Joseph "Mike " McCune, M.D., Ph.D.
Back when people thought AIDS affected only gay men or injection-drug users, Joseph “Mike” McCune, M.D., Ph.D., had just started his internal medicine residency at the University of California, San Francisco (UCSF). It was 1982, and scores of men, many his age, were being brought to the wards of San Francisco General Hospital, gasping for breath and heading toward death.
“About all we could do for them was to provide supportive care, listen to them, and try to make them feel a bit better,” Dr. McCune recalls. But the scientist in him wanted to look beyond providing immediate care and learn how to make the virus go away.
Dr. McCune, now an associate professor of medicine at UCSF, has spent the intervening years trying to do just that—by studying HIV, the virus that causes AIDS. Along the way, he has helped unlock key mechanisms underlying HIV disease progression and has learned how to apply new treatments to bolster his patients’ well-being.
Recently, Dr. McCune was named director of the UCSF Clinical and Translational Science Institute, which pools expertise and resources by conducting training programs, building research infrastructure, and providing other incentives necessary to take “breakthrough” discoveries out of the laboratory and into the real world. Dr. McCune hopes the institute will help in the discovery of an effective vaccine against HIV.
Currently, translating basic HIV/AIDS discoveries into clinical use often fails because of numerous hurdles it faces in many parts of the world. “Reality hits,” Dr. McCune said. “There are people who don’t have refrigerators to store the new drugs or even a safe water supply to help swallow them down. We still have a ways to go. We need to do for HIV what we did before for smallpox: find an effective way to prevent this disease around the world.”
Dr. McCune’s interest in science began in childhood, but he gained a real appreciation of health care systems when he studied traditional medicine in Botswana and in Sri Lanka for a year after college. Watching the “trance dance” of the African Bushmen, a ritual dance intended to heal the sick, he realized that it wasn’t simply pills and shots that made people better. Many people felt that simply the laying on of hands would alleviate their aches and pains. It became clear to him, however, that the people suffered from infectious diseases that traditional medical systems could not touch.
He returned to the United States to earn a medical degree at Cornell University Medical College and a doctorate in immunology and cell biology at Rockefeller University, imagining that this would launch him into a research-oriented career in medicine. Dr. McCune stayed on at Rockefeller to work under the legendary immunologist Henry Kunkel, who is best known for pioneering studies on immunoglobulins. “When I told him I wanted to have a research career and to work only in the lab, he hit the roof,” Dr. McCune says. “He told me that I had to learn about clinical medicine, too.”
Taking his advice, Dr. McCune moved across the country and right into San Francisco’s AIDS epidemic. He was a resident and an infectious disease fellow at UCSF before becoming a postdoctoral fellow at Stanford University. He would later become a founder of two biotechnology companies engaged in HIV research, before becoming an Associate Professor of Medicine at UCSF.
In the early days of HIV research, scientists would study the virus in cell lines continuously grown in tissue culture. But the virus quickly adapts to the conditions of the plastic dish and becomes different from the type of virus that grows best in people. Dr. McCune knew there had to be a better way to study HIV. He obtained “primary” virus isolates—the purest form of the microbe—from patients’ blood and injected them into a mouse model. This animal test model has proved so useful that researchers and pharmaceutical companies still use it in preclinical testing to predict how their drugs will act in living systems.
Award after award enabled Dr. McCune to explore his radical ideas, which have changed the way researchers have studied HIV. He received a Burroughs Wellcome Fund Clinical Scientist Award in Translational Research in 2000 to study how HIV infects and destroys the thymus—the organ that makes new T cells, which play a critical role in the body’s immune system.
Dr. McCune’s work has helped answer one of the most vexing questions in HIV research: does an infected person’s immune system collapse because it’s destroyed or because it can’t be rebuilt? Previously, scientists thought that HIV was causing too many T cells to die. Dr. McCune wanted to see if HIV might also result in less cell birth. He found that HIV does indeed prevent the production of new T cells in the thymus, ones that might replace the cells that are destroyed by HIV. “Even since that finding, we’ve been trying to find a way to turn the thymus back on,” Dr. McCune said.
Based on the success of his research in animals and in small, tightly focused studies in humans, Dr. McCune feels that it’s now time to set up systems that make it much easier to study disease mechanism and treatment in the clinic. But making such a shift is daunting, requiring infrastructure and teamwork not normally seen in the more basic realms of scientific pursuit. “It’s one of the most exciting times in terms of medical discoveries,” he said. “We now need to take advantage of that to improve health care.”
When not working in the lab or treating patients, Dr. McCune spends time with his 13- and 16-year-old daughters, Emma and Louise, and his wife, Karen. He also tries to run for at least an hour every day, both to have the chance to think and to train for a few marathons a year. Just as he pioneered the path from basic discoveries to better treatments for his patients, Dr. McCune also likes to lead his family into unfamiliar parts of the world. Last year, they went to Sri Lanka. Their next trip is planned for Texas, not only to visit his sister, he said, but because “my girls and I like roller-coasters, and some of the biggest and best are there.”
By Boonsri Dickinson, a freelance journalist basedout of New York. Ms. Dickinson is currently an editorial intern for Discover.