The Gulati Lab at Icahn School of Medicine at Mount Sinai
Translational skin research at the intersection of immunology and oncology
Our Mission
The immune system plays a pivotal role in the pathogenesis of most of the skin diseases and drug rashes that dermatologists encounter daily in clinical practice. However, the immune system can also be harnessed to help fight skin cancers, benign skin tumors, and cancers outside of the skin. Oncodermatology is an emerging subfield within dermatology that is concerned with treating skin toxicities that result from various anti-cancer therapies. Immunotherapy involves activating the immune system to attack tumor cells, and is becoming one of the primary treatment modalities for skin and other cancers. Human skin serves as a uniquely accessible model for the study of the immune system in the setting of cancer.
Why particular skin toxicities occur in certain cancer patients during their therapies is unknown, and the appropriate methods to treat these reactions while still maintaining anti-tumor efficacy represent major clinical needs. Increased understanding of the immunology underlying these toxicities offers an untapped source of potential therapeutic strategies. Our ultimate goal is to improve human health through a deeper understanding of the relationship between the immune system and cancer in the skin.
Our Approach
We seek to obtain a deep understanding of skin immune reactions in the setting of both systemic and topical immunotherapies. We accomplish this by leveraging single-cell and spatial multi-omic approaches applied directly to patient skin tissue. Through techniques such as single-cell RNA-sequencing (scRNA-seq), we obtain a detailed view of gene expression profiles in various cell populations found within the skin. Also, to more precisely map positional relationships of different cell types within skin tissue, we employ spatial transcriptomics (ST) and multiplexed ion beam imaging (MIBI). In addition, we study patient blood samples through spectral flow cytometry and proteomics to correlate skin immune profiles with those found systemically. We were the first to combine these modalities to comprehensively profile patients receiving immunotherapy.
Our lab has an active clinical trials component, so we are able to treat our patients with novel therapeutics and repeat profiling after the treatment course. This ensures a robust bench-to-bedside approach that allows us to directly apply what we learn in the lab to patient care.