Brazil Platform

UMMS Dean Woolliscroft (center) receiving a token of friendship
UMMS Dean Woolliscroft (center) receiving a token of friendship from the University of São Paulo brought to him by Dr. Edmund Baracat (left) and Dr. Ana Claudia Latrônico (right)

Faculty members in the University of Michigan Medical School (UMMS) have been collaborating with partners in Brazil for more than a decade and twenty-five Global REACH Faculty Associates are currently engaged in Brazil Platform. UMMS has Memoranda of Understanding with both the Institute of Biomedical Sciences at the University of São Paulo (ICB-USP) and the University's Faculty of Medicine (FMUSP). FMUSP is widely considered to be the best medical school in Latin America, with a large research capacity and a network of hospital and ambulatory centers serving hundreds of thousands of patients.

In recent years, UMMS has been actively strengthening its collaborations with USP, building on a number of existing UMMS-FMUSP research programs. In September 2012, University of Michigan President Mary Sue Coleman led a delegation to Brazil to explore institutional partnerships. Two of the UMMS Brazil Platform faculty (Drs. Gary Hammer and Michele Heisler) served on the planning committee for the President's visit and accompanied her to Brazil as members of the delegation.

During her trip, President Mary Sue Coleman signed collaboration agreements with the University of São Paulo (USP) and the State of São Paulo Research Foundation (FAPESP), one of the main funding agencies in Brazil. The new agreements aim to stimulate collaboration between U-M researchers and researchers throughout higher education and research institutions in the São Paulo state.  

If you have any inquires or suggestions about Brazil Platform, please contact Elisa Teixeira at elisadut@umich.edu.

View list of Global REACH Faculty Associates collaborating in Brazil here.

 

News and Updates

Dr. Tate delivering her lecture at Lucy Montoro Rehabilitation Hospital in Sao Paulo, Brazil.
  • March 2012: Estate Gift supports Community Health Training Programs in Brazil (see Page 39 of 2012-13 GR report)

  • September 2012:  President Mary Sue Coleman traveled to Brazil with a delegation of U-M faculty and staff. A pre-trip interview with Dr. Heisler and Dr. Sueann Caufield (another member of the delegation) can be seen hereAn article that appeared in the Detroit Free Press on January 14, 2013 can be found here.

  • December 2012Dr. Denise Tate presented on the importance of collecting uniform data on SCI care to professionals at the Lucy Montoro Rehabilitation Hospital,  a state of the art facility in the city of São Paulo. 

  • January 2013: One of its first initiatives following President Coleman's trip to Brazil was to establish a joint FAPESP-UM Call for Scientific Proposals to support new research projects between U-M and Brazilian collaborators.

  • January 2013Dr. Elisa Duarte Teixeira (elisadut@umich.edu) was hired as a part-time Project Intermediate Manager for Brazil Platform. She will be working with Dr. Heisler and the Global REACH team to determine and implement strategic plans for building research and educational collaborations between the University of Michigan and Brazilian universities and research centers. 

  • December 2013-January 2014: Four Brazilian medical students visit UMMS as part of the first formal exchange program

  • February-March 2013UM Occupational Health student, Grettel Zamra-Beridi went to Brazil for M4 International Elective

  • May 2013: Three UMMS projects were awarded funding through the joint FAPESP-UM initiative:

    Dr. Michele Heisler (Internal Medicine/Veteran Affairs): Developing long-term population-based cohort studies and interventions to improve health care and outcomes in the western region of São Paulo

    Dr. Katherine Spindler (Microbiology and Immunology): Neuropathogenesis of oropouche virus 

    Dr. Denise Tate 

    (Physical Medicine and Rehabilitation): Development of standard methods to evaluate driving among older individuals with and without disabilities

  • August 2013: First University of Michigan-FIOCRUZ Symposium held at FIOCRUZ, Rio de Janeiro.  UMMS faculty participants included Michele Heisler, Alexandra Stern, Denise Tate, Garry Hammer, Gary Smith, Joel Howell, Kate Stanley, Kenneth Langa, and Lisa Hammer.

  • August 2013: Project Manager Elisa Teixeira traveled to São Paulo to meet FMUSP collaborators Dr. Ana Claudia Latrônico, from Endocronology, Dr. Edmund Baracat, from Gynechology, Talita Almeida, FMUSP International  Relations Specialist, Dr. Manoel Jacobsen Teixeira and Dr. Daniel Ciampi, from Neurosurgery, and Dr. Klaus Hartfelder, from FMRP.

  • October 2013: Dr. Kate Stanley, UM neonatologist, goes to Belo Horizonte to participate in a Milk Bank International Meeting , as part of the UMich-FIOCRUZ Collaboration (more information, In Portuguese, here: http://www.youblisher.com/p/749759-rBLH-Comunica-N-171-Boletim-da-Rede-de-Bancos-de-Leite-Humano/)

  • December 2013: Michele Heisler traveled to Brazil with other UM researchers to have the first meeting of the UM-FAPESP Grant project she wrote with Dr. Alexandra Brentani, from FMUSP Pediatrics Department.

  • January 2014: A pilot course on Portuguese for Spanish-Speaking Health Professionals began for UMMS medical students and faculty.

  • February 2014:  The 2014 Call for Scientific Proposals to support new research projects between U-M and Brazilian collaborators from São Paulo state has been announced by the Vice Provost for Global and Engaged Education.  This small grant program was one of its first initiatives following President Coleman's trip to Brazil in 2012. Application Deadline is April 1, 2014. More information can be found here (PDF). Questions related to this Call for Proposals may be emailed to: UM-FAPESP-Proposals@umich.edu.  Information for Brazilian collaborators can be found here.

  • March 2014: The first annual Meet & Greet was held.  About 40 U-M investigators who collaborate with partners in Brazil were in attendance.

Shown above are participants in the Winter 2014 Portuguese for Spanish-Speaking Health Professionals pilot course. From left to right: Dr. Bernando Rodrigues, MD, PhD (Brazilian fellow at Movement Disorders), Stephanie Chalifour*, Pooja Agrawal*, Elizabeth Kaselitz, LLMSW (Clinical Research Project Manager at the U-M Division of General Medicine), Marlon Bohorquez*, Thaisa Barbosa**, Leonardo Lima**, Simanjit Mand*, and Miguel Rovira*
*Faculty-Led Trip to Brazil scholarship recipients; **Visiting Brazilian Medical Students

    Research Programs

    Adrenal and Other Endocrinological Cancers and Disorders

    • Brazil has one of the highest concentrations of adrenal cancer in the world with 15 percent more prevalence than anywhere else.
    • USP is the South American hub of activity in regard to adrenal cancer work, and U-M’s Endocrine Oncology Program is an lnternational Destination Program Center of Excellence for the treatment of adrenal cancer.
    • The two programs have collaborated on research studies over the years, and are now working to create combined data registries. Other joint projects include developing mass spectrometry methods to comprehensively examine steroid production and to detect partial blocks in specific steps in cortisol synthesis.
    • A recent publication by researchers from the two institutions shows that the two common mutations in adrenal cancer are critical for the induction of the disease in humans and in mouse models.  It is a powerful example of how international collaboration (which is critical to make progress in the disease) AND how genomic platforms together with animal modeling can shed light on the pathogenesis of rare diseases like adrenal cancer.  The work was funded in part by NIH and in part by the Schembechler Adrenal Cancer Research fund.
    • Collaborators are also working on a joint Center grant application.
    • View a video interview with Dr. Gary Hammer about the importance of the adrenal cancer collaboration with the University of Sao Paulo.

    UMMS Contact

    Gary Hammer, MD, PhD
    Millie Schembechler Professor of Adrenal Cancer, Professor of Internal Medicine, Professor of Molecular and Integrative Physiology, Director of Center for Organogenesis and Professor of Cell and Developmental Biology, Medical School


     

    Photo by Fabio Venni under a Creative Commons license: BY-SA
    Photo by Fabio Venni under a Creative Commons license: BY-SA

    Health Equity and Chronic Disease Management

    • FMUSP has a mandate to run all primary care centers (Basic Health Units- UBSs) in Sao Paulo’s low-income neighborhoods of Western Region (Região Oeste).
    • These centers are organized into healthcare teams consisting of 1 doctor, 2 nurses, 2 medical assistants, and 6 community health workers from the served communities.
    • U-M faculty members are working with USP colleagues to develop and test innovative approaches to improve community health worker-led self-management training for patients with chronic disease in Região Oeste.
    • The Região Oeste project itself is interdisciplinary, bringing together faculty and students from numerous USP departments and schools—including engineering, urban planning, environmental sciences, sociology, economics, and psychology, among others—to conduct interdisciplinary projects to study and improve conditions in the poor urban communities in the Região Oeste.

    UMMS Contact

    Michele Heisler, MD, MPA
    Associate Professor of Internal Medicine, Medical School and Associate Professor of Health Behavior and Health Education, School of Public Health
    Co-Director, Robert Wood Johnson Foundation Clinical Scholars®, Research Scientist, Center for Clinical Management Research, Ann Arbor VA HSR&D


    Reproductive Endocrinology and Technology

    • UMMS researchers and USP researchers have been collaborating on projects since 2004.
    • UMMS Professor of Obstetrics & Gynecology Dr. Gary Smith serves as the Off-Site Scientific Director of the Huntington Centers for Reproductive Medicine of Brazil (HCRMB), which is now the largest in-vitro fertilization (IVF) clinic in the Americas performing over 3,000 cycles per year.
    • The collaborative team has completed phase I and II clinical trials, implemented state-of-the-art infertility treatment and fertility preservation technologies, and improved fertility healthcare. There have been 10 collaborative peer-reviewed publications since 2006, 23 national/international meeting presentations and abstracts, and 11 physician, fellow and/or student exchanges since 2004.
    • Current aims are to continue reciprocal training, research, and improvement of healthcare in reproductive endocrinology, gamete/embryo biology, and treating infertility.
    • The team is working to implement a Fertility Preservation Program at USP. This will provide on-site and off-site (across the entire country of Brazil) service of male and female gamete cryopreservation for individuals at risk of losing fertility due to gonadotoxic treatments for cancers, immune diseases, and transplant therapies.

    UMMS Contact

    Gary D. Smith, PhD, HCLD
    Professor of Obstetrics & Gynecology, Professor of Physiology, Professor of Urology, Co-Director, Taubman Consortium for Stem Cell Therapies; Co-Director, Reproductive Sciences Program; Visiting Professor, University of Sao Paulo; Off-Site Scientific Director of Huntington Centers for Reproductive Medicine of Brazil (HCRMB)


    Spinal Cord Injury

    SCI co-investigator, Dr. Julia Greve (USP), visiting the U-M SCI outpatient clinic to observe patient walking with robotic assistive device
    • The incidence and prevalence of spinal cord injury (SCI) in the US and Brazil are among the highest in the world. The cost of caring for someone with SCI continues to exceed that of most disease conditions.

    • UMMS and MFUSP researchers are working together to develop a common database to collect information to be used in research to aid clinical care. The collaboration emphasizes the importance of standard datasets to guide clinical treatment and research in SCI. They have translated and completed psychometric studies of the SCI Bowel Function Basic dataset and are currently in the process of completing others for joint use in future clinical validation studies. Testing these datasets adds to the current studies being conducted at the U-M SCIMS which focus on examining the influence of bowel and bladder management on complications and quality of life after SCI. 
    • Comparing data cross culturally is another added benefit of this international collaboration. The Presidents of the International Spinal Cord Society (ISCoS) and the American Spinal Injury Association (ASIA) have approved the project and the most recent updates were presented at the September 2012 meetings of the International Spinal Cord Society (ISCoS) in London.
    • Kidney failure is the number one cause of SCI related mortality. This group is interested in studying the best methods for neurogenic bladder and bowel care in this population.
    • The collaborating team is developing a short-term training program on SCI care and research for USP residents and an exchange program for UMMS PM&R residents giving them the opportunity to work with SCI inpatients and outpatients who are clinically and characteristically very different from SCI patients seen in Michigan.

    UMMS Contact

    Denise Tate, PhD, ABBP, FACRM
    Professor of Physical Medicine & Rehabilitation, Medical School; Associate Chair for Research and Director, Model Spinal Cord Injury (SCI); Director, Advanced Rehabilitation Research Program


    Endocrine Genetics Collaboration

    • Collaborations have existed for a number of years with shared publications and presentations, and UMMS faculty have taught short-duration courses at USP attended by students and faculty.
    • Dr. Carlos Carvalho, one of the major mouse users at USP, was a postdoc in Dr. Sally Camper’s lab at UMMS. Camper and Carvalho have a collaboration aimed at identifying stem cell markers in pituitary gland using mouse models. The use of animals in research at USP is currently minimal, but expanding. One USP researcher using zebrafish is studying the effect of environmental toxins on fertility.
    • Camper also collaborates with Carvalho’s colleagues Dr. Mendonca and Dr. Arnhold. Mendonca is internationally known for her work in disorders of sexual development, while Arnhold is an expert in short stature.
    • Sao Paulo used to be the only site in Brazil that could treat patients with growth hormones, so they have a large cohort they are following from childhood through adulthood. Carvalho, Arnhold, and colleagues identify mutations in patients with short stature and growth hormone deficiency, Camper’s lab advises and assists with developing the functional tests when needed.
    • Plans are in the works to do SNP typing and exome sequencing on patients who have growth hormone deficiency, but have no mutations in known genes.

    UMMS Contact

    Sally Camper, PhD
    James V. Neel Collegiate Professor of Human Genetics; Chair, Department of Human Genetics; Professor of Human Genetics and Professor of Internal Medicine, Medical School


    Brains from mice infected with an encephalitic virus (bottom row) show disruption of the blood-brain barrier (green dye permeability) that is not seen in control uninfected mice (top).

    Neuropathogenesis of Oropouche Virus

    • Oropouche virus (OROV) is second only to dengue in causing febrile illnesses in Brazil. Infection can be quite debilitating, although the virus does not cause death. OROV is currently rated as a BSL-3 (Biosafety Level 3) virus, 4 being the most dangerous. UMMS does have a BSL-3 facility, but one of the aims of this collaboration is to petition to reduce OROV's rating to BSL-2 to faciliate additional research.

    • The arthropod vector of OROV is primarily biting midges (Culicoides paraensis). Deforestation and global climate change impact the potential for expansion of the range of the vector and increase of the disease in South and North America.

    • Two forms of the OROV disease exist, a classic febrile form and one that progresses to aseptic meningitis in approximately 5% of patients seeking medical care. Nearly 60% of patients have a recurrence of clinical signs 1-2 weeks after their initial disappearance. There is a gap in knowledge about the cells or organs in which OROV replicates and in how it causes relapses and meningitis. Currently, there are no treatments or vaccines.

    • The long-term goal of this project is to improve therapy for people with arboviral disease by understanding how viral gene products interact with the host to cause disease. Toward that goal, this team seeks to determine how OROV infects the central nervous system (CNS) using and further developing mouse models in which there is severe CNS involvement. 

      Dr. Eurico Arruda (left) and Dr. Kathy Spindler in Dr. Arruda's laboratory, University of São Paulo Medical School at Ribeirão Preto, FMRP
    • Dr. Spindler and her Brazilian collaborator, Professor Eurico de Arruda Neto from the Cell Biology and Virology Research Center at the University of São Paulo Medical School at Ribeirão Preto (FMRP), have known each other through scientific meetings since 2008. In 2012, Dr. Arruda was on the PhD committee of Luiza Antunes de Castro Jorge, who is now a post-doc in Dr. Spindler’s lab with a “Science Without Borders” scholarship.  

    UMMS Contact
    Katherine Spindler, PhD
    Professor of Microbiology and Immunology, Medical School


    Immunological/Pulmonary Diseases

    • Collaborations between UMMS and USP date back more than 10 years. Many high-level publications have resulted from these collaborations.
    • This partnership has resulted in many visiting scholars from Brazil, including three PhD postdocs and four PhD students. Two of the postdocs now hold faculty appointments and remain collaborators; one is at Sao Paulo State University, one at the Federal University of Rio De Janeiro.
    • Dr. Peters-Golden is a formal collaborator on grants held in Brazil by Professor Jancar and former trainee Professor Medeiros (Araraquarra).
    • During a visit in the fall of 2011, Peters-Golden visited with Dr. Carlos Carvalho, Professor of Internal Medicine and Director of Pneumonology, and his department. Based on their discussion, there is mutual interest to further explore possible opportunities for research collaboration and exchange of trainees at the fellowship level (i.e., individuals who have completed MD and internal medicine residency, and are in subspecialty training in Pulmonary and Critical Care Medicine).

    UMMS Contact

    Marc Peters-Golden, MD
    Professor of Internal Medicine, Medical School, Pulmonary & Critical Care Medicine

    UMich-Fiocruz Collaboration

    The UMich-Fiocruz Collaboration is a joint project involving researchers of the University of Michigan and Rio de Janeiro’s Oswaldo Cruz Foundation, Fiocruz.  The program is part of the University of Michigan's Presidential Initiative on Brazil, launched in 2012, and is managed by Bebete Martins, Brazil Initiative Program Manager at the Latin American and Caribbean Studies Center (LACS).

    The collaboration brings together researchers from both institutions working in the areas of health status, determinants, outcomes, interventions, and histories to engage in substantive and medium-range projects. The research methods are interdisciplinary, including quantitative and qualitative approaches (implementation studies, survey data collection, ethnography, archival research, and more). Researchers from both institutions work primarily in these areas:

    1. Management and Prevention of Chronic Diseases 
    2. Women’s and Children’s Health 
    3. Historical and Anthropological Studies of Medicine, Health, and Health Sciences 
    4. Health and Environment 

    On the Michigan side, the interdisciplinary faculty group includes researchers based in the SPH, UMMS, SNRE, LS&A, and ISR. This three-year research collaboration was consolidated at a research symposium held August 7-9, 2013, at the Fiocruz campus, in Rio de Janeiro, Brazil. A summary report of the symposium can be downloaded here (PDF). 

    LACS is now overseeing pilot fund to support research in the identified areas. If you are interested in learning more about this collaboration, please contact Bebete Martins at bmartins@umich.edu.