DISTINCTION. Sahlgrenska Academy’s recipient of the 2021 Minor Fernström Prize is Anders Rosengren, professor at the Department of Neuroscience and Physiology. Anders Rosengren conducts very broad research into type 2 diabetes – from cellular level, via clinical research and to the population level.
The official name of the prize is the Eric K. Fernström Prize for young, especially promising and successful researchers, but is simply known as the Lilla [Minor] Fernström Prize. It is a personal prize of SEK 90,000 from the Eric K. Fernström Foundation that is awarded annually to a researcher chosen from every medical faculty in Sweden.
“It is both gratifying and encouraging to receive the award, especially in view of the impressive list of research colleagues who have received the award before me.”
Anders Rosengren completed his medical studies at the Lund University, then moved immediately into his doctoral studies. After defending his doctoral thesis and residential training, he was a post-doc in Seattle, where he began working with bioinformatic methods. He moved to the University of Gothenburg in 2016, and has established collaborations with several other research groups, including those led by Fredrik Bäckhed, Patrik Rorsman and Anders Stahlberg. Rosengren runs a broad research group linked to the Wallenberg Centre for Molecular and Translational Medicine, and he is the recipient of a 2019 ERC Consolidator Grant.
Together with colleagues in Gothenburg and at other universities, he has developed a simple but effective tool for changes in lifestyle. The lifestyle tool is a kind of personal diary about health and is linked to self-reflection about what changes you want to make and how these should be achieved. There are now 50,000 users of the tool and it seems to produce long-lasting results. Just a few weeks ago, Rosengren’s new book, Hela livet: en läkares erfarenheter om hälsa, forskning och vardagens utmaningar, [All my life: A doctor’s experience of health, research and daily challenges], puts the lifestyle tool and his own thoughts about evidence-based health in a wider context.
Personalized treatment for diabetes
For a long time, diabetes researchers around the world confined themselves to dividing the disease into the two accepted forms, type 1 and type 2, but three years ago, researchers in Lund showed that there are four additional sub-groups within type 2 diabetes. This new categorization opens up for more personalized treatment, and Rosengren’s group is among the first to try out the idea in practice. They are in the final phase of a clinical study that tests giving two types of established diabetes drugs (SGLT2 inhibitors and GLP1) to 200 patients with diabetes. Half of the study participants have reduced insulin sensitivity and half have low insulin production. As half of each patient group trials each drug, there are four different patient groups in the study.
“It is a simple approach, but strangely enough, this type of study has not been systematically done in the past, despite official guidelines emphasizing the importance of personalized treatment for several years. The study has been delayed due to the pandemic, and it is going to be very exciting to see the results, which we should have toward the end of the year.
If it turns out that one of the groups has a better therapeutic response to one type of drug, it opens up completely new possibilities for specific treatment. But even it turns out that the different diabetes groups do not have different results from the treatments, it is also a scientifically interesting result. This may give a reason to reassess our specific focus on person-based treatment and perhaps also the importance of the sub-groups that have been identified.”
Researchers plan to continue to follow patients for years to come through the various registers in which they are included.
Research at cellular level
In addition to research on changes in lifestyle at the population level and clinical research aimed at finding the best treatment, Anders Rosengren also conducts translational basic research on insulin-producing beta cells.
“Our theory is that high levels of fat and sugar in the diet stress the cells to regress to a more immature stage. It is a complex process in which many genes are involved and where different pools of beta cells are affected in different ways.”
Experimental basic science
The beta cells are located in cell clusters (the islets of Langerhans) in the pancreas. Beta cells in different pools appear to be different in response to blood glucose levels. The aim of the project is to understand in detail how the highly responsive cell pools work and to identify gene expressions that could become new drug targets for increasing the function of beta cells that fail.
“We break tissue samples from the Islets of Langerhans down into single cells and use a fluorescent method to sort these according to their responsiveness. We then use RNA sequencing to link gene expression to the function of individual beta cells, which reduces the signal noise that often impedes single cell studies.”
He notes that many years of research remain before this basic science project can lead to clinical benefit.
“I think it is fun to work along the entire research range, from experimental single cell basic research that will take ten or fifteen years for the results to perhaps be translated into patient benefit and all the way to the lifestyle tool that is already used by patients today. It stimulates both my scientific interest and my curiosity, and my desire to benefit patients.”
ABOUT ERIC K. FERNSTRÖM
Eric K. Fernström was born in Karlshamn in 1901. He began his career as a successful manager for his family’s granite company. The company’s black dolerite covers the base facade of the Empire State Building in New York. In 1978, the Eric K. Fernström Foundation was founded to promote scientific medical research. The Foundation awards prizes to outstanding medical researchers.
BY: ELIN LINDSTRÖM
PHOTO: JOHAN WINGBORG