CURRICULUM VITAE
Current
Appointments:
Professor of Medicine (Clinical Pharmacology and
Infectious Diseases), The Johns Hopkins University School of Medicine.
Appointment effective 6/1/05.
Professor of
Pharmacology and Molecular Sciences, The Johns Hopkins University School of Medicine.
Appointment effective 6/1/05.
Professor of International Health, The Johns Hopkins
University, Bloomberg School of Public Health.
Appointment effective 6/1/05.
Associate Vice Chair for Academic Fellowship Programs,
Department of Medicine, The Johns Hopkins University School of Medicine.
Appointment effective 1/1/03.
Associate Director, Interschool Graduate Training
Program in Clinical Investigation, The Johns Hopkins University School of
Medicine and Bloomberg School of Public Health. Appointment effective 7/1/92.
Associate Director, General Clinical Research Center,
The Johns Hopkins University School of Medicine. Appointment effective 3/1/03.
Principal Investigator, The Johns Hopkins University
AIDS Clinical Trials Unit. Appointment effective 9/1/00.
Medical Staff, The Johns
Hopkins Hospital. Appointment effective 7/1/89.
Personal Data:
Business Address:
Osler 503
The Johns Hopkins Hospital
600 N. Wolfe Street
Baltimore, MD 21287-5554
Phone:
410-955-9712
Fax: 410-614-9978
e-mail: flex@jhmi.edu
Education and Training:
Undergraduate: B.S.,
1978 Stanford University Biology
Graduate: M.D., 1982 The
Johns Hopkins University Medicine
School
of Medicine
Internship: 1982-1983 Stanford University Hospital Medicine
Residency: 1983-1985 Stanford University Hospital Medicine
Laboratory
Fellowship: 1985-1988 Laboratory
of Viral Diseases Virology
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Clinical
Fellowship: 1988-1989 The Johns Hopkins
University Infectious Diseases/
School
of Medicine Clinical
Pharmacology
Department
of Medicine
Infectious
Diseases and Clinical Pharmacology
Previous Professional Experience:
1996-2005 Associate
Professor of Medicine The
Johns Hopkins University
(Clinical Pharmacology School of
Medicine
and Infectious Diseases)
Associate Professor of Pharmacology and Molecular Sciences
Associate Professor of International Health Bloomberg School of Public Health
1989-1996
Assistant Professor of
Medicine The Johns
Hopkins University
(Clinical Pharmacology School of
Medicine
and Infectious Diseases)
Assistant Professor of Pharmacology and Molecular Sciences
1990-1996 Assistant Professor of International
Health The Johns Hopkins
University
School
of Hygiene and Public Health
1998-2003
Assistant Director The
Johns Hopkins University
General Clinical
Research Center School of Medicine
Publications:
Peer-Reviewed Original Research Articles:
1.
Gerkens JF, Flexner C, Oates JA,
Shand DG. Prostaglandin and
histamine involvement in the gastric vasodilator action of pentagastrin. J Pharm Exptl Ther 1977; 201: 421‑426.
2.
Gerkens JF, Shand DG, Flexner C, Nies AS, Oates JA, Data JL.
Effect of indomethacin and aspirin on gastric blood flow and acid secretion. J Pharm Exptl Ther 1977; 203: 646‑652.
3.
Flexner C,
Weiner JP, Saudek CD, Dans PE. Repeated hospitalization for diabetic
ketoacidosis: the game of "Sartoris." Am J Med 1984; 76: 691‑695.
4.
Flexner C,
Hugin A, Moss B. Prevention of vaccinia virus infection in immunodeficient mice
by vector‑directed IL‑2 expression. Nature 1987; 330: 259‑262.
5.
Walker BD, Flexner C, Paradis TJ, Fuller TC,
Hirsch MS, Schooley RT, Moss B. HIV‑1 polymerase is a target for
cytotoxic T lymphocytes in infected individuals. Science 1988; 240: 64‑66.
6.
Flexner C,
Murphy BR, Rooney JF, Wohlenberg C, Yuferov V, Notkins AL, Moss B. Successful
vaccination with a polyvalent live vector despite existing immunity to an
expressed antigen. Nature 1988; 335:
259‑262.
7.
Flexner C,
Broyles S, Earl P, Chakrabarti S, Moss B. Characterization of human
immunodeficiency virus gag/pol gene products expressed by recombinant vaccinia
viruses. Virology 1988; 166: 339‑349.
8.
Walker BD, Flexner C, Birch-Limberger K, Fisher L,
Paradis TJ, Aldovini A, Young R, Moss B, Schooley RT. Long‑term culture
and fine specificity of human cytotoxic T lymphocyte clones reactive with
HIV-1. Proc Natl Acad Sci USA 1989;
86: 9514-9518.
9.
Lorentsen KJ, Hendrix CW,
Collins JM, Kornhauser DM, Petty BG, Klecker RW, Flexner C, Eckel RH, Bartlett JG, Lietman PS. Dextran sulfate is
poorly absorbed after oral administration. Ann
Intern Med 1989; 111: 561-566.
10.
Flexner C, Moss B, London WT, Murphy BR. Attenuation and
immunogenicity in primates of vaccinia virus recombinants expressing human
interleukin‑2. Vaccine 1990; 8:
17-21.
11.
Polydefkis M, Koenig S, Flexner C, Obah E, Gebo K, Chakrabarti S, Earl P, Moss B, Siliciano
R. Anchor sequence-dependent processing of human immunodeficiency virus 1
envelope glycoprotein gp160 for CD4+ T cell recognition. J Exp Med 1990; 171: 875-887.
12.
Hosmalin A, Clerici M, Houghten R, Pendleton CD, Flexner C, Lucey DR, Moss B, Germain
RN, Shearer GM, Berzofsky JA. An epitope in HIV-1 reverse transcriptase
recognized by both mouse and human cytotoxic T lymphocytes. Proc Natl Acad Sci USA 1990; 87: 2344-2348.
13.
Flexner, C, Barditch-Crovo P, Kornhauser DM, Farzadegan H, Nerhood
L, Bell K, Hendrix C, Lorentsen K, Chaisson R, Petty BG, Lietman PS.
Pharmacokinetics, toxicity, and activity of intravenous dextran sulfate in
human immunodeficiency virus infection. Antimicrob
Agents Chemother 1991; 35:
2544-2550.
14.
McEntee MF, Sharma DP, Zink MC, Adams RJ, Flexner C, Clements JE, Narayan O.
Rhesus monkey macrophages infected with simian immunodeficiency virus cause
rapid lysis of CD4-bearing lymphocytes. J
Gen Virol 1991; 72; 317-324.
15.
Moore RD, Kessler H, Richman DD, Flexner C, Chaisson RE. Non-Hodgkin lymphoma in patients with
advanced HIV infection treated with zidovudine. JAMA 1991; 265: 2208-2211.
16.
Flexner C, Hildreth JE, Kuncl RW, Drachman DB. 3-deaza-adenosine
and inhibition of human immunodeficiency virus. Lancet 1992; 339: 438.
17.
Hugin A, Flexner
C, Moss B. Clearance of recombinant vaccinia virus expressing
interleukin-2: role of local host immune responses. Cell Immunol 1993; 152: 499-509.
18.
McEntee MF, Flexner
C, Farzadegan H, Pitha P, Narayan O. Comparison of the effects of
3'-azidothymidine with those of neutralizing antibodies on simian
immunodeficiency virus infection in macrophages. Antimicrob Agents Chemother 1993; 37: 360-362.
19.
Flexner C,
van der Horst C, Jacobson M, Powderly W, Barditch-Crovo P, Petty BG, Ganes D,
Yacobi A, Duncanson F, DesJardins R, Norden C, Polsky B. Relationship between
plasma concentrations of 3'-deoxy-3'-fluorothymidine (alovudine) and
antiretroviral activity in two concentration-controlled trials. J Infect Dis 1994 ; 170: 1394-1403.
20.
Hendrix CW, Flexner C, Szebeni J, Kuwahara S, Pennypacker S, Weinstein J,
Lietman PS. Dipyridamole's effect on
zidovudine pharmacokinetics and short-term tolerance in asymptomatic
HIV-infected subjects. Antimicrob Agents
Chemother 1994; 38: 1036-1040.
21.
Petty BG, Cornblath DR, Adornato BT, Chaudhry V, Flexner C, Wachsman M, Sinicropi D,
Burton LE, Peroutka SJ. The effect of systemically administered recombinant
human nerve growth factor in healthy human subjects. Ann Neurol 1994; 36: 244-246.
22.
Dezube B, Lederman M,
Spritzler J, Chapman B, Korvick J, Flexner
C, Dando S, Mattiacci M, Ahlers C, Zhang L, Novick W, Kasdan P, Fahey J,
Pardee A, Crumpacker C. High-dose pentoxifylline in patients with AIDS: Inhibition
of TNF production. J Infect Dis 1995; 171: 1628-1632.
23.
Haubrich, RH, Flexner C,
Lederman MM, Hirsch M, Pettinelli CP, Ginsberg R, Lietman P, Hamzeh FM, Spector
S, Richman DD, for the ACTG 213 Team. A
randomized trial of the activity and safety of Ro 24-7429 (tat antagonist)
versus nucleoside for HIV infection. J Infect Dis 1995; 172: 1246-1252.
24.
Chavan SJ, Bornmann WG, Flexner C, Prochaska HJ. Inactivation of human immunodeficiency
virus type 1 reverse transcriptase by oltipraz: evidence for formation of a
stable adduct. Arch Biochem Biophys
1995; 324: 143-152.
25.
Tosi P-F, Schwartz D, Sharma U, Mouneimne Y, Hannig J,
Li G, McKinley G, Grieco M, Flexner C,
Lazarte J, Norse D, Nicolau C, Volsky DJ. Human erythrocytes bearing
electroinserted CD4 neutralize infection in vitro by primary isolates of human
immunodeficiency virus type 1. Blood
1996; 87: 4839-4844.
26.
Heldman AW, Hartert TV, Daoud EG, Kowalski TE, Pompili
VJ, Ray SC, Sisson SD, Tidmore WC, vom Eigen KA, Lietman PS, Petty BG, Flexner C. Oral antibiotic treatment of
right-sided staphylococcal endocarditis in intravenous drug-users: prospective
randomized comparison with parenteral therapy. Am J Med 1996; 101: 68-76.
27.
Vinetz JM, Glass GE, Flexner CE (sic), Mueller P, Kaslow DC. Sporadic urban leptospirosis.
Ann Intern Med 1996; 125: 794-798.
28.
Fischl MA, Richman DD, Flexner C, Para MF, Haubrich R, Yeramian P, Karim A, Holden-Wiltse
J, Meehan P. Phase I study of the toxicity, pharmacokinetics, and activity of
the HIV protease inhibitor SC-52151. J Acq Immunodef Syndr 1997; 15: 28-34.
29.
Sharma UK, Song HF, Willingham FF, Hannig J, Flexner C, Farzadegan H, Nicolau
C, Schwartz DH. Diagnosis of human
immunodeficiency virus infection using citrated whole blood. Clin Diag Lab Immunol 1997; 4: 261-263.
30.
Yu X-F, Dawson L, Tian C-J, Flexner C, Dettenhofer M. Mutations of the human immunodeficiency
virus type 1 p6Gag domain result in reduced retention of Pol proteins during
virus assembly. J Virol 1998; 72:
3412-3417.
31.
Lucas G, Lechtzin N, Puryear W, Yau L, Flexner CW, Moore RD.
Vancomycin-resistant and vancomycin-sensitive enterococcal bacteremia: a
comparison of clinical features and outcomes. Clin Infect Dis 1998; 26: 1127-1133.
32.
Barditch-Crovo P, Trapnell CB, Ette E, Zacur H, Coresh
J, Rocco LE, Hendrix C, Flexner C. Comparison
of the effects of rifampin and rifabutin on the pharmacokinetics and
pharmacologic effects of a combined oral contraceptive. Clin Pharmacol Ther 1999; 65: 428-38.
33.
Finzi D, Blankson J, Siliciano JD, Margolick JB,
Chadwick K, Pierson T, Smith K, Lisziewicz J, Lori F, Flexner C, Quinn TC, Chaisson RE, Rosenberg E, Walker B, Gange S,
Gallant J, Siliciano RF. Latent infection of CD4+ T cells provides a mechanism
for lifelong persistence of HIV-1, even in patients on effective combination
therapy. Nature Med 1999; 5: 512-517.
34.
Turchin A, Lehmann HP, Flexner CW, Hendrix CW, Shatzer JH, Merz WG. Active Learning
Centre: Potential uses and efficacy of an interactive Internet-based teaching
tool. Medical Teacher 2000; 22:
271-275.
35.
Speck RR, Flexner C, Tian C-J, Yu X-F. Comparison
of human immunodeficiency virus type 1 Pr55Gag and Pr160Gag-Pol
processing intermediates that accumulate in primary and transformed cells
treated with peptidic and non-peptidic protease inhibitors. Antimicrob Agents Chemother 2000; 44: 1397-1403.
36.
Hendrix CW, Flexner
C, MacFarland RT, Fuchs EJ, Redpath E, Bridger G, Henson GW.
Pharmacokinetics and safety of AMD-3100, a novel antagonist of the CXCR-4
chemokine receptor, in human volunteers. Antimicrob
Agents Chemother 2000; 44: 1667-1673.
37.
Raines CP, Flexner
C, Sun E, Heath-Chiozzi M, Lewis RH, Fields C, Deetz C, Apuzzo A, Eshleman
SH, Jackson JB, Gallant JE. Safety, tolerability, and antiretroviral effects of
ritonavir-nelfinavir combination therapy administered for 48 weeks. J Acquir Immune Defic Syndr 2000;25:
322-328.
38.
Dowell P, Flexner
C, Kwiterovich PO, Lane MD. Suppression of preadipocyte differentiation and
promotion of adipocyte death by HIV protease inhibitors. J Biol Chem 2000; 275: 41325-41332.
39.
Flexner CW, Cargill VA, Sinclair J, Kresina TF, Cheever L. Alcohol
use can result in enhanced drug metabolism in HIV pharmacotherapy. AIDS Patient Care STDS 2001; 15: 57-58.
40.
JG
Gerber, S Rosenkranz, Y Segal, J Aberg, R D’Amico, D Mildvan, R
Gulick, V Hughes, C Flexner, F Aweeka,
A Hsu, J Gal, for the ACTG 401 Study Team. The effect of ritonavir/saquinavir
on stereospecific pharmacokinetics of methadone in HIV-infected, methadone
using subjects: results of ACTG 401. J Acquir Immune Defic Syndr 2001; 27:
153-160.
41.
Ratner
L, Lee J, Tang S, Redden D, Hamzeh F, Herndier B, Scadden D, Kaplan L, Ambinder
R, Levine A, Harrington W, Grochow L, Flexner
C, Tan B, Straus D, for the AIDS Malignancy Consortium. Chemotherapy for human immunodeficiency
virus-associated non-Hodgkin's lymphoma in combination with highly active
antiretroviral therapy. J Clin Oncol 2001;
19: 2171-2178.
42.
Speck RR, Yu X-F, Hildreth, JE, Flexner C. Differential effects of P-glycoprotein and multidrug
resistance protein-1 on productive HIV infection. J Infect Dis 2002; 186: 332-340.
43.
Lucas GM, Flexner
CW, Moore RD. Directly administered antiretroviral therapy in the treatment
of HIV infection: benefit or burden? AIDS
Patient Care STDS 2002; 16: 527-535.
44.
Lu
J-F , TF Blaschke, C Flexner, S Rosenkranz, LB Sheiner.
Model-based analysis of the pharmacokinetic interactions between ritonavir,
nelfinavir, and saquinavir after simultaneous and staggered oral
administration. Drug Metab Dispos
2002; 30: 1455-1461.
45.
Kresina TF, Flexner
CW, Sinclair J, Correia MA, Stapleton JT, Adeniyi-Jones S, Cargill V,
Cheever LW. Alcohol use and HIV pharmacotherapy. AIDS Res Hum Retroviruses 2002; 18: 757-770.
46.
Hamzeh
FM, Benson C, Gerber J, Currier J, McCrea J, Deutsch P,
Ruan P, Wu H, Lee J, Flexner
C, for the AIDS Clinical Trials Group 365 Study Team. Steady-state
pharmacokinetic interaction of modified-dose indinavir and rifabutin. Clin
Pharmacol Ther 2003; 73: 159-69.
47.
Washington
CB, Flexner C, Sheiner LB,
Rosenkranz SL, Segal Y, Aberg JA, Blaschke TF, for the ACTG 378 Study Team.
Effect of simultaneous versus staggered dosing on pharmacokinetic interactions
of protease inhibitors. Clin Pharmacol Ther 2003; 73: 406-416.
48.
Benson
CA, Williams PL, Currier JS, Holland F, Mahon L, Hojczyk P, MacGregor RR,
Inderlied C, Flexner C, Neidig J,
Chaisson R, Notario GF, Hafner R, for the ACTG 223 Protocol Team. A prospective, randomized trial comparing
the efficacy and safety of clarithromycin in combination with either
ethambutol, rifabutin or both for the treatment of disseminated Mycobacterium avium complex (MAC)
disease in persons with AIDS. Clin Infect
Dis 2003; 37: 1234-1243.
49.
Rufo P, Lin PW, Andrade A, Jiang L, Rameh L, Flexner C, Alper SL, Lencer WI.
Diarrhea-associated HIV-1 aspartyl protease-inhibitors potentiate muscarinic
activation of Cl- secretion by T84 cells via prolongation of
cytosolic Ca2+ signaling. Am J
Physiol Cell Physiol 2004; 286: 998-1008.
50.
Hendrix CW, Collier AC, Lederman MM, Schols D, Pollard
RB, Brown S, Jackson JB, Coombs RW, Glesby MJ, Flexner CW, Bridger GJ, Badel K, MacFarland RT, Henson GW, Calandra
G, for the AMD3100 Study Group. Safety, pharmacokinetics, and antiviral
activity of AMD3100, a selective CXCR4 receptor inhibitor, in HIV-1 infection. J Acq Immunodef Syndr 2004; 37: 1253-1262.
51.
Frank
I, Bosch RJ, Fiscus S, Valentine F, Flexner C, Segal Y,
Ruan P, Gulick R, Wood K, Estep S,
Fox L, Nevin T, Stevens M, Eron JJ, for the
ACTG 307 Protocol Team. Activity, safety, and immunologic effects of
hydroxyurea added to didanosine in antiretroviral naïve and experienced HIV-1 infected
subjects: a randomized, placebo-controlled trial, ACTG 307. AIDS Res
Hum Retroviruses 2004; 20: 916-926.
52. Nettles RE, Kieffer TL,
Kwon P, Monie D, Han Y, Adnan S, Parsons T, Cofrancesco J, Gallant JE, Quinn T,
Jackson B, Flexner C, Carson K, Ray
S, Persaud D, Siliciano RF. Intermittent HIV-1 viremia and the evolution of drug resistance in
patients on highly active antiretroviral therapy. JAMA 2005; 293: 817-829.
53. Nettles RE, Kieffer TL,
Cofrancesco J, Gallant JE, Quinn T, Jackson B, Flexner C, Carson K, Wu A, Siliciano RF. Psychological distress and
physical pain appear to have no short-term adverse impact on plasma HIV-1 RNA
levels in patients on successful HAART. HIV
Clin Trials 2005; in press.
54. Nettles RE, Kieffer TL, Parsons
T, Johnson J, Cofrancesco J, Gallant JE, ,
Carson K, Siliciano RF, Flexner C. Marked
intraindividual variability in antiretroviral concentrations may limit the
utility of therapeutic drug monitoring. Clin
Infect Dis 2006; in press.
Review Articles:
55.
Flexner C, Perlroth MG. Cyclosporine ‑ a powerful new
immunosuppressant. Western J Med
1985; 143: 92‑93.
56.
Moss B, Flexner
C. Vaccinia virus expression vectors. Ann
Rev Immunol 1987; 5: 305‑324.
57.
Moss B, Fuerst T, Flexner
C, Hugin A. Roles of vaccinia virus in the development of new vaccines. Vaccine 1988; 6: 161‑163.
58.
Moss B, Flexner
C. Vaccinia virus expression vectors. Annals
NY Acad Sci 1989; 569: 86-103.
59.
Flexner C. New Approaches to Vaccination. Adv Pharmacol 1990; 21: 51-99.
60.
Flexner C. Management of occupational exposure to HIV: an update. AIDS Med Report 1991; 4: 13-20.
61.
Flexner C. New antiretroviral agents in clinical development. Curr Opin Infect Dis 1992; 5: 798-805.
62.
Piscitelli SC, Flexner
C, Minor JR, Polis MA, Masur H. Drug interactions in HIV-infected patients.
Clin Infect Dis 1996; 23: 685-693.
63.
Flexner C. Pharmacokinetics and pharmacodynamics of HIV protease
inhibitors. Infect Med 1996; 13 (Suppl. F): 16-23.
64.
Flexner C. Drug interactions. PRN
Notebook 1997; 2 (1): 24-29.
65.
Flexner C. Principles of clinical pharmacology in post-exposure
prophylaxis. Am J Med 1997; 102
(Suppl 5B): 32-38.
66.
Pham PA, Flexner
C. Antiretroviral drug interactions in the HIV-infected patient. HIV Advances in Research and Therapy 1997;
7 (2): 10-17.
67.
Flexner C. HIV-protease inhibitors. New Engl J Med 1998; 338: 1281-1292.
68.
Maenza J, Flexner
C. Combination antiretroviral therapy for HIV infection. Amer Family Physician 1998; 57:
2789-2798.
69.
Flexner C. Drug-drug interactions in the HIV-infected patient. Improving Management of HIV Disease,
1998; 6 (2): 31-36.
70.
Flexner C. Understanding and managing drug interactions. PRN Notebook 1998; 3 (3): 9-15.
71.
Flexner C. Double jeopardy: the hazards of drug-drug interactions. HIV Research Initiatives and Treatment 1998;
4: 3-8.
72.
Flexner C. Fat city: understanding HIV lipodystrophy. Hopkins HIV Report 1998; 10: 14-15.