A Message From Leadership
2023 marked the second year since the relaunch of our “Great Minds, Greater Discoveries” strategic research plan. In September, I had the opportunity to provide an update on our progress during Dr. Runge’s “Minute with Marschall” video blog that I encourage you to watch for a more in-depth description of our plan and related initiatives.
When we first began sketching the framework for the plan, we understood that our people, our “Great Minds,” are the strength and glue that will lead to its ultimate success. Faculty, staff, and learners have remained an utmost priority as we have invested in diverse research areas. As health equity continues to be a strategic priority across all three missions of Michigan Medicine, the Michigan Institute for Clinical and Health Research's $81 million renewal of its NIH grant will strengthen and build new resources that help researchers address health disparities. Launched in partnership with our colleagues on central campus, dozens of Michigan Medicine investigators are now members of the new Opioid Research Institute, which aims to catalyze and expand research, programs, and partnerships in the space. Inflammation research, a broad area that touches on many disciplines, was the topic of the first-ever Dean’s Lecture this fall, bringing together over 200 attendees to discuss how inflammation impacts diseases and chronic conditions. These are just a few examples of the robust investments we have made in supporting our vibrant research communities.
As you read further in this annual report, you’ll note that we have significant numbers to share. For instance, we had $777 million in award dollars for FY2023. Our publication output has continued to grow, with our researchers producing 11,706 publications in FY2023, compared to 8,313 last year, marking a 40% growth over FY2022. What I find especially exciting and gratifying is that those numbers are indicators that the community building we’re striving for across our scientific enterprise, the great minds working together on greater discoveries, is coalescing into innovations that will ultimately impact patients and their families, across Michigan and around the world.
Michigan Medicine, and I personally, remain totally committed to supporting and advancing basic science research and discovery. Our incredible faculty and staff are the “Great Minds” that will lead the future of health care and biomedical research.
Gene Therapy for Brain Tumor Shows Promising Early Results in Humans
A new study shows promising early results that a therapy combining cell-killing and immune-stimulating drugs are safe and effective in extending survival for patients with gliomas, a highly aggressive form of brain cancer.
Finally, after many years, we’re thrilled to report the results of testing this approach in human patients, obtaining results that will lead to better treatments for this group of brain tumor patients.
AI Can Predict Certain Forms of Esophageal and Stomach Cancer
In the United States and other western countries, a form of esophageal and stomach cancer has risen dramatically over the last five decades. Rates of esophageal adenocarcinoma, or EAC, and gastric cardia adenocarcinoma, or GCA, are both highly fatal. A new artificial intelligence tool accurately predicts certain forms of cancer at least three years prior to a diagnosis.
This study, which leveraged invaluable data from millions of U.S. veterans, exemplifies the power of team science, data and machine learning to improve cancer prevention.
As the Opioid Overdose Epidemic Shifts, We're Seeing Treatment Disparities
The opioid epidemic, fueled by both prescribed and illicit versions of the drugs, has wreaked havoc on this country. But determining how to help people who are in pain or who have use disorders is a complex issue. U-M researchers are learning more about treatment access barriers for individuals who use substances, both in the context of pain or a substance-use disorder and across a variety of healthcare settings and in their homes, schools, and across the community.
The disproportionate rise in overdoses for marginalized communities will require multidisciplinary public health approaches that recognize broader social drivers of addiction and pain. We cannot focus on the substance use alone, we have to recognize the social drivers of addiction, pain, and suffering and work together to address these disparities.
Uncovering Drivers of Racial Disparities in Uterine Fibroids and Endometriosis
Stress, racism, poor diet and pollution aren’t subjects typically discussed in fibroids and endometriosis research. But social, behavioral and environmental exposures may be important clues to help researchers understand why Black Americans have a disproportionately higher risk of developing severe fibroids than white peers, according to a new review by U-M researchers.
Very little research on fibroids and endometriosis are based on the general population, making these conditions woefully understudied. This further demonstrates that there’s been a lack of investment in two of the most two prevalent diseases in reproductive-aged women. There’s even less data on other racial and ethnic groups that are underrepresented in the medical literature.
Obesity Leads to a Complex Inflammatory Response Inside Fat Tissue
Fat tissue, for as much as it’s been vilified, is an incredibly complex and essential bodily organ involved in energy storage and hormone production, among other functions. Yet, modern lifestyles have led to a worldwide epidemic of obesity, and a corresponding increase in related conditions like type 2 diabetes and cardiovascular disease. Researchers are attempting to uncover the basics of how fat tissue is structured and, specifically, inflammation associated with obesity, in the hopes of unlocking the connection between the accumulation of fat and poor health outcomes. A new study uses single cell analysis of gene expression combined with spatial transcriptomics to reveal previous unrecognized immune cell types and interactions within adipose tissue.
Researchers in training like Cooper are making significant contributions to our research enterprise by uncovering and answering important basic questions, providing insights into molecular mechanisms of human diseases towards advancing new treatments and medicines.
Study Finds Improved Survival for Incurable Brain Tumor
For the first time, researchers have found a potential drug candidate that improved outcomes for patients with a type of childhood brain tumor for which there are no effective treatments. The compound, called ONC201, nearly doubled survival for patients with diffuse midline glioma or diffuse intrinsic pontine glioma, compared to previous patients. In addition to reporting on the results of two early-stage clinical trials, the paper reveals the underlying mechanisms behind the compound’s success in these tumors.
It’s an incredibly difficult tumor to treat. Prior to this study, there have been more than 250 clinical trials that have not been able to improve outcomes. These results are potentially a major crack in the armor.
Black and Socioeconomically Disadvantaged Patients with Vascular Disease Have Worse Symptoms, Bypass Outcomes
A Michigan Medicine study finds that Black and socioeconomically disadvantaged patients with a common vascular disease have more severe symptoms before bypass surgery – and are at greater risk for amputation and other complications after the procedure. The analysis zeroed in on more than 7,000 patients with peripheral arterial disease (PAD), when the vessels carrying blood from the heart to the legs are blocked by plaque, who underwent lower extremity bypass to improve circulation. Investigators found that Black and socioeconomically disadvantaged patients had a higher prevalence of chronic limb-threatening ischemia, the most severe form of PAD.
The observed disparities in surgical outcomes and advanced presentation are ultimately downstream manifestations of historical and contemporary structural inequities and the policies that drive them. Policy-level interventions are likely to have the greatest impact by addressing upstream factors contributing to disparities, however, identifying vulnerable patients during the clinical encounter with unmet social need could prove beneficial.
Expanding Medicaid Improved Care Without Crowding Out Other Patients
People with low incomes who live in states that expanded Medicaid got more of the kind of health care that can keep them healthier in the long run, compared with similar people in non-expansion states, a new study finds. They also received more health care overall, specifically clinic visits. But they didn’t crowd out patients covered by Medicare or private insurance such as from an employer, the study finds. Those groups continued to have clinic visits and receive preventive care at the same rate as before Medicaid expanded.
Expanding Medicaid not only expanded low-income adults’ overall access to health care, but it also specifically expanded access to preventive care that could pay off down the road in better health. At the same time, concerns that other patients would receive less care, or more hurried care with less focus on prevention, did not pan out.
Research Finds Potential Target for Cardiovascular Disease in Diabetes
Over 10% of the population in the United States has been diagnosed with diabetes, and around 7.5% of these patients will experience cardiovascular events like heart attack or stroke in their lives. U-M researchers have found a potential target, learning that the overproduction of neutrophil extracellular traps is an important contributing factor to vascular dysfunction in diabetes.
By treating the excess of NETs in diabetic patients, we think it is possible that we would be able to reduce vascular dysfunction and the complications that follow it. Finding a solution for vascular dysfunction could greatly improve the lives of diabetic patients.
Stories courtesy of Michigan Medicine Health Lab and The Fundamentals podcast. Department of Communication story credits: Nicole Fawcett, Noah Fromson, Kara Gavin, Jordan Goebig, Valerie Goodwin, Kelly Malcom, Anna Megdell, Beata Mostafavi, and Jina Sawani.