Dr. Hilakivi-Clarke

Austin, Minn. Leena Hilakivi-Clarke, PhD, Professor at The Hormel Institute, University of Minnesota, has received the Masonic Cancer Center’s (MCC) 2023 CRTI Exceptional Translational Research Award. The award will provide $100,000 over two years to support a pilot study led by Drs. Hilakivi-Clarke at The HI and Anne Blaes at MCC that will investigate the effects of racial discrimination on the gut microbiome and heart failure risk among Black, Native American, and White breast cancer patients who have been treated with aromatase inhibitors. 

Minnesota has the fourth-highest rate of breast cancer incidence among U.S. states, and the majority of these patients receive aromatase inhibitor therapy to prevent breast cancer recurrence. Aromatase inhibitors target an aromatase enzyme in multiple cell types located not only in the ovary and breast, but also in blood vessels, bones, skin, and the brain to lower the body’s estrogen levels, since estrogen can fuel the growth of breast cancer cells. 

However, aromatase inhibitor therapy also increases the risk of heart failure, especially among patients who already have increased heart failure risk due to myriad factors, one example being having gut dysbiosis (an imbalance of healthy and harmful gut bacteria), which can arise due to numerous causes, including stress due to racial discrimination.

“Breast cancer patients are more likely to die of adverse cardiac events than of breast cancer recurrence. Particularly vulnerable might be Black and Native patients who suffer from health disparities, which include increased risk of heart failure and cancer mortality,” said Dr. Hilakivi-Clarke. “It is important to determine if discrimination related to structural racism further increases the risk of developing heart failure among breast cancer patients taking aromatase inhibitors, and if racial discrimination also induces gut dysbiosis, which, in turn, is linked to heart failure.” 

Racial discrimination is a major causative factor for health disparities, but little is known of its impact on the gut microbiome. Other factors increasing health disparities include access to healthcare, health professionals’ bias towards BIPOC (Black, Indigenous, and people of color), poverty, socioeconomic status, and lack of access to green spaces.

To ensure better health outcomes and longer lifespans for all, it is essential to build a better understanding of how racial discrimination impacts BIPOC individuals so that additional risks can be properly mitigated. That’s where this research comes in.

“Although elimination of structural racism is the ultimate societal goal, it is critical to discover ways to reduce its impact on health,” said Dr. Hilakivi-Clarke. “If we find that racial discrimination causes gut dysbiosis and increases the risk of heart failure in breast cancer patients treated with aromatase inhibitors, we could attempt to reverse gut dysbiosis by suppressing biological changes induced by stress linked to discrimination, such as activation of beta-adrenergic signaling of the autonomic nervous system. Beta-adrenergic blocker propranolol is known to have several health-promoting effects on the gut microbiome, and could be safely given to breast cancer patients. Other means to reverse gut dysbiosis might include consumption of dietary fiber and branched chain amino acids.”

It is anticipated that this pilot study will lead to a project that will be submitted for external funding. That future project will investigate whether successful reversal of gut dysbiosis will prevent heart failure linked to aromatase inhibitor therapy.

The MCC’s Cancer Research Translational Initiative (CRTI) Exceptional Translational Research Award supports translational cancer research projects in any area of cancer that can “apply or accelerate discoveries into testing in clinical or population settings.” More information about CRTI and the award is available on the MCC website.

Raquel Hellman
Marketing & Communications Manager

The Hormel Institute is an independent biomedical research department within the University of Minnesota’s Office of the Vice President for Research. Collaborative research partners include Masonic Cancer Center UMN (a Comprehensive Cancer Center as designated by the National Cancer Institute, NIH), Mayo Clinic, and many other leading research centers worldwide. The Hormel Institute, which tripled in size in 2008 and doubled again in size in 2016, is home to some of the world’s most cutting-edge research technologies and expert scientists. Over the next few years, The Hormel Institute will broaden its impact through innovative, world-class research in its quest to improve human health.