Heidi Wendell Brown, MD, MAS
Dr. Heidi Brown is an Assistant Professor in the Department of Obstetrics & Gynecology in the School of Medicine and Public Health. Her mentor is Jane Mahoney, MD, Professor in the Department of Medicine. Dr. Brown’s research focuses on a critically important and under-addressed mature health need: incontinence. More than 60% of community-dwelling older U.S. women experience urinary and/or bowel incontinence, the combined annual cost of which exceeds $30 billion. In addition to their significant negative impact on quality of life, urinary and bowel incontinence increase the risk of falls, depression, caregiver burnout, hospitalization, and nursing home placement. Fortunately, effective treatments exist to improve or cure these conditions, even without medication or surgery. Unfortunately, over half of women with urinary incontinence and almost three-fourths of women with bowel incontinence do not seek care, and therefore cannot access these treatments.
Dr. Brown’s research focuses on barriers to care-seeking for incontinence as well as application of health education and chronic disease self-management principles to both urinary and bowel incontinence, to identify effective methods to improve symptoms and increase awareness of treatment options. Her program is based on a community-based continence promotion program proven to improve symptoms and increase care-seeking for urinary incontinence in Canadian and United Kingdom (UK) populations. She is using her K12 award to adapt this evidence-based intervention for the seniors in our community, adding information and management strategies for bowel incontinence, as well as incorporating components of other successful health promotion interventions in our community. Once this community-based education and self-management program is demonstrated to be effective in Wisconsin, it will be more widely disseminated to target the epidemic of incontinence throughout the United States. View Dr. Brown’s CV.
Teresa Te-Ying Liu, PhD
Dr. Liu is an assistant scientist in the School of Veterinary Medicine, and her mentor is Will Ricke, PhD, associate professor in the Department of Urology, School of Medicine and Public Health. Dr. Liu’s research focuses on the role of estrogen receptors on benign prostatic hyperplasia (BPH) development and progression. BPH affects a high percentage of aging men, and disease progression has been associated with inflammation, proliferation, and altered steroid homeostasis. While the prostate is generally thought of as an androgen dependent organ, the altered steroid hormone milieu associated with aging could increase signaling of estrogen receptors. However, the role of estrogens and estrogen receptor activity is not well described in the prostate.
A change in the steroid hormone milieu in the prostate is often associated with BPHdevelopment; we are specifically interested in the protective effects of estrogen receptor β. We are currently using high-throughput sequencing technologies to define estrogen receptor gene networks in BPH. In combination with receptor dimerization studies, these data will be a valuable resource for the benign prostate research community. Additionally, these gene networks could reveal potential biomarkers or druggable targets that could provide novel combination therapy for BPH. View Dr. Liu’s CV.
Michael W. Wood, DVM, PhD, DACVIM (SAIM)
Dr. Michael Wood is an assistant professor in the Department of Medical Sciences in the School of Veterinary Medicine. His mentor is Dale Bjorling, DVM, professor in the Department of Surgical Sciences in the School of Veterinary Medicine. Dr. Wood’s research focuses on understanding the innate urothelial defense to infection with the long–term goal of developing alternative treatments that correct underlying urothelial defects and thereby prevent infection. Over 60% of women will develop a urinary tract infection (UTI) during their lifetime, with 25% of them being re-infected within 6 months of clearing the first. Unfortunately in 25-30% of people the defect allowing re-colonization is not identified resulting in a frustrating cycle of repeat infections and antimicrobial treatment. In recent years, an increase in the development of multidrug resistant uropathogenic bacterial strains has led to treatment failure. The problem of recurrent infections paired with the emerging problem of antibiotic resistance has created a dire need for understanding of what urothelial defenses are present, how these defenses fail, and what treatments can repair or prevent this failure.
Dr. Wood’s research examines both immunologic and mucosal barrier changes ex vivo in real time by utilizing a Ussing chamber model of acute urinary tract infection. By isolating the urothelial microenvironment from recruited inflammatory cells, his work focuses on the local production and response of the urothelium to cytokines including interleukin-6. This work has uncovered an interleukin-6 mediated anti-inflammatory and barrier restorative response within the urothelium that includes the local production of glycosaminoglycans. Given the evidence that increased urinary concentrations of glycosaminoglycans reduces urothelial bacterial colonization, promoting glycosaminoglycan production may yield a lasting defense and help to prevent infection in at-risk patients. View Dr. Wood’s CV.
Alejandro Roldán-Alzate, PhD
Dr. Roldán is an Assistant Professor in the Department of Radiology, School of Medicine and Public Health, and Mechanical Engineering, College of Engineering. His mentors are Will Ricke and Wade Bushman. Dr. Roldán has particular expertise in measurement of flow and determination of fluid dynamics by non-invasive imaging, particularly magnetic resonance imaging (MRI). He research will rely on application of this expertise in conjunction with developing technology in MRI to better characterize the size, conformation, and mechanical properties of the prostate, as well as the relationship of these characteristics to urine flow.
Imaging of the prostate to assess the size, conformation, and consistency of the prostate in men with benign prostatic hyperplasia (BPH) remains confusing. Studies seeking to correlate prostate size determined by non-invasive imaging with lower urinary tract symptoms have produced conflicting, inconsistent results. A major reason for this is that very little attention has been paid to the capacity of imaging – particularly magnetic resonance imaging or MRI – to assess the mechanical properties of the prostate. Using mouse models and patients with BPH, Dr. Roldán will test the following hypothesis: benign disease of the prostate results in decreased elasticity and compliance of the prostate and urethra that is accompanied by increased severity of lower urinary tract disease. MRI has been used extensively to characterize size and mechanical properties of the liver. The accuracy of MRI for this purpose has been confirmed by biopsy, surgery, and autopsy findings. Technology increasing the versatility and accuracy of MRI for assessing mechanical properties of solid organs is rapidly developing, but use of this technology to assess benign prostatic disease lags behind. The long term goal of this research is to use MRI to provide clinicians with more specific, accurate data regarding structural properties of the prostate. These data will guide choices of therapy and improve overall outcome of treatment of BPH.
Diego Hernando, PhD
Dr. Hernando is an Assistant Professor in the departments of Radiology and Medical Physics, School of Medicine and Public Health. His mentors are Will Ricke and Wade Bushman. Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS)contribute markedly to morbidity and reduced quality of life in aging men. BPH is highly prevalent, affecting ~50% of men in their 50s and ~90% of men in their 80s. Given the increasing life-span in the Western world, BPH will become an increasing burden on men and society. Although prostate volume is correlated with LUTS, prostate volume has only a moderate impact on prostate symptom scores, and patients with normal sized prostates often develop LUTS. Studies in animal models, as well as clinical studies in men, suggest that other mechanisms, particularly inflammation and fibrosis of the prostate, play an important role in development of BPH/LUTS. For these reasons, the development of methods to quantify inflammation and fibrosis of the prostate is highly desirable, as it will enable improved subclassification of patients according to etiology and selection of the most efficacious treatment.
Dr. Hernando’s research will develop and validate non-invasive magnetic resonance imaging (MRI)-based methods for assessment of inflammation and fibrosis of the prostate in patients with BPH/LUTS. The proposed methods are based on ferumoxytol-enhanced MRI for assessment of inflammation, and diffusion MRI for assessment of fibrosis. Additionally, emerging evidence suggests that metabolic syndrome and obesity contribute to BPH/LUTS through alterations in the phenotype of bladder and prostate gland. He will therefore also quantify the correlation between BPH/LUTS and recently developed MRImarkers of metabolic syndrome and abdominal obesity.