Salim Hayek, MD, joins Jennifer Smith, PhD, as an Associate Director for Cohort Development at Precision Health. Hayek is an assistant professor in the departments of Internal Medicine and Cardiovascular Medicine, and the current Medical Director of the Frankel Cardiovascular Center Clinics. In this Q&A, Hayek talks about his research and his new role in Cohort Development.

How does a precision-health approach inform research and patient care for you?
My research is influenced by the advent of technologies that allow for in-depth characterization of physiologic and pathologic processes (i.e., proteomics, metabolomics, genomics), coupled with the ability to process and analyze these data cost effectively. My research interests lie in determining how we can apply these findings to clinical care: for example, studying how blood-based biomarkers (including -omics) can be used to personalize management of patients. Our lab’s biobank has amassed over 30,000 samples from various cohorts and clinical trials, creating an invaluable resource for the study of various diseases including cancer and kidney and heart disease. Through this precision-health approach, we have identified new pathways to treat heart and kidney disease, designed diagnostic strategies for cardiotoxicity due to cancer therapies such immune checkpoint inhibitors, and used a biomarker strategy to predict the risk of patients with severe COVID-19, facilitating the triage of patients presenting in the ED. These research successes have real clinical impact, and are owed to the participants in these studies—a fact that I always remind myself of and emphasize to all the patients I care for in clinic.

How do you incorporate biobanks/study cohorts and their resulting datasets into your own research?
My research relies heavily on the development and study of large clinical cohorts and biobanks to answer the most pressing clinical questions in a multi-dimensional approach—integrating demographics, clinical characteristics, and social determinants of health, in addition to blood-based biomarkers (proteomics, metabolomics, and others) and genomics, to understand trends and identify new pathways of disease. For example, at the onset of the pandemic, we recognized the importance of the rigorous study of COVID-19 and established the Michigan Medicine COVID-19 Cohort (M2C2), an ongoing prospective observational cohort and biobank in which patients hospitalized specifically for COVID-19 were enrolled. We established the logistics for M2C2 within a week of diagnosis of the first COVID-19 case in Seattle. In addition to producing its own high impact science, M2C2 has become a nationwide resource, contributing to multiple national and international studies that have provided foundational knowledge surrounding COVID-19.

How do you hope to add to/enhance the work of Cohort Development?
Developing unique cohorts that will allow scientists to answer relevant and impactful questions is central to the mission of Precision Health. As a physician-scientist with extensive experience in the logistics of cohort development and clinical translation, I hope to expand the work of Cohort Development to developing a unified and sustainable Precision Health platform and research infrastructure to be leveraged by scientists across disciplines and institutions in their quest to advance health.

What are you currently researching that you are most excited about?
I am most excited about our recent discovery of a new therapeutic target for heart disease called soluble urokinase plasminogen activator receptor, or suPAR for short. SuPAR is a protein that is produced by the immune system that normally serves as a trigger for immune cells to infiltrate tissues and defend the body. When suPAR levels are high for a prolonged period of time, such as in patients with diabetes, the immune system is abnormally and persistently active, leading to chronic inflammation and accelerated atherosclerosis or coronary artery disease. We hope that targeting suPAR through reducing its levels or blocking its effects can prevent or treat heart disease by slowing down the abnormally activated immune system. This discovery is a great example of a precision health approach to treating heart disease, by which we use specific markers to identify which pathways of disease are the most activated in patients, and treating those with targeted therapies—rather than using a one size fits all approach.