors Vice Chairman for Events and Public Relations Executive Committee Lynne and Martin Baron Barbara and H. Tod Berman Paul Cejas John Drury Annie Esformes Linda and Jay Finkelstein Bernard Fogel, M.D. Edward T. Foote, II Samuel J. Fox Lisa and Mark M. Freedman C. Thomas Gallagher Gladys and Martin Gelb Linda and Barry Gibb Yvonne Gibb Dwina and Robin Gibb Bella Goldstein Jane Goodman Senator Bob Graham Mary Lou and Robert T. Held, Jr. Fana and Abel Holtz Lola and Donald Jacobson Stanley M. Kossoff Robert Leichtung Sidney Levy Charlotte and Eugene Milgram Martha Mishcon Marge Kleiman Mintz Stephen Muss Judy and J.P. Newell, III Edward James Olmos Blanche Rosenblatt Florence and Arnold Rubin Rowland Schaefer Donna Shalala Serena and Leon J. Simkins Oscar Sotolongo Ferne and Daniel Toccin Dottie and Jack S. Weiss Kelley Kosow Werner Lenny Wolfe Sari Addicott Bernard Beber, M.D.* Diane Beber* Juan Elias Calles* Bruce Fishbein Jerrold Goodman* Rene W. Guim Barry Hauser* Barbara Herzberg Javier Holtz Norman Kenyon, M.D. Vito La Forgia Sandra Levy* Micki Mele Carol Nudelman, Ph.D. Ramon Poo* Cristina Poo Deborah Rand Michelle Robinson* Madelyn Rubin Rosa Schechter James Sensale Jacci Seskin Lou Steiner Don Strock Gary Studley Stephen Wagman Rita Weinstein Linda Widrich Weitz Sonja Zuckerman* * also member of the National Board of Directors Risa Pulver* Directors Barbara Annis Diane L. Cohen Peter L. DiCapua Kim Dickstein Joel S. Friedman Richard M. Fuscone Jay N. Goldberg* Marc S. Goldfarb Esther Goodman* Marc S. Goodman* Alan Kava Meryl Lieberman Samantha Shanken David Sherr Kenneth A. Shewer* Steven Silva Thomas P. Silver Thomas D. Stern* Geoffrey L. Symonds William J. Fishlinger* Barbara Hatz John Luebs Hon. C. Raymond Radigan Charles Rizzo* Directors Barry Ballen Michele Bongiorno Peter Bongiorno Debra Carrion John Carrion Douglas R. Donaldson Joan Fishlinger Iris Feldman Addy Fritzhand Jon Hatz Brian Landow Jill Landow Frances Luebs Louise Pashcow Marie Rizzo Miriam Shiff Bruce Waller Roberta Waller Delia Whitton [diabetes research institute foundation] 44 drif [staff ] National Office Mary Revie Northeast Region Administrative Assistant Robert A. Pearlman Rick Lepkowski President and Chief Executive Officer Helen Segel Deborah L. Chodrow Mylinda Auguste Chief Operating Officer Data Entry Clerk Jeffrey Young Marisol McKay Chief Financial Officer Data Entry Clerk Tom Karlya Lori Hester Vice President Receptionist Jill Shapiro Miller Eddy Garcia Vice President of Gift Planning Courier Lauren Schreier Director of Marketing & Communications Jill Ann Pall Special Events Director Jill Salter Development Coordinator Long Island Region Anthony E. Childs Long Island Regional Director Lily Scarlett Lori Weintraub, APR Vice President of Marketing & Communications Northeast Regional Director Executive Assistant Director of Special Events Florida Region Melinda Ginsberg Sheryl Sulkin Special Events Coordinator Director of Special Events Brian Huether Associate Director of Special Events Margaret Cassani Administrative Assistant/ Receptionist Barbara Singer Director of Special Projects Stacy Zolotin Gift Planning Manager Nicole Otto Assistant Director of Special Events Aurora Nunez Administrative Assistant Natasha Norris Communications Coordinator Karen Paraboo Administration and Database Coordinator Laurie Cummings Communications Assistant Oneida Osuna Accounting Assistant 45 [2009 annual report] . Diabetes Research Institute Foundation Long Island 410 Jericho Turnpike Suite 201 Jericho, NY 11753 Telephone 516.822.1700 Fax 516.822.3570 Northeast 381 Park Avenue South Suite 1118 New York, NY 10016 Telephone 212.888.2217 Fax 212.888.2219 DiabetesResearch.org Designed by Franz Franc Design Group National Office Florida Region 200 South Park Road Suite 100 Hollywood, FL 33021 Telephone 954.964.4040 Toll-free 1.800.321.3437 Fax 954.964.7036