Research

Do low thyroid hormone levels contribute to heart dysfunction?

Wed, 15 Apr 2026 07:00:00 GMT

Thyroid hormones play a fundamental role in cardiovascular function. They influence how the heart responds to adrenaline, how the heart uses energy and how constricted or relaxed blood vessels are. However, their effect on the strength of cardiac contraction is less understood.

Glowing thyroid gland emerging from circuit-board lines.

To better examine the role of thyroid hormones in cardiac contractility, endocrinology clinicians at UC Davis Health examined patients with myxedema coma, the most severe form of hypothyroidism. This life‑threatening condition offers a rare opportunity to observe the heart in a state of profound thyroid hormone deprivation.

Cardiac effects of hypothyroidism and critical illness

Individuals with low thyroid hormone levels (hypothyroidism) often exhibit changes in cardiac function, including delays in the onset of contraction, prolonged contraction and relaxation times and abnormalities in blood flow during cardiac filling.

A similar pattern of cardiac dysfunction is commonly observed in septic shock, a leading cause of death in intensive care units. In this setting, low circulating triiodothyronine (T3) levels occur in up to 95% of patients, a phenomenon often referred to as non‑thyroidal illness syndrome.

At the same time, approximately 30 - 40% of patients with septic shock develop septic cardiomyopathy, characterized by impaired myocardial contractility and reduced cardiac output.

“These observations raise an important question,” explained Joaquin Lado, chief of Endocrinology, Diabetes and Metabolism at UC Davis Health. “Is it possible that untreated low thyroid hormone levels contribute to heart dysfunction?”

Traditionally, endocrinologists have been reluctant to treat low thyroid hormone levels during acute illness, viewing them as an adaptive metabolic response rather than a true hormone deficiency. However, this long‑held assumption is increasingly being challenged.

“If thyroid hormone deficiency weakens the heart,” Lado added, “why wouldn’t a prolonged deficiency worsen septic cardiomyopathy?”

Transportation problems disrupt dialysis care for patients with kidney failure

Wed, 08 Apr 2026 07:00:00 GMT

A new UC Davis Health study reveals that transportation challenges create major barriers for patients with end-stage kidney disease who receive hemodialysis at a clinic. These challenges also have a negative impact on dialysis clinic staff.

Male caregiver help senior man get in car

The study was published in the Journal of Nephrology Social Work.

Hemodialysis and kidney disease

Chronic kidney disease affects an estimated 35.5 million Americans, or more than 1 in 7 U.S. adults.

Hemodialysis patients typically travel to a clinic three times a week to get treatment.

End-stage kidney disease, also known as kidney failure, represents the last stage of chronic kidney disease. This is when the kidneys function at less than 15% of their normal ability. Kidney failure can lead to unexplained weight loss, inability to urinate, loss of appetite and fatigue.

The most common treatment for kidney failure is hemodialysis at a treatment facility. During hemodialysis, a machine moves the patient’s blood through a filter outside the body to remove waste and extra fluids. The filtered blood is then returned to the body.

Hemodialysis patients typically travel to a clinic three times a week, which makes reliable transportation essential.

Listening to hemodialysis patients and clinic staff

The research is based on 78 in‑depth interviews with patients and staff at four Northern California dialysis clinics. It highlights how unreliable and complex transportation systems directly affect health, safety and treatment success.

“Our study shows that transportation isn’t just a detail — it’s a core part of dialysis care,” explained the study’s lead author Na’amah Razon. “When rides are late or unreliable, it directly harms patients’ health and puts tremendous pressure on clinic staff.” Razon is an assistant professor in UC Davis Department of Family and Community Medicine and Division of Nephrology. She is faculty affiliated with UC Davis Center for Healthcare Policy and Research.

Transportation challenges overwhelm hemodialysis patients

The study showed that patients often face a confusing mix of transportation options. These include paratransit (door-to-door service), public transit, ride‑hail services (like Uber and Lyft) and insurance‑based non‑emergency medical transportation

Many patients said that figuring out who to call, how to schedule rides, and what to do when a driver did not show up was overwhelming. One patient described long wait times and poor communication, calling transportation companies “untouchable.”

The quality of transportation was an even bigger concern. Patients reported late pickups, no‑show rides, unsafe driving and drivers who did not understand the needs of dialysis patients. Some patients were left waiting outside clinics for hours, even while feeling dizzy or weak after treatment.

These transportation struggles caused significant emotional distress. Many patients said they experienced daily anxiety about whether rides would arrive on time. Several explained that the stress of unreliable transportation added to the mental burden of dialysis itself.

Despite these obstacles, patients emphasized their strong commitment to attending treatment, knowing that missed sessions could quickly lead to dangerous fluid buildup and emergency medical crises.

Transportation issues disrupt the work of dialysis clinic staff

Dialysis clinic staff described similar challenges. Unreliable transportation caused late arrivals, early departures or shortened sessions, all of which disrupted clinic schedules. Staff said they often struggled to safely manage patients whose treatments were cut short because drivers would not wait. One nurse described it as a “snowball effect,” where one late ride could throw off the entire clinic workflow.

The study also found that staff often took on additional responsibilities, acting as transportation coordinators, translators and advocates. Social workers, in particular, spent significant parts of their days on hold with transportation companies, reducing the time available for counseling and other essential patient support. Many staff members described emotional exhaustion from witnessing patients stranded or distressed because of transportation.

Ultimately, both patients and staff agreed that missed or shortened treatments caused by transportation failures had serious health consequences. They may even affect the patients’ eligibility for kidney transplants, which require consistent attendance.

“The findings make it clear that health care and transportation systems must work together. Dialysis patients deserve reliable, respectful and safe transportation every time they go for treatment,” said the first author on the study, Bethney Bonilla-Herrera. Bonilla‑Herrera is a clinical research analyst at the Center for Healthcare Policy and Research.

This project was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences (grants UL1TR001860 and KL2 TR001859) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (grant K23 DK140602). It was also supported by the Paul F. Gulyassy Endowment at UC Davis.

Coauthors on the study are Navkirn Saini, Iris Corina, Bertha Dickerson, Maria Elena Grijalva, Daniel Jovan Pulido, Baback Roshanravan, Joshua J. Fenton and Laura M. Gottlieb.

UC Davis School of Medicine ranks among top U.S. schools

Mon, 06 Apr 2026 07:00:00 GMT

The UC Davis School of Medicine is among the top in the nation for educating primary care physicians and remains a high performer in research funding. That’s according to data released by U.S. News & World Report.

A group of 10 students, most in white coats, stand side by side as they walk in a courtyard at the UC Davis School of Medicine.

In the publication’s 2026 Best Graduate Schools issue, in the medical school category, UC Davis ranks in the top tier nationwide for primary care medical education and in the second tier for research.

For many years, U.S. News assigned numerical rankings to institutions for these two categories, but it now groups schools into four tiers. Last year, UC Davis was also ranked in Tier 1 for primary care and Tier 2 for research.

“This year’s rankings underscore our school’s longstanding leadership in training physicians committed to serving all of California’s communities, while also advancing groundbreaking research that is transforming the lives of patients worldwide,” said Susan Murin, dean of the UC Davis School of Medicine.

That commitment extends to rural and medically underserved areas where patients face barriers to access primary care doctors.

The U.S. News ranking also reflects the school’s ongoing success in research funding. This has brought national attention to its dedication to study diseases, develop new treatments, improve patient care and test new medical technologies.

In addition to the tiered rankings, the school was listed as No. 16 in the category of most graduates practicing in primary care (up from No. 17 the year before).

Many UC Davis medical students gain experience in primary care medicine while caring for patients at student-run clinics.

Primary care: A priority since the school’s creation

Primary care is the bedrock of the health care delivery system. It includes the fields of family medicine, pediatrics and internal medicine. Primary care providers are responsible for coordinating a patient’s care, managing their chronic conditions and helping them prevent diseases.

Training students to become primary care doctors has long been a core component of the medical school.

UC Davis School of Medicine was approved by the California Legislature in the 1960s with a mandate to produce more primary care physicians to help fill workforce shortages.

“Historically, there’s always been this unique, strong culture and emphasis to admit students with interests in primary care,” said Mark Servis, the medical school’s vice dean for medical education. “UC Davis offers more clinical rotations in primary care settings for students than most schools in the country.”

Students also gain primary care experience through volunteering: Hundreds of medical students and UC Davis undergraduates are involved in about a dozen student-run clinics. These clinics provide care to uninsured and underinsured Sacramento-area residents.

The medical school has also created numerous academic tracks, or pathways, to serve specific populations and regions of the state, most often in primary care settings.

Among the pathways is ACE-PC, a fast-paced program that allows medical students committed to primary care to complete school in three years instead of four — the only such program in California. Recently, the pathway, formally known as Accelerated Competency-based Education in Primary Care, added a psychiatry component, called Rural ACE-PCP.

“The UC Davis primary care ranking highlights the institution’s commitment to health equity and community well-being, and it reflects how seriously the school takes its responsibility to the communities it serves,” said Alicia González-Flores, executive director of ACE-PC. She is also an internal medicine physician.

She added: “It is deeply fulfilling to work at a school that places primary care at the heart of its mission and as a core expression of its values and responsibility to our communities.”

Servis said the school’s focus on primary care training will continue to benefit communities across California.

“The investments we've made in the last dozen years,” he said, “are going to continue to pay off in terms of graduates going into the right places to meet health care disparities and needs.”

Research funding leads to scientific breakthroughs

The Tier 2 U.S. News ranking for research highlights a School of Medicine priority that is driving innovation and transforming the health of Californians.

U.S. News uses multiple indicators to assess research rankings. They include the school’s total research funding, National Institutes of Health (NIH) funding and research productivity per faculty member.

This year, UC Davis School of Medicine was ranked among the nation’s leading medical schools in terms of NIH research funding. In the latest report by Blue Ridge Institute for Medical Research, the medical school placed 31st nationally, with a record total of $233 million in NIH grants. Twelve departments ranked in the top 20 nationally in their fields, and two were in the top 10.

Professor Jonathan Calvert, an expert in neural engineering, is developing technologies for patients with spinal cord injury.

“We are delighted to be ranked in Tier 2 for research,” said Kim E. Barrett, vice dean for research and distinguished professor of physiology and membrane biology. “While our position is limited, to some extent, by the smaller size of our faculty compared to our competitor schools, we are proud of the substantial impact of our research programs and their translation into new treatments and cures as well as improvements in community health.”

The school’s Alzheimer’s Disease Research Center (ADRC) is home to some of the biggest NIH-funded clinical trials and studies on Alzheimer’s and other dementias. Professor Rachel Whitmer is the PI with the largest NIH funding at UC Davis and in public health sciences nationwide. She studies age-related dementia, cognitive impairment and brain pathology among different ethnic groups. Also, Distinguished Professor in the Department of Neurology Charles DeCarli is the PI on a $15.8 million grant to study brain aging in Hispanic-Latino community living in the United States.

School of Medicine researchers have been achieving national and global recognition for advancing scientific knowledge innovation.

A research team led by fetal surgeon Diana Farmer has safely performed the world’s first spina bifida treatment combining fetal surgery with stem cells. The results from the Phase 1 ongoing CuRe clinical trial have been published in The Lancet.

Neurosurgeon David Brandman and neuroscientist Sergey Stavisky were named to the 2026 TIME100 Health List of the World’s Most Influential Leaders in Health. The designation recognizes their outstanding work on developing a brain-computer interface (BCI) that helped an individual with ALS "speak" again.

Also, Professors David Segal of the Department of Biochemistry and Molecular Medicine, and Janine LaSalle, of the Department of Medical Microbiology and Immunology, were recently elected as AAAS Fellows. They were recognized for their work to decipher complex neurodevelopmental conditions, such as autism and Angelman syndrome.

Research conducted at UC Davis Health has global impacts, too.

Researchers in the Department of Pathology and Laboratory Medicine have created a new tuberculosis (TB) blood test that can detect the active, infectious form of the disease. The discovery enables faster diagnosis and treatment. It also helps prevent the spread of TB by quickly identifying those who are contagious.

Regulatory T cells altered in children with autism

Thu, 02 Apr 2026 07:00:00 GMT

Two new studies from the UC Davis MIND Institute examined regulatory T cells (Tregs) and their potential role in neuroinflammation and behavioral changes associated with autism.

A 3D illustration of pink immune cells with blue spikes floating against a soft, light background.

Tregs act as immune system "brakes," calming inflammation to prevent overreaction. They are often decreased in autistic individuals.

Previous studies have found higher levels of inflammatory immune cells in the blood, brain and gastrointestinal tissues of people with autism. These increased inflammatory responses are often linked to greater behavioral support needs, while higher levels of Tregs are associated with improved behavioral outcomes. Despite this, Tregs have not been well studied in autistic children, and their potential as a therapeutic target remains largely unexplored.

Rachel Moreno, first author of the study, is a postdoctoral fellow at the UC Davis MIND Institute.

Altered Tregs in autistic children

The first study, published in the Journal of Neuroinflammation, characterized Tregs in children with autism. It determined if gastrointestinal (GI) issues, a common co-occurring condition, altered Tregs in a unique way.

The researchers found autistic children had altered Tregs both in number and in the genes those cells use. This was compared to typically developing children. All participants were enrolled in the CHARGE study (Childhood Autism Risk from Genetics and Environment), an ongoing study that supports autism research.

The researchers compared the number and type of Tregs in 36 children with autism and 18 typically developing children. They also examined gene expression in Tregs to determine if there were differences between the two groups. In addition, they looked at the relationship between Tregs and gastrointestinal symptoms in autistic children.

The researchers found children with autism showed altered Tregs. Compared to typically developing children, children with autism had:

A lower number of Tregs. Tregs were generally reduced in autistic children but decreases in specific Treg populations differed depending on whether a child had GI issues. Children with autism and GI issues had fewer Tregs capable of producing anti-inflammatory proteins. Children without GI issues had fewer Tregs capable of dividing after activation.
Differentially expressed genes. Tregs from autistic children had 213 differentially expressed genes, with 171 upregulated (increased output) and 42 downregulated (decreased output).

The upregulated genes mainly help cells reorganize and repair DNA and adjust how they manage energy and fat metabolism. The downregulated genes were mostly involved in energy production, such as the conversion of oxygen and nutrients into usable energy.

The researchers note that more research is needed, but that these changes in metabolism and DNA organization suggest the identity of Tregs is unstable. One commonality was that having fewer Tregs was associated with more challenging behaviors in both typically developing children and children with autism.

“These differences in Treg populations may help explain the higher levels of inflammation seen in autism and could be linked to both gastrointestinal problems and certain behavioral traits,” said Rachel Moreno, a postdoctoral fellow at the MIND Institute and first author of the study. “This data further supports the idea that the immune system plays an important role in autism in at least some individuals.”

Children with autism and GI problems (ASDgi) had lower expression of GITR (an immune modulator) than those without GI problems (ASDnogi) and typically developing children (TD).

Exploring Tregs as potential biological therapies

There is growing interest in biological therapies for autism that target Tregs.

In a second study, also published in the Journal of Neuroinflammation, the authors assessed whether increasing Tregs could reduce inflammation and behavioral challenges.

They used a mouse model of altered neurodevelopment, maternal immune activation (MIA), in which offspring exhibit autism-like behaviors.

The team transferred Tregs from healthy mice into male and female MIA mice, and evaluated tissues commonly inflamed in autism, including blood, brain and gut.

They found significant sex differences in the MIA mouse offspring that received the Treg transfer, with males showing greater changes than females.

NIH awards $15.8 million to UC Davis Health for major Hispanic-Latino brain health study

Wed, 01 Apr 2026 07:00:00 GMT

The National Institutes of Health (NIH) has awarded UC Davis Health a $15.85 million grant to support the next phase of one of the nation’s most extensive studies on brain aging in Hispanic-Latino communities.

Hispanic family of six: grandparents, parents, a girl, and a little boy

Latinos are one of the fastest growing demographic groups in the United States. They also have a higher risk of heart and vascular diseases and are more prone to developing mild cognitive impairment (MCI) or dementia than people from other groups. Still, Latinos remain underrepresented in research on aging and dementia.

The grant will support the creation of the most comprehensive long-term dataset on Hispanic and Latino brain aging to date.

“Our goal is to identify the factors that matter most for healthy cognitive aging — and ultimately reduce the burden of dementia for millions of families. Our new study will give us an unprecedented ability to understand how the brain changes over time in Latino communities,” said Charles DeCarli, UC Davis distinguished professor of neurology and the study’s principal investigator. DeCarli is also the co-director of the UC Davis Alzheimer’s Disease Research Center.

The study will track brain and cognitive changes in Latinos from diverse backgrounds, reflecting the wide range of ancestry, culture and health experiences within Latino populations that can influence how the brain ages.

“Latino communities have been historically overlooked in aging research. This grant allows us to change that,” said UC San Diego professor Héctor González, co-principal investigator on this new grant. “By studying brain health in a diverse and deeply characterized Latino cohort, we can develop better tools for early detection and more effective strategies for prevention that truly reflect our communities.”

Two researchers elected as AAAS Fellows for shaping science of neurological conditions

Thu, 26 Mar 2026 07:00:00 GMT

UC Davis School of Medicine Professors Janine LaSalle and David J. Segal have been elected Fellows of the American Association for the Advancement of Science (AAAS). With this lifetime honor, they join a century-long UC Davis legacy of AAAS Fellows who lead exceptional science scholarship.

Side by image of Professor Janine LaSalle and David Segal

School of Medicine scholars shaping science of neurological conditions

Janine LaSalle is a professor of Medical Microbiology and Immunology, affiliated with the MIND Institute and the Genome Center. She is also deputy director of the Environmental Health Sciences Center and co-director of the Perinatal Origins of Disparities Center. She was elected an AAAS Fellow for her pioneering research on gene x environment epigenetics (heritable chromosome changes that affect gene functions), specifically for autism. She’s also being honored for her research on epigenetic mechanisms in neurodevelopmental conditions and the placenta.

Professor Janine LaSalle with members of her lab.

David J. Segal is a professor and chair of the Department of Biochemistry and Molecular Medicine. He also holds appointments in the Department of Pharmacology, the UC Davis Genome Center and the UC Davis MIND Institute. Segal was recognized for his distinguished contributions to the field of molecular and translational genetics. He is a leader in developing gene editors like zinc finger (distinct DNA-binding protein structures that include zinc ions), TALE and CRISPR and applying them to treat neurologic conditions.

“This national recognition of Dr. Segal’s and Dr. LaSalle’s remarkable contributions to deciphering complex neurodevelopmental conditions, like autism and Angelman syndrome, speaks to their success in advancing science that can transform lives,” said UC Davis School of Medicine Dean Susan Murin. “Becoming an AAAS Fellow is among the most distinct honors within the scientific community, and we are proud that their impactful work is being recognized.”

Professor David Segal with his lab members.

A century of UC Davis AAAS Fellows

In 1926, Professor Tracy Storer became the first UC Davis elected a AAAS Fellow. Since then, 358 UC Davis professors have been elected. This year, in addition to Segal and LaSalle, two UC Davis professors were elected to this distinguished honor.

Joanna Chiu is a professor and chair of the Department Entomology and Nematology. She is recognized for her great contributions to the understanding of the molecular mechanisms by which circadian clocks integrate environmental and metabolic signals to regulate animal biological rhythms.

Gitta Coaker is a professor and Fiddyment Endowed Chair in the Department of Plant Pathology. She was elected for her work on plant pathology and immunity, particularly elucidating how plant receptors and bacterial components interface in disease. She is also recognized for her outstanding leadership and service to foster early career researchers.

The new Fellows have been invited to the annual Fellows Forum that will be held in Washington, D.C. on May 29.

Advancing global health: UC Davis test identifies active, infectious form of TB

Mon, 23 Mar 2026 07:00:00 GMT

03/23/2026

Advancing global health: UC Davis test identifies active, infectious form of TB

Tuberculosis is a global disease that kills millions. A new test could speed up diagnosis and help prevent its spread

World Tuberculosis Day is celebrated on March 24 every year to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global TB epidemic. Learn more here.

(SACRAMENTO)

Researchers in the UC Davis Department of Pathology and Laboratory Medicine have created a new tuberculosis blood test that can detect the active, infectious form of the disease.

The discovery enables faster diagnosis and treatment. It also helps prevent the spread of tuberculosis (TB) by quickly identifying those who are contagious.

Current TB screening tests do not differentiate between active TB disease and a latent (inactive) infection. Positive TB tests must be followed up with additional tests.

However, these additional tests can also have limitations. For example, sputum tests can miss TB outside the lungs, and children usually can’t easily produce the sputum samples needed for accurate testing.

The test was evaluated in a clinical trial in India, which bears about a quarter of the global TB burden.

TB is a global disease that kills more than 1 million people

TB is caused by the bacterium Mycobacterium tuberculosis. It spreads when a person with an active infection coughs, sneezes, or speaks — putting close contacts like family, friends, coworkers and classmates at the greatest risk.

TB most often attacks the lungs but can strike almost any part of the body. Although it is generally curable with a long course of antibiotics, completing treatment can be difficult.

Despite being treatable, TB remains one of the world’s deadliest infectious diseases.

In 2024, an estimated 1.23 million people around the globe died from the disease, and about 10.7 million fell ill. In the U.S., more than 10,000 cases were diagnosed — 2,000 of them in California.

The largest number of new TB cases occurred in South-East Asia, with India accounting for 25% of the global total.

“TB is often a disease of poverty, especially in developing countries,” explained Imran H. Khan, a professor in the UC Davis Department of Pathology and Laboratory Medicine. “And like most other poverty-related problems, it is a major cause of human suffering worldwide,” he said. His desire to help alleviate global poverty was a key motivation for developing the new test.

If we can stop the spread of TB by more easily identifying active infections, we can make a significant difference in decreasing global numbers of this devastating disease.” — Imran H. Khan, Professor, Department of Pathology and Laboratory Sciences

Current screening tests cannot tell if TB is active or latent

Health care providers use two main types of tests to help diagnose TB:

Mantoux Tuberculin Skin Test. In this test, a small amount of sterile tuberculin protein is injected into the skin. If the TB skin test shows a bump within two to three days, it indicates exposure to TB.
Interferon-gamma release assay (IGRA). This blood test assesses how the immune system responds when a small amount of the patient’s blood is mixed with TB proteins. A positive test result indicates the blood has reacted to TB proteins, signaling infection.

The challenge is that neither test type distinguishes between active TB (the patient has the disease) or latent infection (the patient had exposure to TB but is not currently sick). Only active TB disease is contagious.

Khan explains: “About 35% to 40% of the general population in TB endemic countries is latently infected — meaning they have been exposed — but they may never develop TB. A test that gives a positive result with latent infection is not useful in finding active TB cases, in which someone might have the disease and inadvertently spread it to others.”

The Mantoux Tuberculin Skin Test can detect TB exposure with a red bump, but not whether the TB is active.

New UC Davis blood test only detects active TB

In response to these diagnostic challenges, Khan and his lab at UC Davis Health developed a blood test that can detect an active TB infection.

As with other TB blood tests, like the IGRA, the new test measures the immune system’s response to TB proteins. Unlike them, it specifically detects antibodies associated with active tuberculosis. This means that a positive test identifies an active TB infection, addressing a key shortcoming of other tests.

TB test performed well at clinical trial in India

Khan worked with a medical technology company to adapt the test for routine clinical use.

The test’s effectiveness was evaluated in a clinical trial in India from 2019 to 2023. More than 600 people participated.

“The test performed surprisingly well,” Khan said. “In addition to the expected good performance in adult pulmonary TB, which accounts for approximately 60% to 70% of TB infections, it was also able to identify harder-to-detect TB cases in children as well as TB that was in other organs in the body, not in the lungs.”

Mycobacterium tuberculosis bacteria seen with a scanning electron microscope (Credit: CDC PHIL).

Researchers hope to bring test to more countries

Khan submitted data analysis and a clinical trial report to the Indian Council of Medical Research (ICMR). The ICMR is India’s top institution for the formulation, coordination and promotion of biomedical research. If approved by ICMR, the test could expand to neighboring countries.

“If you just look at India, Pakistan and Bangladesh, those countries alone have about 30% to 40% of the entire world's TB population,” Khan said.

To commercialize the test, Khan co-founded AppGenex Diagnostics, a Bay Area startup in Mountain View.

“If we can stop the spread of TB by more easily identifying active infections, we can make a significant difference in decreasing global numbers of this devastating disease,” Khan said.

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How an imbalanced gut microbiome worsens chronic kidney disease

Thu, 19 Mar 2026 07:00:00 GMT

03/19/2026

How an imbalanced gut microbiome worsens chronic kidney disease

By Lisa Howard

A destructive feedback loop increases a kidney-damaging toxin; findings point to possible treatment

(SACRAMENTO)

Researchers at UC Davis School of Medicine have uncovered how an imbalanced gut microbiome escalates the production of metabolic byproducts by certain gut bacteria. This imbalance drives a feedback loop that worsens chronic kidney disease (CKD) in mice. The scientists identified an investigational drug that might break the destructive cycle. The findings were published in Science.

The team showed that kidney impairment increased nitrate levels in the colon. The nitrates turbocharged Escherichia coli’s (E. coli) production of indole, an organic compound that turns into a harmful waste product — indoxyl sulfate — that further damages the kidneys.

Blocking the production of a single enzyme in the gut — inducible nitric oxide synthase (iNOS) — was capable of stopping this destructive cycle.

Andreas Bäumler (left) and Jee-Yon Lee (right) found chronic kidney disease causes specific gut bacteria to release a toxin that worsens kidney damage.

“Previous research has shown that chronic kidney disease is linked to an elevated fecal abundance of Enterobacteriaceae,” said Jee-Yon Lee, first author of the study and a project scientist in the Department of Medical Microbiology and Immunology.

Enterobacteriaceae is a large family of bacteria that includes both harmless and pathogenic species.

“This study identifies nitrate from the host as a switch that turns common gut bacteria like E. coli into indole producers capable of accelerating chronic kidney disease,” Lee said.

CKD affects about 1 in 7 adults in U.S.

Chronic kidney disease, which is a gradual loss of kidney function, affects about 1 in 7 adults in the U.S., or an estimated 35.5 million Americans. About 1 in 3 people with diabetes and 1 in 5 people with high blood pressure have kidney disease. Globally, about 788 million people were estimated to have CKD in 2023.

In mice, kidney disease increased nitrate levels that boosted E. coli growth and indoxyl sulfate production.

For people with kidney failure, hemodialysis is a life-saving procedure that removes waste and extra fluids from the blood. But indoxyl sulfate cannot be removed by dialysis because it binds to serum albumin, a common protein in the blood. Higher serum indoxyl sulfate levels are associated with more severe chronic kidney disease.

“By identifying the driver responsible for an increase of Enterobacteriaceae during chronic kidney disease, and by demonstrating the importance of these bacteria for indole production and disease progression, our research points to iNOS as a potential target for intervention strategies,” said Andreas Bäumler, distinguished professor in the Department of Medical Microbiology and Immunology, and senior author of the paper.

Methods and possible therapy

The researchers tested specific strains of E. coli in mice. They also tested fecal samples from people with and without CKD.

In mice, they found:

Kidney dysfunction caused an increased transcription of Nos2 (the gene responsible for creating iNOS) in the colon’s mucous layer.
Increased iNOS led to an increase in nitric oxide, which reacted with oxygen radicals to form nitrate.
Increased nitrate levels fueled E. coli growth, leading to a higher production of indoxyl sulfate, a kidney toxin, creating the damaging feedback loop.

In addition to the mouse findings, the researchers found fecal samples from people with CKD showed the same effect seen in the mice. Although fecal samples from people with kidney disease showed higher levels of E. coli, indole production increased only when nitrate was added, compared with healthy controls.

To determine whether reducing iNOS levels could improve outcomes in the mice, researchers tested aminoguanidine, an investigational drug known to inhibit iNOS. Mice given the aminoguanidine showed reduced mucous nitrate, lowered indoxyl sulfate and improved kidney outcomes.

In mice, kidney disease increased nitrate levels that boosted E. coli growth and indoxyl sulfate production.

Limitations and next steps

Although the results are promising for finding a mechanism to reduce indole sulfate — and potentially improve the progression of kidney disease — the researchers note several limitations.

Kidneys are responsible for filtering waste in the body. Chronic kidney disease affects about 1 in 7 adults in the U.S.

Although the human gut bacteria mirrored the nitrate‑dependent surge of indole in mice, more studies will be needed to confirm the results in people. Clinical trials are also needed to test whether iNOS inhibitors, or other agonists or inhibitors, could safely lower indoxyl sulfate and improve outcomes in people with CKD.

And finally, they note the gut ecosystem is complex. E. coli is not the only gut bacterium that produces indole, and long‑term suppression of nitrate pathways may carry unknown trade‑offs.

“This study shows that altering the gut environment — not just the microbes themselves — can have profound effects on disease progression,” Bäumler said. “Targeting host pathways that shape microbial metabolism may represent a new way to intervene in chronic kidney disease.”

A complete list of authors and funders appears in the paper.

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New training model helps surgeons practice minimally invasive spina bifida repair

Mon, 16 Mar 2026 07:00:00 GMT

A team of development engineers at UC Davis Tech Foundry and medical professionals at UC Davis Health has developed a teaching model to train pediatric surgeons on fetoscopic repair of spina bifida.

Demonstration of a model for training pediatric surgeons on fetoscopic repair.

Spina bifida is a congenital condition where spinal tissue fails to fuse properly in the womb, leading to lifelong health problems. Fetoscopic repair is a minimally invasive surgical procedure to address conditions like spina bifida in a fetus. It is a type of laparoscopic surgery, where surgeons make tiny incisions and insert very small tools and a long, thin camera inside the patient’s body.

“Fetal surgery, and fetoscopy for spina bifida in particular, is one of the more technically complex procedures in pediatric surgery, yet there are very few opportunities for surgeons to practice it,” said Payam Saadai, an associate professor of surgery at UC Davis Health. He had the initial idea for a training model.

One of the biggest benefits of fetoscopic repair over similar treatments for spina bifida is that it allows the mother to have a vaginal delivery in the future, due to its minimally invasive nature.

From idea to rough sketch to fully realized tool

Saadai passed his idea on to laboratory supervisor Christopher Pivetti and surgical research resident Elizabeth Reynolds, who both work in Professor of Biomedical Engineering and Surgery Aijun Wang’s lab at Aggie Square in Sacramento. Aggie Square is UC Davis’ innovation district where researchers, industry professionals and entrepreneurs work side by side.

The first 3D-printed fetus model. (Courtesy of Valerie Quiroz)

Also at Aggie Square, on the first floor of the district’s flagship building is Tech Foundry, a 7,500-square-foot device development facility. This set up an ideal situation to collaborate.

When Pivetti and Reynolds had more time to sit and think about Saadai’s idea, they sketched out notes and diagrams on graph paper. As they developed the idea for the fetoscopy model, they brought in pediatric neurosurgeons Cameron Sadegh and Marike Zwienenberg, both members of the fetal surgery team at the UC Davis Health Fetal Care and Treatment Center, for their expertise in fetal closure of spina bifida. Then, they brought their sketch to Tech Foundry to see if the team there could bring the idea into reality.

For Valerie Quiroz, the development engineer who took on the project, the sketch was all she needed. She transformed the sketch and medical jottings into a working prototype featuring 3D-printed, silicone-cast and laser-cut components.

A Teaching Model

The model simulates a fetus suspended in amniotic fluid inside the uterus. It features a chamber that can be filled with liquid and holds a small doll. It also includes a dome with small holes through which laparoscopic instruments can fit.

On the backside of the doll is a raised area of skin, almost like a balloon. This is to mimic fetal myelomeningocele, the most severe form of spina bifida. It’s when the fetus’s spine and spinal canal remain open at the bottom of the spinal column, creating a bulge of skin.

“The raised area will be a consumable part that will be replaced for the next user,” Quiroz said. “[It] is intended to mimic multiple layers of tissue, such as skin, dura mater and placode, and allow surgeons to practice surgical techniques, including suturing.”

Elizabeth Reynolds and Christopher Pivetti demonstrate a model for training pediatric surgeons on fetoscopic repair of spina bifida at Aggie Square. (Matt Marcure/UC Davis)

Due to the small area of skin on the fetus, and the fine laparoscopic tools, fetoscopic repair is one of the most technical and delicate pediatric procedures. With the new teaching model, pediatric surgeons at UC Davis Health can now practice and perfect the technique for treating spina bifida before ever entering the operating room.

“The fetal operation requires technical precision and is only available at a few centers in the world,” Saadai said, “so the fetal model directly supports this work by creating a safe, reproducible environment where our team can train and refine these techniques, dramatically shortening the learning curve for such a complex operation.”

Christopher Pivetti and Professor of Biomedical Engineering and Surgery Aijun Wang are using the model to explore the next iteration of the CuRe Trial, which applies a stem cell patch in its surgical treatment of spina bifida. (Nadine Yehya/UC Davis Health)

Advancing the CuRe

Thanks to the teaching model, fetoscopic surgery will be an option alongside the CuRe trial at UC Davis Health. The CuRe Trial, or Cellular Therapy for In Utero Repair of Myelomeningocele, is a groundbreaking treatment using a stem cell patch to repair spina bifida tissue.

The trial is led by Wang and Distinguished Professor and chair of the Department of Surgery Diana Farmer , with Pivetti, Reynolds and Saadai as members of the clinical research team. The trial is a world first and was recently found to be safe in a paper published in The Lancet, but requires invasive surgery.

“For the CuRe Trial, we use an open surgical approach to treat the fetus, meaning we make a larger cut on the uterus and float the baby's defect to that opening for repair. The disadvantage to this approach is that these moms cannot have a standard vaginal delivery again,” Pivetti said.

Pivetti explained that the training model will be used in the next stage of the CuRe trial. The goal is to replace the open surgery with a minimally invasive fetoscopic surgery. During the procedure, a surgeon would administer the small stem cell patch with laparoscopic tools before closing the incision to allow the tissue to regenerate.

“By developing not just fetoscopic techniques but also the training infrastructure, which we have never had at UC Davis before, we position our health center as one that is advancing the next generation of both fetal therapy and surgical innovation,” Saadai said.

First-ever in-utero stem cell therapy for fetal spina bifida repair is safe, study finds

Thu, 26 Feb 2026 08:00:00 GMT

A UC Davis Health research team has safely performed the world’s first spina bifida treatment combining fetal surgery with stem cells, according to results from Phase 1 of an ongoing clinical trial. These results have been published today in The Lancet.

Surgeons in the operating room

The study, called “Feasibility and Safety of Cellular Therapy for In-Utero Repair of Myelomeningocele (CuRe Trial): a First-In-Human, Phase 1, Single-Arm Study," tested whether adding a layer of human placenta-derived stem cells to standard fetal surgery could be done safely. Spina bifida, also known as myelomeningocele, occurs when spinal tissue fails to fuse properly during the early stages of pregnancy. The birth defect can lead to a range of lifelong cognitive, mobility, urinary and bowel disabilities.

“Putting stem cells into a growing fetus was a total unknown. We are excited to report great safety,” said Diana Farmer, the CuRe Trial’s principal investigator and chair of the UC Davis Department of Surgery. “It paves the way for new treatment options for children with birth defects. The future is exciting for cell and gene therapy before birth.”

The first phase of the trial was funded by a $9 million state grant from the state’s stem cell agency, the California Institute for Regenerative Medicine (CIRM).

About the treatment

During fetal surgery, a small opening is made in the uterus. The surgeons then float the fetus up to that incision point so they can expose the back of the fetus and the spina bifida defect. The care team places a small patch containing living stem cells directly over the fetus’s exposed spinal cord, before closing the layers of the back to allow the tissue to regenerate. The stem cells, taken from donated placentas, are designed to protect the developing spinal cord from further damage before birth.

It is the world’s first in-utero stem cell therapy for spina bifida, and the only trial aimed at improving the outcomes for the children over fetal surgery alone.

Key Phase 1 findings

The first six babies in the trial were monitored closely from surgery through birth. Researchers reported:

No safety concerns related to the stem cells.
There were no infections, spinal fluid leaks or abnormal tissue growth or tumors formed at the repair site.
All surgeries were successful, and the stem cell patch was placed as planned for every patient, and all the wounds were completely healed.
MRI scans showed reversal of hindbrain herniation in all infants, which is an indicator of surgical success.
No babies required a shunt for hydrocephalus before hospital discharge.

Because the early safety results were strong, the Food and Drug Administration and an independent monitoring board approved moving forward with the next phase of the study.

Tobi was part of the CuRe trial.

Why this matters

Spina bifida affects 1,500 to 2,000 children in the United States every year. While fetal surgery has greatly improved outcomes since it was introduced more than a decade ago, many children still struggle with mobility and have other long-term complications. The CuRe Trial is exploring whether stem cells can add regenerative power to surgery, potentially improving mobility and quality of life.

“This is a major step toward a new kind of fetal therapy, one that doesn’t just repair but potentially helps heal and protect the developing spinal cord,” said Aijun Wang, co-inventor of the placental-derived stem cell treatment technology and the study’s co-principal investigator with Farmer. He is co-director of the UC Davis Center for Surgical Bioengineering.

For CuRe Trial participant Michelle Johnson, the decision to participate in the trial was life changing.

"Our family couldn't feel more blessed and fortunate to participate in the CuRe Trial,” said Johnson, whose son Tobi was born in 2022. “Tobi's physical and mental abilities are nothing short of a miracle. We are forever grateful for the many health professionals who supported Tobi's journey and continue to watch him conquer the world.”

Next steps

The CuRe trial is now enrolling up to 35 patients in its Phase 1/2a study. Children will be followed through age 6 to evaluate long-term safety and early signs of improved movement, bladder and bowel function.

The Phase 1/2a study is funded by CIRM and Shriners Children’s.

UC Davis medical school among nation’s best in NIH funding

Wed, 25 Feb 2026 08:00:00 GMT

The UC Davis School of Medicine is among the nation’s leading medical schools in National Institutes of Health (NIH) research funding. In the latest ranking by Blue Ridge Institute for Medical Research, the medical school placed 31^st nationally, two spots higher than last year, and with a record total of $233 million in NIH grants.

Undergraduate student Iliya Voytsyshyn, left, has developed an app to help quantify the growth patterns of neuronal cells in brain organoid models.

“I couldn’t be prouder of our outstanding faculty researchers who, in a challenging funding environment, have gone above and beyond in submitting a record number of successful grant proposals," said School of Medicine Dean Susan Murin. "It is a testament to their commitment to science, to UC Davis and to our patients.”

Twelve departments in the Top 20

This year, 12 School of Medicine departments ranked in the top 20 nationally in their respective fields, two of which are in the top 10. They include:

Public Health Sciences #3
Neurology #6
Medical Microbiology and Immunology #11
Cell Biology and Human Anatomy #12
Physiology and Membrane Biology #12
Neurosurgery #14
Physical Medicine and Rehabilitation #15
Dermatology #15
Urologic Surgery #16
Biochemistry and Molecular Medicine #17
Emergency Medicine #17
Pharmacology #19

The top three departments in overall NIH funding were Neurology (nearly $38 million), Public Health Sciences ($30.8 million) and Internal Medicine ($26.3 million). All UC Davis basic science departments ranked in the top 20 nationally.

Professor Kit Lam is testing “smart” nanotechnology that could transform cancer treatment by delivering drugs directly into tumors while sparing healthy tissue.

Top NIH-funded principal investigators and centers

This fiscal year, 262 principal investigators (PIs) were awarded 383 NIH grants. The following is a list of the top 10 PIs for NIH funding.

For the third year in a row, professor Rachel Whitmer is the PI with the largest NIH funding at UC Davis and in public health sciences nationwide, with a total of about $13.4 million. She co-directs the Alzheimer’s Disease Research Center (ADRC), studies age-related dementia, cognitive impairment and brain pathology.

Charles DeCarli, co-director of the ADRC and a distinguished professor in the Department of Neurology, is the PI for $12.5 million in funding. The grant for his study on incidental white matter lesions on MRI amongst people with cognitive complaints (INDEED) is the highest NIH grant ($9.3 million) for UC Davis.

Dennis Hartigan-O’Connor, a professor in the Department of Medical Microbiology and Immunology, is the PI for $6.1 million in NIH support. He studies immunotherapies for chronic infections, autoimmunity and cancer.

Peter James’ $5.1 million NIH grant explores environmental exposures and brain health. James is an associate professor in the Department of Public Health Sciences and director of Center for Occupational and Environmental Health.

Cynthia Schumann is the PI on $3.2 million in NIH grants to study changes in primate brain development after prenatal immune challenge, and brain aging across the lifespan in neurodevelopmental disorders. Schumann is a professor of neuroscience and faculty affiliated with the UC Davis MIND Institute. She is the director of the Brain Endowment for Autism Research Sciences (BEARS) and Brain Endowment for Mental Health (BEMH).

Rebecca Schmidt, professor in the Department of Public Health Sciences and the MIND Institute, is the PI for grants totaling $3.1 million. She leads BUILDS MARBLES, a longitudinal study of pregnant women who have an autistic child, and prenatal environment and child health (PEACH) study in ECHO. She also studies the molecular and neurodevelopmental changes linked to prenatal wildfire exposures.

Four PIs manage grants that support leading UC Davis centers and programs:

KC Kent Lloyd ($5.7 million): UC Davis Mouse Biology Program
Ted Wun ($5.1 million): Clinical and Translational Science Center (CTSC)
Primo Lara ($4.4 million): UC Davis Comprehensive Cancer Center
Alice Tarantal ($4.3 million): Primate Center for Gene Therapy

Aggie Square, a first-of-its-kind innovation district on the UC Davis Sacramento campus, is home to many School of Medicine research labs.

“I’m delighted to see the School of Medicine continue its advance in the Blue Ridge rankings. I am particularly proud of the record number of our departments who are now in the top 20 for their respective disciplines,” said Kim E. Barrett, vice dean for research and distinguished professor of physiology and membrane biology. “This year also includes funding for a record number (32) of NIH K awards made to early career researchers. This validates our investments in programs designed to grow new PI’s from within our own ranks and helps to secure our future success.”

In May 2025, Aggie Square opened as a first-of-its-kind innovation district on the UC Davis Sacramento campus. The district brings together UC Davis researchers and students, industry partners, entrepreneurs and the community to work side-by-side to accelerate ideas and bring them into the world. It is home to many School of Medicine research labs.

Learn about some of the impactful federally-funded research that drives innovation from labs to lives.

‘I feel seen.’ One family shares their autism research experience

Tue, 24 Feb 2026 08:00:00 GMT

02/24/2026

‘I feel seen.’ One family shares their autism research experience

By Marianne Russ Sharp

‘From Labs to Lives’ series highlights human impacts of federally funded scientific research

(SACRAMENTO)

It’s not every day that someone brings a hand-sewn Big Bird costume to a research appointment at the UC Davis MIND Institute. But 11-year-old Benjamin Awalt really knows how to make an impression.

11-year-old Benjamin Awalt in his handmade Big Bird costume at a recent MIND Institute research visit.

Benjamin loves theater and creating costumes in his garage workshop. He is also autistic, diagnosed at age 3. Now, he’s taking on a new, important role: a participant in the Autism Phenome Project (APP). The federally funded research seeks to identify different subtypes of autism.

“The APP is about understanding the different developmental trajectories of autistic children,” said Christine Wu Nordahl, a professor in the Department of Psychiatry and Behavioral Sciences. “How do they change as they grow up? Are there subsets of children that follow distinct patterns of development? Our hope is to apply what we learn to help predict outcomes and support autistic individuals as they grow up.”

Because autism is a wide spectrum, Nordahl explained, there’s no single intervention or support that works for everyone. The APP team gathers blood samples, conducts behavioral assessments and tracks development from early childhood into early adulthood. They also obtain brain scans, which turned out to be a highlight of Benjamin’s visit.

“I saw my brain,” he said with a grin. “It was fun, honestly. I had to do something called an MRI.”

Benjamin Awalt works with a research team member at a recent MIND Institute visit.

Still, it wasn’t all easy. “I was experiencing something somewhat nervous for me,” Benjamin remembered. “I was a little scared of getting my blood taken.”

His courage paid off. Benjamin enjoyed talking with the researchers about his interests and activities and showing them his costume.

“I felt seen,” he said.

Taking part in research was also important to Benjamin’s mom, Brooke Myers-Awalt. “I think that knowledge is power, and I think that it’s really important that there is credible research being done and that it continues to be done, especially currently,” she said. “I think it’s super important to continue to learn more so we can support people with autism and people with other disabilities.”

Benjamin Awalt and Autism Phenome Project researchers pose for a photo outside the MIND Institute.

From Labs to Lives: The human impact of research

In 2025, UC Davis launched a campaign to increase public understanding of the impact of university-led research. From Labs to Lives spotlights the impact of research across fields, from medicine to agriculture, technology to the environment.

Long-running research studies like the APP highlight the value of building a strong scientific foundation to improve identification, intervention and more personalized care.

The APP began in 2006 and has been federally funded since 2011. “We have about 600 autistic children in the study and are actively following about 300 of them,” Nordahl said. “It is probably the largest cohort of children in the world who have been followed for this duration of time — from about 2 to 20 years of age — with these comprehensive assessments.”

It is a privilege to have families like Benjamin and Brooke open themselves up to research. I don’t take it for granted that they are willing to let us into their lives.” — Christine Wu Nordahl, professor, Department of Psychiatry and Behavioral Sciences

A path to more effective autism support

Over the years, the APP team has identified several different subtypes of autism. “One example of this is children who have what we call the big brain form of autism, or early brain enlargement,” Nordahl explained. “We are following them to identify their needs as they get older.”

Other examples include autistic children with GI symptoms and others who are more likely to experience anxiety.

“Anxiety is very common in autistic children, and we are looking at the precursors to anxiety,” Nordahl said. “At age 3, what does the brain look like? What are the behavioral predictors? Then, in future years, hopefully we can intervene early before it becomes a full-blown anxiety condition.”

Research participant Benjamin Awalt works with researcher Andrew Dakopolos during a recent visit to the UC Davis MIND Institute.

Making connections through research

Nordahl’s favorite part of her job as a scientist is working with families like Benjamin’s. “I learn so much from them. They guide my research and have taught me to focus on strengths as well as challenges. It is a privilege to have families like Benjamin and Brooke open themselves up to research. I don’t take it for granted that they are willing to let us into their lives.”

Benjamin and his family will be back at the MIND Institute in about four years for another research visit, but Benjamin wants to come back sooner.

“It was just a really fun experience,” he said.

A natural performer, he even offered to appear in videos and photos for the MIND Institute. He recently played Sebastian in his school’s production of “The Little Mermaid,” and of course, he helped to design the costume.

“I don’t think that I can say enough good things about the MIND Institute,” Myers-Awalt said. “I think that’s one of the few places where Benjamin can be 100% authentically himself and he is embraced and understood and just really is seen there. Everyone appreciates who he is and there’s no need to do any kind of masking or change who he is as a person because everyone there just gets him.”

The UC Davis MIND Institute in Sacramento, Calif. is a unique, interdisciplinary research, clinical, and education center committed to deepening scientific understanding of autism and other neurodevelopmental conditions. It is a highly collaborative center, bringing together families, researchers, clinicians, community leaders and volunteers with the common goal of developing more personalized, equitable, and scientifically proven systems of support and intervention. The institute has major research efforts in autism, fragile X syndrome, chromosome 22q11.2 deletion syndrome, attention-deficit/hyperactivity disorder (ADHD) and Down syndrome. More information about the institute and its Distinguished Lecturer Series, including previous presentations in this series, is available on the Web at https://health.ucdavis.edu/mind-institute/.

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Researchers develop new platform to define protein function in extracellular vesicles

Mon, 23 Feb 2026 08:00:00 GMT

UC Davis biomedical engineers are cracking the code of the body’s message system.

Professor of Biomedical Engineering Cheemeng Tan, left, works with Tanner Henson, center, and Professor of Biomedical Engineering and Surgery Aijun Wa

Extracellular vesicles, or EVs, are tiny biological bubbles that carry nucleic acids and proteins between cells, playing an essential role in tissue repair, neuroprotection and immune health. By isolating the surface proteins of these bubbles, researchers can understand more about their biology and build tools to transform extracellular vesicles into next-generation drugs for cancer, neurological conditions and other diseases. The findings are detailed in a paper published in ACS Nano.

“EV-mediated intercellular communication is a very powerful system that controls many physiological and pathophysiological phenomena,” said Aijun Wang, a corresponding author of the new study. Wang is Chancellor’s Fellow and professor of biomedical engineering and surgery. “We know that EVs are therapeutically useful. But how do we define what dictates their functions?”

Decoding the functions of EV surface proteins

Currently, EV surface proteins are like words lost in translation. They’re perceivable, they carry meaning, but what each one means and how it changes the significance of the sentence (or, EV) is unclear.

The UC Davis team’s Vesicle Engineering Systems using Synthetic Expression and Loading system, or VESSEL, will allow researchers to probe protein function and create something like a biological dictionary for EVs. It creates a particle with only one EV surface protein, enabling researchers to test its specific role in isolation.

VESSEL uses cell-free systems as the basis for producing synthetic EV surface proteins. This approach is notable for its ability to produce proteins rapidly and is widely used as a biological factory throughout academia and industry. It makes VESSEL an accessible and scalable platform for others to investigate EV surface proteins.

“The design of the system really makes it generalizable, meaning, if you have a cell-free system, then you can already go and make EV surface proteins,” said Cheemeng Tan, a corresponding author on the paper and a Chancellor’s Fellow and professor of biomedical engineering.

The UC Davis-developed VESSEL system will help researchers define the biological functions of extracellular vesicles, opening the door for next-generation medications. (Mario Rodriguez/UC Davis)

Therapeutic potential of EV surface proteins

In the paper, Tanner Henson, first-author on the paper and a biomedical engineering Ph.D. student co-mentored by Wang and Tan, used VESSEL to profile the protein distribution of EVs derived from mesenchymal stem cells, notable for their regenerative properties. One of the significant findings was that the CADM1 protein, previously unreferenced in medical literature, shows promise for ensuring vesicle intake by cells.

While more research is needed, findings like this point toward a future where biomedical engineers can create next-generation therapeutics with engineered EVs. By knowing which proteins serve which functions, researchers can build EVs for specific purposes like LEGO.

“VESSEL will enable us to understand EV-based therapeutics more deeply and much more tangibly than ever before,” Henson said. “Translation: that's a bigger picture. We're moving towards various translational applications of VESSEL, especially in treating neurological disorders.”

The research was supported by the National Institute of Neurological Disorders and Stroke, the National Institute of General Medical Sciences and the National Institute of Biomedical Imaging and Bioengineering.

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Read the full paper on ACS Nano: https://pubs.acs.org/doi/full/10.1021/acsnano.5c05047.

$2 million grant fuels UC Davis fight against pancreatic cancer

Thu, 19 Feb 2026 08:00:00 GMT

Pancreatic cancer research is getting a boost at UC Davis Comprehensive Cancer Center, thanks to a $2 million funding infusion.

Cancer cells vis - 3d rendered image

The Mark Foundation for Cancer Research announced the grant recently as part of the launch of a new coalition of leading organizations dedicated to solving early detection of some of the deadliest cancers. The focus includes pancreatic, ovarian and esophageal cancers — all of which have poor long-term survival rates.

Pancreatic cancer has been a research priority at UC Davis Health. Julie L. Sutcliffe, co-director for the UC Davis Center of Molecular and Genomic Imaging, and a professor of medicine and biomedical engineering, will lead one of six research teams for the coalition. Her team includes researchers Brian M. Wolpin and Andrew J. Aguirre at Dana-Farber Cancer Institute, and Laura D. Wood at Johns Hopkins University.

Pancreatic cancer researcher Julie Sutcliffe is co-director for the UC Davis Center of Molecular and Genomic Imaging.

Sutcliffe’s team is responsible for developing special imaging tools to help doctors find early changes in the pancreas — even before cancer fully forms. Using PET scans, they hope to detect tiny warning signs and early stages of pancreatic cancer so patients can get care sooner.

The research focuses on developing small, safe radioactive tags that light up cells to detect pre-cancerous cell changes called pancreatic intraepithelial neoplasia (PanIN). The research will look at microscopic changes in the cells that line the small tubes (ducts) of the pancreas. These cells can sometimes slowly develop into pancreatic ductal adenocarcinoma (PDAC), which starts in the cells that line the ducts of the pancreas. It is the most common type of pancreatic cancer.

“This grant gives us a powerful opportunity to move pancreatic cancer research forward,” said Sutcliffe. “PanIN lesions have not been visible with conventional imaging and the ability to non-invasively detect and monitor PanIN allows us the opportunity to intercept PDAC at its earliest stages. Ultimately, our goal is to bring new options and real hope to patients who urgently need better outcomes.”

Sutcliffe’s team and five others from across the nation are sharing $12 million in funding from the Mark Foundation for Cancer Research and its coalition partners: American Association for Cancer Research, Lustgarten Foundation, Break Through Cancer and The Honorable Tina Brozman Foundation (Tina’s Wish).

Each team is responsible for pursuing a research project aimed at overcoming the most pressing obstacles in early detection of cancer.

Sutcliffe is recognized internationally for her translational research efforts in the field of radiotheranostics. She leads several clinical trials at UC Davis using radiopharmaceuticals developed by her team to detect and treat cancer. She is a fellow of the Society of Nuclear Medicine and Molecular Imaging, a fellow and a past president of the World Molecular Imaging Society and a fellow of the American Institute of Medical and Biological Engineering.

Virtual reality exam checks eye health and screens for early signs of Alzheimer’s

Fri, 13 Feb 2026 08:00:00 GMT

02/13/2026

Virtual reality exam checks eye health and screens for early signs of Alzheimer’s

By Lisa Howard

UC Davis researchers are using virtual reality technology to make eye exams easier for seniors and to investigate its potential for spotting brain changes before symptoms appear

An audio-described version of this video is available here.

(SACRAMENTO)

In the recreation room at Eskaton Village in Carmichael, Bonnie Dale, one of the residents, is trying on a virtual reality (VR) headset.

Colorful exercise balls of different sizes line one wall, and behind Dale is a rack with equally colorful arm weights. Just outside the room, residents swim laps in the facility’s pool.

A trained operator helps Dale put the device on her head and then places a controller in her hand to help her navigate the device’s program. Dale practices pressing the trigger with her finger and then gets started.

The operator tracks her progress on a tablet.

Although it looks like Dale is playing a game, the VR platform is checking her eyesight.

Bonnie Dale, a UC Davis Health patient and resident at Eskaton Village, takes part in a virtual eye exam.

A virtual assistant, “Annie,” gives Dale instructions as she clicks her way through the program, which tests things like visual acuity, the ability to see different colors and shapes and how her pupils react to light.

The entire eye exam takes Dale about fifteen minutes. The results are displayed on the tablet and can be automatically transmitted to her ophthalmologist.

Dale, a retired health care consultant, is a patient and supporter of the UC Davis Eye Center.

“Being able to have the tests done, absent being at the Eye Center, but having the results go right to the doctor, is wonderful for the aging community. It’s a wonderful, wonderful gift,” Dale said.

Eyes can reveal brain changes

The eye testing at Eskaton Village is part of a pilot program designed by Yin Allison Liu. Liu is a neuro-ophthalmologist at the UC Davis Eye Center who also holds appointments in the departments of Neurology and Neurosurgery.

Liu wants to bring virtual eye exams to the community. She’s also trying to find out if a research program like hers could help identify neurological conditions, including Alzheimer’s disease, before people even experience symptoms.

“Recently, research has found that visual processing changes occur about 10 to 12 years before a formal diagnosis of Alzheimer’s disease,” Liu says. “Most people don’t realize this, but the eye is part of the central nervous system. We can see vision changes through different types of ophthalmic testing, which will reflect brain changes.”

Last year, Liu and her colleagues at the Eye Center published a review paper documenting changes in the eye, specifically the retina, the thin layer of cells at the back of the eye, observed in patients with mild cognitive impairment. The condition sometimes precedes Alzheimer’s disease.

Liu explains that the virtual reality platform, Olleyes, does not diagnose Alzheimer’s disease or any neurological conditions.

“But it helps us screen for vision conditions or visual changes that can indicate cognitive dysfunction and therefore provide information about the overall brain health,” Liu says. “This way, we have another angle at the diagnosis or even early detection of the disease.”

The ultimate goal is to make early detection accessible for everyone, so that their eye and brain conditions can be detected and addressed before major issues occur." — Yin Allison Liu, Associate Professor of Ophthalmology, Neurology, and Neurosurgery

Virtual reality eye exams may eventually screen for neurologic diseases

The device Dale used at Eskaton is one of two models from Olleyes, which was co-founded by neuro-ophthalmologist Alberto Gonzalez-Garcia.

The idea behind the virtual reality device is to make eye care more accessible and efficient using artificial intelligence and virtual reality technology.

Gonzalez-Garcia trained as a doctor in his native Cuba, specializing in neuro-ophthalmology.

In 2007, he studied glaucoma during a fellowship at UC San Diego. In 2018, he co-founded Olleyes, which is based in Summit, New Jersey.

The company collaborates with university researchers like Liu, who use the virtual reality eye device in their research.

Some studies have looked at using the device for eye exams in emergency departments and free health clinics. Others have used it to make pediatric eye exams more like a fun video game.

Liu is among the first researchers to use the VR platform to look for changes in vision and responses to commands that might indicate neurological conditions like Alzheimer’s disease.

Olleyes helped customize the program for Liu’s pilot study, allowing her to note issues like hearing problems alongside visual decline, or if participants struggled to follow the virtual assistant’s simple instructions, all of which could be linked to cognitive changes.

Gonzalez-Garcia hopes to one day integrate a cognitive testing module into the device, but most of the tests validated through years of study, such as the Montreal Cognitive Assessment (MoCA), are proprietary.

Neuro-ophthalmologist Yin Allison Liu, left, reviews the results of Bonnie Dale’s virtual eye exam.

Cognitive tests are often done with a piece of paper or sometimes a tablet. MoCA asks test participants to name various animals (lion, rhinoceros, camel), draw a clock, and recall a list of words given early in the assessment. A trained health care professional administers the test.

But Gonzalez-Garcia notes that a virtual test may eventually be preferred. All the functions that require a pencil can be done with a controller. “Another significant advantage is that the instructions would be delivered in a standardized way by an AI virtual assistant, ensuring a consistent evaluation experience for all test takers,” Gonzalez-Garcia said.

The need for Alzheimer’s testing is expected to rise significantly.

An estimated 6.7 million older adults have Alzheimer's disease in the United States. By 2060, that number is expected to nearly double, to 14 million.

Liu’s goal with her pilot program is to find scalable ways to increase the chance for early detection of cognitive diseases. By bringing the program to a senior community at an assisted living facility, where residents may find it harder to attend an in-person eye exam, she hopes to make detecting vision changes and cognition-related visual dysfunction even easier.

“Early diagnosis or early detection will give us the power to make lifestyle modifications or open the doors to clinical trials or new treatments,” Liu said. “The ultimate goal is to make early detection accessible for everyone, so that their eye and brain conditions can be detected and addressed before major issues occur.”

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Lisa Howard

Scientists test “smart” nanotech to target cancer tumors with more precision

Fri, 13 Feb 2026 08:00:00 GMT

UC Davis Comprehensive Cancer Center scientists are testing “smart” nanotechnology that could transform cancer treatment by delivering drugs directly into tumors while sparing healthy tissue. The research is being conducted at the cancer center’s new Experimental Therapeutics Laboratory.

AI biotechnology concept 3d render

The lab team has designed transformable nanoparticles (ultrafine particles) that travel through the body as tiny particles and then reshape into nanofiber networks when reaching the cancer sites. These fibers cling to tumors but naturally fade away much more quickly in healthy organs, creating a built‑in targeting system.

UC Davis Distinguished Professor Kit S. Lam in his lab.

The work is being led by Distinguished Professor Kit S. Lam with the UC Davis Health Department of Biochemistry and Molecular Medicine and the Division of Hematology and Oncology. The research recently received a boost from a prestigious $3.1 million National Institutes of Health (NIH) R01 research project grant. R01 federal grants are given through the NIH’s National Cancer Institute to mature research projects that have strong preliminary data.

“This NIH (NCI) grant opens the door to accelerating this whole new way of treating cancer,” said Lam. “Instead of flooding the entire body with medicine, we can now ‘park’ these nanoparticles at the tumor sites and activate treatment only when we choose to.”

Once the nanoparticles form a web of tiny fibers around a tumor, researchers can deliver therapeutic molecules using a highly specific “click chemistry” reaction. This refers to chemical reactions that are fast, efficient and reliable.

This second step allows clinicians to add medicines on demand — including small-molecule drugs, toxins, and immune‑boosting molecules or proteins — that can augment the anti-tumor effects of the immune system.

The nanoparticles can stay in the tumor areas for up to a week, Lam said, but they fade from healthy organs like the liver and lungs within just two days.

“That gives us a unique advantage,” Lam said. “We can use this long‑lasting presence in tumors to introduce cancer‑fighting treatments only when and where we want them.”

Phased-in approach to pursuing drug development

The UC Davis team refers to this as a two‑component, two‑step strategy:

Step one: The nanoparticles locate the tumor and transform into a long‑lasting molecular framework.
Step two: Doctors administer therapeutic agents that lock onto the drug delivery system and begin working within the tumor microenvironment.

Main goals

The project includes three major goals:

Design and refine nanoparticles that target receptors found in cancers such as non‑small cell lung cancer.
Use advanced imaging to understand how the nanoparticles behave in living systems.
Test the safety and effectiveness of this approach in preclinical cancer models.

If successful, the technology could dramatically change how oncologists deliver effective treatments, reducing side effects and increasing precision.

“This platform gives us the flexibility to deliver multiple treatments in sequence or combination for whatever the patient needs at that moment,” Lam said. “Our goal is to create a robust, long‑lasting immune response that helps the body fight the cancer on its own.”

Exposure to intense wildfire smoke during pregnancy may be linked to increased likelihood of autism

Thu, 12 Feb 2026 08:00:00 GMT

New research suggests that exposure to intense wildfire smoke during pregnancy may be associated with increased likelihood of autism in children. The study, by researchers at UC Davis Health and UCLA, was published in the journal Environment International.

Smoky air over Los Angeles from a wildfire

The study of more than 8.6 million births in California is the largest to date examining how wildfire-specific air pollution may impact early neurodevelopment. Scientists combined detailed wildfire smoke data with state birth records from 2001 to 2019. They matched these with autism diagnoses from California Department of Developmental Services through 2022.

The researchers considered the timing and intensity of wildfire smoke exposure, as well as the type of background air pollution that families usually experienced. They focused on wildfire-related PM 2.5, or tiny particles of smoke about 30 times smaller than the diameter of human hair.

High‑intensity wildfire smoke events show strongest associations

Overall, average wildfire smoke levels during pregnancy showed only weak associations with autism diagnosis. But during high‑intensity smoke events — days with particulate levels in the top 10 percent — the associations grew stronger. In regions with generally cleaner air, such as rural areas, it was most pronounced.

“The most intense wildfire smoke exposure is where we see the clearest links,” said UC Davis Health’s Rebecca J. Schmidt, senior author and professor in the Department of Public Health Sciences and the UC Davis MIND Institute. “And these intense wildfire events are becoming more common in the West.”

The researchers estimated wildfire smoke exposure for three months before, during and for one year after pregnancy. They used advanced models of particulate matter that included sources like wildfire maps, air monitors and satellites and adjusted for wind currents and geography.

They separated particulate matter from vegetation burning and from wildland urban interface sources such as homes, vehicles and other materials.

“These models help us understand not just how much smoke was in the air, but where it came from,” said Schmidt, who is also affiliated with the UC Davis Environmental Health Sciences Center.

Among the key findings:

Pregnancies in the top 10 percent of wildfire smoke exposure had a 6% higher likelihood of autism after adjusting for other kinds of air pollution.
In areas with cleaner air, known as low background pollution, the link was much stronger. In these areas, pregnancies in the top 10 percent of wildfire smoke exposure had a 50% higher likelihood of autism.
Very smoky days mattered. When wildfire smoke particles reached 35 micrograms per cubic meter or higher, a level considered very smoky, autism likelihood increased. Lower‑level smoky days did not show the same pattern.
The strongest links were seen in non‑metropolitan areas, where there is generally less pollution from traffic and industry and smoke spikes stand out more.
Smoke from wildland‑urban interface fires — where homes and buildings burn — was linked to higher autism likelihood even in large cities, possibly because these fires release more toxic particles.

UC Davis scientists David Brandman and Sergey Stavisky named to 2026 TIME100 Health List

Wed, 11 Feb 2026 08:00:00 GMT

TIME has named neurosurgeon David Brandman and neuroscientist Sergey Stavisky to the 2026 TIME100 Health List of the World’s Most Influential Leaders in Health. The designation recognizes their outstanding work on developing a brain-computer interface (BCI) that helped an individual with ALS 'speak' again. They developed and tested the BCI as part of the BrainGate2 clinical trial.

Stavisky and Brandman stand together smiling for the camera

The TIME100 Health list spotlights the 100 most influential leaders in health this year. These leaders have pushed new ideas ahead to build healthier populations around the world.

Brandman and Stavisky share more than this very prestigious recognition. They both joined UC Davis in October 2021 as assistant professors in the Department of Neurological Surgery. Together, they established and co-direct the UC Davis Neuroprosthetics Lab that develops BCI to restore speech and communication to people with paralysis.

“Being named to the Time100 Health List is a reflection of the extraordinary leadership of Dr. Brandman and Dr. Stavisky and their groundbreaking research program,” said Kia Shahlaie, chair of the UC Davis Department of Neurological Surgery. “They are internationally recognized innovators. Their vision and rigor have helped build a remarkable multidisciplinary team focused on restoring communication for people living with severe neurologic disease.”

David J. Segal appointed chair of Department of Biochemistry and Molecular Medicine

Wed, 04 Feb 2026 08:00:00 GMT

02/04/2026

David J. Segal appointed chair of Department of Biochemistry and Molecular Medicine

By Lisa Howard

Researcher is known for advances in gene-editing technologies used for research and therapeutic applications for rare diseases

(SACRAMENTO)

The UC Davis School of Medicine is pleased to announce the appointment of David J. Segal as chair of the Department of Biochemistry and Molecular Medicine. Segal holds appointments in the departments of Biochemistry and Molecular Medicine, Pharmacology, the UC Davis Genome Center and the UC Davis MIND Institute.

“Dr. Segal is a nationally recognized leader in genome engineering and molecular therapeutics," said Susan Murin, dean of the UC Davis School of Medicine. "He brings more than two decades of groundbreaking research, visionary program development and a deep commitment to training the next generation of scientists to his role as chair.”

Segal joined the UC Davis faculty in 2005. His work has produced foundational advances in gene-editing technologies, including ZFNs (Zinc Finger Nucleases), TALENs (Transcription Activator-Like Effector Nucleases) and CRISPR/Cas9-based platforms.

David J. Segal has been appointed chair of the Department of Biochemistry and Molecular Medicine.

Redefining what’s possible in ‘incurable’ diseases

Segal’s work is reshaping what is possible in treating neurological and genetic disorders once deemed “incurable.” He and his colleagues are developing targeted molecular tools capable of reactivating silenced genes, correcting gene dosage defects and repairing transcriptional dysfunction.

Rare genetic disorders targeted by his lab include Angelman syndrome, SYNGAP1 deficiency, ADNP syndrome, neurofibromatosis type 1, and other neurodevelopmental and neurodegenerative diseases.

“Although rare diseases are individually rare, collectively, they affect more people than cancer and AIDS combined,” Segal said. “But most have no treatments.” He notes that for him, finding cures for rare diseases is more than a scientific story.

“Working closely with the Angelman Syndrome community has allowed me to see the human side of the disease, including the tremendous need, the hopes of families and the responsibility of researchers to create therapies that can be accessible to those who need them,” Segal said. “These experiences have inspired my thinking about what we can accomplish together at UC Davis. I am excited to serve such a vibrant department in this new role.”

Dean Murin expressed gratitude to the interim chair. “We are grateful to Dr. Luis Fernando Santana for his outstanding leadership and guidance of the department as interim chair since 2021,” Murin said.

Segal has authored or co-authored more than 120 papers in peer-reviewed journals and holds 25 patents. He has received numerous prestigious grants from the National Institutes of Health (NIH), the California Institute for Regenerative Medicine (CIRM), as well as awards from foundations and nonprofits.

In addition to his appointments at the UC Davis School of Medicine, Segal is an investigator in the NIH Somatic Cell Genome Editing Consortium and field chief editor of Frontiers in Genome Editing.

Segal received a B.S. in biology with honors from Cornell University, followed by a Ph.D. in biochemistry from the University of Utah. He completed a postdoctoral fellowship in molecular biology at the Scripps Research Institute in La Jolla, Calif.

Segal served as an assistant professor in the Department of Pharmacology & Toxicology at the University of Arizona, Tucson, before joining the UC Davis faculty. He has had several leadership positions in his more than 20 years at the School of Medicine, including co-chair of the Integrative Genetics and Genomics graduate program and associate director of the UC Davis Genome Center.

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Clinical trial offers first-of-its-kind heart failure treatment

Mon, 02 Feb 2026 08:00:00 GMT

Heart failure occurs when the heart muscle cannot pump enough blood to meet the body’s needs. About 6.7 million adults in the United States are affected, and about one‑third of adults are at risk of developing it.

A medical team stands together in a procedure room holding an “ALLAY‑HF Clinical Trial” banner.

Treatment for heart failure relies on medications to improve heart function and relieve symptoms, but many patients continue to struggle with shortness of breath, difficulty doing routine activities and even frequent hospitalizations.

Researchers in cardiovascular medicine at UC Davis Health want to change this. They are hosting a clinical trial, that offers patients a minimally invasive procedure that could reduce extra pressure in the heart and address the source of many of their symptoms.

“Historically, heart failure care has relied mostly on medications and treating root causes, leaving patients with stable heart failure with limited interventional choices,” explained Tai Pham, assistant clinical professor of interventional and structural cardiology and co-investigator of the study. “This clinical trial is especially exciting because it introduces a new therapeutic approach for a group that has had few options.”

Trees — not grass and other greenery — associated with lower heart disease risk in cities

Wed, 21 Jan 2026 08:00:00 GMT

A multi-institutional study led by the University of California, Davis, finds that living in urban areas with a higher percentage of visible trees is associated with a 4% decrease in cardiovascular disease. By comparison, living in urban areas with a higher percentage of grass was associated with a 6% increase in cardiovascular disease. Likewise, a higher rate of other types of green space, like bushes or shrubs, was associated with a 3% increase in cardiovascular disease.

Two images: One shows mature trees along a street and the second shows a wide green lawn in front of high-rise buildings.

The new research was published in Environmental Epidemiology.

“Our findings suggest public health interventions should prioritize the preservation and planting of tree canopies in neighborhoods,” said Peter James, first author of the study. James is an associate professor in the UC Davis Department of Public Health Sciences and director of the Center for Occupational and Environmental Health.

“Urban forestry initiatives and policies that protect mature trees are likely to yield greater cardiovascular health benefits compared to investments in grass planting,” James said.

In 2023, more than 900,000 people died from cardiovascular disease in the U.S. That's the equivalent of 1 in every three deaths, according to the Centers for Disease Control and Prevention.

Cardiovascular diseases are serious conditions that affect the heart and blood vessels. This includes problems with the heart — such as arrhythmia, heart valve disease and heart failure — and problems with blood vessels, like blood clots (including stroke) and peripheral artery disease.

More than 350 million street view images were analyzed to estimate the amount of trees, grass, or other green space.

Study uses machine learning and street-level images

Previous research using satellite imagery has shown that urban green spaces can be beneficial to public health. But satellite imagery can classify a wide range of vegetation as green space.

“Satellite imagery has allowed for important new understandings about how the landscape — built and natural — can influence human health. But because the view is from far, far above, and lumps all types of vegetation into one category, it can mask differences that may be significant,” James explained.

James is a prominent researcher known for innovative use of street-level imagery and satellite imagery in environmental health research. Street-level imagery, most commonly derived from platforms such as Google Street View, captures neighborhood environments photographed from the vantage point of what a pedestrian would see and has been increasingly used in public health research.

The new study was among the first to create a street-level assessment of how trees, grasses and other green spaces could impact cardiovascular health.

The researchers used deep learning to analyze more than 350 million street view images to estimate how much of each neighborhood was covered by trees, grass, or other green space.

They then linked those findings to nearly 89,000 women in the ongoing Nurses’ Health Study. They determined the type and percentage of greenery — trees, grass or other green space — within about 500 meters of each participant's home address.

They then compared the types and percentages of greenery with 18 years of health data — including medical records and death certificates — to determine which study participants developed cardiovascular disease.

Pioneering fracture repair research wins gold in Switzerland

Fri, 16 Jan 2026 08:00:00 GMT

01/16/2026

Pioneering fracture repair research wins gold in Switzerland

By Sonia Kumar

Traumatologist Augustine Saiz was honored at AO Trauma Research Olympiad

(SACRAMENTO)

Augustine Saiz, a traumatologist at UC Davis Health, was recently awarded the Gold Medal for outstanding research at the third annual AO Trauma Research Olympiad in Davos, Switzerland.

Augustine Saiz with his Gold Medal for outstanding research.

Long before traveling to the Swiss Alps, the foundation for this victory was built in the lab. A recipient of the prestigious K08 award from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Saiz is dedicated to solving the biological puzzles of fracture repair.

His lab is currently leading critical studies on how polytrauma — severe injuries to multiple body parts — creates systemic effects that alter fracture repair. They are also investigating the localized impact of muscle injury on bone regeneration.

The winning research

Saiz secured the top honor for his presentation titled: "Hydrogel Co-Delivery of Mesenchymal Stem Cells and Disordered Peptides Attenuates the Early Local Inflammatory Response and Improves Fracture Healing in Polytrauma."

The research team explored whether a new type of gel could help the body heal broken bones after severe injuries. The gel contains hyaluronic acid, a natural material already used in some medical treatments, along with mesenchymal stem cells and a lab‑designed protein called P2.

P2 was engineered to act like osteocalcin, a protein the body uses to build and maintain healthy bone. In a murine model of multiple traumas, the combination of P2 and stem cells helped reduce the intense inflammation that often follows major injuries and slows bone healing.

The study found that P2 sends steady, bone‑building signals at the fracture site, while the stem cells help calm inflammation. Used together, they sped up bone repair, produced more consistent healing and supported the growth of stronger, healthier bone. This work was recently published in The Journal of Tissue Engineering.

Building a global network

The AO Trauma Research Olympiad is a premier global event designed to connect the next generation of thought leaders. Saiz was one of only 10 early-career surgeons selected worldwide to present their work to a panel of distinguished experts.

Beyond the podium, the event served as a forum for building an international network. As a finalist, he gained exclusive access to the AO Research Institute and the AO Innovation Technology Center. He spent time connecting with fellow researchers, discussing future fellowship opportunities, and attending the renowned AO Davos Courses alongside more than 300 faculty members and 1,000 participants.

Augustine has earned this recognition through incredible focus and determination. His ability to produce high-impact basic science research while maintaining an active trauma surgery practice is genuinely rare." — Mark Lee, chief of Trauma Service

A win for the department

The AO Trauma Research Olympiad Gold Medal is the most prestigious research award through the AO. The win highlights Saiz's talent and reflects the high caliber of research being conducted within UC Davis Health Orthopaedic Surgery.

"Augustine has earned this recognition through incredible focus and determination. His ability to produce high-impact basic science research while maintaining an active trauma surgery practice is genuinely rare. His translational approach ensures that his laboratory discoveries will someday benefit patients, and I expect he will continue making significant contributions to the field for years to come,” said Chief of Service Mark Lee.

Saiz is actively involved in AO Trauma North America and was selected for the esteemed AO John Border Memorial Fellowship in 2021 and studied with Christoph Sommer in Chur, where modern fracture surgery was developed.

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Kitten’s brain surgery at UC Davis could transform care for human patients

Wed, 07 Jan 2026 08:00:00 GMT

01/07/2026

Kitten’s brain surgery at UC Davis could transform care for human patients

By Pamela Wu

A novel procedure to save a kitten highlights UC Davis’ unique partnership between human and animal health experts

(SACRAMENTO)

UC Davis’ unique integration of human and animal health expertise has given a fluffy, friendly kitten a chance at survival — and opened the door to ideas that could someday help human patients.

Hydrocephalus: a life-threatening diagnosis

When Erin Cooper noticed her Maine Coon kitten Viggo had an oversized head, she never imagined it meant something serious. But an MRI revealed feline hydrocephalus: a buildup of fluid inside the brain that is often fatal.

“These kittens, they don’t feel well,” said Karen Vernau, veterinary neurologist at UC Davis. “They may circle, they can’t stand, and when it really gets terrible, their brain can herniate, and they pass away.”

Treatment options are rare and often fail. Most kittens with hydrocephalus are euthanized within months.

A new approach inspired by human neurosurgery

Enter Cameron Sadegh, pediatric neurosurgeon at UC Davis Children’s Hospital. He treats the same condition in babies.

Pediatric neurosurgeon Cameron Sadegh leads a research team that designs cellular and genetic therapies to treat hydrocephalus.

“We’ve been using a technique for human hydrocephalus that, although effective, hasn’t changed in about 70 years,” Sadegh said. “I think we can do better.”

Standard treatment for hydrocephalus uses a ventriculoperitoneal (VP) shunt to drain fluid from the brain to the abdomen. For tiny babies, surgeons use a ventriculosubgaleal (VSGS) shunt to divert fluid under the scalp. Another option, endoscopic third ventriculostomy (ETV), creates a natural drainage pathway without shunts, but often fails in the smallest patients.

Sadegh came up with a novel idea: combine ETV with VSGS. The VSGS would serve as a bridge while the young brain grows and adjusts. Once the brain matures, the drainage from the ETV should keep working on its own.

When Sadegh learned about Viggo's case, he saw a rare chance to work with his counterparts in veterinary medicine to save a cherished pet — and shape future treatment for humans.

We’ve been using a technique for human hydrocephalus that, although effective, hasn’t changed in about 70 years. I think we can do better.” — Cameron Sadegh, Pediatric Neurosurgeon

First-of-its-kind surgery

On surgery day last May, Sadegh joined veterinary neurosurgeons Ji-Hey Lim and Adrien Dupanloup at UC Davis Veterinary Teaching Hospital. With an endoscope, a tiny camera just one millimeter wide, they navigated Viggo’s brain to create a precise opening in the third ventricle. A small tube called a catheter then allowed fluid to disperse under the scalp.

“It was amazing,” Sadegh recalled. “We were looking at the fluid spaces in this sort of magical, underwater-type voyage. Then that moment when we got in for the first time and could see this big artery down in the brain stem pulsating right in front of us.”

The delicate procedure succeeded.

The life-saving surgery performed on Viggo, a Maine Coon kitten, is helping to inform pediatric neurosurgery research at UC Davis Children’s Hospital.

Hope for future patients

Months later, Viggo returned for an MRI. The images showed what Sadegh hoped to see: less fluid, thicker brain tissue and a catheter still in place.

Recovery wasn’t instant. Viggo needed to relearn some kitten behaviors. But six months later, owner Erin Cooper says he’s thriving: “He’s playing, grooming, eating. I feel like we have Viggo at 95 percent back.”

To Vernau, the outcome is remarkable. “This brings hope for kittens where we had no hope before,” she said.

For Sadegh and his research team in the Brain Fluids Lab, Viggo’s surgery offers a glimpse of what might be possible for human babies. “My hope is that we’ll get to try this several more times and see the longer-term outcomes,” he said. “Then — eventually — confidently provide that as a new option to some human patients.”

Another kitten has already had the same procedure, adding valuable knowledge for future research.

Cooper feels awed that Viggo’s surgery could someday transform care for the smallest and most vulnerable humans. “Him being a part of helping not only other animals, but humans and babies — it’s amazing.”

The novel procedure pediatric and veterinary neurosurgeons performed on Viggo could shape future treatment for humans.

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When (and why) doctors might ask patients about guns

Wed, 07 Jan 2026 08:00:00 GMT

To assess a patient’s overall well-being and potential health risks, clinicians routinely ask questions on a wide range of topics, such as car seats, mental health, diet, sexual activity, alcohol, exercise and smoking.

Doctor talks with patient and takes notes

Physicians and researchers at the University of California, Davis, want providers to consider a new item for their list: firearms.

In a new paper published in the New England Journal of Medicine Evidence, the authors make a case for why discussions about firearms are appropriate in the exam room for patients who may be at risk of harm.

Their suggestion is supported by statistics.

In 2022, there were 48,204 firearm deaths in the United States.

More than half of those — 56% — were suicides, and 41% were homicides. Additionally, every year, an estimated 85,000 people sustain firearm injuries, which can leave survivors with long-lasting harm.

“Clinicians routinely ask about safety concerns, but most feel unprepared to talk about firearms,” said Amy Barnhorst, first author of the study and a psychiatrist at UC Davis Health. “And it can be a difficult topic because it’s often politically charged.”

Barnhorst is a professor of psychiatry and the director of the BulletPoints Project, which is funded by the state of California. The initiative trains health providers to identify patients at risk of firearm injury and help them reduce that risk.

“Patients view their health care provider as a trusted source of information. That trust needs to be maintained. Our framework gives clinicians practical tools to identify risk and engage patients in harm-reduction strategies without judgment or politics,” Barnhorst said.

A growing need as gun ownership and beliefs change in the U.S.

Firearm ownership is increasing in the U.S. Almost one third (32%) of adults own firearms, and an additional 10% live in households with firearms.

Between January 2019 and April 2021, about 7.5 million people became new firearm owners, three times the expected number based on prior trends.

The belief that firearms make a home safer has also increased. In 2000, 35% of the general public thought having a firearm made a home safer, which rose to 63% in 2014.

The percentage of firearm owners who thought guns made the home safer rose from 75% in 2017 to 81% in 2023.

Researchers point out that although firearms in the home may offer a sense of protection, they also pose risks.

People with firearm access have more than triple the risk of suicide and double the risk of being a homicide victim than those without firearm access.

A large-scale study in California found that handgun owners had firearm suicide rates that were almost eight times higher for men and 35 times higher for women than nonowners.

New trial at UC Davis Health shows promising results for rare liver disease

Tue, 23 Dec 2025 08:00:00 GMT

12/23/2025

New trial at UC Davis Health shows promising results for rare liver disease

By Liam Connolly

Monoclonal antibody could provide relief for patients with primary sclerosing cholangitis

(SACRAMENTO)

A multicenter study led by UC Davis Health tested a new treatment designed to improve care for people with a rare liver disease called primary sclerosing cholangitis. Researchers learned that an anti-inflammatory and anti-fibrotic monoclonal antibody known as nebokitug was safe and showed potential efficacy in patients with PSC.

Published in the American Journal of Gastroenterology, these results offer encouraging news for patients with PSC, for which there are currently no effective treatments short of liver transplantation. The trial also lays the groundwork for a pivotal phase 3 study to further evaluate the drug’s effectiveness, which could lead to U.S. Food and Drug Administration (FDA) approval.

“In the trial, nebokitug demonstrated that it has the potential to change the lives of patients with PSC by reducing fibrosis and inflammation, which should lead to improved outcomes,” said Christopher Bowlus, chief of Gastroenterology and Hepatology at UC Davis Health and one of the lead authors of the publication. “These results are good news for patients with PSC, who are in desperate need of an effective, FDA-approved therapy.”

“These results are good news for patients with PSC, who are in desperate need of an effective, FDA-approved therapy.” — Christopher Bowlus

What is primary sclerosing cholangitis?

PSC is a rare, chronic liver disease that causes inflammation and scarring of the bile ducts. These ducts carry bile from the liver to the small intestine to help digest fats. When they become damaged and narrow, bile builds up in the liver, leading to liver injury over time.

The exact cause of PSC is not fully understood, but most patients also have inflammatory bowel disease, suggesting a direct link between intestinal inflammation and the liver. Symptoms can include fatigue, itching and jaundice, though some people have no symptoms at first. There is no cure, and treatment focuses on managing symptoms and complications. In advanced cases, a liver transplant may be needed.

How does the new treatment work?

Nebokitug is a lab-made antibody designed to block a protein called CCL24. This protein plays a role in inflammation and scarring by interacting with certain inflammatory cells in the liver.

In PSC, CCL24 levels are higher than normal and are found around the bile ducts, where they contribute to liver damage. Studies have shown that blocking CCL24 can reduce these harmful processes. In experimental models of PSC, this approach has demonstrated potential benefits, suggesting that this treatment may help slow disease progression by targeting both inflammation and fibrosis.

For the Phase 2 SPRING trial, PSC patients were randomly assigned to receive nebokitug at two different doses or a placebo through an IV every three weeks for 15 weeks. The main goal was to check safety. Researchers also measured liver health using blood tests, imaging and markers linked to liver scarring. Patients who completed the first part could continue nebokitug for up to 48 weeks. The study enrolled 76 patients across five countries and most eligible participants joined the extension.

Results showed nebokitug was safe and well tolerated. Patients, especially those with more advanced liver scarring, had improvements in key measures like liver stiffness and fibrosis markers compared to placebo.

“These results suggest this treatment may help slow PSC progression by reducing inflammation and scarring, though more research is needed to confirm its long-term benefits,” added Bowlus.

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New endowed professorship will expand impact of light-based technologies in health care

Mon, 22 Dec 2025 08:00:00 GMT

Laura Marcu, professor in the Departments of Neurological Surgery and Biomedical Engineering, has been appointed to the Endowed Professorship of Neurosurgical Research. This distinguished appointment is made possible by an anonymous donation. It provides funds for scientific discovery and development that have the potential to improve the lives of patients with neurological injury or disease.

Professor Laura Marcu sitting in a lab

“I am deeply grateful for this endowment. It will enable transformative research, accelerate clinical translation and expand the impact of emerging light-based or biophonic technologies in patient care,” Marcu said.

Pioneer in biophotonic technologies

Marcu is the founding director of the National Center for Interventional Biophotonic Technologies (NCIBT) at UC Davis. The center is funded in part by the National Institutes of Health.

At NCIBT, Marcu is building on her pioneering work in medical applications of light-based technologies, particularly Fluorescence Lifetime Imaging (FLIm). FLIm is a pen-like device that surgeons can use to scan and highlight unhealthy tissue in real time to treat cancer and heart disease.

First developed in an engineering lab by Marcu and her team, FLIm is one of the most advanced clinical fluorescence lifetime imaging systems in the world. It’s currently being used at UC Davis Health — with great accuracy and success — to collect data and prove its value for widespread use.

Endowed Professor of Neurosurgical Research Laura Marcu with members of her lab.

Expanding NCIBT’s impact

The endowment was made possible through a generous $1.5 million anonymous gift.

“Philanthropy is very important because it provides the flexibility needed to accelerate the translation of technologies such as FLIm from discovery at the bench top to clinical applications, and ultimately to the broader population,” Marcu explained. “Through this endowment, I am hoping to better emphasize the role that the NCIBT can play, not just institutionally, but nationwide, and expand its visibility and impact.”

The NCIBT — the first center of its kind at UC Davis — is critical to the dissemination and future commercialization of a range of optical spectroscopy and imaging technologies. It’s also critical for training the next generation of scientists. The endowment ensures that this work will continue to advance innovation and education for years to come.

Endowed chairs and professorships are among the university’s highest faculty honors and are created through donor support. Their invested funds generate enduring resources that empower professors to advance research, mentor students and drive innovation that benefits society.

Targeted approach for cancer and heart disease

Marcu’s lab is advancing the use of FLIm across several medical specialties, with the goal of giving clinicians clearer, real-time insight into tissue health. Their work currently focuses on surgical oncology, cardiovascular diagnostics and regenerative medicine.

FLIm technology integrated into transoral robotic surgical system to detect cancerous tissues.

While operating on a tumor, FLIm allows surgeons to detect abnormalities in tissue. Because tumor cells have different optical properties than healthy tissue, their fluorescence changes under the device’s light — helping surgeons more accurately identify cancerous areas. FLIm has already been tested and validated in brain cancer and in head and neck cancer surgeries.

For the prevention and care of cardiovascular disease and stroke, FLIm can identify signs of damage to blood vessels, such as plaque buildup in coronary arteries.

“We are developing intravascular catheter systems that better characterize the plaques that are more likely to rupture and lead to critical events such as the heart attacks,” Marcu said.

This can assist with better therapies, understanding the history of these plaques and what treatment may be more appropriate for a particular patient.

“Cardiovascular disease and cancer are the leading causes of death in the United States,” Marcu said. “These are just a few examples of how this technology can be used to address major societal health problems.”

Bridging the gap from bench to bedside

Working at the intersection of engineering and medicine has always been at the core of Marcu’s work.

“There can be a language barrier between engineers and clinicians who have different ways of thinking and doing things,” said Marcu. “Working in a clinical environment taught me how to communicate with physicians and surgeons, and that helped me bridge between scientific and medical communities.”

Professor Laura Marcu with Julien Bec, engineering director at the Marcu Laboratory.

Marcu’s research in FLIm and other imaging systems demonstrates this interdisciplinary expertise and the importance of developing tools that translate from the research lab to patient care.

“I have always enjoyed connecting ideas across disciplines and interacting with people who have come from different domains and perspectives,” Marcu said. “This is what stimulates creativity and technological innovation with impact on patient care.”

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Genetic testing saves lives — many don’t know they carry an inherited cancer risk.

Mon, 15 Dec 2025 08:00:00 GMT

Researchers with UC Davis Health have launched a study they hope will help improve health outcomes of Latinas who may be genetically predisposed to breast cancer.

A woman in a white sweater sits on a couch, leaning toward a medical professional holding a clipboard.

The study aims to recruit Latina breast cancer survivors age 20 to 79 to explore their awareness and understanding of genetic testing for cancer predisposition. Specifically, the researchers want to understand what makes it hard or easy for them to access genetic counseling and testing.

Researchers hope to reach at least 300 Latina women breast cancer survivors through an in-person or telephone survey. They expect to follow up with a smaller group of participants in person, via video, or by phone, with more detailed questions.

The survey and follow-up interviews are scheduled to be completed by the end of next year, with results expected in 2027.

The study is called Entendiéndonos — the Spanish word for “understanding each other.”

Breast cancer rates among Latinas are lower overall than in non-Hispanic white women, but Latinas are often diagnosed at later stages. Latinas are nearly a third more likely to die from the disease. In addition, mammography screening rates for Latinas are much lower than for non-Latinas.

Latinas and their family members are also less likely to seek genetic testing for breast cancer than non-Hispanic white women.

Wendy Marie Campana appointed chair of Department of Cell Biology and Human Anatomy

Wed, 10 Dec 2025 08:00:00 GMT

12/10/2025

Wendy Marie Campana appointed chair of Department of Cell Biology and Human Anatomy

By Lisa Howard

Distinguished neuroscientist has made groundbreaking discoveries about nerve injury and the biological mechanisms of chronic pain

(SACRAMENTO)

The UC Davis School of Medicine is pleased to announce the appointment of Wendy Marie Campana as chair of the Department of Cell Biology and Human Anatomy. A distinguished neuroscientist and educator, Campana brings a wealth of experience in academic leadership, groundbreaking research and a deep commitment to mentorship.

“Dr. Campana is a dynamic and collaborative leader with an impressive research portfolio," said Susan Murin, dean of the UC Davis School of Medicine. "We are excited to see how the department will grow and thrive under her leadership."

Wendy Marie Campana, a leading expert on how nerve and support cells drive chronic pain, has been appointed chair of the UC Davis Department of Cell Biology and Human Anatomy.

Campana joins the UC Davis faculty from UC San Diego, where she served as professor in the Department of Anesthesiology and the Program in Neuroscience. She also served as a research biologist at the San Diego VA Healthcare System and will continue her VA appointment at the Northern California VA Health Care System.

“Dr. Campana is an exceptional addition to the UC Davis School of Medicine’s basic science leadership,” said Luis Fernando Santana, vice dean for basic sciences. “We anticipate that her expertise and collaborative approach will help foster further innovation and groundbreaking advances in research and patient care."

Campana said she is honored to join an institution recognized for its collaborative and innovative research culture.

“UC Davis brings together physicians and researchers who are not only dedicated to treating pain but are actively pursuing groundbreaking solutions in the cell biology field for complicated conditions such as painful peripheral neuropathy and complex regional pain syndrome," Campana said. "I look forward to leading the department and contributing to this dynamic environment and advancing research that can improve patient care.”

Campana’s research has transformed the understanding of how nerve cells and supporting cells respond to injury and contribute to the development of chronic pain. She has authored over 75 peer-reviewed publications in peripheral nerve biology, spinal cord injury, Schwann cell physiology and neuropathic pain.

Campana holds two patents for innovative therapies targeting nerve regeneration and pain management: one related to repair “scaffolds” for nerve cells, the other a method for regenerating nerve cells.

Her research has been funded by the National Institutes of Health (NIH), the U.S. Department of Veterans Affairs, the Department of Defense, industry and UC Office of the President.

Campana has done extensive research on LRP1 (low-density lipoprotein receptor-related protein 1), a protein receptor in cell membranes. She discovered critical roles for LRP1 in controlling inflammation and promoting nerve regeneration.

She specifically studies Schwann cells, which play a crucial role in nerve health and repair. By exploring new strategies such as LRP1-based signaling and Schwann cell-derived extracellular vesicles, Campana’s research points toward promising therapies for preventing or reversing neuropathic pain.

Campana earned a Bachelor of Science degree from UC Berkeley and completed a Ph.D. in biochemistry and endocrinology at Pennsylvania State University. She continued her training as an NIH Fellow in Neurosciences at UC San Diego, followed by a postdoctoral appointment. Campana went on to hold faculty roles at UC San Diego. She holds an adjunct professorship in the Department of Experimental Medicine at La Sapienza University in Rome.

Murin expressed gratitude to Professor Colleen Clancy for guiding the department during the search for a new chair. “We are thankful to Dr. Colleen Clancy for her steady leadership as interim chair. Her contributions have advanced the department’s mission and prepared it for this exciting new chapter,” Murin said.

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Lisa Howard

New research shows species-specific ‘shedding’ may distort conventional testing of cancer drugs targeting TIGIT

Wed, 03 Dec 2025 08:00:00 GMT

A new study published in the Journal of Biological Chemistry from UC Davis Comprehensive Cancer Center finds that TIGIT, an immune checkpoint receptor targeted by cancer immunotherapy drugs, triggers a different response in rhesus macaques compared to humans.

A 3D illustration of immune modulation showing a representational Immune checkpoint protein in orange and terracotta against a blue background.

The findings could have implications for cancer immunotherapy drugs targeting TIGIT.

TIGIT acts like a brake on the immune system

TIGIT (T cell immunoreceptor with Ig and ITIM domains) is a “brake” on the immune system. It sits on immune cells, such as T cells and natural killer (NK) cells, and prevents them from attacking too aggressively. Cancer cells exploit this “brake” to evade the immune system.

That’s why scientists are developing cancer immunotherapy drugs to block TIGIT, enabling the immune system to fight tumors more effectively.

However, multiple anti-TIGIT antibodies have failed in Phase III trials for solid tumors, raising questions about the underlying mechanism.

Rhesus macaques 'shed' TIGIT from immune cells

The study’s findings show that rhesus macaques — but not humans — shed TIGIT from the surfaces of immune cells when exposed to plasmin. Plasmin is a natural enzyme involved in the breakdown of blood clots. The enzyme is highly upregulated (increased) in almost all solid cancers.

Previous research has shown that primates are less vulnerable to cancer than humans. TIGIT shedding is a natural mechanism in monkeys that removes TIGIT-mediated brakes that could lead to cancer and infectious disease. Although TIGIT adds a regulatory brake to fine-tune the human immune response, the evolutionary TIGIT mutation is associated with increased cancer risk in humans.

In the context of cancer therapeutics, the TIGIT shedding creates a soluble form of TIGIT that can still bind anti-TIGIT monoclonal antibodies, such as tiragolumab, a cancer treatment antibody that failed in clinical trials

The result is that in macaques, antibodies may be soaked up by free-floating TIGIT instead of blocking immune suppression on the tumor-fighting cells.

“We know from our study that the dilution of the drug away from T-cells in macaques may not predict safety and dose estimation data for human clinical trials,” said Jogender Tushir-Singh, an associate professor in the Department of Medical Microbiology and Immunology and senior author of the study. Tushir-Singh said. “TIGIT biology may be more complex than expected.”

Difference in amino acid makes it easier for plasmin to cut TIGIT

The researchers looked at TIGIT proteins from humans and monkeys.

They made lab versions of these proteins and exposed them to plasmin to see what would happen.

They found that in monkeys, a single difference in the protein’s amino acid compared to humans (at position 119) made it easier for plasmin to cut TIGIT.

When they added plasmin to human and monkey immune cells, only the monkey cells shed TIGIT from their surfaces. They then checked whether the shed TIGIT in monkeys could still stick to cancer drugs — and it could.

TIGIT testing in macaques may produce unreliable data

The researchers say more studies are needed, but the findings provide insights for current and future TIGIT-targeted cancer trials. They note that testing TIGIT cancer drugs in macaques may have produced unreliable safety and efficacy data. This may help explain why TIGIT therapies have underperformed in late-stage trials.

Coauthors on the study include Eric Pirillo, Francis Freenor V, Brice E.N. Wamba, Sanchita Bhatnagar and Tanmoy Mondal of UC Davis Department of Medical Microbiology and Immunology.

The research was funded by the National Institutes of Health National Cancer Institute (R01CA233752) and the Ovarian Cancer Alliance of Greater Cincinnati (SP0A243532).

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High risk of metastatic recurrence among young cancer patients

Wed, 26 Nov 2025 08:00:00 GMT

A new study of adolescents and young adults (AYAs) with seven common cancers reveals that nearly one in ten patients diagnosed with non-metastatic disease later develop metastatic recurrence — a condition associated with significantly worse survival outcomes. Metastasis is when cancer cells spread from the initial or primary site to other parts of the body.

Photo of young pretty cancer girl lying in hospital

UC Davis Comprehensive Cancer Center scientists led the research. The findings highlight the urgent need to identify and address survivorship needs for young cancer survivors.

“As treatments improve survival, young patients with cancer face unique challenges,” said Ann Brunson, UC Davis research analyst and the study’s lead author. “Our research deepens understanding of survivorship and the impact of metastatic recurrence, using statewide data to reveal trends and guide future studies.”

Cancer researchers Ann Brunson and Theresa Keegan.

The research, based on data from more than 48,000 AYAs in California, was published in JAMA Oncology on November 26. It is the first study of its kind to examine metastatic disease in this population.

Researchers analyzed data from the California Cancer Registry linked with statewide health care records from the California Department of Health Care Access and Information (HCAI). The study group included AYAs aged 15–39 diagnosed with cancer between 2006 and 2018, with follow-up through the end of 2020. Metastatic recurrence was identified by specific diagnosis codes HCAI or cancer cause of death.

The median follow-up time was 6.7 years and the median age at diagnosis was 33. Most patients were non-Hispanic white (48%) or Hispanic (32%), lived in high socioeconomic status neighborhoods (43%) and had private or military insurance (76%).

High rates of metastatic disease and recurrence

Among the 48,406 AYAs studied, 9.2% had metastatic disease at diagnosis while 9.5% developed metastatic recurrence later. AYAs with colorectal cancer (44.2%) and sarcoma (41.7%) had the highest overall proportion of metastatic disease, followed by patients with breast (23.9%), cervical (23.6%) and testicular (21.6%) cancers.

For AYAs initially diagnosed with nonmetastatic disease, the five-year cumulative incidence of metastatic recurrence was highest for those with:

Sarcoma (24.5%)
Colorectal cancer (21.8%)
Cervical cancer (16.3%)
Breast cancer (14.7%)

Cervical cancer had particularly high recurrence rates across all stages, with stage 3 patients experiencing a cumulative incidence of 41.7%.

The study also found that recurrence rates varied over time. Cervical cancer recurrence increased from 12.7% in 2006-2009 to 20.4% in 2015-2018, while colorectal cancer and melanoma saw declines. Notably, stage 1 cervical cancer showed the most pronounced increase, while stage 3 melanoma had a significant decrease in recurrence.

Survival after metastatic recurrence was worse than survival for those diagnosed with metastatic disease initially, except in testicular and thyroid cancers. Breast cancer patients with metastatic recurrence had nearly a threefold increased hazard of death, while cervical, melanoma, sarcoma, and colorectal cancer patients also faced significantly higher hazards of death.

To make sure their method for detecting metastatic recurrence was accurate, the researchers compared their findings to Kaiser Permanente Northern California and found an overall concordance rate of 96.9% when they accounted for patients who were never completely disease-free.

“These findings highlight the significant burden of metastatic recurrence among adolescents and young adults and the need for tailored survivorship care,” said Theresa Keegan, the study’s senior author. “Understanding these patterns helps us identify inequities and evaluate how well our efforts are working to prevent, detect and treat both early and metastatic disease.”

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