Uncovering the Molecular Drivers of Gastroesophageal Reflux Disease (GERD), Bringing Relief to Millions

THIS STUDY UTILIZES THE DHF BIOREPOSITORY Principal Investigator: Marie-Pier Tétreault, PhD, Assistant Professor of Medicine (Gastroenterology and Hepatology), Northwestern Medicine, Northwestern Feinberg School of Medicine Gastroesophageal reflux disease (GERD) affects up to 27% of the adult U.S. population, resulting in more than seven million patient visits annually. Over time, GERD leads to serious complications such as erosive esophagitis, Barrett’s esophagus and esophageal cancers. However, how GERD functions at the molecular level is unclear, making it difficult to develop better treatments for patients living with this condition. This year, DHF is supporting Dr. Marie-Pier Tétreault’s work in identifying the molecular mechanisms that drive the development and progression of GERD, in the hopes of changing the future for patients living with this destructive esophageal condition. DHF funding will enable researchers to utilize state-of-the-art, single-cell RNA technology to rapidly look at the precise gene expression patterns of tens of thousands of cells in hopes of uncovering and identifying rare populations of diseased cells. Previous successful DHF funding of the Tétreault team uncovered valuable new insights and created new technology in profiling the unique cells involved in eosinophilic esophagitis (EoE) and scleroderma esophageal disease. This year, the research team is focusing on the widespread disease of GERD with a focus on new, critical treatment options for patients to decrease the risks of major esophageal complications, including...

Division of Gastroenterology and Hepatology Northwestern Medicine/Feinberg School of Medicine
Center for Artificial Intelligence and Mathematics in Gastroenterology

Division of Gastroenterology and Hepatology Northwestern Medicine/Feinberg School of Medicine Center for Artificial Intelligence and Mathematics in Gastroenterology The Center for Artificial Intelligence and Mathematics in Gastroenterology (AIM-GI) is a first of its kind program developed in a division of Gastroenterology.  Artificial Intelligence and Machine Learning have the potential to vastly improve our ability to accurately predict, diagnose and treat our patients living with digestive diseases.  Through collaboration with engineers at the McCormick School of Engineering and physician scientists at the Feinberg School of Medicine at Northwestern University, our team has been incorporating mathematical modeling and advanced programming to study the mechanisms that lead to poor gastrointestinal function.  This work led to the development of a more formalized center that focuses on three main initiatives. Development of virtual organs which can be used to study the effects of surgery and medications; Development of new hybrid diagnostic tools using AI and machine learning to enhance diagnosis; Using machine learning and neutral networks to predict disease outcome. Although this is a new program, we have already had success developing an NIH funded Center of Research Expertise (CORE) and we have also developed new AI prototypes that can improve diagnostic accuracy and reliability of motility tests.  This work is supported by the generosity of the Digestive Health Foundation and these funds help provide the computational power and expertise required to continue to develop these innovative tools.  Our goal is to continue invent and develop new approaches and our partnership with the Digestive Disease Foundation will continue to allow us to grow and evolve this...

Molecular Changes in Scleroderma Esophageal Disease

Principal Investigator: Marie-Pier Tétreault, PhD Scleroderma is considered an autoimmune disease (the immune system erroneously attacks the body) causing stiffening of the body’s connective tissues of numerous organs leading to stiffening and functional disruptions. More than 95 percent of scleroderma patients develop GI problems, with the esophagus being the most commonly affected organ. Weakening muscle tissue and impairing function, scleroderma esophageal disease can result in complications such as gastroesophageal reflux (GERD), Barrett’s esophagus, and/or adenocarcinoma. Despite efforts to better understand the nature of scleroderma in multiple organs, how scleroderma damages the esophagus remains unclear. Consequently, no treatment exists to change the course of scleroderma esophageal disease. Determining the molecular mechanisms underlying the disease process is critical to developing effective therapies. Using a powerful new technology called single-cell RNA sequencing (scRNA-seq), Dr. Tétreault will examine esophageal biopsies from patients with scleroderma esophageal disease. By pinpointing specific molecular changes in this patient population compared to those of healthy patients, her team hopes to identify novel targets for diagnosis and treatment of this complex...

Evaluating a novel endoscopic ultra sound-guided technique for tissue acquisition for diagnosing pancreatic tumors

The thought of potentially having cancer is stressful enough without undergoing an invasive biopsy to diagnose it and finding out that the procedure needs to be repeated due to inadequate sample collection. This project aims to optimize strategies for acquiring tissue samples to assist gastroenterologists (and pathologists) in diagnosing many diseases, including cancers. Relying on endoscopic ultrasound guidance, the two methods currently utilized are fine needle aspiration, which is the gold standard, and a new method called fine needle biopsy. Drs. Komanduri and Schenck are conducting the largest study to date to compare these different strategies. After collecting data from patients who have undergone one of these procedures over a five-year period, the investigator will perform advanced statistical modeling to determine the strategy that best optimizes patient outcomes (including obtaining accurate diagnoses and minimizing repeat invasive procedures) and costs. Once identified, this strategy will ultimately be implemented throughout the Northwestern Digestive Health Center to enhance patient...

How do opioids affect the esophagus?

Principal Investigator: Dustin Carlson, MD; Co-Principal Investigator: Erica Donnan, MD In 2017, more than 191 million opioid prescriptions were dispensed in the United States. Opioids frequently cause many gastrointestinal side effects such as bloating, reflux and constipation, yet not much is known about how opioids affect the esophagus and swallowing. Opioids can lead to symptoms that mimic esophageal disorders such as achalasia that could result in unnecessary invasive procedures including surgery. The largest study of its kind, this project will look into how opioids affect esophageal motility. Using the Esophageal Center of Northwestern’s motility registry, Drs. Carlson and Donnan have access to some 4,000 patients who have undergone high-resolution manometries to assess esophageal function. The team will look at patients who have had motility studies at Northwestern while on opioids and evaluate volunteer patients on opioids without swallowing symptoms. Given the widespread use of opioids, patients with opioid- induced swallowing problems will become more common. This study is essential in determining how opioids affect the esophagus so that clinicians can correctly evaluate and treat these...