BWHers share their predictions about breakthroughs that will dramatically impact patient care, change the course of research or significantly shift how we provide care.

“The field of applied microbiome medicine and fecal microbiota transplantation (FMT) is among the most exciting in medicine today. By harnessing the power of microbes, we have already been able to deeply impact the lives of patients suffering from recurrent Clostridium difficile infection with FMT, now a well-accepted therapy when antibiotics fail. With the emergence of FMT capsules, we are on the verge of a paradigm shift in the treatment of C. difficile and now have the ability to potentially treat patients with FMT earlier in their course. This approach has the potential to prevent patients from suffering through cycles of expensive and ineffective antibiotic and truly get to the heart of the problem: missing microbes.”

– Jessica Allegretti, MD, MPH, Division of Gastroenterology, Hepatology and Endoscopy

“In 2016, BWH will open the Brigham Building for the Future (BBF) which will include the first U.S. installation of a new generation 7.0 Tesla MRI in a clinical facility. This device offers higher resolution than even the most powerful clinical MRI now in use and will allow clinicians and researchers to visualize critical structures and pathologies that until now were not visible by MRI. As a result, we hope to gain new insights to allow our physicians to discriminate among different diseases or conditions where symptoms may be similar, allowing them to choose the best treatment option for our patients and setting the stage for scientific breakthroughs for years to come. For example, in my field of study, it will allow us to measure new brain chemicals that could potentially provide a major breakthrough in diseases such as brain injury, cancer and the neurosciences.”

-Alexander Lin, PhD, Center for Clinical Spectroscopy, Department of Radiology

“In surgery, there are significant trends which are leading to numerous breakthroughs. One trend we can look forward to in 2016 is increasingly personalized surgery. This uses imaging to guide all aspects of surgical decision making in order to tailor surgery to the individual patient making it less invasive and more effective. Neurosurgery was an early adopter of advances in imaging which could be used not only for diagnosis but also for guiding treatment. Now those advances are starting to be used by other specialties as well. For example, new technologies are being develop to guide surgery for early stage lung cancer and prostate cancer. On the tissue level, we are starting to develop technologies to use during surgery to learn individual details of tumors like cellular composition,margins, spread, and if there are particular molecular changes which can impact therapy. BWH is at the forefront of innovation bringing together advances in imaging technology with surgical champions. The AMIGO suite, funded by NIH, is a state-of-the-art medical and surgical research environment that houses an array of advanced imaging equipment and interventional surgical systems which are used to develop the next generation of surgical interventions. With the hospital’s long history of image guided surgery as the National Center for Image Guided therapy, BWH will be at the vanguard of this trend.”

-Alexandra Golby, MD, Department of Neurosurgery

“The recent introduction of stem cell organoids offers unprecedented capabilities to perform more physiologically relevant studies. Moving ahead in 2016, we will see more collaborations between biologists developing organoid systems and bioengineers to steer the cell composition and their 3D organization to further enhance the utility of organoids in research and development of regenerative therapies. In addition to uses for regenerative therapies, organoids derived from the tumors of cancer patients have been shown to closely replicate important properties of the original tumors. Influencing how cells internally process exogenous signals offers a new layer of control that will quickly mature, allowing the fine-tuning of organoids with genome editing and genetic circuits. Organoid research is definitely in for an exciting 2016!”

-Jeffrey Karp, PhD, Division of Biomedical Engineering, Department of Medicine

“I anticipate that the use of focused ultrasound for the temporary disruption of the blood-brain barrier so that therapeutic drugs can be delivered directly to brain tumors in patients in the US will be a breakthrough for image-guided therapy in 2016.  Nathan McDannold and his team at BWH continue to power this groundbreaking technology. I also anticipate that the real-time analysis of tissue samples using mass spectrometry during surgery, by Nathalie Agar and her team, will be a big breakthrough for how different clinical specialties at BWH — neurosurgery, general surgery, radiology and pathology — research together in the AMIGO suite to deliver results for our patients.”

-Tina Kapur, PhD,  Department of Radiology

“Behavioral health conditions are widely under-diagnosed and under-treated in the United States, and we have unique opportunities in the year ahead to advance and transform the way that mental health problems are addressed and care is delivered in this country. Specifically, we can leverage technology to improve access and quality by driving evidence-based solutions that will bridge the gaps that we know exist in our field.  I believe that digital health innovations – apps and other consumer and clinician facing technology – can revolutionize mental health care and that we will begin to see this happen in 2016.”

-David Ahern, PhD, Department of Psychiatry

“There is resurgent interest in vaccines against cancer, including brain cancer. One type of vaccine involves the use of genetically modified viruses (oncolytic viruses) that selectively destroy cancer cells in the brain and, by doing so, also provoke an immune response against the dying tumor cells. In the fall of 2015, the FDA approved the first oncolytic virus as a treatment for melanoma. In 2016, we hope to start a clinical trial here for patients with brain cancer that will involve using another oncolytic virus that was developed here.”

-Ennio Chiocca, MD, PhD, Department of Neurosurgery

“This year, investigators in BWH’s Kidney Division are poised to build on their breakthrough progress in generating kidney organoids from stem cells. We are using these organoids to better understand diseases of the kidney such as polycystic kidney disease and diseases of the glomerulus, the filtering units of the kidney. Using these technologies, there is hope for a strong potential impact on a variety of clinical and translational applications, including kidney tissue bioengineering to replace lost kidney tissue, renal assist devices to treat acute and chronic kidney injury, drug toxicity screening, screening for novel therapeutic agents and human kidney disease modeling. Using these new approaches, we are trying to develop new therapies to prevent failure and new therapies to replace kidney function if failure occurs.”

-Joseph V. Bonventre, MD, PhD, Renal Division and Division of Biomedical Engineering

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