An Engineer’s Perspective on Autoimmunity

Erika Moore builds biomaterials to study disparate lupus outcomes.

Aparna Nathan

Aparna is a freelance science writer pursuing a PhD in bioinformatics and genomics at Harvard University. Her writing has also appeared in The Philadelphia Inquirer, Popular Science, PBS NOVA, and more.

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Dec 10, 2021
Erika Moore studies lupus using a unique biomaterial that she developed.
Erika Moore, PhD

Long before she took the helm of her engineering lab as an assistant professor of materials science and engineering at the University of Florida, Erika Moore was fascinated by the careful dance between immune cells and biomaterials engineered to interact with living systems. Now, her curiosity has led her to design biomaterials to help diverse lupus patients receive personalized care.

How did you first realize that biomaterials could be useful for studying the immune system?

I had to start wearing contacts when I was 11 years old, and as I put something into my eye every day that was foreign to my body, it really piqued my interest in understanding biomaterials. While doing my undergraduate degree at Johns Hopkins University, I started to realize that immune cells are probably going to be an important part of how our bodies respond to biomaterials.

My area of expertise is at the meeting point of immunology, biomaterials science, and translational medicine. I was classically trained as a biomedical engineer, so the combination of engineering and medicine is just ingrained into me. Then I was drawn to creating new materials and using those materials to study immunology, but I'm not a classically trained immunologist. Biomedical engineers have been designing materials and putting them into rodents to validate them, but we haven't always considered how the immune system responds to these materials. During my PhD studies at Duke University, I focused on macrophages and understanding their contribution to biomaterials.

How did you connect this to studying autoimmunity and lupus specifically?

My personal connection to systemic lupus erythematosus (SLE), the autoimmune disease that I study, is that I identify as a woman of color, as a Black woman. SLE is a hugely sex-differential disease. About 90% of the people with SLE are women. If you break down that 90%, about 70% of that 90% are women of color. I actually have many friends with lupus; there are women in my life who have died from lupus, and I never realized how much of a health inequity and health disparity it was. When I realized that there was this autoimmune disease that disproportionately affects communities that I identify with, I wanted to use my privilege and education to try to improve outcomes for that disease.

Erika Moore developed a jello-like tissue system to study how immune cells stimulate tissues and blood vessel growth.
Erika Moore, PhD

That brings us back to the science. If we want to study something in the clinic, we have to enroll patients. But that takes a lot of time, effort, and energy. So, during graduate school, I wanted to create a tissue model outside the body that would recreate or mimic some of the interactions that occur in the body. The 3-D model system that I created then is a little bit squishy—like jello—mimicking some soft tissues in the body. You can take images of it, destroy it, and create it again. I used this system in graduate school to understand how macrophages help us build new tissues and blood vessels.

If we introduce other variables, we can study tissue responses in specific human contexts. For example, women with lupus usually have super inflammatory immune cells, including a lot of macrophage activation. If we take immune cells from healthy controls or patients with lupus and study them in our biomaterial models, what differences do we observe in those cells? And what does that tell us about what might be happening clinically?

The promise of our model system is that we can have personalized medicine approaches in our mini-jello tissues that we create in the lab. Maybe in the future, we can take some patient cells, put them in our system, and then introduce a drug to see how they respond. Does it get better? Does it get worse? That's better than just putting volunteers on a drug without any prior knowledge or background.

How do you consider the variation in lupus between populations?

I want to understand the contribution of ancestry to disease pathology and disease progression. We use markers of genetic ancestry to understand how different patients respond. We also use socio-cultural, educational, and financial markers because we understand that ancestry doesn't always capture lived experience. We know that environment and genetics—nature and nurture—combine to inform biology and cell function. We can declare those variables and use them to determine which groups we encapsulate into our jello biomaterial tissue models, and then understand how their cells respond differently. For example, does the number of discrimination events you have seen inform how your cells respond?

What are the challenges for this kind of interdisciplinary work?

The hardest part so far has been knowledge. I am personally driven to study this autoimmune disease because of its disproportionate impact, so I really want to learn, and I'm still learning. Because my work is interdisciplinary, I have to master multiple fields. I'm really grateful for my collaborators who have been helpful in educating me to ask the right questions, because not all questions are worth answering immediately. You have to prioritize. I know a lot of people with lupus, and I ask, what's helpful? What's not working? It's a shared community effort. I am really sharing the voices of many people, not just myself.

This interview has been edited and condensed for clarity.