Principal Investigator: Jonah J. Stulberg, MD, PhD, MPH | Salva Balbale, PhD The national opioid crisis continues to adversely affect millions of lives, including a growing number of individuals with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. Studies have suggested that long-term opioid use among IBD patients can result in serious detrimental effects on GI function. Opioid use disorders in this population have also been linked to longer hospital stays, increasing health care costs, and deaths. Yet a comprehensive understanding of the opioid usage and pain management needs of these patients remains elusive. Additionally, no published studies have explored the decision-making process that IBD providers use when prescribing opioids. Dr. Stulberg’s study will lay the groundwork for developing best practices to optimize the use of opioids for IBD patients. The researchers will conduct interviews with IBD providers, in addition to focus groups with IBD patients to ensure all voices are heard and incorporated in future opioid safety efforts to enhance the care and pain management for patients with inflammatory bowel disease. (Dr. Stulberg led a previous DHF-funded study in 2017 that tracked and greatly reduced opioid prescriptions and risk of misuse in GI surgery...
Principal Investigator: Beatriz Sosa-Pineda, PhD Pancreatic cancer has one of the worst survival rates in the world, and patients have very limited therapeutic options to fight the disease. It is predicted that close to 47,000 Americans will succumb to pancreatic ductal adenocarcinoma (PDAC) in 2020. Meeting the dire need for new therapies and diagnostic methods requires a better understanding of the fundamental biology of PDAC. Learning more about the molecular mechanisms that govern tumor formation, progression, and spread (metastasis) is critical to improving outcomes. In this study, Dr. Sosa-Pineda intends to build on her lab’s previous findings to firmly establish the role of a new gene regulator, the transcription factor ONECUT2, in the development of pancreatic cancer. This project will use molecular approaches to abolish the expression of ONECUT2 and test its effect on pancreatic tumor function. The Sosa-Pineda team will employ additional approaches to identify specific pathways and functions regulated by ONECUT2 in pancreatic...
Principal Investigator: Sri Komanduri, MD | Co- Principal Investigator: Domenico Farina, MD Esophageal cancer is a deadly and increasingly common disease in the United States. Up to 15 percent of patients with gastro-esophageal reflux disease (GERD) will develop Barrett’s esophagus (BE), a pre-cancerous state that can develop into esophageal cancer. While BE is highly treatable, the progression to esophageal cancer still commonly occurs due to missed detection and diagnosis of Barrett’s esophagus, which often returns despite treatment. A new technology, Wide-Area Trans-Epithelial Sampling (WATS-3D), may offer improved detection of abnormal cells (dysplasia) in Barrett’s. WATS-3D uses brush sampling to examine larger areas of the esophagus than is achieved in conventional biopsies. Preliminary studies show improved detection of cancerous changes in Barrett’s esophagus surveillance. Dr. Komanduri’s team hopes to determine if the addition of WATS-3D increases the rate of detection of recurrent Barrett’s following treatment. If so, this could be a game changer for patients, allowing for earlier re-treatment of Barrett’s and, ultimately, for the prevention of esophageal...
Principal Investigator: Joshua Wechsler, MD An allergic/immune condition, the inflammatory process of eosinophilic esophagitis (EoE) leads to chronic swallowing problems and food impaction. These symptoms develop when large numbers of white blood cells called eosinophils build up in the inner lining of the esophagus. EoE is on the rise in the United States, contributing to more than $1.4 billion in health care costs annually. Recently, EoE patients have been found to experience abrupt food-induced responses of the esophagus (FIRE). Symptoms occur immediately after the ingestion of foods that don’t typically trigger eosinophilic inflammation. Preliminary data from Dr. Ikuo Hirano of the Northwestern Medicine Digestive Health Center suggests these patients are sensitized to specific allergy-related antibodies directed at FIRE-associated foods. An antibody linked to food allergies, IgE typically involve mast cells—immune cells present within tissues such as the esophagus that are increased in patients with EoE. Dr. Wechsler’s study will examine esophageal biopsies to determine whether IgE is present on mast cells and whether increased IgE+ mast cells are increased in patients with FIRE when compared to those without FIRE...
Principal Investigator: Joshua Wechsler, MD Eosinophilic esophagitis (EoE) is an allergic inflammatory disease of the esophagus. Specific foods can trigger esophageal inflammation leading to pain, difficulty swallowing and malnutrition. Elimination diets remain a mainstay for identifying triggers since effective biomarkers or testing are currently nonexistent in this chronic disease. Previous work of Dr. Wechsler’s team revealed an immune response of white blood cells (T-cell receptors) in patients with active EoE who underwent rigorous dietary elimination and reintroduction regimens. Pursuing this promising line of research, Dr. Wechsler intends to examine esophageal biopsies for evidence of the specific immune response of white blood cells to specific foods. The investigators will use deep sequencing of the T-lymphocyte receptor to identify how frequently certain types of T-cells exist between adults with similar and unique food triggers. Findings from this study could open the door to building a digital library of T-cell receptors that identify specific foods and allow for more personalized...
