Education and Communication

Local School Visit

Ann Arbor STEAM is a local elementary and middle school with a project-based learning approach which focuses on an integrated curriculum with real-world applications. As a result, the school's mission statement aligns very closely with our team's as well as iGEM's as a whole. We connected with Ms. Jennie Allan, a 7th and 8th grade science teacher, when she was planning the 8th grade genetics unit. Their unit was focusing on the myostatin gene for hypermuscularity in cattle as found in the Belgian Blue breed. After discussion with Ms. Allan on appropriate difficulty level and scientific focus, we organized materials for and taught a class on key concepts used in our project, namely alleles, DNA amplification, platelets, and LAMP in order to highlight the applications of what they were learning. In order to maintain student interest we had an interactive presentation, as well as a worksheet on the concepts we presented on. We specifically designed the worksheet to utilize tangible concepts like dog breed traits, as recommended by Ms. Allan, to help students connect the topics we presented on to other information they have learned in past class sessions.

Lastly, we used a pre and post-survey method in order to gauge how our research was communicated to and understood by the students. The surveys were primarily to gauge how the students' perceptions and understanding changed throughout the course of the lecture. From these surveys, we were pleased to see that students felt they gained understanding in specific topics in genetics from our class session. We also felt the student feedback was valuable in terms of our future educational initiatives.

Here, we have provided blank copies of our surveys for use by other interested parties:

Example of pre-survey work. Questions include 'What is an SNP? and 'What does DNA amplification do?'
Example of pre-survey work (student identifiers removed)
Example of post-survey work. Students are asked questions about ancestral alleles of different dog breeds.
Example of post-survey work (student identifiers removed)

SNP Databases

Our SNP Database was partially suggested by Dr. Smith with regards to using our LAMP amplification and fluorescence platform to detect many different SNPs, expanding beyond cardiovascular disease. This discussion with Dr. Smith, along with Dr. Holinstat's research, prompted us to seek to provide a basis for SNP involvement in drug response in our SNP database. Holinstat's research has suggested a link between patient response to standard-of-care antithrombotic drugs and the SNP of interest in our project, rs773902. We wanted to provide a central location for researchers to find the resources they would need for using the platform, such as the wild-type gene sequence, role in drug response, and SNP sequence change. We envision future researchers expanding on the SNP detection method we used in our project for detection of SNPs listed in the database, or applying other methods based on their community needs or expertise.

SNPs Involved in Drug Response

Our platform holds great potential to empower physicians to make more informed medical decisions, particularly in the context of prescribing medications. Information regarding potential patient sensitivity or resistance to certain medications can be very influential in medical decision making, so this kind of patient-specific data is highly valuable in medicine. In our example of the rs773902 SNP, information regarding whether or not the patient has this variant can dramatically alter the antiplatelet therapy prescription made by a physician. The importance of this kind of information supports our SNP detection platform as a valuable method of obtaining this data in a low-cost and efficient manner practical for point-of-care settings. In order to support the application of our SNP detection platform in the context of other prescription decisions in other disease settings, our team has compiled a database of SNPs implicated in drug response. We have also designed custom LAMP primers for each SNP. Using this list, any clinical team interested in testing for a specific variant can refer to our list, then use the reagents in our kit and our suggested LAMP primers to easily develop an SNP test of their own.

SNPs Involved in Drug Response
SNPs Involved in Drug Response
# SNP Name Gene Name Link to Wild-Type Gene Sequence SNP Sequence Change Role in Drug Response Source LAMP Primer
1 rs773902 F2RL3 Ala120Thr Renders some antiplatelet therapies ineffective
2 rs6314 HTR2A 5-HT2AR vs H452Y variants Decreases response to clozapine (antipsychotic medicine)
3 rs1800588 CYP2D6 G>A Homozygosity for the A version of this allele is associated with slower metabolism of tricyclic antidepressants, leading to a higher risk of adverse side effects
4 rs4680 COMT Val158Met Increases efficacy of antidepressant paroxetine
5 rs1799971 OPRM1 Asn40Asp Predicts response to drug naltrexone in treatment of alcohol dependence
6 rs10192566 LPIN1 G>C Affects response to rosiglitazone treatment for type 2 diabetes
7 rs35599367 CYP3A4 C to T Resistance to HIV treatments
8 rs9939609 FTO T to A Metabolic disturbance to HIV/HCV treatment
9 rs6265 BDNF G to A Association to drug dependence in antidepressant and other psychological disorder treatments
10 rs3892097 CYP2D6 G to A Poor metabolization of drugs such as codeine, tamoxifen, and some antidepressants
11 rs1789924 ADH1C C>T Postoperative adjunct radiotherapy for esophageal squamous cell cancer was less effective in CT genotype
12 rs11572080 CYP2C8 G:G to A:G or A:A Increased risk of gastrointestinal bleeding when using NSAIDs like ibuprofen and naproxen
13 rs10509681 CYP2C8 T:T to C:T or C:C Increased risk of gastrointestinal bleeding when using NSAIDs like ibuprofen and naproxen
14 rs1799855 CYP2C9 C:C to C:T or T:T Increased risk of gastrointestinal bleeding when using NSAIDs like ibuprofen and naproxen
15 rs3219484 MUTYH A>G A:G genotype has low risk of developing neutropenia toxicity from cisplatin-based chemotherapy for ovarian cancer
16 rs4986893 CYP2C19 G>A Poor metabolism of Memphenytoin
17 rs3812718 SCN1A A>A, C>T Poor metabolism of anti-epileptic drugs phenytoin
18 rs3745274 CYP2B6 G>A, G>C, G>T Higher exposure to Plasma during HIV therapy
19 rs4292394 UGT2B7 C>A, C>G, C>T Resistance to opiod addiction treatments
20 rs3842 ABCB1 T>C CC phenotype is associated with increased bioavailabilty of efavirenz, a medication used to treat HIV
21 rs7295 VKORC1 C>T Patients with the SNP may have higher warfarin (anticoagulant medication) dose requirements than those without the SNP
22 rs7412 APOE C>T CT genotype is associeted with increased response to fluvastatin than CC genotype. Fluvastatin can lower cholesterol and triglyceride levels in the blood.
23 rs20455 KIF6 A>G Patients with the SNP are more susceptible to coronary heart diesease than people without the SNP, but statin therapy was more effective for patients with the SNP than those without.
24 rs693 APOB G>A Associated with bleeding complications in patients with warfarin treatment after mechanical cardiac valves
25 rs1142345 TPMT T>A, T>C, T>G Codes for inosine triphosphate pyrophosphatase variant incapable of detoxifying certain antineoplastic and immunosuppressant drugs such as mercaptopurine
26 rs2069707 IFNG G>A, G>C Decreased response to Hepatitis C treatment
27 rs37973 GLCCI1 G>A, G>C, G>T Patients with the G allele showed less improvement in lung function in response to inhaled glucocorticoids (asthma medication) than patients with the A allele.
28 rs3812718 SCN1A C>T Patients with SNP may be at risk of resistance to Carbamazepine, one of the most used antiepileptic drugs
29 rs4673993 ATIC T>C Patients with the SNP are more likely to be nonresponsive to the medication methotrexate, the most used drug for rheumatoid arthritis treatment
30 rs776746 CYP3A5 T>C Patients with the SNP when treated with midazolam have increased midazolam plasma levels and greater clearance of the drug
31 rs578776 CHRNA3 A>G Increases likelihood of nicotine dependence
32 rs11045879 SLCO1B1 T>C Increases likelihood of toxicity response when treated with methotrexate
33 rs8113308 ZNF613 T>C This SNP is associated with reduced survival in ER-positive breast cancer patients treated with endocrine.
34 rs2817101 GSTA1 C>T Breast cancer patients with the TT allele respond poorly to doxorubicin treatment compared to patients with the CC allele.
35 rs2740574 CYP3A4 C>A,G,T Found to result in virological rebound and low TDM levels in some patients with the CYP3A4 variant when treated with LPV/r for HIV-1.
36 rs744591 MIR3196 C>A Colon cancer patients with this variant were found to have poor response to capecitabine-based chemotherapy.
37 rs2114358 MIR1206 G>A,C Colon cancer patients with this variant were found to be prone to more adverse events during chemotherapy than patients without.
38 rs2282055 PD-L1 G to T G allele is associated with better response to Nivolumab for advanced Non-Small-Cell Lung cancer patients.
39 rs12083537 IL6R A to G G is assocciated with reduced responsiveness to tocilizumab in rheumatoid arthiritis patients
40 rs1695 GSTP1 A to G Patients with the A allele had reduced risk of bladder cancer recurrence after intravesical chemotherapy.
41 rs4925 GSTO1 C to A Patients with the C allele had reduced risk of bladder cancer recurrence after intravesical chemotherapy.
42 rs1532624 CETP C to A Patients with the A allele have reduced responsiveness to statin therapy.
43 rs1065852 CYP2D6 C:C to C:T to T:T Decreased or non-functioning variants; possibly less response to some drugs, including tamoxifen
44 rs28934895 BCKDHB C:C to C:G to G:G Allele encodes a proline (P), and it is the most frequent mutation leading to Maple Syrup Urine Disease,
45 rs1801282 PPARG C:C to C:G to G:G Relation with insulin resistance and response to treatment with pioglitazone in type 2 diabetes
46 rs1801133 MTHFR C:C to C:T to T:T Individuals have ~30% of the expected MTHFR enzyme activity, and rs1801133(C;T) heterozygotes have ~65% activity, compared to the most common genotype, rs1801133(C;C).
47 rs4794067 TBX21 C:C to C:T to T:T Be at 2.15 fold higher risk (CI: 1.26-3.64) for aspirin-induced asthma
48 rs1800460 TPMT G:G to A:G or A:A Cannot detoxify byproducts of some antineoplastics and immunosupressants, toxicity is greater if there are two incorrect alleles
49 rs1800462 TPMT G:G to C:G or C:C Cannot detoxify byproducts of some antineoplastics and immunosupressants, toxicity is greater if there are two incorrect alleles
50 rs1801253 ADRB1 G:G to C:C Affects ability of beta blocker binding and resulting blood pressure drop
51 rs3892097 CYP2D6 G:G to A:G or A:A Disrupts mRNA formation and has nonfunctioning CYP2D6 protein, poor metabolism of many drugs
52 rs1057910 CYP2C9 C:C to A:C or A:A Clears drugs like celecoxib twice as slowly, poor metabolism with other drugs
53 rs4244285 CYP2C19 A:A or A:G Loss of effectiveness of Clopidogrel
54 rs11563250G UGT1A1 A:G Better tolerance to irinotecan-induced neutropenia
55 rs121434295 MTHFR G:A Body is unable to process homocysteine and methionine properly
56 rs12979860 IFNL3 C:T higher likelihood of developing chronic hepatitis upon infection with HCV
57 rs683369 SLC22A1 G:C G allele results in less response to imatinib
58 rs34447885 SLC22A1 C:T T allele results in increased Metformin transport
59 rs12208357 SLC22A1 C:T T allele results in decreased Metformin transport
60 rs2282142 SLC22A1 C:T T allele results in decreased Metformin transport
61 rs34059508 SLC22A1 G:A A allele results in decreased Metformin transport
62 rs113993960 CFTR A>G F508del allele. Patients treated with lumacaftor/ivacaftor had increased lung function (measured by changes in lung clearance index 2.5 and ppFEV1) and decreased sweat chloride levels following 24 weeks of treatment compared to patients treated with a placebo.
63 rs267606618 MT-RNR1 T>C Allele C is associated with Ototoxicity when treated with gentamicin in children as compared to allele T.
64 rs3808607 CYP7A1 TT>GG Genotype GG is not associated with response to atorvastatin as compared to genotype TT
65 rs1048977 CDA C>T Capecitabine and CDA is related to Drug Toxicity, hand-foot syndrome and Hyperbilirubinemia (Toxicity)
66 rs2058878 GRIN2B A>T Allele A is associated with increased response to acamprosate in people with Alcoholism as compared to allele T
67 rs351855 HER2 G>A Reduces overexpression of HER2 gene, which is a target for efficacy of Herceptin
68 gs308 G6PD C>T Prevents protein production, which can cause hemolytic anemia when taking glipizide in treatment for diabetes
69 rs11045585 SLCO1B3 A>G, T 63% higher chance of developing docetaxel-induced leukopenia/neutrophenia
70 rs55886062 DPYD T > G Increased toxicity to 5-fluorouracil, which is a common cancer treatment, and to capecitabine another kind of chemotherapy
71 rs3918290 DPYD G > A Increased toxicity to 5-fluorouracil, which is a common cancer treatment, and to capecitabine another kind of chemotherapy
72 rs67376798 DPYD T > A Increased toxicity to 5-fluorouracil, which is a common cancer treatment, and to capecitabine another kind of chemotherapy
73 rs7089580 CYP2C9 A > T Increases dosage requirement of Warfarin (widely-used anticoagulent) by increaseing the drug clearance in associated cells
74 rs2395029 HCP5 T > G Increases the risk of hypersensitivity to Abacavir, a drug used to treat HIV

SNPs Involved in Hypercoagulability

Our SNP detection platform can also be used to evaluate patient risk for a variety of conditions, as SNPs are commonly associated with increased susceptibility to certain pathologies. Currently, risk assessments are not commonly performed in medicine due to the high price and difficulty associated with genetic testing. In contrast, our platform offers the ability to make genetic assessments quickly, easily and cheaply. The ability to assess patient risk for a condition enables preventative action to be taken early on, helping to maintain health long-term and to reduce total medical costs. In the context of cardiovascular disease, various populations have differing risk levels, which contributes to differential treatment outcomes across demographic groups. The ability for individual patients to understand their risk level for cardiovascular disease, then take appropriate preventative measures, has the potential to dramatically improve outcome equity. In order to support this goal, our team has compiled a database of SNPs known to increase patient risk of hypercoagulability, the increased tendency of blood to thrombose. We hope this information will encourage the development of a point-of-care risk assessment platform as another avenue to progress our mission of improving cardiovascular health equity.

SNPs Involved in Hypercoagulability
SNPs Involved in Hypercoagulability
# SNP Name Gene Name Link to Wild-Type Gene Sequence SNP Sequence Change Role in Drug Response Source Lamp Primer
1 rs773902 F2RL3 Ala120Thr Renders some antiplatelet therapies ineffective
2 rs268 LPL A>G The G allele is linked to increased susceptibility to hypertriglyceridemia, heart disease, Type-2 diabetes, and idiopathic venous thromboembolism.
3 rs55837134 NPC1L1 A>T The A allele is associated with future cardiovascular risk in coronary patients. "Niemann-Pick C1-like 1 (NPC1L1) is involved in dietary cholesterol absorption and is the direct molecular target of the LDL-lowering drug ezetimibe."
4 rs5443 GNB3 C>T The C allele is associated with increased risk of hypertension.
5 rs699 AGT A>G The A allele is associated with higher plasma angiotensin levels and higher blood pressure leading to increased risk for hypertension associated disorders
6 rs5051 AGT C>A,G,T The C allele is associated with higher plasma angiotensin levels and higher blood pressure leading to increased risk for hypertension associated disorders
7 rs1799998 CYP11B2 A>G,T The A allele is associated with higher plasma aldosterone-to-renin (ARR) ratios and increased odds of developing hypertension and/or coronary artery disease.
8 rs6025 F5 Arg534Gln The SNP causes resistance of Factor Va to degradation, increasing the risk of venous thromboembolism.
9 rs1799963 F2 G>A The SNP causes excessive production of prothrombin, increasing risk of deep vein thrombosis and pulmonary embolism.
10 rs2289252 F11 C>T The SNP increase the risk of deep vein thrombosis.
11 rs2066865 FGG C>T The SNP increases the risk of deep vein thrombosis by reducing plasma fibrinogen γ′ levels.
12 rs13146272 CYP4V2 C>A The SNP increases the risk of venous thromboembolism.
13 rs1613662 GP6 G>A The SNP increases the risk of venous thromboembolism in cancer-free subjects.
14 rs1801133 MTHFR C>T Thermolabile MTHFR with reduced enzyme activity, and homozygosity for this mutation is associated with elevated homocysteine levels, which has been linked with an increased risk of venous thromboembolism
15 rs1799889 PAI-1 Guanine insertion or deletion This SNP in the promoter region of the PAI-1 (plasminogen activator inhibitor-1) gene influences the gene's expression. The 4G allele is associated with higher PAI-1 levels, which can increase the risk of thrombosis because PAI-1 inhibits fibrinolysis.
16 rs2036914 F11 T>C This SNP increases the risk for deep vein thrombosis (DVT).
17 rs2232354 IL-1 T>G This SNP increases the risk for venous thrombosis.
18 rs9574 PROCR C>A,C,T These polymorphisms are likely risk factors of venous thromboembolism (VTE)
19 rs1049636 FGG G>A,C These polymorphisms are likely risk factors of venous thromboembolism (VTE)
20 rs148685782 FGG G>C Causes congenital afibrinogemiea and abnormal bleeding
21 rs2304167 GP6 C>T Polymorphisms in the platelet-specific collagen receptor GP6 are associated with risk of nonfatal myocardial infarction in Caucasians.
22 rs2227589 SERPINC1 C>A,T The T allele is associated with increased risk in pulmonary embolism
23 rs710446 KNG1 T>C,G The C allele is associated with decreased activated partial thromboplastin time levels, increasing risk for venous thrombosis
24 rs8176719 ABO ->C Risk of major bleeding in patients with incident venous thromboembolism
25 rs2814778 ACKR1 T>C There is a suggested link between the Duffy antigen and coagulation, potentially explaining the difference in white blood cell count between Caucasian and non Caucasian
26 rs8176592 TFPI T>C Any changes that occur in TFPI have the potential to impact the ability of the coagulation pathway, which may affect the occurrence and the development of venous thrombosis.
27 rs1063856 VWF A>G Commonly inherited VWF variants can directly influence the protein and may contribute to hemostatic and thrombotic disease risk/severity.
28 rs16861990 NME7 A > C This SNP is associated and increases the risk of deep vein thrombosis
29 rs7978987 STX2 A > G Associated with venous thromboembolism
30 rs2069951 PROCR G > A Associated with venous thrombosis
31 rs4149755 F9 T > A Associated with venous thrombosis

Discover Engineering Camp

Three MSBT members at the Discover Engineering Camp.
Two MSBT members holding a sign that says Biomedical in front of a University of Michigan block M.
Representatives from our team at the Discover Engineering Camp

University of Michigan's Discover Engineering Camp is geared towards 8th — 10th grade students who want to thoroughly explore various engineering disciplines. MSBT partnered with the Biomedical Engineering Department to design and run their workshop. The workshop we designed introduced the campers to scientific methods, wet lab work, and the applications of biomedical engineering and synthetic biology. Our workshop had the campers simulate a drug delivery system by creating alginate beads with BSA (a model drug) in calcium chloride, half of which were treated with an acid wash and half that remained the original state. This acid wash increased the bonding throughout the beads and made the BSA diffuse out of the beads at a slower rate. We had the students hypothesize this relationship through graphs as well as predict the outcome of an assay that would show the amount of BSA in solution through a color change.

We were able to share our love of synthetic biology and the many applications beyond the classroom activity, such as MSBT's project and other opportunities at the University of Michigan.

Health Equity Symposium

We strongly feel that medical inequity is an issue that extends even beyond our local community and iGEM project for this year. As a team, we felt it was important to contribute to a growing discussion of research and efforts towards promoting medical equity at both the local and global scales. From our past collaborations with iGEM teams, we know that many teams have shared interests and commitment to bettering their local communities, especially in the topic of medical equity. MSBT decided to host a virtual medical equity symposium for teams to converge and share information about how their projects aim to address specific areas of medical equity while utilizing synthetic biology, as well as host a discussion space where teams could ideate and plan future joint community initiatives. The teams we reached out to that signed up for the symposium were PathoGlow, OASYS, Metriotect, Oxford, Tonji China, William and Mary, and GeneHackers. A recording of the symposium is available on our 'Michigan iGEM' Youtube page.

The symposium yielded great discussion and ideas floating between teams. Attendees expressed their agreement that having a diverse set of projects, from point of care SNP diagnostics, to water quality testing and soil and environmental health, benefitted the perspectives we were able to gain. MSBT learned about how local policies or access to resources greatly impacted the perceived medical equity across regions, and we brainstormed with other teams about various educational and scientific initiatives to promote application of the intersection of synthetic biology and community action. In addition, we also found the symposium as a helpful way to share ideas between teams on the timelines of their human practices initiatives, and what strategies they found to be most impactful. We discussed embarking on collaboration early in the next project season, when project feedback may be most useful, and also discussed plans to make shared resources for human practices, similar to the educational materials prepared by teams in the United Kingdom, as suggested by team Oxford. Overall, we feel that the medical equity symposium succeeded in its goal of promoting dialogue in medical equity research and fostering collaboration amongst iGEM teams.

Collaboration with UChicago iGEM

Our team recognizes that biomedical research is a collaborative endeavor, and that coming together with other research teams can yield valuable new perspectives and opportunities. This year, our team collaborated with the University of Chicago's iGEM team. Together, we forged several collaborative initiatives of mutual benefit.

Through discussing each team's current wet lab struggles and points of need, our collaboration yielded ways in which the other team's access to equipment and/or expertise could aid our projects. Our team was primarily interested in gaining secondary validation of our test's efficacy. Our project's end goal is to develop an end-to-end kit that can be purchased by any healthcare team and used to easily perform our described assay. We planned that UChicago iGEM would serve as a mock end-user; we were to send their team all reagents we anticipate including in our kit along with instructions for use, then having them perform our assay on a test sample. This would enable our team to receive secondary validation that our kit's mechanism is biochemically sound and reproducible, and that our instructions of use are straightforward and easily followed. Due to project setbacks and a lack of assay functionality, this validation step was never performed. However, we feel that this confirmation of results is crucial to the research process, and we hope to implement this kind of validation in future years through continued collaboration with UChicago iGEM.

When discussing the science-related needs of the UChicago team, they highlighted their need to use mass spectrometry to confirm a suspected result of their project. Due to our team's experience with our university's mass spectrometry core facility, we planned for them to send their sample to our university and for our team to run it. This mode of collaboration did not ultimately occur due to setbacks in UChicago's sample production. However, this idea has helped our team recognize that other groups may have access to more specialized equipment or may be more experienced in performing a certain advanced experiment. Therefore, we hope to plan equipment-based collaborations such as this one in the future. Additionally, the UChicago team highlighted their desire to implement machine learning and molecular dynamics into their dry lab work, just as our team has done this season and in past seasons. As such, we planned a follow-up “Computational Modeling” workshop, during which we assisted UChicago team members with dry-lab experimental planning (eg. softwares to use, analyses to run, etc.). Further, we also discussed strategies for teaching computational modeling to new team members, as very few people who enter both teams have prior experience in the area.

Zoom screencapture of dry lab workshop hosted by MSBT's Computational Modeling Chair
Dry lab workshop hosted by our Computational Modeling Chair, Surya, to help UChicago iGEM with implementing machine learning and molecular dynamics into the modeling aspect of their project.

In terms of our team's human practices initiatives, we have begun to plan a seminar for next year in which our team members will discuss their experiences studying biology and engineering in college, performing research, and participating in iGEM with local middle and high school students. We aspire for this event to motivate and inspire students in our community to pursue university-level study in these fields, and to perhaps one day pursue careers in synthetic biology. In our collaboration with UChicago iGEM, they have agreed to speak at this event in the capacity of providing additional perspectives on these matters.

Our teams also ideated several long-term initiatives to collaborate on. Between our two groups, we proposed an in-person meetup due to the close proximity of our universities. With each of our groups being focused within the field of synthetic biology, a very niche field in the broader context of our universities, we figured that in-person collaboration would provide the unique opportunity to interact with others interested in this area of research. Additionally, our teams hope to collaborate to establish a stronger community of undergraduate researchers and iGEM teams in the Midwest region of the United States, where both of our teams are located. We proposed hosting a regional undergraduate research conference in which students from surrounding states would have the coveted opportunity of presenting their work. Alternatively, we suggested planning a local iGEM meetup in which local teams would be invited to an event spurring collaboration across projects and brainstorming about synthetic biology initiatives.

Zoom screen capture of MSBT and UChicago GeneHackers members.
Screen capture of our productive meeting with UChicago iGEM

Heart Healthy Recipes on Instagram

Recipes to be Heart Healthy by the Michigan Synthetic Biology Team

We acknowledge that in addition to genetic factors like the rs773902 SNP, lifestyle choices play a key role in one's risk of cardiovascular disease, especially one's dietary choices. We promoted heart-healthy dietary choices on our Instagram with a compilation of a few recipes that aim to help reduce or prevent cardiovascular disease while still tasting amazing. We hope to show that heart-healthy eating does not have to be difficult or boring!

The Mount Sinai health system states that the goals of a heart-healthy diet should be to “obtain or maintain healthy levels of cholesterol and blood pressure.” In order to achieve this, a heart-healthy recipe should be low in saturated fat, simple sugars, and sodium and rich in nutrients. According to the Memorial Sloan Kettering Cancer Center, high intake of salt can increase blood pressure leading to hypertension, and hypertension is a major risk factor for cardiovascular disease. It is recommended that someone at risk for cardiovascular disease limit their salt intake to no more than 1,500 mg/day. Additionally, saturated fats can lead to the buildup of plaques in the blood vessels also contributing to cardiovascular disease. Saturated fats are predominantly found in dairy products and red meat. The USDA dietary guidelines recommend limiting saturated fats to less than 10% total daily calories. Intake of saturated fats can be reduced by choosing lean meats and low-fat dairy products or opting for healthier fats. Monounsaturated fats and omega-3 polyunsaturated fats are considered heart-healthy and can be found in nuts, fish, avocados, olives, olive oil, canola, soybean, or walnut oil. Finally, simple carbohydrates have been found to contribute to high levels of cholesterol. It is recommended to choose carbohydrates that are high in fiber such as fruits, vegetables, and whole grains. Diets that can help reduce or prevent cardiovascular disease include the DASH diet (Dietary Approaches to Stop Hypertension) and the Mediterranean Diet. More information can be found through the Sloan Kettering Cancer Center2 and the Mount Sinai3 websites.

Consultations

Meeting with Dr. Holinstat (Wet Lab Advisor)

Dr. Holinstat authored a paper that identifies the rs773902 SNP in the human PAR-4 gene as a key actor in platelet signaling, which differentiates along racial lines1. We met with him to gain greater insight into his research and present our project plans to him. One of the important takeaways we had from his presentation to us included the use of appropriate terminology when discussing the SNP, such as using “abundance of the threonine allele”. We also discussed with Dr. Holinstat some other papers identifying PAR-4 as a gene of interest in thrombosis, as well as relevant statistics concerning the high correlation between race and genotype in relation to factors in platelet signaling.

Another takeaway was understanding the work being done to increase equity in clinical trials, an aspect his team is very conscious of. During the discussion, he noted that the U.S. Food and Drug Administration (FDA) issued a draft guidance in 2022 to increase enrollment of participants from underrepresented racial and ethnic populations in the U.S. into clinical trials. Our informative discussion with Dr. Holinstat fueled our decision to make medical equity a focus of our human practices work in relation to our project.

After Dr. Holinstat's presentation, we showed him our wet-lab plans for the project, including incorporating the use of LAMP and fluorescent probes for our SNP diagnostic test. We also discussed our cell culture testing plans for the project, and some of the limitations the team might encounter with timeline and safety priorities. We spoke about using a breast cancer cell line, and Dr. Holinstat offered our team a potential partnership to utilize blood samples for future testing.

MSBT members in a classroom listening to Dr. Holinstat present
Our team listening to Dr. Holinstat present

Meeting with Dr. Smith (Clinician Advisor)

Dr. Eric Smith is a Clinical Instructor in the Division of Cardiovascular Medicine and a member of the Inherited Cardiomyopathy Program at the Frankel Cardiovascular Center at Michigan Medicine. His background in both electrical engineering and cardiology drew us to ask for his input on our project.

He advised us on the reframing of our project in the sense of treating it as a stepping stone in the direction of a multiple SNP detection system to consolidate multiple potential risk factors for cardiovascular disease. He was one of the main influences for our decision to build a database of SNPs, particularly in researching specific SNPs that are clinically relevant to hypercoagulability, or that contribute to a genetic risk of stroke.

Meeting with Dr. Deotare (Fluorescence Advisor)

Dr. Parag Deotare is an associate professor in electrical engineering and computer science at the University of Michigan. His primary area of research is in the development of low-energy photonic and excitonic devices for applications in data communication and life sciences. We explained our overall project to him and discussed with him specifics relating to our goal of building a low-cost fluorometer. We came to Dr. Deotare with a preliminary design, along with many questions we needed to answer before moving onto finalizing our design and beginning of prototyping. Our questions for Dr. Deotare included:

  • How intense of a light source do we need?
  • Do we need to focus light from an LED to the sample or is close placement enough?
  • Is there a specific focal length we should go for with the lenses? What specific types of lenses should we be working with?
  • Should we be using a prism or a filter to discriminate the light going to the photoresistor?
  • Would we expect an issue where the light source drowns out the light emitted from the fluorescent sample, and if so how could we circumvent this issue?
  • Is there any modeling software we could use to computationally model the system?

Per his advice, we opted to use a laser and photodiode instead of an LED and photoresistor. We discussed focusing light being a better choice instead of utilizing sample proximity to light source, as well as using a filter instead of a prism to discriminate light. It was incredibly helpful to get early feedback on our fluorometer plans, as it allowed us to save time on prototyping suboptimal designs, as well as work out a balance between cost-effectiveness and apt designs.

References

  1. Tourdot, B. E., Stoveken, H., Trumbo, D., Yeung, J., Kanthi, Y., Edelstein, L. C., Bray, P. F., Tall, G. G., & Holinstat, M. (2018). Genetic Variant in Human PAR (Protease-Activated Receptor) 4 Enhances Thrombus Formation Resulting in Resistance to Antiplatelet Therapeutics. Arteriosclerosis, thrombosis, and vascular biology, 38(7), 1632–1643. https://doi.org/10.1161/ATVBAHA.118.311112
  2. Heart healthy dash or cardiac diet – what it is. Memorial Sloan Kettering Cancer Center. (n.d.). https://www.mskcc.org/experience/patient-support/nutrition-cancer/diet-plans-cancer/cardiac-diet
  3. Heart-healthy diet. Mount Sinai Health System. (n.d.). https://www.mountsinai.org/health-library/report/heart-healthy-diet