The Rensselaer-Mount Sinai Collaborative Research Projects program spearheads studies under the affiliation between the Icahn School of Medicine at Mount Sinai and Rensselaer Polytechnic Institute.
These collaborative efforts have produced the Center for Engineering and Precision Medicine (CEPM), which strives to accelerate biomedical breakthroughs and advance new and more precise therapeutic interventions. Precision medicine integrates the complexity of biological systems (including genomics, proteomics, metabolics, and systems analysis) with data science and analytics, and engineering science and technologies. It is particularly appropriate for the more complex and intractable diseases because the more complex the condition, the greater the need for accuracy, precision, and computational expertise—skills that are the heart of engineering and engineering science.
The center will focus primarily on three broad areas: immunoengineering, neuroengineering, and reparative and regenerative medicine.
Immunoengineering involves the manipulation of the human immune system to protect against key threats to human health, including infectious disease and cancer. The human immune system is perhaps the most advanced sense-and-respond platform known to mankind. Constantly on surveillance to seek out and eliminate pathogens and aberrant cells, the immune system can be tailored to function even faster, more precisely, and more efficiently.
A challenge to engineering the human immune system is its exquisite complexity. However, through multiscale engineering, data analytics and artificial intelligence, and fundamental immunology and biological sciences, the CEPM is well suited to address this challenge. With respect to cancer, immunoengineering serves as the enabler of immunotherapy. To manipulate the body’s immune response, we need to consider small molecules, peptides, recombinant antibodies, vaccines, and cellular therapeutics, which in aggregate have proven especially helpful as immune checkpoint inhibitors and cell-based therapies. Of direct relevance to cancer therapy, the CEPM is addressing immune-driven immunosuppression, developing safer and more effective therapeutics, and enabling physicians to provide personalized treatment strategies for improved outcomes.
The other main focus of our immunoengineering efforts involves infectious disease. COVID-19 has demonstrated the importance of being able to understand and address new and emerging infectious agents leading to epidemics and global pandemics. In addition, increasing rates of antibiotic resistance are forcing us to seek new ways to tackle microbial infection and contamination. The CEPM is working on multiple interdisciplinary fronts, ranging from new routes to immunomodulation to high-throughput screening and drug repurposing for anticancer and antiviral agents, microbial drug resistance, and biomanufacturing for scale-up and production of engineered immunomodulators and immune cells.
The loss of neurons (called neuronal atrophy) in the main functional hubs of the brain can affect the lines of communication throughout the body–and may be responsible for the symptoms and progression of neurologic diseases such as Alzheimer’s disease, epilepsy, Parkinson’s disease, neuropathic pain, and depression. These main functional hubs of the brain include the hippocampus, thalamus, amygdala and trigeminal nuclei. Scientists are beginning to identify some of the pathways taken by many of these diseases, paving the way for use of new, minimally invasive, highly targeted interventions, such as neuromodulation, for patients who cannot be helped by medication or surgery.
CEPM is involved with research that would enable modulating the brain’s networks and pathways to treat a wide range of neurological symptoms. This nonsurgical approach could take place either in the home or outpatient setting. Our short-term goal is to be use this approach on patients who cannot handle surgery. In the long term, we hope this approach could replace invasive procedures altogether.
A second area of exploration is developing comfortable, wearable, thin-film electronic sensors to monitor neural activity. In this way, we could provide modulation precisely when and where needed. Research suggests that performing integrated analysis of neural signals using machine-learning algorithms could help develop these portable devices. And this type of product would enable care providers to monitor patients at home and provide responsive treatment.
Reparative and Regenerative Medicine
This field has been around for about a century. It was first used to transplant bone, soft tissue, corneas, and skin. In the 1950s, surgeons began transplanting entire organs, including kidneys, hearts, and lungs, from one person to another. Then, as researchers began to understand more about the mechanisms that govern cells, tissue, and organ development, we have been able to generate functional tissue and organs in the laboratory and transplant them into humans.
Tissue generation, however, remains a complex challenge. Stem cell biology may be one approach to developing functional tissue. The center is exploring the composition, regulation and properties of the stem cell microenvironment to see how it could regenerate cells or encourage other cells to repair and regenerate themselves in a diseased or compromised environment. We are also working to develop tools that might help us manipulate this microenvironment. In addition, we are researching how the tissue should be organized and connected to the brain’s physical, mechanical, and biochemical pathways within the stem cell microenvironment.