Smith Research Program

Smith Research Program

Contact information:

James Smith, MD, MS
james.smith@ucsf.edu

Funding:  Department of Urology, NIH, UCSF

Current Research Program and Interests:

Dr. Smith’s principal research interests center on cancer, fertility preservation, and cancer treatment effects on male reproductive biology. In collaboration with several other researchers, Dr. Smith seeks to answer questions in several keys areas:

Current Research Program and Interests:

Dr. Smith’s principal research interests center on his desire to help men and boys with cancer achieve fatherhood. In collaboration with several other researchers, Dr. Smith seeks to answer questions in several keys areas:

Mechanism and Regulation of Sperm Motility
Men treated with chemo- and radiation therapy for cancer often suffer from significant declines in sperm concentration or motility, key measures of sperm function. In this NIH funded collaboration with Dr. Polina Lishko, a faculty member in the UC Berkeley MCB Department, we are exploring the functional properties of human sperm at different stages of their development using the “Sperm Patch Clamp” technique. This technique allows for measurement of current through sperm membrane ion channels. We have identified several novel promoters and inhibitors that regulate these channels. With this approach, we seek to better understand the effect of cancer treatments on functional properties of sperm.

Effect of Targeted Cancer Therapy on Male Reproduction
Tyrosine kinase inhibitors (TKI) and Mammalian Target of Rapamycin (mTOR) are targeted classes of cancer treatments that offer many cancer patients new ways of fighting their disease. In collaboration with Dr. Lishko, this study of men receiving TKI or MTOR inhibitors evaluates the fertility effect of these targeted cancer treatments on semen analysis properties along with its potential for inhibition of sperm functional characteristics. Recruitment began November 2012.

Differentiation of Spermatogonial Stem Cells (SSC)
Differentiation of SSC to mature sperm has been demonstrated in model animal systems. No study has yet successfully developed this capability in humans. This approach offers potential as a treatment for men left without sperm after cancer treatment. Collaborating with Dr. Nam Tran, we have demonstrated the ability to identify and grow SSC from normal human testicular tissue. We continue to explore methods to induce in-vitro differentiation of SSC to early meiotic sperm cells and induce meiotic cells to mature into
spermatozoa.   

Access to Fertility Care
In studies based on retrospective and prospective cohorts of patients seeking fertility care, performed in collaboration with Dr. Patricia Katz of the Institute for Health Policy Studies, Smith continues to explore issues affecting access to reproductive care including the utilization of fertility care, out-of-pocket fertility expenses, time costs associated with fertility care, and socioeconomic disparities couples face when seeking reproductive health care. New studies are investigating disparities in access to reproductive care that exist in low resource communities.