The National Institutes of Health (NIH) is, by its own admission, the largest biomedical research agency in the world. Because of the agency, Americans today are living longer and healthier lives. Life expectancy went from 47 years in 1900 to 78 years in 2009. And disability in people over age 65 has dropped dramatically in the last 30 years.
In large part because of the support of the NIH, scientists across the United States and around the globe conduct wide-ranging research to enhance health, lengthen life and reduce illness and disability. As part of the U.S. Department of Health and Human Services (HHS), the NIH is the nation’s medical research agency. As such it is the largest public funder of biomedical research in the world, investing more than nearly $37.3 billion annually in medical research for Americans.
In 2018, the NIH received top scientific honors for groundbreaking research the agency funded, including two NIH-supported scientists who earned Nobel Prizes and three NIH-funded researchers who earned prestigious Lasker Awards.
The following is a sample of NIH-supported research accomplishments from 2018, several of which benefit aging Americans:
Impaired brain drainage in aging and Alzheimer’s
Only recently were vessels discovered that allow waste products to drain out of the brain. Researchers led by Sandro Da Mesquita, Ph.D. and Jonathan Kipnis, Ph.D. at the University of Virginia in Charlottesville reported in the journal Nature in August that these waste-clearing vessels do not work as well in older mice, leading to waste buildup. When the scientists enhanced vessel drainage in the older mice, their cognitive abilities improved. When they disrupted these vessels, the buildup of Alzheimer’s disease-related proteins increased. The results, say researchers, suggest a possible way to combat cognitive decline in aging and age-related diseases. The study was supported by NIH’s National Institute of Aging (NIA). “It was long thought that the brain didn't have a lymphatic system and instead relied solely on waste slowly diffusing from brain tissue into the cerebral spinal fluid,” NIH Research Matters Assistant Editor Tianna Hicklin, Ph.D. wrote on the study. “This system, managed by brain support cells called glial cells, is called the glymphatic system. Recently, researchers found conventional lymphatic vessels in the meninges, the tissue that covers the brain. These vessels surround blood vessels in the meninges, allowing waste products from the cerebral spinal fluid to drain out."
Hicklin said previous studies have shown that aging can lead to protein buildup in the brain. That buildup—called amyloid-be—is a hallmark of Alzheimer’s disease. “It may be very difficult to reverse Alzheimer’s, but maybe we would be able to maintain a very high functionality of this lymphatic vasculature to delay its onset to a very old age,” Kipnis said. More research is needed, however, to determine whether altering lymphatic vessels in people would have any benefit.
Blood test detects several cancer types
Researchers at Johns Hopkins University developed a blood test in 2018 that can detect signs of eight common solid tumors—breast, colorectal, esophagus, liver, lung, ovary, pancreas and stomach—and pinpoint their source. Funded in part by the NIH’s National Cancer Institute (NCI) and the National Institute of General Medical Sciences (NIGMS), researchers worked to develop tests that detect bits of tumor material in bodily fluids such as blood, urine or saliva. Results were published online on January 18, 2018, in Science.
“This test represents the next step in changing the focus of cancer research from late-stage disease to early disease, which I believe will be critical to reducing cancer deaths in the long term,” said co-lead researcher Bert Vogelstein, M.D.
Cancer treatment is more likely to work when the disease is detected early. That’s why screenings are so important. They often detect cancer before any symptoms develop. With further development, these tests, sometimes called liquid biopsies, could catch several types of cancer earlier than ever.
Appropriately called CancerSEEK the test evaluates the presence of 2,001 genetic mutations and levels of eight proteins. According to NIH Research Matters Editor Harrison Wein, Ph.D. the researchers tested CancerSEEK in 1,005 patients who had been diagnosed with cancer but whose cancers hadn’t yet spread at the time of enrollment. They tested 812 healthy controls for comparison.
“Overall, CancerSEEK detected 70% of the cancers. Sensitivity ranged from 98% for ovarian cancers to 33% for breast cancers. Sensitivity varied by cancer stage: 78% for Stage III cancers; 73% for Stage II cancers; and 43% for Stage I cancers,” Wein wrote. “The scientists used machine learning to predict the underlying cancer type in the 626 cancer patients who had positive CancerSEEK tests. They were able to narrow the source of the cancer to two organs in 83% of the patients and to a single organ in 63%.”
Johns Hopkins scientists estimate test cost at less than $500. “The eight cancer types studied account for more than half of cancer deaths nationwide, and current screening tests with proven benefit are limited to only a few types of cancer,” Wein wrote. “Earlier detection could potentially reduce deaths from these diseases. However, there were several limitations to this study. Further testing will be needed to measure the accuracy and predictive value of CancerSEEK in a clinical setting.”
Wearable ultrasound patch tracks blood pressure
Researchers led by Sheng Xu, assistant professor at the University of California, San Diego (UCSD), engineered a blood pressure sensor that uses ultrasound technology and can be worn as a flexible skin patch. The technology could replace other methods of monitoring blood pressure in the future.
Researchers set out to develop a thin, wearable blood pressure sensor using ultrasound transducers which make high frequency sound waves that bounce off the blood vessel. “The transducer then receives the echo patterns and sends them to a computer to create a representation of the vessel’s changing diameter, called a waveform,” wrote NIH Research Matters Assistant Editor Geri Piazza. “When calibrated to a patient’s blood pressure, these waveforms can be used to monitor changes in blood pressure.”
Many people who suffer from high blood pressure or hypertension don't know it, because it usually doesn’t cause warning symptoms. A blood pressure check is the only way to detect it.
The pressure of blood flowing through arteries and other blood vessels can harm organs when it remains too high for too long leading to heart attack, stroke, kidney disease and other health problems, Piazza wrote. Through the use of ultrasound technology in the form of the flexible skin patch developed by researchers, high blood pressure could be detected before problems arise. The wearable ultrasound patch can track blood pressure in a deep artery or vein in the neck and produce waveforms for vessels as deep as 4 centimeters below the skin surface.
The work was supported in part by NIH’s National Institute of Biomedical Imaging and Bioengineering (NIBIB). Results were published in Nature Biomedical Engineering on September 11, 2018.
“Wearable devices have so far been limited to sensing signals either on the surface of the skin or right beneath it. But this is like seeing just the tip of the iceberg,” Xu said. “By integrating ultrasound technology into wearables, we can start to capture a whole lot of other signals, biological events and activities going on way below the surface in a non-invasive manner.”
The precision and accuracy of the skin patch has yet to be compared to the catheterization method of measuring blood pressure, Piazza wrote. For the next phase of development, the team would like to engineer a way to make the skin patch wireless, she wrote.
A full listing of the agency’s research highlights from 2018 can be found here. For an overview of the NIH, its history and how research dollars are spent, click here.
