The Year in Research
I have such pride in our School of Medicine research teams, which are full of inspired scientists, caring mentors, and collaborative researchers."
Blossom Damania, PhD, Vice Dean for Research at the UNC School of Medicine
In fiscal year 2024, UNC School of Medicine researchers led the drive toward important discoveries aimed at improving human health and the lives of people in North Carolina, thanks to their dedication, ingenuity, and collaborative spirit. Their funding streams remain significant and impressive, allowing our clinical, translational, and foundational researchers to pursue their scientific curiosity.
From July 2023 through June 2024, the UNC School of Medicine research endeavor totaled more than $648 million, including $373 million from the National Institutes of Health.
Total research funding portfolio in 2024
“I have such pride in our School of Medicine research teams, which are full of inspired scientists, caring mentors, and collaborative researchers,” said Blossom Damania, PhD, Vice Dean for Research at the UNC School of Medicine, the Boshamer Distinguished Professor of Microbiology and Immunology, and member of the UNC Lineberger Comprehensive Cancer Center. “They not only pursue excellence in biomedical sciences; they create an environment where other young, promising, extremely passionate investigators want to work. Thanks to our students, staff, postdocs, fellows, residents, and faculty, the future at the UNC School of Medicine is brighter than ever.”
Research funding for the School of Medicine has grown more than $137.8 million over the past five years since fiscal year 2019.
The UNC School of Medicine accounts for more than half of all research funding at UNC-Chapel Hill, which surpassed the $1.2 billion milestone in 2024.
In February 2024, the Blue Ridge Institute for Medical Research published rankings for schools of medicine based on NIH funding. Our School of Medicine ranked 19th in the country, 6th among public peer universities. Each of our six foundational science departments were ranked in the top 10, with genetics ranked 1st among public schools and cell biology & physiology ranked second in both categories. Eleven clinical departments were ranked in the top 30.
Although the National Institutes of Health funds more than half of UNC School of Medicine, the school of medicine also receives research funding from the State of North Carolina, PCORI, the Department of Defense, the National Science Foundation, and many nonprofit organizations and private foundations.
The accomplishments of UNC School of Medicine researchers are too many to detail here, but readers can visit news.unchealthcare.org to find research stories the UNC Health/UNC School of Medicine communications team covered this past year. You can even search by month or topic.
Below we highlight three unique research stories from fiscal year 2024 that our UNC Health team covered.
Revealing a New Villain in Breast, Ovarian, and Prostate Cancers
Our DNA is not indestructible. Throughout the course of our lives, DNA can break in response to natural and environmental factors. Thankfully, our bodies have dedicated enzymes and proteins that can glue our broken DNA back together in several different ways, known as DNA repair pathways.
Some cancers, though, can hijack these pathways for their own benefit. Susanna Stroik, PhD, and Dale Ramsden, PhD, both researchers in the Department of Biochemistry and Biophysics in the UNC School of Medicine and the UNC Lineberger Comprehensive Cancer Center, have pieced together the lesser-known DNA repair pathway, called polymerase theta-mediated end joining (TMEJ).
This pathway has been found to be more prevalent in many patients with hereditary breast cancer, ovarian cancer, and prostate cancer, specifically cancers involving BRCA1 and BRCA2 genetic mutations. Their research findings have been laid out step by step in a published article in Nature, arguably the world’s finest scientific journal. This new knowledge could lead to new therapies for cancer.
“People with these breast cancer mutations, their cancers rely on polymerase theta’s repair pathway to keep the tumors alive and repair DNA damage in the cancerous tissue,” said Stroik, a postdoctoral researcher in Ramsden’s lab. “Now that we know more about this pathway, scientists could, in theory, produce a drug that could disrupt key pieces of the pathway in cancer cells, as opposed to using conventional chemotherapies that destroy healthy cells along with the cancer.”
Susanna Stroik, PhD
Dale Ramsden, PhD
Surprising New Details about Street Fentanyl
Unregulated use of fentanyl and overdose deaths have increased dramatically in recent years, and this trend was made more alarming when authorities found fentanyl laced with the animal tranquilizer xylazine. Some addiction specialists and public health officials feared the added xylazine would impede the fast-acting effects of the drug naloxone, which can effectively treat patients experiencing respiratory depression – when the brain stops the body from breathing properly, the most serious side effect of opioid use that can lead to death.
Zoe McElligott, PhD
In a recent research discovery published in the journal Addiction Neuroscience, scientists at the University of North Carolina School of Medicine found that xylazine is a kappa opioid receptor agonist, meaning it activates kappa opioid brain receptors in the same way fentanyl activates opioid receptors. This result was surprising because previously xylazine was thought to only bind to the α2-adrenergic receptor. The more kinds of brain cell receptors a drug latches onto, the more wide-ranging effects a drug can have on a person. This finding suggests a reason why withdrawal from fentanyl in combination with xylazine is so severe.
This research, led by the lab of Zoe McElligott, PhD, associate professor of psychiatry and pharmacology, provides important insights into the subtle cellular realities underlying opioid use – especially in light of the added anesthetic xylazine to fentanyl – and naloxone, the leading treatment used to prevent death from fentanyl overdose.
“Many people thought xylazine operated exclusively through a different mechanism in the nervous system,” said McElligott, who is also a member of the UNC Bowles Center for Alcohol Studies. “But because we show xylazine is an agonist at kappa opioid receptors in the brain and body, in addition to acting at other targets, we may have gleaned insight into why withdrawal from the combination of fentanyl and xylazine is so harsh.”
Because severe withdrawal results in extremely strong symptoms, people often choose to continue using drugs to keep the physical and psychological effects of withdrawal at bay, according to McElligott. Her lab’s discovery, accomplished in collaboration with other researchers at UNC-Chapel Hill, could have big implications for future scheduling recommendations for xylazine and how clinicians might treat patients in the future.
“A big ‘take-home’ message is that we want to make sure people are administered naloxone as a life-saving treatment,” McElligott said. “When xylazine first came on the scene, there was a lot of talk about how it wouldn’t respond to naloxone. Our data suggest otherwise, and we don’t want people to not administer naloxone because they suspect someone has xylazine in their system.”
Enlarged Brain Spaces Linked to Risk of Autism
Throughout the day and night, cerebrospinal fluid (CSF) pulses through small fluid-filled channels surrounding blood vessels in the brain, called perivascular spaces, to flush out neuroinflammation and other neurological waste. A disruption to this vital process can lead to neurological dysfunction, cognitive decline, or developmental delays. Lack of proper sleep, FYI, can disrupt this much-needed flushing.
These results suggest that perivascular spaces could serve as an early marker for autism"
For the first time, UNC School of Medicine researchers Dea Garic, PhD, and Mark Shen, PhD, both in the UNC Department of Psychiatry, discovered that infants with abnormally enlarged perivascular spaces have a 2.2 times greater chance of developing autism compared to infants with the same genetic risk. Their research also indicated that enlarged perivascular spaces in infancy are associated with sleep problems seven to 10 years after diagnosis.
“These results suggest that perivascular spaces could serve as an early marker for autism,” said Garic, assistant professor of psychiatry and a member of the Carolina Institute for Developmental Disabilities (CIDD).
The researchers studied infants at increased likelihood for developing autism, because they had an older sibling with autism. They followed these infants from 6-24 months of age, before the age of autism diagnosis. Their study, published in JAMA Network Open,found that thirty percent of infants who later developed autism had enlarged perivascular spaces by 12 months. By 24 months of age, nearly half of the infants diagnosed with autism had enlarged perivascular spaces.
Starting ten years ago, there has been a resurgence of research on the important functions of CSF in regulating brain health and development. Shen’s lab was the first to report that excessive volume of CSF was evident at 6 months of age in infants who would later develop autism. This latest study is the first to show that excessive CSF at 6 months was linked to enlarged perivascular spaces at 24 months.
This research is the latest in a long line of infant imaging studies using MRI overseen by Joe Piven, MD, director of CIDD, and made possible through a large network of international researchers and families of children with autism.
