Investing in the Advancement of Science

As this issue of Missouri Medicine makes clear, emergency medicine plays an essential role in responding to an array of often life-threatening health concerns and never more so than during the ongoing COVID-19 global health crisis.

Recognizing the growing complexity of this specialty, Washington University School of Medicine announced in 2020 that it was elevating its Division of Emergency Medicine to a full-fledged academic department to be headed by Opeolu M. Adeoye, MD, a leader in emergency medicine and a physician-scientist whose research focuses on improving outcomes for patients who have suffered strokes or other injuries to the brain.

The new department aims to attract and recruit the nation’s top physicians, raise the bar on undergraduate and graduate medical education, and greatly expand clinical research with a goal of improving how patient care is delivered at the earliest possible moment of illness or injury.

Washington University emergency physicians provide urgently needed medical care to more than 150,000 patients annually at Barnes-Jewish and St. Louis Children’s hospitals, and because these interactions take place in the context of an academic research and teaching institution, the benefits extend far beyond the care provided.

Each year, a new class of residents and fellows comes to Washington University to gain knowledge and cutting-edge skills in emergency medicine. Each year, graduates filter out into the world to bring these skills to patients. All the while, our faculty physicians and trainees conduct critical research and share this knowledge with peers, to the benefit of patients everywhere.

COVID-19 Developments

Looking back on more than two years of pandemic challenges, it’s hard to imagine a time when the unique paradigm and capabilities of academic medicine have been more important to society.

Because of the nation’s long-standing investment in basic medical research and training, our medical communities have the skills, tools, and infrastructure in place to respond to new and little-understood global health threats. Through innovation and often improvisation, we’re finding ways to get patients the care they need while also contributing to the development of new and effective testing techniques, vaccines, antiviral drugs and antibodies.

For example, the world’s first nasal vaccine for COVID-19 – based on technology licensed from Washington University – was approved in September 2022 in India for emergency use. Because the vaccine is delivered via the nose, right where the virus enters the body, it has the potential to block infection entirely and break the cycle of transmission. Our scientists developed the nasal vaccine in collaboration with Bharat Biotech International Limited in India.

While injectable COVID-19 vaccines have been shown to elicit protection against severe disease, this route of administration is thought to be less effective at preventing infection and possibly transmission. Our early studies showed that nasal vaccine delivery creates a strong immune response throughout the body, especially in the nose and respiratory tract. This promising development reflects Washington University’s commitment to translating our ground-breaking science and bringing more of it to the bedside.

Also, early in the pandemic, Washington University emergency department physicians and staff played a pivotal role in clinical trials investigating the accuracy of COVID-19 diagnostic tests, which were in short supply at the time. Because the school already had a strong infrastructure for conducting clinical trials, our staff was in an ideal position to enroll large numbers of study participants, providing a pipeline of valuable data that helped the Food and Drug Administration quickly approve the most effective COVID-19 tests. A more recent trial is investigating a combination test administered by health-care workers that detects the presence of SARS-CoV-2, influenza A and influenza B.

Another example of the symbiotic relationship between clinical and research work at Washington University is a centralized biorepository set up early in the pandemic to store and manage blood, urine, and saliva specimens provided by COVID-19 patients who consent to participate in research studies involving the virus. The streamlined collection process has allowed emergency room staff to provide thousands of samples to more than 20 Washington University labs working to understand the basic biology of the infection as they seek ways to prevent or treat it.

Grants and Donations Spur Research

That these things were possible to mobilize amid the pandemic’s chaos and fear is due in large part to the important work being done every day at university-based medical research and teaching institutions, work that is generously supported by a range of federal grants and private donations.

In federal fiscal year 2021, researchers at our school were awarded nearly $576 million in funding from the National Institutes of Health (NIH), an all-time high for the school and an increase of nearly $88 million over federal fiscal year 2020. With this sixth consecutive year of growth in NIH grant awards, the school now ranks fourth among U.S. medical schools in NIH funding.

Research grants to the school from all sources — including foundations, donors, and government agencies such as the Department of Defense and the Centers for Disease Control and Prevention — totaled nearly $750 million in fiscal year 2021. Together with increased institutional support, the total annual investment in research has reached well over $1 billion.

While research funding is important to the university, it also makes critical contributions to regional and state economic growth. Our NIH research portfolio now supports an estimated 12,000 jobs in the region, and we expect that funding to grow by as much as 30% over the next five years. As the state’s perennial powerhouse for attracting outside biomedical research funding, the school has become a magnet for health-minded entrepreneurial pursuits, serving as founding anchor of the 200-acre Cortex Innovation Community, one of the fastest-growing business and technology hubs in the United States. By spurring development of new medical services and technologies, the medical school continues to lure new companies to the St. Louis business community, infusing more private investment, money, and jobs into the state’s economy.

Investing in the Advancement of Science

We invest these funds in education and research to bring improvements to clinical care, better outcomes for patients and better health for the community. Our goal is not to get grants per se. Our goal is advancing science. Our goal is curing diseases through our discovery capabilities, and these discoveries lead to new therapies and innovations that improve patient care.

This is the “virtuous cycle” of academic medicine that underpins the school’s ongoing growth and success.

At Washington University, we know patients benefit when front-line care providers have the opportunity to work side by side with leading researchers. Our clinicians help researchers identify important areas for study. Our researchers get a chance to tailor new treatments to the unique needs of individual patients, ushering in the promise of a new era of personalized medicine.

Even during a pandemic, the wonderful minds at our institution are always considering what we can do to advance health care and science. Among our newest initiatives, the School of Medicine and BJC HealthCare have partnered with CuriMeta, a new company that will accelerate life-saving research in the fight against chronic and acute diseases that impact our communities. We’re engaging in this venture to bring sophisticated data sets in support of research that seeks to predict, prevent, and cure a broad variety of diseases, using advanced, state-of-the-art technologies to protect patient privacy and confidentiality.

CuriMeta has specialized expertise in managing “real-world” data collections, which hold great promise in terms of making research faster and more efficient. CuriMeta will create a secure platform to share such real-world data sets with life science companies whose research goals align with those of the School of Medicine and BJC HealthCare, all while ensuring that patients’ identities are kept private.

Via another new collaboration — between Siteman Cancer Center and the University of Missouri Health Care’s Ellis Fischel Cancer Center in Columbia — cancer research will get a boost in Missouri. Siteman is based at Barnes-Jewish Hospital and the School of Medicine.

The ultimate goal of this new relationship is to maximize the research capabilities at both cancer centers and improve cancer care throughout Missouri. A major focus of the collaboration involves scientists at both institutions working together on research projects and jointly pursuing competitively funded research grants, including those supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH). The collaboration also will enhance efforts in cancer prevention so that the general public can be better informed about cancer risk and about access to resources for cancer prevention and screening.

Construction in Personalized Medicine, Aging, and Mental Health

Allowing us to expand our mission and goals are construction projects underway on our campus, three of which will be buildings specifically designed to bring researchers and clinicians closer together to better meet the needs of patients. These projects will support our efforts to establish international centers of excellence in three key areas: personalized medicine, aging and mental health.

Neuroscience

One of the largest neuroscience research buildings in the country is being built on campus adjacent to St. Louis’ rapidly expanding Cortex technology hub. Designed to advance world-leading neuroscience research into mysteries of the brain and nervous system, the 11-story facility will bring together more than 100 research teams, including some 875 researchers from areas such as neurology, neuroscience, neurosurgery, psychiatry and anesthesiology. It is scheduled to open in 2023.

Cancer

Our Siteman Cancer Center, a National Cancer Institute-designated comprehensive cancer center, is planning a nine-story, 659,000-square-foot facility dedicated solely to outpatient cancer care. The facility will provide a central home for nearly all aspects of advanced cancer care, providing more personalized care for patients and a more comforting experience for their families. This is scheduled to open in 2024.

Research Laboratories

Construction is underway on a major expansion of medical research laboratory space in the Steven & Susan Lipstein BJC Institute of Health building. The $150 million expansion will add six floors and 160,000 square feet of laboratory space to an existing 11-story research building. The project includes a biologic core facility to provide innovative cellular therapies for cancer and a high-containment, biosafety laboratory for research on SARS-CoV-2 and other infectious viruses.

Growth for the Future

This impressive growth is a reflection of the remarkable depth and breadth of our faculty, staff and students and their willingness to rise to new challenges and perform at high levels to achieve our mission: caring for patients to the highest standards today, while also doing the research that will allow us to enhance that care in the future.

At Washington University School of Medicine, we are always asking: How we can have more impact on our community and improve the health of our neighbors, urban and rural? How can we improve the economy in our region, since we know that economic status plays such an important role in health outcomes?

As always, we invite you to share suggestions on how our school might work in partnership with the state’s fine medical institutions and physicians to better serve the state of Missouri. For more on our school’s initiatives, please visit http://medicine.wustl.edu.