Councilor for the West
Evan Snyder, MD, PhD, FAAP
I’ve devoted my career to bridging the scientific and clinical worlds and trying to inspire and teach others to do the same. I’m a board-certified pediatrician, neonatologist, and child neurologist (possibly the first to be so triple-boarded) as well as a stem cell biologist and developmental neuroscientist. I’ve been gratified to be regarded as one of the “fathers” of the stem cell field, having introduced the concept that neural plasticity, as mediated by neural stem cells (NSCs), might be harnessed therapeutically (we demonstrated the existence of isolatable, engraftable NSCs, arguably the first solid organ stem cell discovered). The insights that made these observations possible derived directly from being at bedside, caring for normal and abnormal babies. Therefore, it was personally rewarding that those findings were first made public at the CNS Annual Meeting. where I received the Philip P. Dodge Young Investigator Award. I’ve spent my career showing that insights and principles derived from the newborn brain are broadly applicable to many disorders and therapies, including in the adult brain. We helped pioneer using stem cells to model development and disease, including complex polygenic processes. Most clinical trials involving stem cells to date are predicated on precepts we described; and those insights derived from the babies for whom I cared. Indeed, I’m preparing to launch a clinical trial using NSCs for neuroprotection in perinatal asphyxia, marshaling a career’s worth of observations on mechanisms-of-action.
As a “bridge person.” I have tried to help reinforce scientific rigor and biological/developmental principles to translational/clinical investigations, while also helping to bring real-world, patient-oriented insights to the basic science world.
I earned my MD-PhD at Penn (via MSTP) and studied psychology, philosophy, and linguistics at Oxford. I completed residencies in pediatrics and neurology and a fellowship in Neonatology at Boston Children’s Hospital (where I also served as Chief Resident in Medicine and then in Neurology). Concurrently, I did postdoctoral research in Genetics at Harvard. In addition to joining Children’s clinical faculty, I started my independent lab there, where I helped define the basic and translational properties of stem cells. I was recruited to Sanford Burnham Prebys and UCSD as a Professor to start/direct a Center for Stem Cells and Regenerative Medicine and help build California’s stem cell program. I’m a Fellow of the American Academy of Pediatrics and have been elected to the Association of American Physicians and to the American Institute of Medical and Biological Engineering. I served two terms as Chairmn of the FDA’s Cell, Tissue, and Gene Therapy Advisory Committee (after helping found its precursor) and presently chair the SAB of NIH’s Human Genetic Disease Biobank. I’m a Diplomate of the Health Leadership Academy. I served as president of the American Society for Neural Therapy and Repair and received its Sanberg Award for lifetime achievement. I’ve produced >300 publications and >30 patents and have mentored >160 trainees at all career levels and from all backgrounds.
My proudest accomplishment was having Steve Ashwal include my biography in his Child Neurology: Its Origins, Founders, Growth and Evolution (2021).
What key experiences within the CNS or other professional organizations have been most impactful or rewarding for you, and how have these experiences influenced your vision for advancing the strategic goals and direction of the CNS?
Four areas that have characterized my academic career were, indeed, nurtured by CNS: (1) The excitement of training the next generation of child neurologists; (2) The thrill of discovery and making an impact on kids’ lives not solely through being facile with today’s skills, but also by advancing beyond what we know now; (3) Serving as a “bridge” between the clinical, translational, basic science, and ethics worlds; (4) Engaging as many kindred spirits as possible in these visions – a commitment to “Diversity, Equity, Inclusion.” Each area nurtures the others.
I’ve always been impelled to share with others – especially trainees – the excitement I feel in trying to understand the newborn brain and in trying to prevent or ameliorate damage. I had a fresh-minted PhD in developmental neurobiology when I entered the NICU as an intern and became enthralled not only with watching the last trimester of CNS development unfold, but also with how little was known about the newborn brain: how to examine it, ensure its healthy development, repair it. It was my amazement at the degree of plasticity I observed at the bedside that impelled me to identify and isolate neural stem cells in the 80s/90s. I continued to embrace pediatric brain diseases as models for delineating the translational potential of the stem cell. My zeal in kindling this excitement in others of bridging bedside-to-bench is why I love being on service with trainees and taking my grad students to the bedside. I love making others see the clinic as a place that constantly challenges our curiosity. How one pursues that curiosity is simply a matter of temperament and interest. Wherever I’ve taught and practiced, I’ve established interactive teaching sessions called “Bedside-to-Bench Rounds” – note: NOT “Bench-to-Bedside.” Here, clinical cases are presented, and participants stimulated, in a Socratic fashion, to contemplate how the conundrums of a clinical manifestation (at the “bedside”) may be broken down into hypotheses regarding etiology, pathophysiology, and treatment that may be tested experimentally (at the “bench”) – and ultimately, brought back to the “bedside.” In addition to writing in standard textbooks, I co-edited Case Files in Neuroscience and have written Clinical Implications of Basic Science pieces for NEJM and Nature Medicine.
I’ve striven to be inclusive in these goals and reach-out. I’ve mentored in the Four Directions Program for Native Americans; sat on the SAB of an NIH Diversity Research Education Program dedicated to grooming physician-scientists from URM communities; served as co-investigator on three NIH grants to bring minorities into the NeuroAIDS, cancer, and addiction fields (receiving a “Pioneer Award”); striven to ensure opportunities for the under-represented as a steering committee member of UCSD’s MD-PhD program; am the director/co-director of 3 California training programs devoted to enhancing DEI; was appointed to the WHO Research Review Roster; serve on the SAB of Americans for Cures; and have advised Congress from the Bipartisan Policy Center’s Expert Panel. I even serve on California’s Emergency Medical Services Authority, and, during the Pandemic, did intensive care in an underserved community in California.
What are the most challenging issues facing child neurologists today, and how would the CNS, under your leadership, help its members meet those challenges?
During my decades as a CNS member, I’ve been impressed with how it has grown, under excellent leadership, in the directions I value, as profiled routinely in the CNS Open Forum. I hope to help foster that continued growth. As noted in my previous statements, I’ve strived to be a “bridge physician” in many areas of the life sciences – creating interfaces between disciplines: basic, translational, and clinical research with patient care; training, education, and outreach with communication; therapeutic development with regulation; ethics with health care politics; academia with the private sector. Navigating these relationships is one of our field’s challenges because life science is now too complex and the requisite skill sets too varied to be siloed. If fortunate to be elected to a leadership position, I would bring my organizational experience in bridging these areas and catalyzing interactions (some of which may actually be grant-worthy and revenue-generating for CNS).
Some ideas:
- Greater engagement with entities that do not yet appreciate that CNS is the “go-to” society for insight into childhood neurological disorders, treatments, and data.
- An example: I serve as chairman of the SAB to NIGMS’s Human Genetic Cell Repository. The majority of the diseases banked and profiled are pediatric/inherited neurologic conditions, yet there is little input from child neurologists. CNS could be involved in expanding and generating both the biobank and the databases. We could not only contribute to, but benefit from this resource. Becoming involved in “Big Data” and personalized/precision medicine (single cell ‘omics, functional cell read-outs, identification of biomarkers and, hence, mechanisms and drug targets) is the future of clinical neuroscience. We, as clinicians and clinician-investigators in CNS should be there.Establishing a series of standing “subspecialty experts bureau” that can provide consultation (on a prn basis) to health care, regulatory agencies, government, legislators, foundations, and (with proper guardrails) even the private sector – on medical needs, clinical trials, bedside realities.Greater outreach to both professional and lay communities on topics of broad interest, not only transmitting information (and combatting misinformation), but also making such groups recognize how central neurologic health is to all of pediatrics, and ultimately medical well-being broadly. I’m constantly distressed by how little is known about pediatric disease in general and neurological disease in particular. Regular podcasts created and sponsored by CNS might be a start.
- Such engagement will help ensure that evidence-based medicine informs clinical care.
- Engaging the passion of trainees through CNS-sponsored mini-rotations/preceptorships in various unique clinical or research settings nationwide.
- “Special Interest Groups” that meet by zoom more frequently than the annual meeting to discuss topics, papers, collaborations, grants, updates, controversies – and come out with position and white papers.
- Commitment to DEI. I subscribe to the notion that bias-proof scientific consensus cannot be reached without diversity. Hence, I advocate for more active outreach to URM communities, starting in college and, of course, med school and residency.
- Championing bringing care to the underserved.