Ivana Kostic is a Bioengineering Systems PhD Alumni at Instituto Superior Técnico who has just discussed her thesis supervised by Lino Ferreita (CNC-UC), Joaquim Cabral (IST-UL) and Jeffrey Karp (MIT). The Serbian Alumni soon realized she wanted to do a PhD in the area of Regenerative Medicine and to impact the lives of patients living with Cardiovascular diseases. In 2010 she entered the MIT Portugal which offered a promising opportunity to work in collaboration with the best engineering labs and hospitals between USA and Portugal.
You have a Masters degree in Human Physiology at the University of Belgrade. After that why did you choose the Bioengineering Doctoral Program of the MIT Portugal Program and Portugal to study?
Just before graduation at University of Belgrade, I got an internship in Physiology lab at the University of Viçosa in Brazil through IAESTE program - International Organization for Exchange of Students for Technical Experience. It was a month and a half of studying and living abroad at the best Universitiy of Brazil in the area of physiology - plant, animal and human. Among other things, I began to learn the Portuguese language, culture and tradition which further affirmed my thought of continuing my studies in connection with Portugal after graduation.
At the same time, I had a clear vision of doing a PhD in the area of Regenerative Medicine and making an impact in the lives of patients living with Cardiovascular diseases. Therefore, immediately after graduation I applied for the First BSRT summer school in Berlin. Within the 2 week program we had lectures, practical sessions, and interaction with patients, doctors and medical staff. All the participants and areas were multidisciplinary - students from chemistry, biology, physics, med school, engineers and we all had the opportunity to learn from each other as well as to learn from the multidisciplinary point of view in Immunology, Bone & Cartilage regeneration and Cardiovascular regeneration and medicine.
In parallel, I volunteered within IAESTE in Belgrade and worked with multiple engineering students from all over the world. Most importantly, I have realized that bioengineering is at the intersection of fields--medicine, biology, physiology, pathophysiology and engineering--necessary for discovering the best solutions, practices and/or therapies for suffering patients.
The main inspiration for my work was drawn from the wonderfully book written by Erich Segal called Doctors. On the first page, 1972 of Harvard Medical School Dean welcomes the new generation of students with only one number on the board, 26 and only one sentence:
I urge you to engrave this on the template of your memories: there are thousands of diseases in this world, but Medical Science only has an empirical cure for 26 of them. The rest is … guesswork.
All in all, the MIT Portugal program offered precisely all of my previously learned design criteria to develop the cure for specific cardiovascular disease/s. The program was promising, particularly the collaboration with the best engineering labs and hospitals between USA and Portugal.
Can you make a short résumé of your academic and professional background before entering the MPP?
After the internship in Viçosa, Brazil, my graduation at the University of Belgrade and eye-opening BSRT summer school visit in Germany, I first started my PhD program at the Belgrade University. Practical part of the thesis was to be performed at the Institute for Medical Research in Belgrade, within the lab for Experimental Hematology, investigating immunological properties of mesenchymal cells. Even though i had a strong interest in pursuing the topic, I was curious enough to explore other, more translational strategies as well as compare how the science and investigation are organized and function in these areas in European Union and in the USA. Therefore, i accepted my MIT Portugal scholarship and followed my dream of doing research in cardiovascular area, despite the high risk and additional requirements of changing the field of study from biology to bioengineering.
I kept in touch with my lab in Belgrade. Furthermore, we had few fruitful collaborative projects with labs from Portugal that worked on similar topics, enabling students and PIs from both labs to visit each other and exchange new knowledge.
You began your Bio PhD in 2010, what´s your opinion about this Doctoral Program?
I am truly grateful for the opportunity to be part of MIT Portugal Bioengineering program. I would follow this path all over again without any regret and strongly recommend it to anyone who would want to pursue PhD degree abroad.
2010 was my first year of study with lectures, two lab rotations and a course on Innovation and Entrepreneurship led by a professor that I truly appreciate and whose work I follow even today - Prof. Luis Filipe Lages. Among other things, this course is one of the things that sets our program apart from all other PhD programs. During six months the teams were developing business plans for the technologies from the Portuguese labs with an official pitch presentation to the investors from the Portuguese Chamber of Commerce. This consolidated our efforts to identify the necessary steps of getting our unique and innovative solution/product to the market and to the patients in a much faster and cheaper fashion.
Our group was multidisciplinary, from engineers (mechanical, bioengineers, IT) to biologist, chemists and medical doctors. This taught us how people from other areas think and function, thus helping us strategize the best way to collaborate in such a group while still making a difference.
What is the main core of your research and thesis?
By 2030 more than 23 million people will die per year from Cardiovascular diseases - CVDs, those with ischemic origins being most threatening. Loss of blood supply to the heart following an infarction leads to death of heart cells, which can cause extensive tissue and functional loss of the heart cells depending on the infarction severity. This can lead to negative remodeling and the development of heart failure. There is an urgent need to develop therapeutics that have a rapid translational potential and off-the-shelf availability to meaningfully impact the lives of patients.
The core of my thesis is to find an innovative solution for resuscitating the dying tissue of the heart due to lack of oxygen and nutrients after an insult, such as myocardial infarction.Through my PhD program, we were determined to compare the effects of umbilical cord blood cells on the cardiac tissue on one side, and the exosomes--nanoparticles secreted from those cells--on the other side. Another challenge was the delivery of both cells and exosomes to the heart tissue in minimally invasive ways. More scientific details on our approach with cell therapies in myocardial infarction can be found in our publication (Scientific Reports, 2015), while other two articles on exosomes are in progress. Interestingly, we have found other potential applications of exosomes. One of them is in the wound healing process and this is being further developed by the startup Exogenus Therapeutics. Other potential applications will be explored as well.
First part of the project was developed within Lino Ferreira’s lab in Biocant and CNC, Coimbra, Portugal while second part within Karp lab of MIT, Harvard and Brigham and Women’s hospital in Boston as well as previously established collaboration with Boston Children’s hospital. Additionally, our project includes collaboration with visiting PI and lecturer from the Royal College of Surgeons in Ireland, Dr. Garry Duffy.
What are in your perspective, the main benefits of this Program?
MIT Portugal program is a unique PhD program in four different areas of engineering: Bioengineering Systems, Transportation Systems, Engineering Design & Advanced Manufacturing and Sustainable Energy Systems. Additionally, all these four areas are intercepting academia and industry in Portugal and in the USA. This specifically is contributing on solving problems of everyday life from medicine to traffic jams, future of transportation on Earth and in space, sustainable consumption of energy and so on and truly applying the newly discovered solutions as rapidly as possible.
Numerous global companies collaborate with the program (Siemens, Stemmatters, Rolls-Royce plc UK among others) as many spin-offs come out of the research projects of the program: Gecko Biomedical, Matera, Silico life, Treat U, Biomode and others while many more are expected.
Finally, the problem solving skills are being exchanged between MIT and Europe which forms a unique collaborative environment and ecosystem of support and development of highly innovative solutions ever made before.
In 2013 you started your work at MIT and you stayed there until 2016, how was the experience?
I had a chance to see similarities and differences between EU and USA in lab organization, grant writing and grant management, how the labs are organized and how the students were delegated. This is not solely dependent on supervisors, but rather on the scientific systems adopted by two different continents.
Most of all, I had a chance to discover MIT in person. What an honour! By being in the program for two and a half years within MIT Portugal program, i was ready for the next step, going to MIT. From the first day excitement is felt in the air, the eagerness, the thrill, the engineering spirit, people and students from all over the world coming there with the same goal - to build something, to make a difference, to work hard. All of this with little time, lot of competition, limited budget. I had a chance to read about this in a book offered by our program Discovering the MIT: The idea factory: How to think at MIT by Pepper White. By reading the book i articulated for the first time, something i was using before for problem solving but didn’t have the name for it - wishful thinking.
MIT is located in Cambridge, MA, which is not only an amazing scholarly and engineering place, but it is surrounded by several biggest hospitals and research institutions in the USA like MGH, BWH, Dana-Farber and others. In parallel, the entrepreneurial mindset of the city is infectious and is one of the most developed in the country. All three components: engineering & science, medicine and entrepreneurship come very often as inseparable parts of any project which sets basis for translational work beneficial for patients all over the world.
As an entrepreneurial city, Boston offers multiple events contributing to translation of various projects, and even ideas. Recently, an increasing number of hospitals are organizing Hackathons where within only 48h medical problems are turned into solutions and potential companies, from the groups formed of scientists, engineers, designers, doctors etc. At the Pediatrics Hackathon in October 2014 my team and I decided to find a solution for simplified delivery of multiple oral, liquid drugs to pediatric patients and got an offer from PureTech investor. This was undoubtedly an inspiration for me to organize a hackathon in Serbia in 2017.
Microsoft center @Kendall square, MIT - 2nd Pediatric hackathon, 2014
You were under the supervision of Professor Jeff Karp, one of your thesis supervisors. How did this experience contribute to your research and to your professional path?
I had a great pleasure of working with two supervisors, Prof. Lino Ferreira from Portugal and Prof. Jeff Karp at MIT and Brigham and Women’s hospital. Both of them did their postdoc research within the lab of Prof. Robert Langer the father of multidisciplinary, problem solving in medicine who started using chemical engineering principles in drug delivery, minimally invasive procedures and other engineering strategies in medicine.
In this environment i had the excellent opportunity to learn from both of them, with complementary approaches in medical problem solving. Both of them are equally successful in this field, each having multiple licensed patents, research grants and companies spun-off from their lab’s research - Gecko Biomedical, Skintifique, Alivio Therapeutics, Frequency Therapeutics were started by Prof. Jeff Karp while Matera and initiation of Exogenus Therapeutics was formed by Prof. Lino Ferreira.
Only in recognizing the differences and focusing on the same goals we can achieve greatness.
This is how we approached challenges of working on MIT Portugal grant on two different continents, time zones and scientific systems of EU and USA. :) I am looking forward to the fruition of out work soon.
Prof. Jeff Karp is wonderful mentor, contributing greatly to my independent work, questioning, thinking and developing medical solutions. He is populating his lab with the brightest people from all over the world from various areas, always looking for inspiration in the nature. Most importantly he is in constant contact with the surgeons, doctors and patients always in search for new, orphaned medical problems to tackle.
In terms of personal experience, how was it? Would you recommend this experience to other students?
I had a chance to perfect portuguese language and master the version from Portugal aside from Brazilian version of portuguese. Today, even 4 years after leaving Portugal i can communicate efficiently in Portuguese, something I am truly proud of. No matter where i decide to live in the world, Portugal will be my Homeland where i will always return with smile on my face.
Besides the project i was working on, which was in area of research, the program enabled me to establish a large network of people with similar interests. While i thought i would be the only biologist among bioengineers who wants to start her own biotech company one day, i discovered multiple similarly oriented people who are ready to educate themselves beyond their initial background in order to fulfill their ideas. Most of my colleagues are my great friends, from both labs, working in the most diverse areas from their own companies to following the academic path to exploring medical industry areas.
I have friends from all over the world and as a traveller, I had a chance to visit the Azorean islands-portuguese islands between Portugal and USA, to visit cousins in Chicago, friends at San Diego and LA, to explore New York, Washington DC, Maine and many parts of New England and capture the spirit of Portugal and the USA.
The Staten Island Ferry, New York
Congratulations, you have just graduated. Would you say that this PhD fulfilled your expectations?
The time has passed so fast, which is so common when you work on things of interest to you no matter how challenging they are. The program and my choices in the program completely fulfilled my expectations. Most importantly, i worked with mentors i wanted to, solving problems i wanted to solve in the countries i though would offer the best conditions to do so. The work is still ongoing in Boston Children’s hospital and i am very eager to assess its impact in the clinic.
Now, what are your plans for the near future? And for the long one?
As i haven’t been in Serbia and Belgrade (my home town) for four years i have decided to spend some time here and make an impact by learning and working on the local entrepreneurial ecosystem, mainly to the medtech areas. My goal is to motivate, support and educate local students to collaborate in multidisciplinary projects, to use their knowledge from various technologies. Serbia is known to have high level talent in almost all tech areas starting from our scientists Nikola Tesla, Mihajlo Pupin, Prof. Gordana Vunjak Novakovic among others, and use it to resolve local medical problems.
We first did this by organizing the first MIT hacking medicine in Belgrade in january 2017 with local IT hub called Startit. Two mentors and co-founders came from Boston, we had 10 teams from more than 200 initial application where all the solutions had application for their own local organization. One of the winners, Break Aphasia, further won Belgrade connect and Berlin connect competitions after our hackathon. They are helping patients with aphasia, which normally transpires after the patient suffers from a stroke, as well as speech therapists working with those patients, making the patient’s work and communication much easier through application and a platform. Candy button is also continuing its initial take-off successfully. They represent diabetes patients and tackle the hypoglycemia through hardware-software, mixed solution.
Long term plans in my career are connected to further development of my PhD project. Mainly i would like to contribute in the innovative space of cardiovascular diseases further, locally and globally.