This proposal describes a 3-year training program for the development of an academic research career in translational research in inflammatory bowel disease. The principal investigator has completed molecular biology training (Ph.D.), and clinical research training (M.Sc.), and will now link basic science and clinical research skills with supplementary training in orphan nuclear receptor biology and transgenic rodent models of intestinal fibrosis. This will provide a critical link to enable the candidate to translate basic science findings to future clinical research in humans. The training program will develop the candidate's skills in nuclear receptor biology, myofibroblast biology, and intestinal fibrosis, through structured learning and an outstanding mentoring team. Dr. Ellen Zimmermann, an expert in intestinal fibrosis, will be joined on the mentoring team by Dr. Sem Phan, an expert in myofibroblast biology, Dr. Victor Thannickal, a translational researcher in pulmonary fibrosis, and Dr. Bertram Pitt, a clinical researcher of the role of spironolactone in cardiac fibrosis and heart failure. The Gastroenterology Division at the University of Michigan provides an ideal setting for training translational physician-scientists by incorporating expertise from many resources into customized training programs for academic career development. This environment is highly advantageous for launching the translational research career of Dr. Higgins. The proposed research will focus on intestinal fibrosis, a feared complication of Crohn's disease with no effective medical treatments. The long-term research goal is to elucidate the mechanisms of TGF?1-driven intestinal fibrosis and to use this information to target anti-fibrotic therapies that can prevent or reverse intestinal fibrosis. Our preliminary data drives our central hypothesis, that spironolactone has a novel property, the ability to inhibit TGF?1 signaling via SMAD2 and SMAD3 through its activation of the orphan nuclear receptor, PXR (pregnane X receptor).
The specific aims i nclude: (1) To determine whether spironolactone utilizes activation of the pregnane X receptor (PXR) to prevent phosphorylation, nuclear translocation, or the transcriptional activity of Smad2 and SmadS in TGF-?1 [sic] stimulated fibrogenic colonic myofibroblasts;and (2) To determine whether spironolactone can inhibit intestinal fibrosis in rat and mouse models of chronic inflammatory bowel disease. These studies will provide insight into the mechanisms of TGF?1 -driven intestinal fibrosis, will help the candidate develop essential skills to become an independent investigator, and may provide the basis of future translational applications of anti-fibrotic therapy. This research is highly relevant to public health because Crohn's disease affects over 600,000 Americans;we have no therapy to prevent intestinal fibrosis;and currently ~75% of these patients will eventually require surgery for fibrotic intestinal strictures.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Clinical Investigator Award (CIA) (K08)
Project #
Application #
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Michigan Ann Arbor
Internal Medicine/Medicine
Schools of Medicine
Ann Arbor
United States
Zip Code
Rodansky, Eva S; Johnson, Laura A; Huang, Sha et al. (2015) Intestinal organoids: a model of intestinal fibrosis for evaluating anti-fibrotic drugs. Exp Mol Pathol 98:346-51
Herfarth, Hans H; Rogler, Gerhard; Higgins, Peter D R (2015) Pushing the pedal to the metal: should we accelerate infliximab therapy for patients with severe ulcerative colitis? Clin Gastroenterol Hepatol 13:336-8
Johnson, Laura A; Rodansky, Eva S; Haak, Andrew J et al. (2014) Novel Rho/MRTF/SRF inhibitors block matrix-stiffness and TGF-?-induced fibrogenesis in human colonic myofibroblasts. Inflamm Bowel Dis 20:154-65
Johnson, Laura A; Rodansky, Eva S; Sauder, Kay L et al. (2013) Matrix stiffness corresponding to strictured bowel induces a fibrogenic response in human colonic fibroblasts. Inflamm Bowel Dis 19:891-903
Johnson, Laura A; Govani, Shail M; Joyce, Joel C et al. (2012) Spironolactone and colitis: increased mortality in rodents and in humans. Inflamm Bowel Dis 18:1315-24
Xu, Jingping; Tripathy, Sakya; Rubin, Jonathan M et al. (2012) A new nonlinear parameter in the developed strain-to-applied strain of the soft tissues and its application in ultrasound elasticity imaging. Ultrasound Med Biol 38:511-23
Johnson, Laura A; Luke, Amy; Sauder, Kay et al. (2012) Intestinal fibrosis is reduced by early elimination of inflammation in a mouse model of IBD: impact of a ""Top-Down"" approach to intestinal fibrosis in mice. Inflamm Bowel Dis 18:460-71
Johnson, Laura A; Sauder, Kay L; Rodansky, Eva S et al. (2012) CARD-024, a vitamin D analog, attenuates the pro-fibrotic response to substrate stiffness in colonic myofibroblasts. Exp Mol Pathol 93:91-8
Higgins, Peter D R; Johnson, Laura A; Sauder, Kay et al. (2011) Transient or persistent norovirus infection does not alter the pathology of Salmonella typhimurium induced intestinal inflammation and fibrosis in mice. Comp Immunol Microbiol Infect Dis 34:247-57
Stidham, Ryan W; Xu, Jingping; Johnson, Laura A et al. (2011) Ultrasound elasticity imaging for detecting intestinal fibrosis and inflammation in rats and humans with Crohn's disease. Gastroenterology 141:819-826.e1

Showing the most recent 10 out of 14 publications