TED Talks Daily - Why do some bodies respond differently to disease? | Erika Moore

Episode Date: February 3, 2025

TED Fellow and equity bioengineer Erika Moore investigates how cells controlling inflammation behave differently depending on a patient's background. By focusing on the "who" behind the disease, Moore is uncovering why certain diseases disproportionately affect certain ethnicities, paving the way for more inclusive and effective health care. Hosted on Acast. See acast.com/privacy for more information.

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living made simple for you. You're listening to TED Talks Daily, where we bring you new ideas to spark your curiosity every day. I'm your host, Elise Hough. Today's talk is from our batch of 2024 TED Fellows films adapted for podcasts just for our TED Talks Daily listeners. TED's fellowship supports a network of global innovators, and we're so excited to share their work with you.

Today, we'd like you to meet equity bioengineer, Erica Moore. One thing's for certain, our bodies are all a little bit different from one another. And we respond to bruises, paper cuts, and major illness in different ways. Erica unpacks her investigation into why diseases affect various populations differently and how this kind of research can ensure better health equity around the world. After we hear from Erica, stick around for her conversation differently, and how this kind of research can ensure better health equity around the world. After we hear from Erika, stick around for her conversation with Ted Fellowes Program Director Lily James-Olds.

When I was younger, I just did not heal the same way. I would see these scabs and like I'd pick at them, they'd take forever to close, and my brother's skin would just close right up. And then you know my sisters could have cramps and they would just take ibuprofen and it would be like nothing. And I would take ibuprofen, I would take a lot of ibuprofen and I would get no response from my whole body. And so I just was like why? Please help me. At first I felt like I got the short end of the biological stick, right?

Why does my body not work the same way? There was a lot of frustration because no one knows how they respond to something until they try it. But it was just, I was different from them. That's all. I'm Dr. Erica Moore and I'm an equity bioengineer. So every single time you get a paper cut or even a bruise,

your immune system is there. Macrophage immune cells are present. They're like the watchdog of the body. I think of them as like squishy balls, and they just kind of are always surveilling around the body. Sometimes they're eating, but other times they're just saying, hey, man, don't be mad. This is cool.

We can heal now, right? Just imagine like a squishy ball that's sometimes angry, sometimes happy. They're super cute. I love them. I really study what function or state they adopt based on what environment they're in and based on whose body they come from. There are a lot of other material scientists, bioengineers who have asked and developed really cool applications, but oftentimes we don't really

consider who is studied. My work really focuses on the who of the disease. So I really want to study the diseases that particularly are health disparities, right, that only certain swaths of the population are affected by, because I think that by shining a light on those diseases, we can ensure better health equity for everyone in the world. I think I'm the first person or lab to really spearhead or cheerlead some of these endeavors, because there are lived experiences that a lot of other people in academia and in traditional PhD training don't really have to consider, right? So there aren't that many women of color who are

assistant professors who run research programs and do these other things. I knew so many women growing up who died from lupus. It was very common. When I went to try to study lupus, there were a lot of people who were like, oh yeah, we're agnostic, like we don't care about the background of the patients. When I went to try to study lupus, there were a lot of people who were like, oh yeah, we're agnostic, like we don't care about the background of the patients. But I was like, we know that like 90% of lupus patients are women, and of that about 70% are women of color. So we really have to consider that, right? It should be a variable. Some women develop lupus, they don't ever have flares, they're fine. Other women develop lupus and have flares back to back to back and pretty much develop major

cardiovascular disease very early on. And so we want to take their patient cells and look at their interactions with blood vessels and see how they confer or propagate different inflammation in the system. And we do that all in this little Jell-O construct. So it's almost like a mini tissue outside of the body. And we put the cells in it, and then we can study how they would respond in a tissue-like environment. What we found was really cool. The patient's background really directly affected the blood vessels in the system. We saw increased number of blood vessel interactions between macrophages that were isolated from African American women

compared to those macrophages that were isolated from African American women compared to those macrophages that were isolated from European women. These tissue models helps us answer some really important questions. What if we could pinpoint why inflammation happens in certain bodies more violently than others? What if we could cure autoimmune illnesses by accounting for disease differences based on your background? What if we could prevent excessive fibrosis by tailoring our macrophages to respond differently to injury?

I think my lived experiences made me more likely to ask these questions, and then I was just willing to try, you know, and I'm still willing to try. I think by continuing to try, we innovate on what's the norm and set new standards for the future. If we pay a little bit more attention to the details,

I think we can easily build a more equitable healthcare system for everyone. That's my goal. And now a special conversation between TED fellow Erica Moore and TED Fellows Program Director, Lily James Olds. Hi Erica, welcome. Hi Lily, I'm so excited to be here. Me too.

I just have to start by saying that I never thought I'd hear macrophages described as cute, but there you are, TED Fellows, always full of innovation. Can you tell us a bit more what new equitable initiatives and efforts and technologies your lab has underway right now? There's so much that you all are working on. I'd love to hear a little bit more of the details. So you know, the electrifying nature of being a part of TED means you're always kind of assessing what's on the forefront and trying to push what we consider.

And so one thing we're working on is with a collaborator, we developed an AI model that's going to help us understand what cells of different backgrounds have been used applied to any field at all. So my work focuses on lupus and we're getting into uterine fibroids. But now with this model we're developing, we're hopefully going to be able to scan all of the literature that exists, years, decades of publications, right? And understand what cells have been considered, in which context of disease and response, and have that kind of at the click of a mouse button, right? I'll also share one of the other things we're really excited about is partnering with anthropologists equity into the bench science that we do.

I'll also share one of the other things we're really excited about is partnering with anthropologists and geneticists to help us integrate measures of lived experience. Like, for example, if you experienced high stress or a stress event as a child, how that changes your immune cell function throughout the rest of your adult life. And so those are two of the kind of new adventures we're on as a lab, and hopefully making waves and changing the innovation of how we conduct bench science. That's amazing. I'm wondering if there are any discoveries from your work that you find really particularly illuminating when it comes to understanding healthcare from a more inclusive perspective and any maybe specific examples that really underscore how different people's bodies and healthcare needs are?

I'll give you an example within the context of lupus. And we actually got this feedback from a grant reviewer, which, you know, was somewhat negative at first, but it really helped us spawn these additional questions. And so lupus is a major health disparity. 90% of the people who have lupus are women, and most of those people are people of color, women of color. And you know, initially we were like, oh, well, let's just focus on their backgrounds. But we realized that actually their lived experiences such as

experience of discrimination or medical distrust or financial strain, those were actually really important metrics for helping us understand disease risk and disease profile in terms of immune responses to different medications that we tested out in our lab. navigating and understanding their cellular responses in the lab. We go into the clinic, we get their blood samples, and we also have them fill out a survey that tells us their experiences of discrimination, financial strain, secondary discrimination through family members, etc. And then we're able to integrate that as a measure, and then use that to basically group individuals in a little bit more nuanced way beyond just that of race and ethnicity.

That's amazing. And I know you said that it's early, you know, in this development of this work and the application. Can you just tell us a little bit more about that kind of timeline and that process? And what could this mean for those of us listening? Yeah, this is a great question. And one, I try to communicate really well because people are always so excited, you know, at the clinical level, we want to be treated with drugs or different medications that are going to better help us, you know, respond to certain maladies that our bodies experience. And the way we get to the clinical level, that high impact level, actually begins at

the bench, right? We need to test these drugs and medications before they can get approved into patients. at the bench. pipeline, we are kind of the ones that are talking anyone can get involved at this stage of research. So we scale all of these partnerships, building up to the clinic, but helping us understand these interfaces at the bench side with your cells

and with different medications that are in consideration for treatments. It's truly just so mind blowing. How do you think with this experience that you have, we can start to build a more equitable healthcare system? Everyone's like, well, what does that have to do with me in the clinic? Right? Like when I go see my doctor, how does my work change how I might talk to my doctor?

And one thing I always say is when we talk to clinicians right now, they're still bifurcating, you know, just by race. So I'll come into the clinic as a young black woman and I tell my doctor, I'm like, hey, I'm having painful menstrual bleeds. And they're like, yeah, that's normal. And I'm like, I'm like, you know, so I would love for them to ask more questions to understand, well, what kind of stress do I sweep? the whole clinical enterprise in one sweep, but by asking more questions, by using the research

that my lab shares, that other labs shares, we can hopefully ask questions that are beyond the norm of just age, sex, and race. We can start considering some of these other factors that actually play really dominant roles in our understanding of disease development and disease treatment. One really cool example I'll give you is with uterine fibroids. And one thing that's not done in the clinic is routine testing for vitamin D. And so we think like we are doing some experiments now where we're just

looking at well how does vitamin D affect fibroids in our tissue models. But if people don't know what their vitamin D level is, then they don't know that they should be taking a multivitamin, right? But that has vitamin D in it. And so this is a way that we connect even our bench side studies all the way to clinic and then hopefully to patient advocacy where patients can say, hey, actually, I'm having heavy menstrual bleeding. Can you check my vitamin D level? Right?

And that's a really simple ask, but it's one way to build more equity in the healthcare system that connects all the way from the bench to clinical practice. And I mean, you've been talking all around this, Erica, but I guess just to bring it out explicitly, can you say why you think this is so important? Why does that matter? Yeah, it's such a good question too, because there are people who are unfortunately dying right now,

or they're getting much more sick because they don't receive proper care. And that's a tragedy in the United States and all over the world. And so my goal with all of the work that we do is to try to educate people so that way we have better resources to treat every single person. We can't assume people are monolith. And I think that's sometimes what happens, right? You just get classified by your age, by your sex, and or by your race and ethnicity. And we're really seeing that that's a really limited perspective of how we consider the medical enterprise. And so with the goal of all the work that we do is to try to help us better treat individually

our personalized experiences with different diseases and maladies and to consider our specific interventions that are needed for certain populations. And then I guess my last question is just if someone is listening to this and they're fascinated with the work and they want to do a deeper dive, what are some resources that you might recommend to them to look into? My lab is really dedicated to science communication. And so we have a LinkedIn page, we have an Instagram. I try to share as much information as possible because I know not everyone's going to have

access to read a peer reviewed paper or article. to share as much information as possible because I know not everyone's going to have access to read a peer-reviewed paper or article. And so we try to make our research and findings accessible. So find us on LinkedIn, Instagram, social media platforms. We're always sharing different endeavors and findings. And we actually also, I make all of my students do this, but we do shorts that are just for any audience to understand what research we're doing and why it's impactful for them.

So cool. Thank you so much, Erica. Of course. Thank you. That was Erica Moore, a 2024 TED Fellow. To learn more about the TED Fellows program and watch all the TED Fellows films, go to fellows.ted.com. And that's it for today.

TED Talks Daily is part of the TED Audio Collective. This episode was produced and edited by our team, Martha Estefanos, Oliver Friedman, Brian Green, Autumn Thompson, and Alejandra Salazar. It was mixed by Christopher Faisy-Bogan. Additional support from Emma Topner and Daniela Balarezo. I'm Elise Hu. I'll be back Topner and Daniela Ballerezo. I'm Elise Hue, I'll be back tomorrow with a fresh idea for your feet.

Thanks for listening. Where can I get help hiring people with disabilities? There are hundreds of thousands of Canadians with disabilities who are ready to work, and many local organizations are available to help you find qualified candidates and make your workplace more accessible and inclusive. Visit Canada.ca slash right here to connect with one near you today. A message from the Government of Canada.