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Richard L Edelson, MD

Anthony N. Brady Professor of Dermatology
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Dermatology

PO Box 208059, 333 Cedar Street

New Haven, CT 06520-8059

United States

About

Titles

Anthony N. Brady Professor of Dermatology

Biography

After graduating from Hamilton College as a Chemistry major, Richard Edelson received his MD from the Yale School of Medicine (YSM).  He then sequentially trained in Internal Medicine at the University of Chicago, Dermatology in the Harvard Program and Cancer Immunology at the National Institutes of Health.  Before being recruited back to his alma mater as Chairman and Professor of the YSM Department of Dermatology in 1986, he was Director of the Immunobiology Group in Columbia University’s Comprehensive Cancer Center, Associate Director of that institution’s General Clinical Research Center and Professor and Director of Research in Columbia’s Dermatology Department.

While on the Yale faculty, he served continuously as Chairman of the Department of Dermatology (1986-2022), and at overlapping times, has also been the Director of the Yale University Comprehensive Cancer Center (2003-9), YSM Deputy Dean overseeing all Clinical Departments (2000-3), Leader of the YSM Cancer Center’s Lymphoma Research Program and the YSM Faculty Representative to the Yale-New Haven Hospital Board of Trustees. On October 1, 2022, after serving as departmental chairman for 37 years (the longest duration of any Yale University departmental chairman in University history), he resigned the position, while remaining a full-time Professor of Dermatology.  He was replaced by Keith Choate, MD, PhD, who is an internationally renowned investigative dermatologist specialized in the study and treatment of genetic diseases of the skin.  Dr. Edelson is an elected member of the American Society for Clinical Investigation and the Association of American Physicians, the Interurban Club, the Lotos Club and an honorary member of several international medical associations.

He is best known for two discoveries and their development.  First, he introduced the unifying concept of Cutaneous T Cell Lymphoma (CTCL), as a malignancy of skin-homing malignant CD4 T cells.  Second, he devised Extracorporeal Photochemotherapy, which became the first FDA-approved immunotherapy for any cancer.  That therapy, through its induction, antigen loading and modulation of physiologic dendritic antigen presenting cells, is now regularly administered in the majority of university medical centers throughout the USA and Europe, to treat advanced CTCL, rejection of transplanted hearts and lungs, graft-versus-host disease following stem cell transplantation and autoimmune disorders.  More than 70,000 patients have received a total of more than 3 million treatments. 

He takes great pride in the level and breadth of the international acclaim of the present Yale Dermatology faculty members, all of whom were recruited to the Department on the Edelson watch.  Each of the Department's four clinical sections (Medical, Pediatric and Surgical Dermatology, and Diagnostic Dermatopathology) is led by a recent president of the relevant national society.  The clinical (residency and fellowship) training programs are distinguished by their production of academic and investigative dermatologists, having launched the careers of more than sixty full-time university-based faculty members, including eight current Dermatology Department chairmen (Stanford, Harvard, NYU, Albert Einstein, Howard, Oregon, Vermont and Eastern Virginia), the current Deputy Director of the National Cancer Institute and four current Directors of Dermatologic Surgery (Yale, Stanford, NYU and Vermont).  The Yale Dermatology faculty currently ranks first nationally in its field, in terms of total federally funded dollars of competitive research support.

Dr. Edelson is the recipient of several National honors, including Castle and Connolly’s National Physician of the Year, the Dermatology Foundation’s Discovery Award, the American Skin Association’s National Mentorship Award and the Society of Investigative Dermatology’s Rothman Award for Career Contributions.  He is one of eight selected graduates of the NIH Physician Scientist Training Program whose investigative careers were featured in an eight-hour audiobook, narrated by actor Alan Alda, released by Audible.Com in December 2020, as a tribute to pivotal federally funded scientifically-driven medical advances.

Education & Training

  • MD:  Yale University (1970)
  • Dermatology Residency:  Harvard (1971-2), NIH (1972-3), Columbia (1975-6)
  • Internal Medicine Internship: University of Chicago Hospital (1970-1)
  • Immunology Fellowship:  Laboratory of Immunology NIAID, NCI of the NIH (1972-5)
  • Board Certification:  Dermatology

 

National Honors

  • Elected Member                       American Society Clinical Investigation             1982
  • Elected Member                              American Association Professors                        1986
  • Elected Member                              (Osler) Interurban Club                                      1989
  • National Physician of the Year        Castle Connolly                                                  2012
  • National Discovery Award               Dermatology Foundation                                    2015
  • National Mentor of the Year            American Skin Association                                 2017
  • Rothman Prize                                Society for Investigative Dermatology                2019                             

  

  Activities and Projects 

  • Referral Clinical Practice
    • Yale Dermatology Group, 2 Church Street, New Haven, CT
    • Special Interest:  Cutaneous Lymphoma and Related Disorders
  • As Chairman of the Yale Department of Dermatology, Oversight of:
    • Faculty Recruitment and Career Development
    • Oversight of Teaching and Research Programs
  • Active Projects of the Edelson Research Team
    • Development and Implementation of Selective Anti-Tumor Immunotherapy
    • Enhancement of Post-Stem Cell Transplantation Graft-vs-Tumor Immunity
    • Production/Modulation of Physiologic Dendritic Antigen Presenting Cells (phDC)
    • Dissection of Exosome and ER Stress Contributions to Anti-Cancer Immunity
    • Rapid Initiation of Protection Against Emerging Infection
    • Creation of Single Day Nanotechnical Evaluation of Anti-Tumor, Anti-Viral T Cell Responses
  • Branford College (Yale College) Fellow and Advisor of Undergraduates

















































Appointments

Education & Training

Senior Resident
Columbia-Presbyterian Hospital (1976)
Resident
Massachusetts General Hospital (1972)
Intern
University of Chicago (1971)
MD
Yale University (1970)
Fellow
National Institute of Health

Research

Overview

Edelson selected Immunology as his scientific area of interest, because it instrumentally influences the health of all body tissue. He chose Dermatology as his clinical specialty, because skin contains and displays all varieties of cellular elements in a highly organized, readily accessed and critically necessary manner. It was this tight interface between Immunology and Skin Disease that enabled his discoveries of CTCL, a physiologic treatment for the cancer and the manner in which monocytes can be naturally directed by platelet signaling to mature into physiologic dendritic antigen presenting cells (phDC), where and when they are required to initiate immunity against microbes or cancer or tolerance to self antigens.

Once phDC (physiologic dendritic antigen presenting cells) were established as the dominant mechanistic contributors to Transimmunization’s anti-tumor efficacy, a series of important conclusions could be drawn. Since, in the best responders, the treatment immunotherapeutically eliminated the malignant clone while apparently leaving normal T cell immunity intact, Transimmunization was clearly inducing a tumor-specific patient-specific clinically potent effect. Since, in a high percentage of recipients rejecting their transplanted hearts and lungs, despite conventional immunosuppression, Transimmunization also lessened the rejection without increasing opportunistic infections, the treatment was clearly capable of producing target tissue tolerance. Since limiting adverse reactions were exceedingly rare in these responders, the anti-cancer immunity and tissue tolerance had to be remarkably selective, a circumstance not reproduced by any “man-made” therapy. Transimmune's remarkable record of immunizing selectively against cancer, while also selectively suppressing destructive T cell attack of transplantation antigens, all largely in the absence of limiting adverse reactions, was entirely novel among immunotherapies and only matched in vivo by the Immune System itself. The attractive possibility that Transimmunization is actually a practical partnership with the normal immune system galvanized the ongoing search for the key guiding principle. Since DC are well known to be absolute requirements for physiologic selective immunity and tolerance, Edelson and colleagues recognized that the Transimmunization must somehow be producing and arming physiologic DC. With this insight, they then discovered that Transimmunization physiologically induces DC as detailed in the Science Advances paper listed below..

In the Transimmunization device, through which patient blood is extracorporeally processed over a two hour period, the following sequence has now been established. Soluble fibrinogen avidly adheres to the plastic surface, forming a substrate for equally avid platelet adherence and activation, just as occurs in wounds. The platelets are then signaled by the gamma chain of the adherent fibrinogen to instantaneously transpose p-selectin to the outside of the platelet surface. This p-selectin, by transiently binding to monocyte surface PSGL-1, then signals passaged blood monocytes to fortify the junction with platelets by capping the PSGL-1, leading to an immediate opening of calcium channels, culminating in NFkBd signaling of genes controlling monocyte-differentiation into phDC. This extracorporeally induced phDC are then tuned by photoactivated 8-methoxypsoralen (8-MOP) to become either immunogenic or tolerogenic to the antigens they are fed or already contain. This large scale production of phDC, cells normally difficult to access for tailoring to a clinical need for they are so rare in the blood stream, potentially opens doors to literally any disorder that can be impacted by the immune system. In the case of cancer, the patient-specific 8-MOP-damaged cancer cells can provide the ideal antigen substrate, while in the case of transplanted organ rejection or graft-vs-host disease following stem cell allografts, the antigenic source is provided by scavenger monocytes containing the tissue debris from target tissues.

Using a minaturized ECP apparatus we developed and which is scalable from mouse-to-man, we have demonstrated, as reported in two of the papers cited below, that we can effectively treat established experimental melanomas, as well colorectal and ovarian cancers, with this approach. Similarly, our colleagues at Northwestern University have shown that we can prolong organ allografts for up to a year in the absence of other immunosuppression. These preclinical studies encourage human trials, currently under consideration.

There are five active major projects in the Edelson laboratory: (1) dissection of the steps by which 8-MOP influences phDC into the tolerogenic mode; (2) testing of the premise that exosomes released from damaged tumor cells transfer relevant antigens to cross-presenting phDC; (3) enablement of intrafamilial haplotype-mismatched stem cell transplants through active tolerance; (4) development of a same-day simple method of subject-specific immunization against emerging infectious agents, such as SARS-CoV-2; and (5) augmentation of therapeutic graft-vs-tumor reactions.

Selected Publications (from More than 300) Relevant to the Above Narative

  • Edelson RL, Kirkpatrick CH, Shevach EM, Schein PS, Smith RW, Green I, Lutzner M. Preferential cutaneous infiltration by neoplastic thymus-derived lymphocytes. Morphologic and functional studies. Annals Of Internal Medicine 1974, 80:685-92.

  • Edelson R, Facktor M, Andrews A, Lutzner M, Schein P. Successful management of the Sézary syndrome. Mobilization and removal of extravascular neoplastic T cells by leukapheresis. The New England Journal Of Medicine 1974, 291:293-4.

  • Broder S, Edelson RL, Lutzner MA, Nelson DL, MacDermott RP, Durm ME, Goldman CK, Meade BD, Waldmann TA. The Sézary syndrome: a malignant proliferation of helper T cells. The Journal Of Clinical Investigation 1976, 58:1297-306.
  • Edelson RL, Brown JA, Grossman ME, Hardy MA. Anti-thymocyte globulin in treatment of T-cell lymphoma. Lancet 1977, 2:249-50.

  • Edelson R, Berger C, Gasparro F, Jegasothy B, Heald P, Wintroub B, Vonderheid E, Knobler R, Wolff K, Plewig G. Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy. Preliminary results. The New England Journal Of Medicine 1987, 316:297-303.
  • Kung PC, Berger CL, Goldstein G, LoGerfo P and Edelson RL. Cutaneous T cell lymphoma - characterization by monoclonal antibodies. Blood 1981. 57: 261-266. PMID: 6160893
  • Berger CL, Hanlon D, Kanada D, Dhodapkar M, Lombillo V, Wang N, Christensen I, Howe G, Crouch J, El-Fishawy P, Edelson R. The growth of cutaneous T-cell lymphoma is stimulated by immature dendritic cells. Blood 2002. 99:2929-2939. PMID: 15514008
  • Choi J, Goh G, Walradt T, Hong BS, Bunick CG, Chen K, Bjornson RD, Maman Y, Wang T, Tordoff J, Carlson K, Overton JD, Liu KJ, Lewis JM, Devine L, Barbarotta L, Foss FM, Subtil A, Vonderheid EC, Edelson RL, Schatz DG, Boggon TJ, Girardi M, Lifton RP. Genomic landscape of cutaneous T cell lymphoma. Nature Genetics 2015. 47:1011-9.
  • Berger CL, Hoffmann K, Vasquez JG, Mane S, Lewis J, Filler R, Lin A, Zhao H, Durazzo T, Baird A, Lin W, Foss F, Christensen I, Girardi M, Tigelaar R, Edelson RL. Rapid generation of maturationally synchronized human dendritic cells: contribution to the clinical efficacy of extracorporeal photochemotherapy. Blood 2010.
  • Gonzalez AL, Berger CL, Remington J, Girardi M, Tigelaar RE, Edelson RL. Integrin driven monocyte to dendritic cell conversion in modified extracorporeal photochemotherapy. Clin Exp Immunol 2014. 175:449-57.
  • Ventura A, Vassall A, Robinson E, Filler R, Hanlon D, Meeth K, Ezaldein H, Girardi M, Sobolev O, Bosenberg MW, Edelson RL. Extracorporeal Photochemotherapy Drives Monocyte-to-Dendritic Cell Maturation to Induce Anti-Cancer Immunity. Cancer Res 2018. 78:4045-4058.
  • Han P, Hanlon D, Arshad N, Lee J, Tatsuno K, Robinson E, Filler R, Sobolev O, Cote C, Rivera-Molina F, Toomre D, Fahmy T, Edelson, RL. Platelet P-selectin Initiates Cross-presentation and Dendritic Cell Differentiation in Blood Monocytes. Science Advances 2020. 6:1580-89.
  • Alvero AB, Hanlon D, Pitruzzello M, Filler R, Robinson E, Sobolev O, Tedja R, Ventura A, Bosenberg M, Han P, Edelson RL, Mor G. Transimmunization resports immune surveillance and prevents recurrence in a syngeneic mouse model of ovarian cancer. Oncoimmunology. 2020. 9:1758869.
  • Kazuki T, Yamazaki T, Hanlon D, Han P, Robinson E, Sobolev O, Yurter A, Rivera-Molina F, Arshad N, Edelson R, Galluzzi L. Extracorporeal photochemotherapy induces bona fide immunogenic cell death. Cell Death Dis. 2019. 10:578.



Medical Subject Headings (MeSH)

Dermatology; Immunotherapy; Lymphoma, T-Cell, Cutaneous; Skin Diseases; T-Lymphocytes

Research at a Glance

Yale Co-Authors

Frequent collaborators of Richard L Edelson's published research.

Academic Achievements & Community Involvement

  • honor

    Lifetime Achievement Award

  • honor

    National Physician of the Year - 2014

  • honor

    USA Top Docs 2020

  • honor

    Connecticut Magazine Top Docs 2020

  • activity

    Cancer Immunization

Clinical Care

Overview

Yale Medicine dermatologist Richard Edelson, MD, is the chair of the Department of Dermatology. Dr. Edelson cares for patients who have any number of skin conditions.

He is a nationally recognized skin cancer expert. His groundbreaking research in the 1980s proved that a skin fungus once called “mycosis fungoides” is actually a cancer of the lymphocytes. He renamed the disease, which affects more than 10,000 people annually, cutaneous T-cell lymphoma (or CTCL). “If untreated, it can spread to the blood and to other internal organs,” says Dr. Edelson. “It is really important to me to help patients fight this cancer.”

Using his research, he invented photopheresis, a treatment for advanced cases of CTCL. It’s a blood-filtering procedure in which blood is partially removed and treated in order to activate the immune system to fight the cancer. Photopheresis is often used with other conditions to bring balance to the immune system as well. A professor of dermatology at Yale School of Medicine, CTCL remains Dr. Edelson’s—and the department’s—central research interest today.

At Yale, Dr. Edelson has also served as director of the Yale Cancer Center, deputy dean for clinical affairs, director of the Cancer Center’s Lymphoma Research Program, and a member of both the Yale-New Haven Hospital Board of Trustees and the Yale Medicine Board of Governors.

Within the dermatology community, he is a member of the American Society for Clinical Investigation and the Association of American Physicians, and an honorary member of several international medical associations.

Clinical Specialties

Dermatology

Fact Sheets

Board Certifications

  • Dermatology

    Certification Organization
    AB of Dermatology
    Original Certification Date
    1977

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Dermatology

PO Box 208059, 333 Cedar Street

New Haven, CT 06520-8059

United States

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