Focus Area: Research

High stress levels and obesity both have consequences for immune cell function and inflammation. This project, led by David Beebe, PhD, professor, Department of Pathology and Laboratory Medicine, aimed to explore the intersection between lifestyle factors, like diet and meditation, and inflammation. High stress levels and obesity both have consequences for immune cell function and inflammation. Previous work at UW–Madison has shown how immune cells respond to injury and help resolve inflammation and that the immune response can be influenced by stress and meditation. However, little research has focused on linking these findings. The research team investigated the links between sugar consumption and stress on immune response by studying blood samples before and after sugar intake. Within one hour of ingestion, the immune cells exhibited heightened activity, suggesting that sugar intake can significantly impact the function of these cells. The team studied mindfulness practices in lupus patients and found initial evidence that these interventions may influence immune response and offer non-pharmacological insights for managing autoimmune conditions.

This project, led by Dr. Jasmine Zapata, aimed to evaluate the feasibility and preliminary outcomes of the Today Not Tomorrow Pregnancy and Infant-Support Program (TNT-PISP). TNT-PISP is a collaborative community-based prenatal care and support group in Dane County that was uniquely designed to serve Black women and infants. Wisconsin’s Black infant mortality rate is the highest in the nation and there is increasing evidence that models of prenatal care that are community-driven, group-based, culturally-relevant and family-centered have the potential to significantly improve maternal and infant health outcomes. The TNT-PISP generated significant short-, medium- and long-term impacts. The program provided valuable peer support and resources for Black mothers, with 98 percent of participants sharing that they would be willing to return. Thematic analyses highlighted positive effects of the program, including providing peer support, a safe space for Black mothers to share their experiences and valuable information about resources for parents, breastfeeding and community-based doula programs.

Birth Cost Recovery (BCR) holds unmarried, non-custodial fathers liable for Medicaid birth costs in Wisconsin, yet there is little known about the impact of this policy on Black birthing people in Wisconsin. This project, led by Tiffany Green, PhD, assistant professor in the departments of Population Health Sciences and Obstetrics and Gynecology, worked to better understand how BCR and other similar social policies impact inequities in health outcomes among low-income Black birthing people in the state of Wisconsin. Dr. Green and a team of interdisciplinary experts in the fields of economics, population health, pediatrics, social work, clinical/social psychology and community engagement created an evaluation framework for BCR as a way of measuring the impact of this policy and collect evidence that can be useful in informing future policies and improving health outcomes statewide.

There are 7,000 different rare genetic disorders that impact approximately 450,000 people in Wisconsin. Gene therapy has the potential to treat these diseases if two major limitations can be addressed: better targeting of the therapy agent and affordability. This project, led by Kinjal Majumder, PhD, assistant professor, Department of Oncology, sought to address these limitations by improving the nuclear targeting of gene therapy vectors. The team used a combination of CRISPR/Cas9 technology, Big Data and high-resolution imaging to study the molecular mechanisms of Recombinant Adeno-Associate Virus (rAAV) vectors for gene therapy delivery and provide insights into engineering better rAAV gene therapy vehicles. Their findings will inform future work in the field of gene therapy, with the potential to improve treatments for rare genetic disorders and develop cancer-targeting gene therapies.

Down syndrome, also known as trisomy 21, is a condition that impacts the brain’s development of neurological pathways resulting in mild to moderate intellectual disability and middle age onset of Alzheimer’s disease. Basal forebrain cholinergic neurons (BFCNs) are crucial in mediating cognitive performance and memory throughout the lifespan, and they are particularly susceptible to degeneration in individuals with Down syndrome. This project sought to explore the mechanisms that underlie BFCN vulnerability in Down syndrome and looked specifically for observable and age-related markers of BFCN dysfunction in trisomy 21. The results showed similar levels of Alzheimer’s-related proteins in the BFCNs of individuals with and without Down syndrome, despite the fact that people with the condition have an extra gene copy that produces these proteins. The research team identified that trisomy 21 BFCNs had elevated levels of aging markers which may contribute to the intellectual disability and middle age onset of Alzheimer’s disease in people with the condition.

This project, Evaluating a Novel Follow-up Intervention to Improve the Delivery of Follow-up Care for Low-Risk Breast Cancer Survivors in Wisconsin, will implement a novel patient-centered intervention, known as REASSURE, to optimize the delivery of follow-up care to early-stage breast cancer survivors who are at low risk of recurrence. Early-stage survivors comprise 60% of Wisconsin’s more than 70,000 breast cancer survivors. This intervention is designed to better prepare and support early-stage breast cancer survivors while also reducing the burden of unnecessary medical visits that are especially difficult for patients who are socioeconomically disadvantaged or reside in rural areas. The study has the potential to advance cancer care more broadly through adaptation to other cancers where frequent follow-up clinic visits have limited benefit.

Through a unique partnership between UW–Madison and the Wisconsin Department of Corrections, this study will provide group cognitive processing therapy to prison inmates. The study will also evaluate the impact of the therapy, with the goal of improving mental health and outcomes for prison inmates as well as informing public policy related to mental healthcare in prisons.

This project, Leaving Prison and Connecting with Medical Care, aimed​​ to evaluate the impacts of two changes to Wisconsin Medicaid policy on health care access, health outcomes and reincarceration for formerly incarcerated individuals. Incarcerated populations have high rates of hepatitis C virus (HCV) and opioid use disorder (OUD), and untreated HCV and OUD lead to severe health and social consequences. Medicaid coverage could reduce adverse health outcomes and reincarceration in former prisoners by improving access to treatment. In 2014, Medicaid eligibility was extended to all poor adults, and in 2015, pre-release Medicaid enrollment assistance was introduced within state prisons, though there has been little research done to assess the effects of these changes on criminal justice-impacted individuals. The project successfully achieved its goals, demonstrating that expanded eligibility and pre-release enrollment assistance increased the number of Medicaid applications before and enrollments at the time of release. The policies improved coverage for both the general population and those with histories of substance use, and they were associated with a 2.5 percent decline in reincarcerations and a 5.2 percent increase in employment procurement. Additionally, the changes to Medicaid policy significantly increased the likelihood of outpatient visits post-release for individuals with substance use histories, although overall substance use disorder-related care remained low.

Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States and the number one risk factor for developing anogenital cancers, such as squamous cell carcinoma of the anus (SCCA). Once HPV-driven anal pre-cancers are diagnosed, there are few treatment options that are effective or well-tolerated. This project further explored recent findings that show select FDA-approved protease inhibitors, previously used orally to treat HIV infection, can also be used topically to prevent HPV-associated cancers, in particular SCCA. This team of interdisciplinary researchers worked to determine the molecular mechanisms supporting these effects and repurpose these drugs as an approach for anal cancer prevention in Wisconsin.

Gaps in lupus care contribute to higher kidney failure, more early death, and worse lupus damage in U.S. patients who are Black or poor. This project used new data analysis methods to study and identify steps in lupus care with the largest impact on patient health. Health care and patient partners then helped select, adapt, and pilot test strategies to reduce health disparities and improve outcomes.