Fifty years of Biomedical Engineering and Collaboration New Perspectives on What's Possible

The Biomedical Engineering department formally became a joint department of the U-M College of Engineering and the Medical School in 2012, just five years before celebrating its 50th anniversary in 2017. But the spirit and impact of the collaboration that spurred its founding five decades ago continue at an ever-increasing pace today.

At the heart of the Department’s many collaborative efforts lie clinicians’ desire to offer new and better solutions to their patients and engineers’ passion for applying their knowledge to solve important health and medical problems.

Take Jacqueline Jeruss, MD, PhD, a surgical oncologist who treats benign and malignant breast disease. An investigator focused on breast cancer biology, she’s also an associate professor of BME. “Once a patient becomes metastatic, that’s when what I as a surgeon can offer to patients falls into the background.”

That disheartening situation led Jeruss to ask, “If I can’t help these patients anymore through my surgical practice, what can I do in the lab?”

The answer: Quite a lot. Jeruss works with William and Valerie Hall Chair and Professor Lonnie Shea (the two also are married) to better understand the cellular changes that lead to metastasis and to devise new methods for detection.

Drs. Jeruss, Shea, and other collaborators have been working to engineer pre-malignant niche sites – areas in other parts of the body that are “primed” to shelter and nurture metastatic cancer cells. Engineered niches offer opportunities to observe how and where cancer cells travel, paving the way for new detection systems and therapies to thwart the process.

What enables such collaboration? “The real opportunity here is having a top-10 engineering school and a top-10 medical school co-located,” Shea says.

“Michigan is very unique in that it’s an incredibly collaborative environment, not just within a department or division but across the schools and colleges,” adds Dr. William Roberts. “It’s very simple and easy to pick up the phone and call someone in BME, talk about a problem and start to develop a research relationship.”

“It’s very simple and easy to pick up the phone and call someone in BME, talk about a problem and start to develop a research relationship.”William Roberts M.D.

Foundation of collaboration

The seeds of collaboration between what is today the BME department and the U-M Medical School were sowed in the 1960s. At the time, faculty from both schools were already working together on joint projects such as nuclear imaging, prosthetics, and signal processing in neurons.

Other early research included electrophysiological studies by Daniel Green that informed our understanding of how humans see in changing light. The work of Clyde Owings, who held appointments in both Pediatrics and BME, led to specialized medical care of abused children, including through the Child Abuse and Neglect Clinical and Teaching Services program he established.

A testament to the many joint projects between the Bioengineering Program and the Medical School, during a difficult time for the Program in the late 1970s, two Bioengineering faculty with Medical School appointments launched a letter-writing campaign. More than 20 distinguished faculty from nearly a dozen medical specialties responded by sharing their strong support.

Among the many fruitful research efforts of that era were development of the “spherocentric knee,” an early ball-in-socket, rather than hinge, design that more closely imitated typical human knee motion by David Sonstegard, Herbert Kaufer, and Larry Matthews. Groundbreaking work by Dr. Robert Bartlett on a new system – extracorporeal membrane oxygenation – provided life support to infants and children with acute respiratory failure. The now famous “Michigan probe,” a multi-channel neural probe still widely used in brain research, was developed by Kensall Wise and David Anderson.

Seeking opportunities

Further cementing collaboration in the early 1990s, then Bioengineering Program Director Charles Cain encouraged faculty from the College and the Medical School to propose joint research to the Whitaker Foundation. Their efforts resulted in a Special Opportunity Award in 1994.

Building on its success, two years later the newly formed BME department – thanks in no small part to Cain’s continued efforts – won a $3 million Whitaker Foundation Development Award to support its growth and continued collaborative work.

Research at the time included co-development of gene-activated matrix technology for wound repair by Steven Goldstein and Jeffrey Bonadio and in situ tissue engineering, which has become an important research technology. Work by Lawrence Schneider on the biomechanics of automotive injuries has led to improved crash-test dummy design and vehicle occupant safety, and advances in ultrasound and multimodal imaging by Paul Carson have led to improved imaging safety and effectiveness.

Creating a sustainable and translational model

With the aim of advancing promising joint engineering and medical research projects from the laboratory to market to clinical settings, in 2005, the Department won a $5 million Wallace H. Coulter Foundation Translational Research Partnership Award, one of only nine universities in the country to do so.

Matthew O’Donnell, BME chair from 1999 to 2006, was thrilled about the award. As he said in the Department’s history, Biomedical Engineering at Michigan: A Product of Vision and Persistence, “…how wonderful, especially for our junior faculty, to be exposed to a world where you don’t just write papers, you put out a device or process or new molecule that people will actually use in the clinic.” The program provided funding for four collaborative clinician-engineer teams in its first year alone.

Four BME department chairs gather for the 50th-anniversary celebration in September 2017. Left to Right: Doug Noll, Charles Cain, Lonnie Shea, and Matt O’Donnell. Photo: Brandon Baier.

Five years later, given its strong track record, U-M received an endowment through the U-M Coulter Partnership for Translational Biomedical Engineering Research. This time, U-M was one of only six universities nationwide to receive the $10 million endowment, with an additional $10 million in matching funds from the College of Engineering and the Medical School.

Coulter projects have led to impressive results, including 14 start-up companies that will no doubt have a positive impact on patients. For example, Charles Cain, J. Brian Fowlkes, Timothy Hall, William Roberts, and Zhen Xu have been developing a non-invasive ultrasonic technique to treat severe congenital heart disease in newborns as well as many other conditions.

“It was an organic thing that evolved,” said Cain, founding BME chair, of his and other long-standing collaborations. “There were [clinical] problems that needed a solution.”

Ever-increasing breadth, depth and impact

Since the early 2000s, collaborative research has expanded continuously. Other game-changing work over the past two decades includes:

  • Intravascular diagnostic ultrasound techniques to detect lipid pools within atherosclerotic plaque by Matthew O’Donnell.
  • Improved functional MRI techniques for brain imaging to improve speed and reduce distortion by Douglas Noll.
  • Advances in image reconstruction for multiple imaging modalities and a low-dose CT scan method that reduces radiation exposure by Jeffrey Fessler.
  • Mechanistic studies to improve ultrasound diagnostics and therapies, including drug and gene delivery by Cheri Deng.
  • Development of optical molecular imaging and diagnostics, including a new optical spectroscopy method to diagnose pancreatic cancer by Mary-Ann Mycek.
  • Creation of a “5-D protein fingerprint” by David Sept and Michael Mayer to provide insights into neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease.
  • Development of modular micro-tissues and biomaterials that direct cell phenotype in order to regenerate bone, cartilage, and blood vessels by Jan Stegemann.

Education to support collaboration and innovation

Enhancements to the BME curriculum over the years are ensuring students receive the training to follow in the footsteps of so many interdisciplinary engineering and medical researchers. Several design courses round out the common BME core. These include Biomedical Instrumentation & Design (BME 458), in which students design an instrument to take electrophysiological measurements, Biotechnology and Human Values (ENG 100), in which students design a new diagnostic test, and the senior capstone design course, BME 450, in which students design and test a prototype for actual stakeholders.

Broadening “bench to beside” translation, the design curriculum has been further bolstered with a year-long graduate course, BME 599, created by Aileen Huang-Saad to expose students to the full innovation process, including commercialization. Rachael Schmedlen introduced a year-long senior capstone design course (BME 451/452) and a clinical-needs-finding course (BME 499). Andrew Putnam created a new course in computer modeling in design (BME 350).

The Department also launched a new medical product development master’s concentration in 2015. Headed by Jan Stegemann, the program was designed to teach students how not only to design a medical device but to address the many regulatory, intellectual property and reimbursement-related factors involved in successfully bringing new products to a competitive market.

In addition, 2015 brought new clinical immersion and experiential learning opportunities to students through greater support for device prototyping, a collaboration with the Medical School’s Clinical Simulation Center, a Clinical Peer Mentors program and the Medical Device Sandbox. All offer the chance for BMEs and medical students and clinicians to work together – ultimately toward improved patient care and safety.

A novel “instructional incubator” course, launched by Huang-Saad in 2016 continues to build on the collaborative nature of biomedical engineering practice by having students themselves create several new short courses. Courses piloted in 2017 included 3D printing and prototype development, biological signaling in neural tissue, and computational modeling for drug development (See the related story: BME-in-Practice: Iterative curriculum design).

Cameron Louttit instructs students.
BME student Cameron Louttit instructs students on proper pipetting technique in Building a Tumor, an Introduction to Tissue Engineering.

Poised for a new era

With 12 new faculty hires in the past three years, BME is well positioned to address both intractable and new health and medical challenges with a next-generation arsenal that includes precision health (molecular imaging and diagnostics, gene and drug delivery, and histotripsy), data analytics (systems biology and multiscale modeling) and regenerative medicine (brain-machine interfaces, immune therapeutics, cell transplantation).

Explore all of the BME research by area, clinical application, or technology used.

In this last area, BME’s David Kohn is co-leading U-M’s Regenerative Medicine Collaborative, comprised of more than 150 faculty across campus. The groundswell recalls BME’s earliest days, when the department was a burgeoning program, its growth and stature fueled by a vision that blurred disciplinary boundaries. The momentum continues, offering clinicians, engineers, and students alike the opportunity to improve lives.

Dr. Parag Patil is a neurosurgeon who works closely with BME’s Cindy Chestek on brain-machine interfaces and welcomes those opportunities. “Engineering helps because when I’m doing my clinical work, I’m always thinking about ways to make things better,” he says.

Zhen Xu, too, is excited by the prospect of opportunity and change. “I hope one day we can tell patients that we can actually remove your blood clots or remove your tumor noninvasively,” she says.

And Dr. Jeruss describes the “renewed sense of optimism about what I can offer to patients. One of the most wonderful things that’s come out of this whole process for me is a new perspective on what’s possible for us to do in our lifetime.”

“One of the most wonderful things that’s come out of this whole process for me is a new perspective on what’s possible for us to do in our lifetime.”Jacqueline Jeruss, M.D., Ph.D.


Lab-grown lung tissue could lead to new cancer, asthma treatments A look at how Michigan Engineers created a biomaterial scaffold to help researchers from the U-M Medical School grow mature human lung tissue.

In a breakthrough that could one day lead to new treatments for lung diseases like asthma and lung cancer, researchers have successfully coaxed stem cells—the body’s master cells—to grow into three-dimensional lung tissue. This could be useful in future cell-based therapies that repair damaged lungs by cultivating new, healthy tissue.

University of Michigan researchers grew the tissue by injecting stem cells into a specially developed biodegradable scaffold, then implanting the device in mice, where the cells grew and matured into lung tissue. The team’s findings were published in the Nov. 1 issue of the journal eLife.

Briana Dye, a PhD candidate in Cell & Developmental Biology at the University of Michigan Medical School, demonstrates the process of developing lung organoid tissue samples. This research was conducted partly in the lab of Lonnie Shea, the William and Valerie Hall Department Chair and Professor of Biomedical Engineering. Photo: Evan Dougherty, Michigan Engineering Communications & Marketing

Respiratory diseases account for nearly 1 in 5 deaths worldwide, and lung cancer survival rates remain low despite numerous therapeutic advances during the past 30 years. Cell-based therapies could be a key to improving treatment, helping damaged lungs heal in much the same way as a bone marrow transplant can treat leukemia. But the complexity of lung tissue makes such treatments much more difficult to develop.

“Lung tissue needs to be able to form into specific structures like airways and bronchi, and they all need to be able to work together inside the lung. So we can’t just add in healthy adult cells,” said Lonnie Shea, the William and Valerie Hall Department Chair of Biomedical Engineering and a professor of biomedical engineering at U-M. “Instead, we’re looking at delivering the precursors to these cells, then giving them the cues they need to develop and mature on their own. This project was a step in that direction.”

While previous experiments had successfully grown lung cells, the cells were immature and disorganized. So Shea worked with a U-M medical school team led by Briana Dye, a graduate student in the U-M Department of Cell and Developmental Biology, on a new approach. They developed a three-dimensional, biodegradable scaffold that helped the lung cells mature and begin to develop into structures like those inside an actual lung.

Made of PLG, a spongy, biodegradable material, the scaffold was shaped like a small cylinder approximately five millimeters wide and two millimeters tall. The team injected stem cells into the scaffold, transplanted it into mice, then allowed the cells to mature for eight weeks.

The scaffold provided a stiff structure that supported growth of the mini lungs after transplantation while still allowing the transplanted tissue to become vascularized, growing blood vessels that supplied it with nutrients.

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When the team examined the tissue, they found that it had not only survived, it had developed tube-shaped airway structures similar to the airways in adult lungs. It also developed mucus-producing cells, multiciliated cells and stem cells similar to those found in adult lungs.

“In many ways, the tissue grown in the study was indistinguishable from human adult tissue,” says senior study author Jason Spence, Ph.D., associate professor in the U-M Department of Internal Medicine and the Department of Cell and Developmental Biology at the U-M Medical School.

The researchers caution that they’re far from growing anything like a complete human lung—the tissue grown in the experiment was a mass of lung cells scattered among other types of cells inside the scaffold. But they say it’s an important early step that can yield valuable information about how healthy cells grow and develop. In the future, that could lead to new treatments for lung disease.

Richard Youngblood, a second year PhD student in Biomedical Engineering at the University of Michigan, demonstrates the construction of a lung organoid PLG scaffold. This research was conducted partly in the lab of Lonnie Shea, the William and Valerie Hall Department Chair and Professor of Biomedical Engineering. Photo: Evan Dougherty, Michigan Engineering Communications & Marketing

“What if we could regrow a portion of a damaged lung, like a patch?” Shea said. “Treatments like that, while challenging, may be possible.”

The lung tissue is one of several types of cultured organ tissue, or “organoids” that U-M research teams have developed—other cell types they’ve created include intestines, pancreatic cells and placenta cells. In addition to their uses in developing new cell-based therapy, Shea says the cells can provide a human model for screening drugs, studying gene function, generating transplantable tissue and studying complex human diseases like asthma.

“Organoids enable us to see the development and formation of an organ without having to conduct a test on an entire organism. And once we understand that, we can find new ways of repairing organs that are injured, or that haven’t developed properly.”

The paper is titled “A bioengineered niche promotes in vivo engraftment and maturation of pluripotent stem cell derived human lung organoids.” The research was supported by the National Institutes of Health (grant number R01 HL119215), by the NIH Cellular and Molecular Biology training grant at Michigan and by the U-M Tissue Engineering and Regeneration Training Grant.

Credits:


U-M Schools and Colleges Form Regenerative Medicine Collaborative

March 31, 2017

ANN ARBOR, MI –A Regenerative Medicine Collaborative, formed with support from U-M Office of Research, College of Engineering, and School of Medicine, aims to foster connections and enable new initiatives among investigators at the major U-M schools and colleges, including: U-M Engineering, Medical School, Dentistry, LSA, Public Health, and Pharmacy.

The University of Michigan Office of Research charged a planning task force to evaluate The University of Michigan’s strength in regenerative medicine. U-M ranks #5 in the world for regenerative medicine related citations and the stakeholder group has received nearly $320 million from NIH over the last five years for related research. We are among the leaders in the number of patents awarded, with faculty interested in regenerative and restorative medicine submitting over 320 invention disclosures resulting in greater than 120 patent filings in the past five years.

A web site (http://regenerativemedicine.umich.edu) and monthly highlights aim to communicate the breadth and depth of regenerative medicine work being done at U-M. Furthermore, the regenerative medicine collaborative will solicit a call for themes to identify areas in which U-M can grow or lead an area. The initiative will, also, facilitate the assembly of teams to be competitive for large-scale initiatives and projects across disciplines.

In addition to the website and monthly highlights, a launch symposium is being planned for the summer of 2017 to welcome the stakeholders. If you are interested in receiving the newsletters or attending the symposium, please send an email request to Amalia DiRita (amdirita@umich.edu).


Nanoparticle Acts Like Trojan Horse To Halt Asthma

Ann Arbor – In an entirely new approach to treating asthma and allergies, a biodegradable nanoparticle acts like a Trojan horse, hiding an allergen in a friendly shell to convince the immune system not to attack it, according to new research from the University of Michigan and Northwestern University. As a result, the allergic reaction in the airways is shut down long term and an asthma attack prevented.

The technology can be applied to food allergies as well. The nanoparticle is currently being tested in a mouse model of peanut allergy, similar to food allergy in humans.

“Small quantities of allergen have been used to de-sensitize patients, and that delivering the allergen using emerging nanotechnologies can provide a more efficient and effective system” said senior author Lonnie Shea, the William and Valerie Hall Chair and Professor of Biomedical Engineering at the University of Michigan and adjunct professor at Northwestern.

The treatment can be applied to any allergy simply by loading the nanoparticle with the target allergen – from ragweed pollen to peanut protein.

In addition, the treatment makes use of an already FDA-approved material; the nanoparticles are composed of PLGA, a biopolymer that includes lactic acid and glycolic acid.

When the loaded nanoparticle is injected into the bloodstream of mice, the immune system sees the particle as innocuous debris. Then the nanoparticle and its hidden cargo are consumed by a macrophage, essentially a vacuum-cleaner cell.

“The vacuum-cleaner cell presents the allergen to the immune system in a way that says, ‘No worries, this belongs here,’” said Stephen Miller, another senior author on the study and the Judy Gugenheim Research Professor of Microbiology-Immunology at Northwestern University Feinberg School of Medicine. The immune system then shuts down its attack on the allergen, and the immune system is reset to normal.

The allergen, in this case egg protein, was administered into the lungs of mice who had been pretreated to be allergic to the protein and already had antibodies in their blood against it. After being treated with the nanoparticle, however, they no longer had an allergic response to the allergen.

The approach creates a more normal, balanced immune system by increasing the number of regulatory T cells – immune cells important for recognizing the airway allergens as normal – while turning off the allergy-causing Th2 T cells.

It’s the first time this method for creating tolerance in the immune system has been used in allergic diseases. The approach has been used in autoimmune diseases including multiple sclerosis and celiac disease in previous preclinical research at Northwestern, and a clinical trial using the nanoparticles to treat celiac disease is in development.

“The findings represent a novel, safe and effective long-term way to treat and potentially ‘cure’ patients with life-threatening respiratory and food allergies,” said Miller.

The asthma allergy study was in mice, but the technology is progressing to clinical trials in autoimmune disease. The nanoparticle technology is being developed commercially by Cour Pharmaceuticals Development Co. A clinical trial using the nanoparticles to treat celiac disease is in development.

More information: Biodegradable antigen-associated PLG nanoparticles tolerize Th2-mediated allergic airway inflammation pre- and postsensitization, PNAS, www.pnas.org/cgi/doi/10.1073/pnas.1505782113

Read more at: http://phys.org/news/2016-04-nanoparticle-trojan-horse-halt-asthma.html#jCp

The research was supported in part by grant EB-013198 from the National Institute of Biomedical Imaging and Bioengineering and grant NS-026543 from the National Institute of Neurological Disease and Stroke, both of the National Institutes of Health (NIH), the Dunard Fund and a predoctoral fellowship TL1R000108 from the NIH National Center for Research Resources and the National Center for Advancing Translational Sciences.


Researchers use ovarian follicles to preserve fertility Technique could be beneficial for women with cancer; study in mice produced live births

From: U-M Comprehensive Cancer Center News
Media contact: Nicole Fawcett, 734-764-2220 |  Patients may contact Cancer AnswerLine™, 800-865-1125

ANN ARBOR, Mich. — Researchers at the University of Michigan have identified a potential new approach to fertility preservation for young cancer patients that addresses concerns about beginning cancer treatment immediately and the possibility of reintroducing cancer cells during the fertility preservation process.

The work, done in mice, has potential to expand options for girls and women undergoing cancer treatments that may impact their future fertility.

The researchers isolated primary ovarian follicles, consisting of the oocyte and surrounding cells. They encapsulated the follicles in a gel and then reimplanted them in mice. All mice transplanted with the follicles resumed normal ovarian cycles. One-third produced live births.

For many young women diagnosed with cancer, concerns about fertility rank high and may influence their decisions about cancer treatment. Current fertility preservation options for women include embryo or egg freezing, performed using hormonal stimulation to induce ovulation. Hormonal stimulation is not possible for all young patients. Some are too young and some cannot afford to delay cancer treatment.

Jacqueline Jeruss“This research is an important advance in the potential expansion of fertility preservation options for young patients who may not be able to undergo hormone stimulation to induce ovulation before beginning chemotherapy,” says study author Jacqueline S. Jeruss, M.D., Ph.D., associate professor of surgery and director of the Breast Care Center at the University of Michigan Comprehensive Cancer Center.

“This study also provides new information on a method to reduce or eliminate cancer cell exposure during the fertility preservation process,” she adds.

Fear of reintroducing cancer

Researchers are also studying ovarian tissue transplantation for patients with cancer. A key concern with this approach is the risk that the ovarian tissue may harbor latent cancer cells that, upon transplantation, could be reintroduced back into the patient. Cancer cells are known to circulate throughout the body even in early stage invasive disease.

In this new study, when researchers isolated the follicles, they substantially reduced the presence of cancer cells. Two of the five tested transplanted materials had no residual cancer cells.

Lonnie Shea“The success rate for traditional in vitro fertilization is approximately 33 percent per cycle. For cancer patients, the oocytes or embryos that are cryo-preserved before cancer treatment may become their entire reproductive future,” says study author Lonnie D. Shea, Ph.D., William and Valerie Hall Chair and professor of biomedical engineering at the University of Michigan.

“The ovary can have tens to hundreds of thousands of follicles. If we can access that pool to preserve fertility, we could potentially create many more chances for reproductive success for these patients,” Shea adds.

Refining the technique

The authors tested three types of biomaterial for preserving the follicles. They hope that by refining their study techniques they can produce even better results. Additional research is also needed to ensure that all cancer cells are consistently eliminated from the follicles every time this tissue is transplanted.

As the work’s promise continues, the researchers envision that ovarian follicles could be extracted and preserved till the woman was ready to pursue pregnancy. At that point, the follicles would be matured and then fertilized. More research is needed before this technique can be tested in humans.

“Fertility is an important part of survivorship for young cancer patients,” Jeruss says. “It’s crucial to identify new techniques to make more fertility preservation options available for women and girls being treated for cancer.”

The study is published in the Nature journal Scientific Reports.

Note to patients: This work was done in mice and is not currently available for use in humans. Call the Cancer AnswerLine at 800-865-1125 to speak to a nurse about available fertility preservation options.

Additional authors: Ekaterina Kniazeva and Teresa K. Woodruff, from Northwestern University; A.N. Hardy from Fox Chase Cancer Center; Samir Boukaidi, from Centre Hospitalier Universitaire de Nice

Funding: National Institutes of Health grant U54 HD076188

Disclosure: None

Reference: Scientific Reports, “Primordial Follicle Transplantation within Designer Biomaterial Grafts Produce Live Births in a Mouse Infertility Model,” published online Dec. 3, 2015,doi:10.1038/srep17709