Over 38 million Americans have diabetes, with 90% of diabetic Americans having Type 2 Diabetes. Diabetes causes an increased risk of complications, including diabetic kidney disease (DKD), a disease that affects kidney filtration. This occurs in the glomerulus, a specialized capillary network of single-layered endothelial cells on one side and podocytes on the other, and their extracellular matrix (ECM). Injury, reduced function, or changes in the ECM of either of these cells cause abnormal filtration and kidney disease. Preliminary data from our group suggests that ECM remodeling driven by endothelial cells is a key feature in DKD in both our mouse model and in humans. Additional preliminary data from our lab indicates that two metalloproteases involved in ECM remodeling, ADAMTS6 and ADAMTS9, are increased in endothelial cells in diabetes via elevated lipids. My hypothesis is that very-low-density lipoprotein (VLDL), a lipid often increased in diabetes, induces increased endothelial cell ADAMTS6 and ADAMTS9 expression, contributing to remodeling the ECM and altering the filtration capacity of the glomeruli. To investigate this, isolated endothelial cells from non-diabetic mice were stimulated with varying VLDL concentrations, alone or with elevated glucose, to simulate diabetes. Following the stimulation, I isolated the RNA from these cells and measured the mRNA expression of Adamts9 and Adamts6 using real-time PCR. To test if endothelial cells isolated from mice with diabetes would respond differently, similar experiments are being carried out in cells isolated from diabetic mice. Western blots are used to verify the altered protein expression I observe. I am utilizing already acquired kidney sections from mice with diabetes with different lipid levels and determining the glomerular endothelial cell ADAMTS9 and ADAMTS6 expression by immunohistochemistry. Results from these experiments will help us understand the mechanisms through which endothelial cells respond to diabetes and thus contribute to DKD.

People with diabetes have an increased risk of developing cardiovascular disease (CVD). Hyperglycemia is the hallmark of diabetes, but diabetic dyslipidemia with increased circulating lipid levels is also present, which is believed to contribute to the augmented CVD seen in diabetes. The Cluster of Differentiation 36 (Cd36) receptor mediates fatty acid and lipoprotein uptake in macrophages. Lipid-loaded macrophages are a key feature of atherosclerosis, the underlying CVD pathology. Preliminary data suggest that monocytes (macrophage precursors) are lipid-loaded via increased Cd36. However, it is unclear what drives the increased Cd36 expression in diabetes. Reduction in blood glucose, but not lipid levels, in diabetic mice reduced monocyte cell surface Cd36 expression. Based on these preliminary data, I hypothesize that hyperglycemia induces increased Cd36 mRna expression in monocytes in diabetes. To address whether glucose or lipids increase monocyte Cd36 mRna expression, I will isolate monocytes from the bone marrow of non-diabetic mice and stimulate them ex vivo. To address if hyperglycemia alters Cd36 expression, I will stimulate monocytes with 4 glucose conditions: 5.6 mM, 15 mM, 30.6 mM D-glucose, and an osmotic control of 5.6 mM D-glucose and 25 mM L-glucose. The 5.6 mM represents non-diabetic blood glucose conditions. To address if dyslipidemia alters monocyte Cd36 expression, I will use the same 4 glucose conditions in conjunction with 50 µg/mL of VLDL, a triglyceride-rich lipoprotein that is elevated in diabetic dyslipidemia. Following a 24-hour stimulation, I will isolate monocyte RNA and use qPCR to determine the amount of Cd36 mRna. If elevated glucose induces an increase in Cd36 expression, this suggests that hyperglycemia stimulates increased Cd36 expression in monocytes in diabetes. However, if the presence of VLDL is required to observe an increase in Cd36 mRna, this indicates that dyslipidemia is needed for increased monocyte Cd36 mRna expression. Results from this study will help us understand the relationship between lipids and hyperglycemia in the context of diabetes-induced monocyte lipid loading.

Gun violence is a prevalent and rising issue in the United States. However, limited research assesses the connection between gun prevalence and public health outcomes. Previous research indicates healthcare professionals are hesitant to have a role in addressing the rising gun violence statistics. Another previously drawn implication is that gun violence is associated with worse behavioral and physical health. These findings led us to pursue our research. This project aims to acquire quantitative insights into the relationship between neighborhood-level gun prevalence and violence and neighborhood-level utilization of primary healthcare. Within the context of this study, neighborhood gun prevalence and violence are defined as instances of violence encompassing firearm-related fatalities or the mean quantity of firearms within households. We define utilization of primary healthcare as a composite of a variety of healthcare variables, including, but not limited to, the percentage of dental check-ups, the percentage of the population with established primary care providers, health indicator screenings, and vaccination rates. We are using data from the Seattle & King County Public Health Database to examine the association between our variables of interest at the neighborhood level. We will conduct a linear regression model to statistically examine the correlation between the utilization of primary health care and neighborhood gun violence statistics. We anticipate that the findings of this study will elucidate a discernible correlation between indicators of primary care access and firearm-related violence at the neighborhood level in the Puget Sound region. We intend to employ this data to aid local public health officials in understanding and addressing the correlation between healthcare disparities and gun violence. Subsequently, this information can serve as a foundation for their efforts in formulating population-level legislation aimed at mitigating healthcare disparities to alleviate firearm violence at the neighborhood level.

Tissues like the meniscus, a wedge-shaped pad of connective tissue found in the knee, are fibrous and have complex architecture that regenerates poorly and undergoes active mechanical stimulation which modifies cell signaling and tissue health. In vitro models are beneficial for characterizing these interactions as they create a controlled environment where single variables can be altered. We previously used the J1 Mechanoculture bioreactor to apply strain on a fibrous polymer scaffold laden with primary meniscal cells and observed nonsignificant variances between testing groups with mock injury vs. no injury. Applied strain was modeled after physiological strain levels, ~10%. Based on the minimal changes in cell behavior observed in mock injury samples, it is likely that the mock injuries in conjunction with the applied strain did not induce comparable plastic deformation to that experienced post injury within the native meniscus. We hypothesize that increasing strain and applied force to achieve plastic deformation within the electrospun samples will create a fibrotic and apoptotic response like that in vivo. Ongoing work is analyzing how the bioreactor will interact with unaligned electrospun polymer samples with no cells present. This will demonstrate the optimal parameters to instigate a significant material response. By inducing significant changes to scaffold material properties and underlying structure, it is more likely cells with demonstrate fibrotic and apoptotic responses in vitro mimicking immediate cell reactions to meniscal injuries in vivo. This response will be assessed by assaying for fibrosis through αSMA activation and apoptosis by caspase-3 activation. On the conclusion of this study, we expect that greater applied stress and associated strain will cause more plastic deformation within the polymer scaffold. This can be applied to an in vitro meniscus injury model to better understand the response of primary meniscal cells to stress in an environment with disrupted mechanics.

It is well documented that women are predisposed to various musculoskeletal injuries, including hip labrum, Anterior Cruciate Ligament (ACL), and meniscus tears. Literature has detailed the regenerative potential of human mesenchymal stromal cells (hMSCs), and clinical trials have confirmed their medicinal application within tissue repair and healing, particularly in the musculoskeletal system. hMSCs are commonly used in the field of tissue engineering due to their immunomodulatory capabilities, differentiation capacity, and autograft availability. Across the lifespan, cells in male and female bodies experience varying levels of estrogen exposure, which elicits different responses. During in vitro cell culture, cells are typically exposed to sources of exogenous estrogens, including phenol red and fetal bovine serum (FBS). Although these additives are commonplace in the practice of cell culture, little research has been done to understand the impact of these additives on hMSCs in in vitro cultures, especially among female hMSCs. To investigate these cellular responses, we studied the impact of these estrogen-mimetic media components on cell proliferation and metabolism in vitro for hMSCs derived from male and female donors. Specifically, we investigated phenol red, which is shown to behave as an estrogen, and FBS, which naturally contains 17β-estradiol (E2). We hypothesized that estrogen-mimetic compounds would be associated with an increase in cellular proliferation and metabolism in a sex-dependent manner. These results clarify the response patterns of male and female hMSCs due to exogenous estrogen exposure, improving our sex-specific understanding of their potency for in vitro studies and regenerative medicine applications.