What's New in Research at University Hospitals in Cleveland, Ohio

Approach to discovery spans basic science to clinical impact

UH Alumni Association e-Newsletter | September 2020

Mukesh Jain, MD

A robust commitment to research has always been part of the identity of University Hospitals. It’s the “discover” in our three-part mission: To Heal. To Teach. To Discover. But what does that look like today at UH?

“The research effort at UH is distinctive today because we are truly committed as a health system to coupling the full spectrum of research - from basic and translational studies to clinical research all the way to population health and aligning this with the clinical enterprise,” says Mukesh K. Jain, MD, Chief Academic Officer at University Hospitals; and Professor of Medicine, Case Western Reserve University School of Medicine. Dr. Jain oversees research and undergraduate and graduate medical education at UH. “Colleges and universities focus on the basic and the translational, but large integrated health systems like UH can do it from soup to nuts, if you will.”

Establishing research centers of excellence

In recent years, UH has established three research Centers of Excellence to align with clinical strengths in the UH system, using this model. These centers span the spectrum of research, from basic all the way to clinical impact – and more are planned.

“To achieve our vision of advancing the science of health, UH is committing institutional investments to support the development of Centers of Excellence as a mechanism to align research activities with clinical excellence, promote team science and impact standard of care for our community and world,” Dr. Jain says. “What these Centers provide is strengths in the various facets of research in each of these areas, along with patients. So they’re meant to be research and clinical, all the way from making new discoveries in the lab to assessing those discoveries in patients.”

The Center for Neurodegenerative Disorders (CENDIVE), for example, led by Alan J. Lerner, MD, Director, Brain Health and Memory Center, UH Cleveland Medical Center; Professor of Neurology, School of Medicine, is working to discover basic mechanisms underlying neurodegenerative disorders and development of early stage pharmaceuticals, primarily for symptomatic Alzheimer’s disease patients, working through the UH Neurological Institute and the Cleveland Brain Health Initiative. An immediate priority for the center is to support the recently NIH-funded Cleveland Alzheimer’s Disease Research Center, a city-wide collaboration between UH, Cleveland Clinic, Case Western Reserve University and the VA hospital.

In the area of cancer is the Center for Translational Neuro-Oncology (CETNO), led by Andrew Sloan, MD, FACS, Director, Brain Tumor and Neuro-Oncology Center, UH Cleveland Medical Center, and Professor of Neurosurgery, School of Medicine, its focus is on novel imaging and blood biomarkers for malignant brain tumors, as well as basic and epidemiological research with the goal of improving clinical care. UH researchers working with colleagues at UH and other institutions have already made significant contributions to the field in these areas, and it’s this unique, multidisciplinary team that CETNO harnesses and empowers. The ultimate goal is to change the standard of care for brain tumors, particularly by identifying biomarkers for treatment response and recurrence, which can then cheaply and rapidly adapted to blood or routine imaging.

The third research Center of Excellence at UH is the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA), led by Sanjay Rajagopalan, MD, Division Chief, Cardiovascular Medicine, UH Cleveland Medical Center, Professor of Medicine, School of Medicine. CINEMA brings together multiple UH disciplines in a unique platform to advance the understanding and treatment of cardiac and vascular complications of metabolic disease. Its focus is at the intersection of vascular disease, Type 2 diabetes and obesity. Given that the major consequence of metabolic disorders are cardiovascular complications such as coronary, cerebrovascular and peripheral artery disease, these are necessarily a priority for the team. However, other rare metabolic diseases with vascular manifestations with scope for cure are also included in the center.

No discussion of research at UH would be complete, however, without highlighting two other critical elements – the UH Clinical Research Center, which facilitates clinical studies and trials under way at UH at the local level, and the Harrington Discovery Institute, which takes UH’s research influence global.

The UH Clinical Research Center, led by Grace McComsey, MD, Vice President, Research and Associate Chief Scientific Officer, University Hospitals; Professor of Pediatrics, School of Medicine, provides support across all aspects of clinical and translational research at UH. Specifically, it provides comprehensive regulatory, pre-award, and post-award support for the conduct of clinical research. Support is available at the main UH campus in Cleveland as well at any UH system hospitals or practices. The mission is clear -- to bring new life-saving therapies to patients to improve human health.

UH is also home to the Harrington Discovery Institute, led by Jonathan Stamler, MD, a unique $350 million initiative that supports drug discovery and development locally, nationally and internationally. Since its founding in 2012, Harrington Discovery Institute has supported more than 120 drugs in the making from 54 institutions around the world and has expanded its model into Canada and the United Kingdom. One relatively recent addition to the Harrington Discovery Institute is a strategic external partnership in rare disease research with University of Oxford.

Rounding out UH’s research portfolio are several Cleveland-wide initiatives with Case Western Reserve University and other clinical partners in the areas of computational biology, brain health, cancer, digestive diseases and AIDS.The impact of all this research activity at UH is significant, looking at raw numbers alone. In 2019, the total UH research portfolio was $161 million in sponsored funding representing a mix of federal, non-federal and clinical trials activities. In that year, UH also made more than 70 innovation disclosures and conducted more than 2,600 clinical research studies.

COVID-19 research efforts

The robust nature of the UH research enterprise has also been a key component of UH’s successful response to the COVID-19 pandemic, Dr. Jain says. The Clinical Research Center was able secure the Remdesivir clinical trial from Gilead for UH patients – one of the first health systems in the country to do so. And it activated its clinical trial and enrolled its first patient within 12 hours, thanks to some round-the-clock work by staff.

Dr. Jain points to other examples of UH research meeting the COVID-19 moment.

“A beautiful demonstration of the breadth and depth of UH’s capability in research was in our response to this major threat to human health,” he says. “We oversaw a local program where we engaged friends of UH who graciously offered resources to support investigators in our community doing research to combat the pandemic. That helped us advance efforts like the Gilead study that you’ve heard so much about, the ARMS-1 study, as well as studies with stem cells and convalescent plasma. In addition UH supported COVID-19 research proposals through the Harrington Discovery Institute. Both efforts required a rigorous review process, all coordinated by our institution and our faculty.”

“It’s a big deal,” he adds. “In a four- to six-week period, these efforts were mobilized and brought to fruition. That’s what happens when you have a centralized infrastructure and incredibly dedicated team members. I don’t know of another health system that has supported both local and national/international efforts to combat COVID-19.”

Going forward, there are plans to add more research Centers of Excellence at UH and build up the infrastructure for doing more population health research. Continuing to grow and enhance the cadre of UH researchers is also a priority.

“We’re going to continue to recruit great people across all domains of research,” Dr. Jain says. “We’re also looking to enhance city-wide research initiatives in partnership with the Case Western Reserve University School of Medicine, other local clinical entities, as well as possibly new external partnerships.”

“We won’t work in isolation,” he emphasizes. “The world doesn’t work that way. We have a commitment to research soup to nuts, as I mentioned, but we do it by engaging partners – our local partners or our national and international partners – to achieve our aspirational mission.”

For more information about research at UH and the UH Research & Education Institute, visit https://www.uhhospitals.org/research-and-education, or email UHAlumniCle@UHhospitals.org.